The association between Mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy

The prevalence and complications of Mycoplasma genitalium and Chlamydia trachomatis infections among women undergoing termination of pregnancy were studied in this nested case-control study at Malmo University Hospital, Sweden, during 2003 to 2007. The study comprised 2079 women presenting for termination of pregnancy. Forty-nine women with M. genitalium infection and 51 women with C. trachomatis infection, together with 168 negative control women, were evaluated. The prevalences of M. genitalium and C. trachomatis were 2.5% and 2.8%, respectively. The M. genitalium was strongly associated with post-termination pelvic inflammatory disease (odds ratio 6.29, 95% CI 1.56-25.2). The increased risk for pelvic inflammatory disease associated with M. genitalium infection after termination of pregnancy suggests a causal relationship.

C-reactive protein, C3, C4 and properdin during the Jarisch-Herxheimer reaction in early syphilis

The occurrence of plasma CRP during the febrile response after the first injection of penicillin was followed in 10 patients with early syphilis. An increase in CRP was noted after 12 hours, with a maximum after 24 hours. The appearance of this acute phase protein could not be correlated to cutaneous reaction, increased body temperature or leukocytosis, nor were baseline values of CRP correlated to clinical or serological activity of the infection. Patients with high levels of CRP prior to treatment suffered the most intense systemic reactions. No activation of the complement system during the Jarisch-Herxheimer reaction was detected from sequential determinations of C3, C4 and properdin.

Monitoring oral health and dental attendance in an outpatient psychiatric population

Impaired mental health has been associated with an increased need for dental care. Population surveys have indicated that people with enduring mental health problems make less frequent planned visits to the dentist and report a greater number of missing teeth than the general population. The study aims to examine oral health status, attendance to dental care, and medication in an outpatient psychiatric sample. A descriptive study combining a structured interview with a visual oral examination carried out in 113 outpatients under psychiatric care. Dental health was described in terms of sound, missing and/or filled teeth, and showed a relation between these categories and types of psychiatric diagnosis, age and numbers of antidepressant and neuroleptic drugs. Oral hygiene was found to be more neglected among men and in patients with the diagnosis of schizophrenia. The need of dental treatment was widespread, although regular dental visits were commonly reported. In order to maintain good oral health, regular dental check-ups should be encouraged for patients under psychiatric care. Further studies are required to reveal contributory causes for/to decreased oral health. The difficulty such individuals have in maintaining additional self-efficacy raises questions about the necessity for oral health interventions in outpatient psychiatric services.

Association of genetic variation on chromosome 9p21.3 and arterial stiffness

OBJECTIVES

Genome wide association studies have consistently reported associations between a region on chromosome 9p21.3 and a broad range of vascular diseases, such as coronary artery disease (CAD), aortic and intracranial aneurysms and type-2 diabetes (T2D). However, clear associations with intermediate phenotypes have not been described so far. To shed light on a possible influence of this chromosomal region on arterial wall integrity, we analysed associations between single nucleotide polymorphisms (SNPs) and degree of stiffness of the abdominal aorta in elderly individuals.

METHODS AND RESULTS

A total of 400 subjects, 212 men and 188 women, aged 70-88 years were included. Arterial stiffness was examined at the midpoint between the renal arteries and the aortic bifurcation. Two CAD- and aneurysm-associated SNPs (rs10757274 and rs2891168) and one T2D-associated SNP (rs1081161) within the 9p21.3 region were genotyped. Aortic compliance and distensibility coefficients were higher in carriers of the rs10757274G and rs2891168G alleles in men reflecting a decrease in aortic stiffness. Adjustment for age and mean arterial pressure had no effect on these associations. The two SNPs were not associated with intima-media thickness or lumen diameter of the abdominal aorta. There were no associations between the rs10811661 SNP and any measure of aortic stiffness.

CONCLUSIONS

Impaired mechanical properties of the arterial wall may explain the association between chromosome 9p21.3 polymorphisms and vascular disease.

Deficits in motor co-ordination and attention at 3 years of age predict motor deviations in 6.5-year-old children who needed neonatal intensive care

BACKGROUND

A total of 189 children without major impairments who needed neonatal intensive care (NIC) were followed up at ages 3 and 6.5 years.

AIM

To determine the prevalence of different motor deviations at age 6.5 years and the co-occurrence of attention deficits; also, to analyse the predictive ability of motor co-ordination and attention assessments at age 3 years for motor deviations at 6.5 years.

METHOD

A combined assessment of motor performance and behaviour (CAMPB) was used at the 3-year examination. The Test of Motor Impairment (TOMI) and the Motor-Perceptual Development (MPU) were used together with the criteria of the diagnostic and statistical manual of mental disorders (DSM-IV-TR) to define motor deviations.

RESULTS

At 6.5 years 64% of the children showed a motor deviation either as a delay according to MPU, a problem according to TOMI or Developmental Coordination Disorder (DCD) according to DSM-IV-TR. Higher proportions of children with attention deficit (50%) were found in the DCD group. The predictive ability of CAMPB was analysed in two ways: when all children with either a co-ordination or attention deficit, or both, at 3 years were considered to be at risk for motor deviations at 6.5 years, the sensitivity reached 78% and the specificity was 42%. But when only the 3 year olds with a combined deficit were considered to be at risk, the sensitivity was 37% and the specificity 89%; however, a positive predictive value of 86% was reached.

CONCLUSION

At 6.5 years of age a majority of NIC children with no major impairments showed motor deviations. To fulfil the DCD criteria in DSM-IV-TR, a strict definition of motor deviations is recommended. Attention deficits are more prevalent among children with DCD. Deficits in motor co-ordination and/or attention in 3-year-old children are strong predictors of motor deviations and, especially, of DCD at 6.5 years of age.

Friction of fatty acids in nanometer-sized contacts of different adhesive strength

The effects of adhesion, contact area, and pressure on the lubricating properties of self-assembled monolayers on steel have been investigated with friction force microscopy. The adsorbed molecules were fatty acids with varying degrees of unsaturation (0-2 double bonds; stearic, oleic, and linoleic acid) and a rosin acid (dehydroabietic acid), adsorbed from n-hexadecane solution. The friction of these loose-packed monolayers was studied in dry N2 gas and in ethanol. Low adhesion (in ethanol) resulted in a linear increase in friction force at low loads, that is, F = muL, whereas higher adhesion (in N2 gas) gave an apparent area-dependence at low loads of the form F = S(c)A, where S(c) is the critical shear stress. A recent model for the contact mechanics of a compliant elastic film confined between stiffer substrates was applied to the data obtained in dry N2. Using this approach, we obtained interfacial energies of the compliant monolayers in good agreement with van der Waals-Lifshitz theory. With a low monolayer elastic modulus of E'(1)=0.2 GPa, we obtained a slightly higher value of Sc for stearic acid than that established for more close-packed stearic acid monolayers. An increase of mu and S(c) was found with increasing degree of unsaturation of the fatty acid.

An outbreak of cryptosporidiosis at a day-care centre in Sweden

In mid-August, several children at a day-care centre in a suburb to Stockholm developed diarrhoea. Faecal samples showed presence of cryptosporidia.

A fault‐tolerant distributed formation protocol for Bluetooth scatternets

A Bluetooth scatternet is a network topology that is formed by inter‐connecting piconets. A piconet is a starshaped ad‐hoc networking unit that can accommodate eight Bluetooth devices, a master and up to seven slaves. By designating certain piconet nodes as bridges, or gateways, we can interconnect piconets by forcing the bridge nodes to interleave their participation in multiple piconets. Bridge nodes form an auxiliary relay connection between adjacent piconet masters and are fundamental for establishing scatternets. In this paper we present a new fault‐tolerant approach to scatternet formation that is selfhealing and operates in a multi‐hop environment. Our Bluetooth Distributed Scatternet Formation Protocol (BTDSP) establishes a flat scatternet topology, allows incremental node arrival, and automatically heals scatternet partitions by re‐incorporating disconnected nodes. By maintaining neighbor associations in soft state, existing links can also be re‐established quickly upon disconnection due to intermittent wireless connectivity. By only using slave/slave bridges, the algorithm is resilient to both node failure and wireless interference. It also prevents time‐slot waste due to master/slave bridges being away from their piconets.

Experiences with the new genetic variant of Chlamydia trachomatis in Orebro county, Sweden - proportion, characteristics and effective diagnostic solution in an emergent situation

A Chlamydia trachomatis variant that contains a 377 bp deletion in the cryptic plasmid was recently reported in Sweden. This deletion includes the targets for Cobas Amplicor, Cobas TaqMan48, and Abbott m2000. We examined the proportion and characteristics of this variant in Orebro county, Sweden and developed an effective diagnostic solution. In total, 2,401 consecutive C. trachomatis culture samples and 536 PCR samples from symptomatic and asymptomatic patients and screened females were included. Culture, Cobas Amplicor, and LightMix 480HT were used for diagnosis. A mutant-specific PCR, plasmid sequencing, omp1 sequencing and multilocus sequence typing (MLST) were used to identify and characterise mutants. In total, 162 (6.7%) of the cultured samples were positive for C. trachomatis. However, 61 (38%) of those were negative when using Cobas Amplicor, and 60 of these were subsequently confirmed as the new variant. 13 of these mutant isolates were further characterised genetically, and all were of identical genotype E and the unique MLST sequence type: 21, 19, 1, 2, 1. Of all culture-positive samples, 161 of 162 were positive in the LightMix 480HT assay. The single negative sample was only weakly positive in culture, and negative in all PCRs. Of the 536 PCR samples, 37 were positive in both Cobas Amplicor and LightMix 480HT, 13 were only positive in LightMix 480HT (mutants), and two were only positive in Cobas Amplicor. Mutated C. trachomatis were prevalent in Orebro county in the period from October 2006 to February 2007, and it appeared to be a single clone. LightMix 480HT seemed sensitive, specific, and enabled high throughput diagnostics. However, rare low positive samples may be false-negative. Frequent surveillance and evaluations of diagnostic methods worldwide are crucial.

Associations of motor co-ordination and attention with motor-perceptual development in 3-year-old preterm and full-term children who needed neonatal intensive care

BACKGROUND

Children who have needed neonatal intensive care (NIC) are considered to be at risk for deficits such as developmental co-ordination disorder and attention-deficit/hyperactivity disorder. By assessing motor-perceptual development, motor co-ordination and attention already at 3 years of age, it might be possible to identify such deficits earlier than they are today.

AIM

To investigate the motor-perceptual development in a group of 202 NIC children but had no major impairments, to describe associations of deficits in co-ordination and attention with motor-perceptual delays, and to estimate the prevalence of NIC children with combined deficits together with a motor-perceptual delay.

METHOD

Co-ordination and attention in children born very preterm (n = 57), moderately preterm (n = 75) and full-term (n = 70) were observed according to a model for Combined Assessment of Motor Performance and Behaviour while they were assessed using a developmental scale, Motor-Perceptual Development, 0-7 years, MPU.

RESULTS

In two out of 14 MPU areas, a larger proportion of very preterm than of moderately preterm and full-term children had marked developmental delay. Overall, the proportion of NIC children having a motor-perceptual delay increased with increasing incoordination and especially increasing lack of attention. Twenty-one (11%) of the NIC children had different motor-perceptual delays combined with pronounced incoordination and pronounced lack of attention.

CONCLUSION

Deficits in co-ordination and attention were associated with motor-perceptual delays in areas important for daily living and development of academic skills. Therefore, to find children at risk for developmental co-ordination disorder and attention-deficit/hyperactivity disorder, assessments of co-ordination and attention should be added to assessments of motor-perceptual development in 3-year-old NIC children.

Measles outbreak in the Øresund region of Denmark and Sweden

Since late January, 18 laboratory confirmed cases of measles have been reported in the Scandinavian region of Øresund; nine in Denmark and nine in Sweden.

Chlamydia Pneumoniae Infection: An Additional Factor for Chronic Allograft Rejection

INTRODUCTION

Chronic rejection (CHR) of organ allografts, one of the most significant problems in modern transplantation, is not fully understood. This study sought to evaluate the influence of selected parameters on late kidney transplant function.

PATIENTS AND METHOD

The studied group consisted of eighty-six patients who received allogeneic transplants between 1988 and 1999 for leukocyte Chlamydia pneumoniae-DNA, immunoglobulin (Ig)A/IgG anti-C pneumoniae, blood lipids, ischemic damage in the donor and during organ preservation, HLA mismatch, and acute rejection episodes.

RESULTS

Eighty-six patients were segregated as 26 patients (30%) with histologically proven chronic graft rejection (CHR[+]) and 59 patients (70%) without (CHR[-]). The presence of C pneumoniae-DNA in peripheral blood leukocytes was significantly more frequent in CHR(+) than CHR(-) group (46% vs 20%). Patients with leukocytes positive for C pneumoniae-DNA more frequently (50%) had CHR than patients negative for C pneumoniae-DNA (22%). CHR(+) patients showed significantly lower HDL levels (47 mg/dL vs 58 mg/dL) and higher triglyceride levels (193 mg/dL vs 148 mg/dL). To study the cumulative effect of differences between the CHR(+) and CHR(-) groups, we applied a multiple binary logistic regression analysis. An econometric model enabled us to calculate the probability of CHR for a given patient taking into account covariates chosen by means of stepwise selection: the presence of C pneumoniae-DNA in blood leukocytes, the use of continuous pulsatile perfusion in hypothermia, myocardial infarction occurrence, and triglyceride concentrations.

CONCLUSION

The presence of C pneumoniae-DNA in peripheral blood leukocytes increased the risk of CHR, which may be predicted by a multifactor analysis of chosen parameters.

Quality of motor performance in preterm and full-term 3-year-old children

BACKGROUND

A combined assessment of motor performance and behaviour (CAMPB) was introduced previously for use in a longitudinal study of children who needed neonatal intensive care (NIC) and were born very preterm (n = 68), moderately preterm (n = 81) and full-term (n = 77) and in a reference group of neonatally healthy full-term children (n = 72). Aim To follow up the quality of motor performance at 3 years of age in the above groups of children.

METHOD

A detailed assessment of motor performance and an assessment of co-ordination were performed according to the CAMPB protocol. The results were compared between the different groups of children, and the relation between the two ways of assessing quality of motor performance was examined.

RESULTS

The detailed assessment showed that the very preterm children had a significantly higher total score of deviations than any of the other gestational age groups of children. Also, some types of deviations were much more frequently observed in the very preterm children than in the other three groups. Some types of deviations were more often seen in children with pronounced incoordination than in children with no incoordination. The results from the two ways of assessing motor performance were strongly correlated.

CONCLUSION

At 3 years of age, NIC children born very preterm have a lower quality of motor performance than NIC children born at a higher gestational age and healthy children born at term. The two ways of assessing quality of motor performance proved useful in identifying children with deviations indicating minor motor impairments.

The effects of tropospheric ozone and elevated carbon dioxide on potato (Solanum tuberosum L. cv. Bintje) growth and yield

An open-top chamber experiment with field grown potato (Solanum tuberosum L. cv. Bintje) was performed in the south-west of Sweden in 1998. The experiment was aimed to investigate individual and interactive impacts of elevated ozone (O(3)) and carbon dioxide (CO(2)) on potato growth and yield. Treatments were ambient and elevated CO(2) with or without the addition of 20 nmol mol(-1) O(3). In addition, plants were grown in ambient air plots. Plants grown in elevated CO(2) and O(3) had a reduced tuber yield, compared to control, by 2% and 8%, respectively. These effects were, however, not statistically significant. Elevated CO(2) caused a significantly larger number of tubers of lower average size, while elevated O(3) induced significantly lower tuber dry matter content. The number of tuber initials (tubers <15 mm) found at harvest was significantly lower in elevated O(3). Visible O(3) leaf injury appeared earlier and the number of yellow leaves 89 days after emergence was significantly larger in elevated O(3). In elevated CO(2), haulm dry weight was significantly (15%) lower at harvest and the haulm/tuber ratio was significantly reduced. There were significant interactive effects of O(3) and CO(2) on the final number of leaves and on stem height. Plants in elevated CO(2) reached final stem height earlier than in the other treatments. In summary, it was concluded: (a) that anticipated future O(3) levels are likely to have a negative impact on potato growth, although tuber yield effects may be hard to demonstrate experimentally in this plant due to large variation; (b) that whether any possible beneficial effect of elevated CO(2) on the magnitude of tuber yield will be expressed, depend on the climatic conditions prevailing; and (c) that potato growth responses to CO(2) and O(3) are not simply additive.

Preschool children with developmental coordination disorder: a short-term follow-up of motor status at seven to eight years of age

At a population-based screening of 5-6-y-old children, 37 children were identified as having definite or borderline motor difficulties consistent with developmental coordination disorder. When 7-8 y old they were re-examined to determine their current motor status and to compare it with that at the age of 5-6 y. The motor status was investigated from three perspectives: by a motor test, by the use of a self-perceived motor competence scale, and from the parents' descriptions. On a group level the children had not changed their motor status when 7-8 y old, according to the total scores in the Movement ABC motor test and the Perceived Motor Competence scale. On an individual level most children with definite motor difficulties remained in their category regarding motor difficulties at the follow-up, while most children with borderline motor difficulties did not. The parents' descriptions indicated an association between willingness to engage in physical activities and degree of motor difficulties.

CONCLUSION

Over a period of 1.5 y most children with definite motor difficulties continued to have such difficulties. The parents' descriptions of their children's motor status and development were in agreement with the children's motor status as measured by a motor test, but were not in total accordance with the children's self-perceived competence.

Expression of nitric oxide synthase in bladder smooth muscle cells: regulation by cytokines and L-arginine

PURPOSE

The expression and regulation of the different isoforms of nitric oxide synthase (NOS) in bladder smooth muscle cells are controversial and to our knowledge have not yet been studied systematically. Therefore, the expression and regulation of NOS were studied in rat bladder smooth muscle cells after stimulation with cytokines, lipopolysaccharide and L-arginine.

MATERIALS AND METHODS

Primary cell cultures were prepared from rat bladders. The expression of NOS mRNA was examined by reverse transcriptase-polymerase chain reaction and inducible NOS (iNOS) protein expression was studied by Western blot analysis and immunohistochemistry. Nitrite accumulation in the culture medium was determined by the Griess assay. The expression of iNOS was also studied immunohistochemically in whole bladder strips stimulated by cytokines.

RESULTS

NOS mRNA expression was not detected in unstimulated cells. Stimulating bladder smooth muscle cells with a cytokine mixture of interferon-gamma, tumor necrosis factor-alpha and interleukin-1beta induced iNOS mRNA and protein expression. The combination of interleukin-1beta plus tumor necrosis factor-alpha appeared to be crucial for iNOS induction in bladder smooth muscle cells. Exposing bladder smooth muscle cells to lipopolysaccharide did not induce iNOS. Adding L-arginine increased nitrite accumulation in cytokine mixture stimulated bladder smooth muscle cells, while iNOS positive cells were detected in the smooth muscle layer of cytokine mixture stimulated bladder strips.

CONCLUSIONS

NOS was not detected in unstimulated bladder smooth muscle cells. However, bladder smooth muscle has the potential to express iNOS when exposed to cytokines known to be produced during urinary tract infection.

Expression of nitric oxide synthase in bladder smooth muscle cells: regulation by cytokines and L-arginine

PURPOSE

The expression and regulation of the different isoforms of nitric oxide synthase (NOS) in bladder smooth muscle cells are controversial and to our knowledge have not yet been studied systematically. Therefore, the expression and regulation of NOS were studied in rat bladder smooth muscle cells after stimulation with cytokines, lipopolysaccharide and L-arginine.

MATERIALS AND METHODS

Primary cell cultures were prepared from rat bladders. The expression of NOS mRNA was examined by reverse transcriptase-polymerase chain reaction and inducible NOS (iNOS) protein expression was studied by Western blot analysis and immunohistochemistry. Nitrite accumulation in the culture medium was determined by the Griess assay. The expression of iNOS was also studied immunohistochemically in whole bladder strips stimulated by cytokines.

RESULTS

NOS mRNA expression was not detected in unstimulated cells. Stimulating bladder smooth muscle cells with a cytokine mixture of interferon-gamma, tumor necrosis factor-alpha and interleukin-1beta induced iNOS mRNA and protein expression. The combination of interleukin-1beta plus tumor necrosis factor-alpha appeared to be crucial for iNOS induction in bladder smooth muscle cells. Exposing bladder smooth muscle cells to lipopolysaccharide did not induce iNOS. Adding L-arginine increased nitrite accumulation in cytokine mixture stimulated bladder smooth muscle cells, while iNOS positive cells were detected in the smooth muscle layer of cytokine mixture stimulated bladder strips.

CONCLUSIONS

NOS was not detected in unstimulated bladder smooth muscle cells. However, bladder smooth muscle has the potential to express iNOS when exposed to cytokines known to be produced during urinary tract infection.

Clinical manifestations of atherosclerosis in an elderly population are related to plasma neopterin, NGAL and endothelin-1, but not to Chlamydia pneumoniae serology

BACKGROUND

Inflammatory mediators secreted by leukocytes are implicated in atherogenesis. Chlamydia (C.) pneumoniae infection has been suggested as a trigger of this process. We investigated relationships between C. Pneumoniae serology, inflammatory mediators and symptomatic cardiovascular disease in old age.

METHODS

In a cross-sectional study at baseline with a prospective 4 year follow-up, intraplatelet cyclic 3'-5'adenosine monophosphate (cAMP) and cyclic 3'-5'guanosine monophosphate (cGMP), plasma neutrophil gelatinase associated lipocalin (NGAL), plasma soluble tumor necrosis factor receptor-1 (TNFR-1) plasma neopterin and plasma endothelin-1 (ET-1) were analysed together with IgG and IgA antibodies for C. Pneumoniae in an elderly reference population (n=140, median age 71 years, 71 females). Twenty-one subjects had clinical manifestations of cardiovascular disease at baseline and another 21 were diagnosed with cardiovascular disease during follow-up.

RESULTS

In age adjusted logistic regression, subjects with cardiovascular disease showed higher plasma levels of neopterin (p=0.02), NGAL (p=0.04), and ET-1 (p<0.01). If subjects with cardiovascular disease at baseline were excluded from the analysis, higher plasma neopterin (p=0.01) and lower serum HDL cholesterol (p=0.03) predicted cardiovascular disease during follow-up. The presence of IgG or IgA against C. pneumoniae was not associated with cardiovascular disease. Neither were there any associations between inflammatory or endothelial parameters and C. pneumoniae serology.

CONCLUSIONS

The inflammatory mediators neopterin and NGAL and endothelial derived vasoconstrictive ET-1 were increased in elderly subjects with symptomatic cardiovascular disease. Increased plasma neopterin predicted cardiovascular disease during follow-up. No relationships were found between C. Pneumoniae serology and cardiovascular disease.

Extent and patterns of RAPD variation in landraces and cultivars of rye (Secale cereale L.) from northern Europe

Little is known about the extent and patterns of distribution of RAPD diversity in outcrossing species. This study is the first step in using RAPD markers to quantify the amount and distribution of genetic variation within and between accessions of 9 landraces and 3 cultivars of cultivated rye from Northern Europe. A high level of RAPD variation was detected, demonstrating the utility of RAPDs for genetic characterisation in rye. The results show that: (1) landraces and improved cultivars maintain roughly the same high levels of RAPD variation, (2) landraces from Norway, Germany and Finland showed the lowest level of variation, probably because of a small amount of seeds from the original samples, (3) most of the RAPD variation was found within rather than between the accessions, which is consistent with the pattern expected for a cross pollinated crop. Both the cluster and the principal coordinates analyses displayed the same pattern of genetic relationship among the accessions studied.