Behandling av bakteriell vaginose i svangerskapet for å forebygge komplikasjoner

ABSTRACT Background. Bacterial vaginosis is a clinical entity characterized by offensive vaginal discharge caused by a disturbance of the normal vaginal bacterial flora. The hydrogen peroxidase producing lactobacilli are replaced by several anaerob bacteriae and the vaginal pH is increased. Bacterial vaginosis during pregnancy is associated with preterm delivery and as much as 40% of preterm deliveries can be linked to bacterial vaginosis. Preterm delivery is the major cause of neonatal morbidity and mortality. The exact pathogenesis for bacterial vaginosis leading to obstetric complications has not been established, though ascending inflammation and initiation of immunological cascades have been proposed. The treatment for bacterial vaginosis is antimicrobial therapy, most commonly Metronidazole or Clindamycin, administered orally or intravaginally. Several studies undertaking the task of preventing obstetric complications by treating bacterial vaginosis with antibiotics have been inconclusive with respect to treatment recommendations. The current guidelines recommend treatment of symptomatic bacterial vaginosis in pregnancy, but not screening of asymptomatic women. Method. Litterature searches in Cochrane library, Pubmed and Embase were performed for the periode 1994 - September 2009 examining whether antibiotics were successful in preventing obstetric complications such as preterm delivery, late abortions and low birthweight. Results. Antibiotics are effective treatment of bacterial vaginosis. The findings were inconclusive in regards to the prevention of preterm birth, late miscarriage and low birthweight. Review articles have proven unable to draw firm conclusions in regards to the effect of interventions for prevention of preterm birth. However, several studies published in recent years with interventions performed early in pregnancy have shown promising results with respect to preterm birth. Discussion. One major methodological problem in reviewing litterature on bacterial vaginosis and pregnancy complication is the heterogeneity with respect to study design, diagnostic measures, onset of treatment, as well as treatment regime. Moreover, there seems to be a lack of understanding of the exact microbiological processes of bacterial vaginosis leading to obstetric complications. Recently published papers have undertaken the task of identifying the microbiological markers of bacterial vaginosis preceding complications. Conclusion Early intervention with antimicrobial treatment has shown promising results in treatment of bacterial vaginosis in order to prevent complications such as preterm birth. Before large screening programs can be implemented, the effect of early antimicrobial treatment on clinically significant endpoints needs to be documented in large-scale controlled studies with standardised diagnostic procedures and treatment regimes. Furthermore, identification of the exact microbiological processes needs to be identified

Deposition of carbon from methane on manganese sources

Carbon has been deposited on HCFeMn slag from methane-containing gas with and without CO2, creating C-MnO composites and giving a hydrogen-rich off-gas as a by-product. The maximum deposited amount corresponds to 38 ± 6% of the carbon required for reduction of all manganese in the slag to metallic Mn. This was achieved at 1100 °C with a H2-concentration in the off gas of 76%. Temperature was an important parameter. At 790 °C, no deposited carbon was detected, at temperatures ≥ 1000 °C, deposition increased with temperature. A lower gas-flow leads to more methane decomposition. Experiments with CO2 in the process gas gave less deposited carbon than other experiments. This could be caused by dilution of methane or chemical reactions involving CO2, or a combination. Investigations of fines formation indicate that the deposited carbon sticks well to the HCFeMn-slag, and would not fall off easily during transport and handling. This demonstrates that biogas can potentially be a non-fossil source of carbon in manganese production.publishedVersio

Koordinerte tjenester for somatisk syke ROP-pasienter - en kunnskapsoppsummering

Master's thesis in Mental health and addiction issuesHensikt: Å undersøke eksisterende forskningsstudier for å identifisere tilnærminger som gav pasienter med samtidig rus- og psykisk lidelser og somatisk sykdom, dvs. pasienter med trippeldiagnose, koordinerte tjenester. Metode: Kunnskapsoppsummering med scoping review som rammeverk. Jeg gjennomførte systematisk søk i tre søkebaser: Cinahl, PsycInfo og Medline. Resultater: Jeg inkluderte tolv studier, av disse var fire kvalitative, syv kvantitative og en mixed methods. Alle studiene var gjennomført i USA, og i ti av studiene var det pasienter som hadde HIV/AIDS som somatisk sykdom i tillegg til rus- og psykisk lidelse. I de to siste studiene var den somatiske sykdommen hepatitt C. Elleve av studiene presenterte ulike program/modeller der målsettingen var å gjøre tjenestene for målgruppen koordinerte. Jeg fant seks ulike aktiviteter som beskrev koordinering. Dette var koordineringsaktivitetene mellom de forskjellige systemene som var involvert i oppfølging av pasienten, og som hadde betydning for i hvilken grad tjenestene kunne sies å være koordinerte. De koordineringsaktivtetene jeg fant var: - Kommunikasjon og avklaring av ansvar. - Lage/vedlikeholde og følge opp endringer i pasientens behandlingsplaner - Støtte opp om mål for egenomsorg og hjelp til koblinger til samfunnets ressurser Funnene viste også at ambulant oppfølging i ulike former var viktig for å nå denne målgruppen. Konklusjon: Forskningslitteraturen viste at det var ulike tilnærminger som var med på å gi pasienter med samtidig rus- og psykisk lidelser og somatisk sykdom koordinerte tjenester

Brain atrophy and clinical characteristics predicting SDMT performance in multiple sclerosis: A 10-year follow-up study

Objectives To identify Magnetic Resonance Imaging (MRI), clinical and demographic biomarkers predictive of worsening information processing speed (IPS) as measured by Symbol Digit Modalities Test (SDMT). Methods Demographic, clinical data and 1.5 T MRI scans were collected in 76 patients at time of inclusion, and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. For the primary outcome of analysis, SDMT was used. Results Worsening SDMT at 5-year follow-up was predicted by baseline age, Expanded Disability Status Scale (EDSS), SDMT, whole brain volume (WBV) and T2 lesion volume (LV), explaining 30.2% of the variance of SDMT. At 10-year follow-up, age, EDSS, grey matter volume (GMV) and T1 LV explained 39.4% of the variance of SDMT change. Conclusion This longitudinal study shows that baseline MRI-markers, demographic and clinical data can help predict worsening IPS. Identification of patients at risk of IPS decline is of importance as follow-up, treatment and rehabilitation can be optimized.publishedVersio

Sosiale medier sin påvirkningskraft på nordmenns holdninger til pels

Formålet med denne oppgaven var å avdekke om det eksisterer en sammenheng mellom sosiale medier og hvilken holdning man har til pels. Vi ønsket å finne ut av om sosiale medier påvirker holdninger til pels negativt eller positivt. Temaet ble valgt på bakgrunn av det økende fokuset på dyrevelferd og debatten rundt om det er etisk å opprettholde pelsdyrnæringen. Oppgavens problemstilling lyder som følger: “Hvordan kan økt synlighet gjennom sosiale medier påvirke nordmenns holdninger til pelsindustrien?” Vi gjennomførte vår undersøkelsen med et kvantitativt tverrsnittdesign. Som datainnsamlingsmetode benyttet vi oss av spørreskjemaundersøkelse. Respondentene ble tilfeldig kontaktet gjennom Facebook og email. For å se om det fantes en sammenheng mellom sosiale medier og holdning til pels, ble de innhentede dataene deretter analysert gjennom programvaren SPSS. Funnene ble videre knyttet opp mot valgt teori. Gjennom vår undersøkelse fikk vi kartlagt at sosiale medier har en signifikant innvirkning på nordmenns holdninger til pels. Regresjonsanalysen viste at jo oftere og jo flere sosiale medier man benytter seg av, desto mer negativ blir man til pels. Vi kan dermed med 95% sikkerhet si, at sosiale medier har en effekt på nordmenns holdninger til pels. Det er likevel viktig å presisere, at det kan foreligge andre faktorer som har en innvirkning på forholdet mellom de valgte variablene. På grunn av tidsbegrensninger i oppgaven, ble det derfor kun fokusert på alder, kjønn, utdanning, dyrevant, eksponering, matvaner og kjennskap

Longitudinal Links Between Spanking and Children’s Externalizing Behaviors in a National Sample of White, Black, Hispanic, and Asian American Families

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91136/1/j.1467-8624.2011.01732.x.pd

Meeting the mammography screening needs of underserved women: the performance of the National Breast and Cervical Cancer Early Detection Program in 2002–2003 (United States)

OBJECTIVE: To examine the extent to which the National Breast and Cervical Cancer Early Detection Program (Program) has helped to meet the mammography screening needs of underserved women. METHODS: Low-income, uninsured women aged 40–64 are eligible for free mammography screening through the Program. We used data from the U.S. Census Bureau to estimate the number of women eligible for services. We obtained the number of women receiving Program-funded mammograms from the Program. We then calculated the percentage of eligible women who received mammograms through the Program. RESULTS: In 2002–2003, of all U.S. women aged 40–64, approximately 4 million (8.5%) had no health insurance and had a family income below 250% of the federal poverty level, meeting Program eligibility criteria. Of these women, 528,622 (13.2%) received a Program-funded mammogram. Rates varied substantially by race and ethnicity. The percentage of eligible women screened in each state ranged from about 2% to approximately 79%. CONCLUSIONS: Although the Program provided screening services to over a half-million low-income, uninsured women for mammography, it served a small percentage of those eligible. Given that in 2003 more than 2.3 million uninsured, low-income, women aged 40–64 did not receive recommended mammograms from either the Program or other sources, there remains a substantial need for services for this historically underserved population