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Biomedical subjects

A Hollmén

Publications and source records attributed to A Hollmén.

At least 19 recordsLinked to original sources
PubMed1995

Maternal expectations and experiences of labour pain--options of 1091 Finnish parturients.

A prospective survey of 1091 Finnish parturients was conducted in order to ascertain mothers' expectations for labour pain relief, to measure the actual pain during all three stages of labour and to question their satisfaction and the adequacy of pain relief on the third day following delivery. Antenatal expectations for pain relief were surveyed. Mothers were questioned on pain levels in the delivery room and 3 days after giving birth. Pain levels were ascertained using a visual pain score method. Antenatally, 90% of all parturients anticipated a need for pain relief during labour. In the delivery room over 80% of all parturients described their pain as very severe to intolerable, only 4% of the multiparous had low pain scores (0-2). After pain treatment 50% of multiparous women still had pain scores from 8 to 10, which reflects a lack of effective pain relief. Dissatisfaction with the childbirth experience was very low, and was associated with instrumental deliveries, but not with the usage of analgesia. 51% of all parturients complained of inadequate pain relief during childbirth, which, in multiparous women, was significantly associated with the second stage of labour.

Analgesia, Epidural↗
PubMed1995

Hand eczema in Finnish farmers. A questionnaire-based clinical study.

In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm dermatoses in a self-administered questionnaire. 138 (80%) of them attended a clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70% were considered work-related. Cow allergy was found in 41 of 104 prick- and patch-tested farmers (39%). Immediate allergy to cow epithelium was encountered in a total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact allergy to cow dander was found in 27/41. The result suggests that in addition to SPTs using commercial cow epithelium extract, PTs using fresh cow dander should also be done, and both immediate and delayed responses should be read.

Adolescent↗
PubMed1995

Dermatoses determined in a population of farmers in a questionnaire-based clinical study including methodology validation.

OBJECTIVES: The study analyzed skin diseases in a population sample of Finnish farmers descriptively and in the process validated the question "Do you have a skin disease now?" METHODS: All farmers from one Finnish municipality were surveyed for dermatoses, first with a questionnaire and then with a clinical examination of those who reported dermatoses. Another population of farmers answered a set of questions immediately before a clinical examination, and the self-report of current dermatosis was validated. RESULTS: Eczema was diagnosed for 66% of the women and 53% of the men who had reported dermatosis in the questionnaire study 6 to 12 months earlier. Toe-web maceration, psoriasis, folliculitis, and acne were, after eczema, the most frequent diagnoses (in that order). In more than 50% of the cases, the location of clinically determined dermatoses corresponded with the skin disease areas reported 6 to 12 months earlier. In the validation study, everyone who reported a skin disease immediately before the clinical examination were found to have a skin disease. In addition 22% of those not reporting dermatosis were found to have a skin disease. Toe-web maceration was the most common dermatosis not reported by the farmers. CONCLUSIONS: Finnish farmers suffered from the same type of dermatoses as other populations. The prevalence of eczema and hand eczema was similar to that of other risk populations. A self-report of current dermatosis is probably a good indicator of the point prevalence of explicit skin diseases in populations.

Adolescent↗
PubMed1994

Parturients' assessment of water blocks, pethidine, nitrous oxide, paracervical and epidural blocks in labour.

This prospective study evaluated the extent to which the analgesic procedures available resulted in efficient pain relief in 833 Finnish parturients. Their pain ratings were recorded according to their own assessment of pain intensity during labour before and after pain management and according to their total pain experience recalled on the third day after delivery. Only regional blocks significantly diminished pain scores during labour and a striking decrease in pain level (P < 0.0001) was maintained until the second stage by epidural analgesia (EDA) alone. The EDA-group consisted mainly of the primiparous (71%) with induced (17%) and most painful deliveries. After delivery 60% of parturients in this group recalled labour pain as being very severe or intolerable. This was partly due to delays in receiving epidural blockade and partly due to the parturient's reticence in requesting analgesia. Pain relief was rated as excellent or good by 94% of the EDA group but by only 50% of the remaining patients.

Journal Article↗
PubMed1989

Comparison of the effects of general and epidural anaesthesia for caesarean section on the neurobehavioural responses of newborn infants.

Thirty-one neonates delivered by elective caesarean section were evaluated at the ages of 3 h, 1 day, 2 days and 4-5 days using Scanlon's Early Neonatal Neurobehavioural Scale and tests for orientation. Thirteen of the mothers received general anaesthesia and 18 epidural anaesthesia. All the mothers were healthy and not in labour. All the neonates weighed 2500 g or more and had Apgar scores of 7 or more at 1, 5 and 15 min. The neonates delivered with epidural anaesthesia scored significantly lower on rooting at the age of 3 h than those delivered with general anaesthesia, but the latter scored significantly lower on habituation to sound and orientation to both animate and inanimate visual stimuli. General anaesthesia seemed to depress the infants' interactive processes (orientation items), and their ability to make an appropriate response to repetitive stimuli (habituation) more than did epidural anaesthesia, indicating greater global depression. This depression was short-lived, however, and there were no differences between the groups on any of the parameters after 24 h.

Adult↗
PubMed1989

The effect of lumbar epidural analgesia on the neurobehavioural responses of newborn infants.

The effects of maternal lumbar epidural analgesia (Th10-L5) on the neonatal neurobehavioural response were studied at the ages of 3 h, 1 day, 2 days and 4-5 days. The subjects were healthy, full-term neonates, born vaginally to 15 mothers with lumbar epidural block and 19 mothers without analgesia. Those delivered with epidural analgesia scored significantly better on alertness at the age of 3 h, 2 days and 4-5 days than the control group. No other statistically significant differences were found between the groups. The formation of the two groups according to the mothers' desire for epidural analgesia may have contributed to differences in the process of labour, but with this reservation it may be suggested that lumbar epidural analgesia may enhance the infant's recovery from the stress of labour and vaginal delivery.

Analgesia, Epidural↗
PubMed1988

The effect of bupivacaine paracervical block on the neurobehavioural responses of newborn infants.

The effects of maternal bupivacaine paracervical block on neonatal neurobehavioural responses were studied at the ages of 3 h, 1 day, 2 days and 4-5 days. Subjects were healthy, term neonates born vaginally to 10 mothers with paracervical block and to 12 mothers without analgesia. No statistically significant differences were found in the responses between the groups. It is concluded that paracervical block with a small dose of bupivacaine, applied by experienced obstetricians to non-risk parturients with healthy foetuses, has no detrimental effects on newborn behaviour or neurological recovery.

Adult↗
PubMed1987

The effect of segmental epidural analgesia on the neurobehavioural responses of newborn infants.

The effects of maternal segmental epidural analgesia on neonatal neurobehavioural responses were studied at the ages of 3 h, 1 day, 2 days and 4-5 days. Subjects were healthy, term neonates born vaginally to 14 mothers with an epidural block and to 15 mothers without analgesia. The only statistically significant differences were found at the age of 1 day, when the epidural group infants habituated and oriented better to inanimate auditory stimuli. It is concluded that segmental epidural analgesia with a low dose of bupivacaine can be regarded as being a safe obstetric analgesic method as regards neonatal behavioural responses.

Acoustic Stimulation↗
PubMed1985

Natural killer cell activity after elective cesarean section under general and epidural anesthesia in healthy parturients and their newborns.

We studied the influence of elective cesarean section, under general and epidural anesthesia, on natural killer (NK) cell activity in 12 healthy parturients and in their newborns. The results of peripheral blood samples taken from the mothers before anesthesia and from the newborns 3 h after birth served as basal values against which the results of samples drawn on the 1st and 5th days following delivery were compared. A significant (p less than 0.05) decrease in the NK cell activity after surgery was found only in those mothers given general anesthesia. The differences between the studied groups were not, however, significant. NK activity in the peripheral blood samples of the newborns was not significantly different in the general anesthesia and in the epidural group during the follow-up period. The results show that the depression induced by operative stress on the NK cell function of parturients can be, at least partly, prevented by using epidural anesthesia.

Adult↗
PubMed1984

Effect of segmental epidural analgesia on changes in peripheral blood leucocyte counts, lymphocyte subpopulations, and in vitro transformation in healthy parturients and their newborns.

Changes in the peripheral blood leucocyte count, lymphocyte subpopulations, and in 'in vitro' responses of lymphocytes to phytohaemagglutinin and tuberculin after induced labour were investigated in 10 normal parturients and their newborns. Every other parturient was given segmental epidural analgesia at level T 10-12 for pain relief during the first stage of labour. The remaining mothers served as controls. The results of blood samples taken from the mothers before induction of labour and from the newborns immediately after delivery served as basal values against which the results of samples drawn on the 1st and on the 5th day following delivery were compared. A significant (p less than 0.05) increase from the basal values in the total leucocyte count after delivery was found only in those mothers not given epidural analgesia and in their newborns. Similarly, a significant (p less than 0.01) decrease in the T cell count characterized by both E rosette formation and acid alpha-naphthyl acetate esterase staining was found in the peripheral blood only in the mothers (but not the newborns) without epidural analgesia. The differences between the research groups were not, however, significant. The lymphocyte response to phytohaemagglutinin on the 1st and on the 5th day after delivery was also significantly (p less than 0.05) lower in the newborns of the mothers not given epidural analgesia than in those of the mothers given it. The present results show that the depression induced by the stress of parturition in some parameters of cell-mediated immunity of mothers and newborns can be at least partly prevented by using segmental epidural analgesia.

Adult↗
PubMed1981

Maternal and foetal drug levels after epicutaneous application of a local anaesthetic formulation containing ketocaine for possible use as pain relief in labour.

A local anaesthetic formulation (A 2358) containing ketocaine, a local anaesthetic drug, was applied epicutaneously to the low back. Two compresses soaked with A 2358 were applied for 1 hour in 26 normal labours for relieving referred pain from the low back. The maternal blood ketocaine levels remained low, compared to higher systemic levels reported in other studies. Maternal heart rate and blood pressure were stable during the application time. The mean umbilical vein/maternal vein and umbilical artery/maternal vein concentration ratios were 0.20 +/- 0.10 and 0.21 +/- 0.09. In addition, the foetal heart rate findings and the conditions of the neonates were satisfactory, thus suggesting the foetal safety of this analgesic method.

Adolescent↗
PubMed1981

The levels of zinc, copper, calcium and magnesium in serum and urine after heart-valve replacement. Effects of oxygenator type and postoperative parenteral nutrition.

We studied the effects of mitral or aortic valve-replacement operations with cardiopulmonary bypass on the levels of zinc, copper, calcium, and magnesium in serum and urine in 23 patients. The specimens of blood and urine were taken preoperatively and on the second and fifth postoperative days. There were remarkable decreases in serum levels on the second postoperative day of all four bioelements in all patients compared to the preoperative levels. At the same time there were also clear decreases of calcium and magnesium in urinary excretions. The urine zinc and copper excretion showed no big variations during the three study periods. On the fifth postoperative day, serum magnesium levels increased in all patients in spite of increased urine excretion. Serum calcium levels decreased on the fifth day further and urine excretion increased again. Serum copper levels increased slightly on the fifth postoperative day compared to the second postoperative day. At the same time serum zinc concentrations increased only in the patients who had parenteral nutrition (approximately 40 kcal per kg of body weight per day) for 4 postoperative days. The effect on zinc levels was the only difference in parameters between patients given conventional fluid therapy with 5% glucose solution or parenteral nutrition with 30% glucose, amino acid, and fat emulsion regimen. There were no differences in the bioelements between patients perfused with bubble or membrane oxygenators.

Adolescent↗