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Biomedical subjects

A K Dykes

Publications and source records attributed to A K Dykes.

At least 19 recordsLinked to original sources
PubMed2004

Bone mineral density changes in young women: a two year study.

Achievement of a high peak bone mass is considered a pivotal preventive strategy against future osteoporotic fractures. The ostensible interaction between physiology and lifestylefor the development of bone mass over time is sparsely outlined among young women. The aim of this study was to follow bone density and bone resorption over time among healthy young women in relation to lifestyle factors and to evaluate the perceived influence of other factors. Data were collected in 1999 and in 2001. Healthy young women (n=152) were given a structured questionnaire, a heel bone scanner (dual X-ray absorptiometry) performed bone mineral density measurements and deoxypyridinoline was measured in urine. Data were analyzed by linear, multiple and logistic regression analysis. Mean bone mineral density (BMD) was 0.562 g/cm2 (+/-0.090). Bone density at baseline was the best predictorfor the bone density atfollow-up. Bone density at baseline together with smoking and alcohol (dichotomized) accounted for 86.5% of the variation in bone density 2 years later. Of the participants 62% had decreased/unchanged bone density and 38% had increased their bone density from 1999 to 2001. Use of oral contraceptives or alcohol at baseline was associated with an increased risk of belonging to the group who decreased their bone density. Deoxypyridinoline was not a strongpredictor to bone density and all potential predictors of deoxypyridinoline had a minor influence (<10%). In conclusion, lifestyle behaviors such as use of oral contraceptives, smoking and alcohol consumption seem to have a negative influence on BMD development among young women and warrant further scrutiny.

Absorptiometry, Photon↗
PubMed2003

Influence of smoking and oral contraceptives on bone mineral density and bone remodeling in young women: a 2-year study.

The objective of the study was to explore the influence of menstrual irregularities, oral contraceptives and smoking on bone mineral density (BMD) development and bone turnover with time. Healthy young women (n = 118) were divided into four categories: (a) women neither smoking nor using oral contraceptives; (b) women who were smokers; (c) women using oral contraceptives; (d) women who were smoking and using oral contraceptives. They responded to a validated questionnaire with 34 questions concerning lifestyle and the Sense of Coherence scale (SOC). BMD was measured by dual energy x-ray absorptiometry (DEXA). Deoxypyridinoline (DPD) was measured in urine. Data were analyzed by multiple linear regression analysis. Among smokers, BMD level decreased during a 2-year period and smoking was associated with a larger negative change in BMD. Use of oral contraceptives moderated the negative impact of smoking. Women using oral contraceptives at baseline and with regular bleeding induced by contraceptive pills had a significantly higher BMD at baseline and at follow-up. They also had lower SOC than women who had natural regular bleedings. Use of oral contraceptives in combination with smoking was linked to high alcohol consumption and higher frequency of self-reported body weight reduction, which reduced the negative BMD change in this category. DPD level and difference were strongly associated with estrogen influence. It is concluded that smokers without OCs had a negative BMD development and BMD in young women with irregular menstruations seems to be improved by OC.

Absorptiometry, Photon↗
PubMed2002

Bone mineral density and lifestyle among female students aged 16-24 years.

The objective of the study was to investigate bone mineral density and bone turnover among female students aged 16-24 years in relation to lifestyle factors, such as dietary habits and physical activity, as well as physiological factors, such as age, body weight, and menstrual pattern. Female college and university students (n = 218) were given a validated questionnaire with 34 questions concerning diet, recreational physical activity, alcohol, smoking, menstrual pattern, weight gain and loss. Bone mineral density (BMD) measurements were performed using a heel bone scanner (DEXA). Deoxypyridinoline (DPD) levels were measured in urine samples. The data were analyzed by linear regression and multiple regression analysis. The mean BMD was 0.568 g/cm2. Multiple regression showed that hormonal age was a better predictor of high BMD and low bone mineral turnover than chronological age. The best model predicting high BMD was composed of physical activity, regular menstruation, hormonal age and body weight. Smoking, alcohol consumption and current calcium intake did not contribute to the model. A negative association between BMD and DPD was found, indicating an enhanced bone remodeling. A correlation was found between DPD and hormonal age, chronological age, sugar intake and time with irregular menses. In multiple regression analysis, hormonal age, high sugar intake and weight loss were the factors best predicting DPD. BMD was positively influenced by a healthy lifestyle, including a physically active life and healthy dietary habits without dieting. Our study shows that hormonal age is a stronger BMD predictor than chronological age. Menstrual disturbances might be an indication of a risk for low BMD and might therefore be a reason for measuring BMD among young females.

Absorptiometry, Photon↗
PubMed2001

Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study.

OBJECTIVE: To compare the antiemetic effect of acupressure at the Neiguan point (P6) in a group of healthy women with normal pregnancy and nausea and vomiting during pregnancy (NVP) with a similar group receiving acupressure at a placebo point and another, similar group not receiving any treatment. STUDY DESIGN: A randomized, placebo-controlled, pilot study involving 60 women. RESULTS: It is possible to reduce NVP significantly with acupressure at P6 as compared to acupressure at a placebo point or no treatment at all in healthy women with normal pregnancies. Relief from nausea appeared one day after starting treatment in both the P6 and placebo groups but lasted for only six days in the placebo group. The P6 group, however, experienced significantly less nausea after 14 days as compared to the other two groups. CONCLUSION: This study involved 60 healthy women with normal pregnancy and suffering from NVP. According to the results, in healthy women with normal pregnancy it is possible to reduce NVP significantly at P6 as compared to acupressure at a placebo point and to no treatment.

Acupressure↗
PubMed1999

Patients' evaluation of pain and nurses' management of analgesics after surgery. The effect of a study day on the subject of pain for nurses working at the thorax surgery department.

The effect of a study day on the subject of pain for nurses working at the thorax surgery department The aims of this investigation were: to describe patients' evaluation of pain and the treatment of pain after thorax surgery via sternotomy; to repeat the evaluation with another group of patients following a study day for nurses, featuring pain and pain treatment; and to examine whether the study day influenced the nurses in their treatment of pain. The investigation included daily evaluation of pain using a visual analogue scale (VAS), and an interview with the patients before discharge, where they were asked to review their experience of pain and its treatment. The nurses on the thorax surgery ward and on the intensive care unit (ICU) completed a questionnaire before and after the study day. Finally, a retrospective study of the case notes of the patients taking part was carried out. The results of the investigation showed a low assessment of pain by most patients during the daily evaluation. Asked to recall their pain when interviewed, the rating was higher. A small group of patients had more evident pain than others. When administering opiates the ICU nurses often chose a lower dose than the standing order prescribed. After the study day the nurses gave larger doses of intravenous opioids and the patients experienced less pain.

Analgesics, Opioid↗
PubMed1989

Chlorhexidine for prevention of neonatal colonization with group B streptococci. V. Chlorhexidine concentrations in blood following vaginal washing during delivery.

Chlorhexidine 2 g/l was applied to the vagina of 96 women during delivery, whereas 28 served as controls. Both groups were given a shower using a chlorhexidine soap, and outer washing of the outer anogenital tract was also performed in all patients using chlorhexidine 2 g/l. Using a gas chromatographic method with a detection limit of 10 ng chlorhexidine per ml blood, 10-83 ng/ml was demonstrated in 34 (35%) of the study group patients, whereas the remaining study group patients and controls showed no detectable chlorhexidine. Performing the washing a second time after 6 hours in 14 patients and a third time in 3 patients after a further 6 hours did not result in increased serum levels. It was concluded that small amounts of chlorhexidine are absorbed through the vaginal mucosa and that chlorhexidine is not accumulated in the blood on repeated usage with 6 hour intervals during delivery.

Administration, Intravaginal↗
PubMed1987

Chlorhexidine for prevention of neonatal colonization with group B streptococci. IV. Depressed puerperal carriage following vaginal washing with chlorhexidine during labour.

The effect of vaginal washing with chlorhexidine acetate, 2 g/l at delivery, on the colonization of the urogenital tract with group B streptococci (GBS) 4 days later was investigated. Patients who were culture-positive for GBS in urethra and/or cervix in pregnancy weeks 32 and 36 as well as at delivery were included in a prospective study. The washing procedure was performed in 31 parturients, and 10 (32%) were culture-negative at day 4 after delivery. In contrast, only 7/47 (15%) non-washed controls were negative at day 4 (p = 0.044). The results demonstrate a prolonged suppressive effect of vaginal washing with chlorhexidine on the recovery of GBS from the urogenital tract in this highly selected patient group.

Administration, Intravaginal↗
PubMed1985

Chlorhexidine for prevention of neonatal colonization with group B streptococci. III. Effect of vaginal washing with chlorhexidine before rupture of the membranes.

A single vaginal washing with 2 g/l of chlorhexidine was performed before rupture of the membranes in 19 parturients who were urogenital carriers of group B streptococci (GBS). Two (11%) of the infants became colonized immediately after birth, in contrast to 16 of 41 (39%) infants to controls (P = 0.02). A significant reduction of GBS colonization of the ear (P = 0.02) and umbilicus (P = 0.01) was noted. Taken together, 2 of 57 (4%) cultures obtained at birth were positive in the chlorhexidine group, in contrast to 30 of 123 (24%) among the controls (P less than 0.01). These findings raise hope for the design of a simple washing procedure which might prevent serious infections in the early neonatal period with GBS but also with other chlorhexidine-sensitive organisms.

Adolescent↗
PubMed1985

Reduced colonization of newborns with group B streptococci following washing of the birth canal with chlorhexidine.

Possible measures for prevention of neonatal group B streptococcal (GBS) septicemia include active or passiv immunoprophylaxis and administration of penicillin to mothers and infants. In a previous study we have found GBS to be extremely sensitive to chlorhexidine. Furthermore vaginal washing with chlorhexidine diminished the recovery of GBS from parturients. In order to study the effect of chlorhexidine washing upon the colonization of newborns, a study group of chronic GBS carriers, i.e. women who were GBS positive in the 32-36 gestational week as well as during labor was selected. In 18 of these females chlorhexidine washing was performed prior to delivery while 33 chronic carriers served as controls. Screening during labor was performed in 945 consecutive patients. Cultures were collected from the external ear, throat and umbilicus of all infants within 5 minutes of birth and at day 4 of life. At birth 22% of the infants of the chlorhexidine washed mothers were colonized with GBS, in contrast to 52% of the infants from the chronic GBS carriers (p less than 0.05). The proportion of infants harboring GBS at day 4 were similar in the two groups (Tab. I). Among the 945 consecutively screened women, 164 harbored GBS and 54 (33%) of their 164 infants were colonized at birth. The colonization rate of the infants from chronic GBS carriers was significantly higher, 17 of 33 infants (p less than 0.05). This may reflect that the risk of contracting GBS by infants increases with the quantity of GBS in the birth channel.(ABSTRACT TRUNCATED AT 250 WORDS)

Cervix Uteri↗
PubMed1985

Chronic carrier state in mothers of infants with group B streptococcal infections.

Seven of eight women who had given birth to infants with early onset or intrauterine infection caused by group B streptococci remained carriers of the same serotype of group B streptococci up to 38 months after their pregnancy. In contrast, only 34 of 88 group B streptococci carriers who had given birth to healthy infants harbored the same serotype at the 34 months' follow-up (P = .009). Among the control subjects, 29 of 71 showed increased serum levels at followup of antibodies against the serotype isolated at delivery, a significantly higher proportion compared with the mothers of infected infants/fetuses. The results indicate that mothers of group B streptococci-infected infants are chronic urogenital carriers of group B streptococci without responding immunologically against the organism.

Antibodies, Bacterial↗
PubMed1983

Chlorhexidine for prevention of neonatal colonization with group B streptococci. I. In vitro effect of chlorhexidine on group B streptococci.

Forty-three strains of group B streptococci (GBS) of types Ia, Ib, II and III were tested for susceptibility to chlorhexidine in concentrations ranging from 256 to 0.25 mg/l using the agar and tube dilution methods. The strains showed minimum inhibitory concentration (MIC) values ranging from 0.5 to 1 mg/l. Serum added to the test medium (50%) increased the MIC values to 4-8 mg/l, while amniotic fluid (50%) had almost no effect, increasing the values to 1-2 mg/l. The minimum bactericidal concentration (MBC) ranged from 1 to 5 mg/l. The killing kinetics were related to the concentration of chlorhexidine and the length of exposure. For example, at a concentration of 63 mg/l, 7 h were required for a bactericidal effect in broth, as compared to 1 h at 500 mg/l chlorhexidine. 200 mg/l chlordexidine had no effect on the adherence of two GBS strains to vaginal epithelial cells, and no effect on the phagocytosis of GBS with mouse peritoneal macrophages.

Bacteriolysis↗
PubMed1983

Chlorhexidine for prevention of neonatal colonization with group B streptococci. II. Chlorhexidine concentrations and recovery of group B streptococci following vaginal washing in pregnant women.

The effect of a single washing of the urogenital tract with 0.5 g/l chlorhexidine was studied in 6 women in weeks 38-40 of pregnancy, among whom 5 were carriers of group B streptococci in urethra and/or cervix. The chlorhexidine concentrations varied between 25 and 200 mg/l during the first hour after washing in 5 of the 6 women, whereas one patient showed concentrations below 25 mg/l. With the exception of one patient, all individuals showed concentrations less than 25 mg/l at 3-24 h after washing. A clear suppression of the number of colony-forming units of GBS was already apparent after 60 min and was still evident 6 h after chlorhexidine washing.

Carrier State↗
PubMedDate not supplied

Factors influencing informed choice of prenatal diagnosis: women's feelings and attitudes.

OBJECTIVE: To obtain knowledge about factors that could influence women's informed choice and extent of prenatal diagnosis, her feelings when implementing it, and her satisfaction. METHOD: A questionnaire including Visual Analogue Scale was given to 823 women and replies received from 662 (80.4%). Ease of choice was the basis for the statistical analysis. RESULTS: The factors that most often influenced choice were the fetus health, maternal age, and knowledge of the consequences. The choice was easy to make, only 2% finding it very difficult. The time period from the amniocentesis until the results were available was the most difficult time reported. CONCLUSIONS: The choice of method for prenatal diagnosis was very easy for most women. Satisfaction with choice was high (98%). Extra support can be needed while awaiting results of invasive prenatal diagnosis.

Amniocentesis↗