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Biomedical subjects

A MacLennan

Publications and source records attributed to A MacLennan.

10 recordsLinked to original sources
PubMed1992

Oestrogen and cyclical progestogen in postmenopausal hormone replacement therapy.

OBJECTIVE: To ascertain the effectiveness, safety and incidence of side effects of a postmenopausal hormone replacement regimen consisting of continuous conjugated equine oestrogens and cyclical medroxyprogesterone acetate given for the first 14 days of each calendar month. DESIGN: A six month, prospective, open label, two centre, outpatient study of continuous Premarin (0.625 mg; Wyeth-Ayerst) and cyclical Provera (10 mg; Upjohn). Dosage adjustment was allowed in one centre. STUDY POPULATION: Seventy-six postmenopausal women in Adelaide and Brisbane. MAIN OUTCOME MEASURES: Menopausal symptom score, serum lipid levels, routine biochemical and haematological indices, endometrial histology and clinical bleeding pattern, blood pressure, weight changes, side effects, withdrawal from the study, compliance and necessary dose adjustment. MAIN RESULTS: Eight women withdrew from the study and nearly 50% experienced some minor side effect. Where dosage adjustment was allowed, almost all side effects were eliminated. Most patients had acceptable regular withdrawal bleeds although some were deemed heavy. There was a statistically highly significant 54% reduction in the menopausal symptoms score at three months and a 62% reduction at six months. Endometrial biopsy at six months showed atrophic or secretory endometrium with no inappropriate proliferation or hyperplasia. Total cholesterol and low density lipoprotein (LDL) cholesterol levels were significantly decreased. The high density lipoprotein (HDL) cholesterol level remained unchanged and triglyceride levels were raised within the normal range. There were no other clinically relevant biochemical, haematological or clinical changes. CONCLUSION: Continuous conjugated equine oestrogens (0.625 mg) and cyclical medroxyprogesterone acetate (10 mg) for the first 14 days of each calendar month proved to be a safe and effective postmenopausal therapy regimen. Initial minor side effects were common but could be readily ameliorated with early follow-up and dose titration.

Adult↗
PubMed1989

Labour induction with low dose PGE2 vaginal gel: result of an Australian multicentre randomized trial.

An open-label, parallel, randomized study was conducted in 6 Australian hospitals involving 320 women near term who required induction of labour. Labour induction with 1 or 2mg of PGE2 in a vaginal triacetin gel repeated if necessary at 6 hours was compared to induction by amniotomy and intravenous oxytocin. Analysis of the 2 groups confirmed matching with regards demographic and clinical data. A significantly longer and more variable mean induction to onset of established labour interval was recorded in the PGE2 group (6.7 +/- 4.8 versus 2.0 +/- 1.1 hours. (p less than 0.001). The mean period of established labour was also longer (8.1 versus 6.0 hours, p less than 0.001) in the PGE2 group. However, 48% of PGE2 treated patients versus 29% oxytocin treated patients (p less than 0.01) were recorded as not experiencing strong contractions. Twelve hours after induction 65% of the PGE2 group and 93% of the oxytocin group were in established labour; 24% of the PGE2 treated group required subsequent augmentation with oxytocin. Spontaneous delivery occurred in 69% of PGE2 treated women and 62% of those treated with oxytocin (N.S.). Analgesic requirements were not statistically different between the groups. Fewer fetal heart rate abnormalities were recorded in the PGE2 treated group (p less than 0.02). No serious and only minimal adverse events were recorded in either treatment group.

Administration, Intravaginal↗
PubMed1986

The effect of porcine relaxin on the fertilisation of mouse oocytes in vitro.

The mouse in vitro fertilisation (IVF) model was used to investigate the effect of porcine relaxin on fertilisation. Porcine relaxin (10 ng/ml) significantly increased the proportion of oocytes fertilised by suboptimal concentrations of mouse spermatozoa. Pronuclear formation was significantly greater in the presence of relaxin. These findings may have clinical importance in the future for improving the success of IVF procedures, and improving pregnancy rates.

Animals↗
PubMed1985

A comparison of intravaginal PGF2 alpha and intravenous oxytocin to stimulate labour after membrane rupture.

A prospective randomized controlled trial of 202 patients was set up to examine the efficiency and safety of 40 mg of intravaginal prostaglandin F2 alpha (PGF2 alpha) in a tylose gel to stimulate labour after artificial or spontaneous membrane rupture. The control group received a standard intravenous oxytocin regimen. The PGF2 alpha treated group had a significantly shorter length of labour (6.2 +/- 3.6 hours) compared to the oxytocin group (7.5 +/- 4.3 hours) (p less than 0.05). The analgesic requirements were significantly reduced in the PGF2 alpha treated patients. In PGF2 alpha treated patients 46 of 105 required no analgesia whereas 17 of 97 oxytocin treated patients required no analgesia (p less than 0.001). There were similar reductions for epidural (p less than 0.005) and pethidine requirements (p less than 0.005). No differences were found between groups with regards mode of delivery. There were no adverse maternal side-effects associated with PGF2 alpha usage. A significant reduction (p less than 0.05) in the incidence of neonatal jaundice requiring phototherapy occurred in the PGF2 alpha group. Prostaglandin F2 alpha appears to be a safe, efficient and better alternative to intravenous oxytocin to stimulate labour in the presence of ruptured membranes, allowing ambulation, a reduction in length of labour and less need for analgesia and intravenous therapy.

Anesthesia, Obstetrical↗