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Biomedical subjects

G G Essed

Publications and source records attributed to G G Essed.

At least 19 recordsLinked to original sources
PubMed1992

[Incidence of postpartum thyroid function disorders in The Netherlands].

In a longitudinal study the incidence of postpartum thyroid dysfunction in the Netherlands was investigated in an unselected open population. There were 293 women who were screened by repeated assessments of thyroid function until 34 weeks postpartum at 6-week intervals. Thyroid dysfunction was defined as abnormal TSH values accompanied by abnormal FT4 and (or) FT3 values. The frequency of postpartum thyroid dysfunction was 7.2% (n = 21). Most of the thyroid dysfunction occurred between 16 and 28 weeks postpartum. There were five women with subclinical thyroid dysfunction: abnormal TSH values with complementary FT4 and (or) FT3 changes within normal limits. Four of them showed (marked) increase in antimicrosomal antibody titres. With the inclusion of the five women the frequency rose to 8.9%. These data appear representative for the Netherlands as a whole, suggesting that every year 14,000 women suffer from (transient) postpartum thyroid dysfunction.

Adult↗
PubMed1992

Reactions of doctors to various forms of feedback designed to improve the sampling quality of cervical smears.

Three different forms of feedback designed to improve the sampling quality of cervical smears were tested in a randomized controlled trial among 179 physicians. The reactions of the doctors to the various interventions are reported as they appeared from their answers in a questionnaire. The influence of the interventions on the employed sampling technique is described on the basis of their answers to a telephone inquiry. The inclusion in laboratory protocols of an evaluation of the sampling quality of the submitted smears was largely appreciated, as was specific advice offered on indication. Monthly overviews comparing the performance of the individual doctor to that of his peers were esteemed by three out of four. Further information, help or training was requested more frequently than average by physicians obtaining inadequately sampled smears relatively often. The number of doctors using the combined spatula and Cytobrush method as sampling technique doubled during the study period.

Feedback↗
PubMed1991

Geographical variations in the sampling quality of cervical smears.

It is generally accepted that cervical smears are adequately sampled when they contain endocervical and/or metaplastic cells. An extensive literature search via MEDLINE and FAMLI for papers on cervical smears yielded 33 articles providing explicit information both on the country where the study was executed and on the relationship between the adequate sampling of smears and the sampling method used. The correlation between the geographic origin of cervical smears and the proportion of those smears that were adequately sampled was examined. The results were controlled for the sampling method. It was found that the proportion of adequately sampled smears reported in studies in the U.K. is exceedingly low, in contrast with the proportion reported from The Netherlands. The differences between the various countries studied are stable over different sampling methods. It is suggested that, in order to ameliorate the sampling quality of cervical smears, factors associated with the working conditions in particular regions also need be considered.

Europe↗
PubMed1990

Haematologic parameters and pregnancy outcome. A prospective cohort study in the third trimester.

The relationship between haematologic parameters and pregnancy outcome was investigated in a prospective study, taking important covariates into consideration. A questionnaire asking information about smoking, alcohol consumption and iron intake was completed by a consecutive series of 796 ambulatory singleton pregnant women at 31-32 weeks of gestation. Subsequently, haematologic parameters were measured. After delivery, birth weight, gestation length and blood pressure values during pregnancy were abstracted from the obstetricians' records. Low birth weight (less than 2.500 g) and preterm birth (less than 37 weeks), were significantly more frequently seen in women with high haemoglobin (greater than or equal to 8.0 mmol/l) or high haematocrit (greater than 38%) values, with Mantel-Haenszel odds ratios varying from 2.4 to 4.2. Also a high erythrocyte count (greater than or equal to 4.5/pl) was correlated with low birth weight, while for mean corpuscular volume (MCV) no such relationships were found. Pregnancy induced hypertension was positively associated with haemoglobin, haematocrit and erythrocyte count, but could not fully explain the relationships between these parameters and adverse outcomes. Using multiple logistic regression with low birth weight and or preterm birth as the dependent variable, the effect of haematocrit still was demonstrable after controlling for smoking, hypertension, parity, alcohol consumption and iron intake. These results are in agreement with the hypothesis that a higher blood viscosity is a risk factor for suboptimal placenta-perfusion.

Adult↗
PubMed1988

Perinatal listeriosis underdiagnosed as a cause of pre-term labour?

Between April 1, 1985, and April 1, 1986, four cases of perinatal listeriosis were reported at the Maastricht Academic Hospital. All cases were of the early-onset type. All mothers were admitted for pre-term labour between 28 and 33 weeks of gestation. Pre-natal symptoms included maternal fever, non-characteristic influenza-like manifestations, leucocytosis and (pre-term) meconium-stained amniotic fluid. Two neonates died, one in utero and one due to listeriosis sepsis. Another neonate developed a hydrocephalus. Only one neonate has survived without damage up to now. Such a high incidence of listeriosis and the high perinatal morbidity and mortality rates are remarkable. Epidemiological, bacteriological and placental sequelae of Listeria monocytogenes are discussed.

Adult↗
PubMed1987

Effect of ritodrine on thyroid hormone concentrations.

In a clinical study of 17 pregnant women treated with ritodrine, a beta-2-sympathomimetic agent used for tocolysis, thyroid hormone status was assessed longitudinally. This was done in order to verify the hypothesis that an increase in T3 levels could result from adrenergic stimulation, since propanolol, a beta blocking agent, has proved to decrease T3 levels in man. We have observed a significant increase in serum T3 concentrations 24-48 h after the start of the ritodrine treatment. The changes were only temporarely since one week after the start the serum T3 concentrations did not differ significantly from the pre-treatment levels. A decrease in T3 levels was found after discontinuation of treatment. No significant changes were found in T4 and TSH concentrations excluding an influence in ritodrine therapy on the pituitary-thyroid axes. It was concluded that stimulation of type I deiodinase was responsible for the changes in T3. These beta-2-mimetic variations may explain, to a certain degree, the unwanted chronotropic cardiac side effects of ritodrine and necessitates much care in using this therapy in hyperthyroidic patients.

Adult↗
PubMed1987

Changes in thyroid status in pregnant women treated with ritodrine.

In a clinical study of 17 pregnant women treated with ritodrine, a beta 2-sympathomimetic agent used for tocolysis, thyroid hormone status was assessed longitudinally. This was done in order to verify the hypothesis that an increase in T3 levels could result from adrenergic stimulation, since propranolol, a beta blocking agent, has proved to decrease T3 levels in man. Indeed, a statistically significant increase in T3 serum concentration and in T3/T4 ratio was found on the second day after the start of treatment with ritodrine (p less than 0.02 and less than 0.01 respectively). After discontinuation of treatment a decrease in T3 serum levels, compared to both treatment and pretreatment levels, was observed. The free T4 concentration showed a significant drop after the first week of treatment (p less than 0.01), but no changes were found in T4 and TSH levels. It was concluded that the beta 2-mimetic-mediated changes in thyroid status provide one more reason for restriction of the use of beta-mimetic drugs in hyperthyroidic patients and might offer an additional explanation for the undesirable chronotropic cardiac side-effects of the therapy.

Adult↗
PubMed1987

A new administration form of ritodrine. Ritodrine plasma levels with sustained-release capsules in a steady state.

A sustained-release administration form of oral ritodrine was introduced to cope with the problem of the short dosage interval inherent to conventional oral ritodrine administration. The bioavailability of this application form was assessed in a clinical study including 11 patients. With a dosage frequency of only 3 times daily and a dosage form index of 1.8, plasma levels of 14.6-26.5 ng/ml ritodrine (equivalent to an infusion rate of approximately 50 micrograms/min) were obtained without serious cardiovascular or metabolic side effects. It was concluded that with this new formulation clinical applicability of orally administered ritodrine in tocolytic therapy has increased.

Administration, Oral↗
PubMed1978

Rectus hematoma: a clinical diagnosis confirmed by ultrasound.

In 2 women the diagnosis of rectus hematoma could be established by ultrasound and the further clinical course. Echoscopy is stressed as a technique which is helpful to the patient and the clinician in avoiding unnecessary operations.

Abdominal Muscles↗