PubMed Health⌕ Search

Biomedical subjects

I Matheson

Publications and source records attributed to I Matheson.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Changes in sales of estrogens 1989-1992. Effects of a national consensus conference?].

In November 1990 a consensus conference was held in Norway on the use of oestrogens for perimenopausal and postmenopausal complaints, and for preventive purposes. The sales statistics reveal an increase in sales of drugs for hormone replacement therapy after the conference, but the trend had already started before the conference was held. We found the conference had had a statistically significant impact on sales of some of the drugs. We also collected information on marketing campaigns before and after the conference. Only a modest change was found in marketing efforts by the pharmaceutical industry. Presentations in the media were considered to have a strong impact on oestrogen promotion.

Adult↗
PubMed1993

[Do we need new guidelines on iron supplementation during pregnancy?].

Studies have shown that the present official Norwegian recommendations on iron supplementation during pregnancy are not followed. A meeting was arranged in February 1993 to discuss the need to change the recommendations. The article describes the conclusions of the panel. It was proposed that the iron status of the pregnant woman, determined as serum ferritin concentration, should be measured early (before the 15th week of gestation) and iron supplement should be given as selective prophylaxis based on the serum ferritin level. The Directorate of Public Health has been asked to issue new recommendations.

Female↗
PubMed1993

[Pregnancy and iron supplementation--are the official guidelines followed?].

In the present study we have examined to what extent the national recommendations concerning iron supplements during pregnancy are being followed. 222 women in childbed were interviewed within one week after delivery concerning their intake of iron and other dietary supplements. We found that no more than 1/4 of the women were using iron supplements according to the national recommendations and that the advice given by doctors, midwives or public health nurses varied considerably. 70% of the women were recommended to take iron supplement, but no more than 66% of them were given specific advice as to which iron preparation they should take, or in what doses. The specific advice that was given varied. 93% of the women who were advised to take iron supplement followed this advice. More women took low-dose iron preparations, while more doctors recommended high-dose preparations. Only 30% of the women thought that iron supplement is vital for all pregnant women. We also found that many of the women (59%) took one or more dietary supplements, alone or in addition to iron.

Female↗
PubMed1992

[Treatment of gynecologic bleeding disorders].

Conclusions reached at an expert meeting arranged by the Medical Products Agency (Läkemedelsverket) in Sweden on the treatment of gynaecological bleeding disorders are presented. An active approach to endometrial diagnosis is recommended when bleeding is protracted and does not respond to medication, and when bleeding occurs more than one year after menopause. A period of expectation is permissible in women younger than 45 years. Exfoliative endometrial diagnosis is highly sensitive and specific and, in recent years, the traditional curettage has been reappraised as the first method of choice. Bleeding during anovulatory cycles is usually managed by treatment with progestagens. Menorrhagia may be diminished by oral contraception, tranexamic acid or NSAID. Endometrial resection offers a promising alternative to hysterectomy. Genital infection is another common cause of irregular bleeding in sexually active women and must be treated before invasive procedures are undertaken. Abnormal bleeding in patients with endometriosis often improves as a result of the treatment given to alleviate other symptoms such as pain. Bleeding irregularities caused by gynaecological malignancy, particularly contact bleeding in cancer of the cervix, are seen during the reproductive years and are accessible for diagnosis. The authors also discuss irregular bleeding caused by coagulopathia or treatment with hormones, as well as the effect of antifibrinolytic drugs.

Adult↗
PubMed1991

[Characterization of birth populations in 2 Norwegian counties, Akershus and Hordaland. A part of a study on smoking habits, alcohol drinking and drug utilization among pregnant women].

Norway participated in an international multicenter study on drug use, smoking, alcohol consumption, antenatal care, and complications in pregnancy. 482 women were interviewed at Akershus Central Hospital (near Oslo) and Haukeland hospital (in Bergen). Interviews were conducted during one of the first days after delivery using a standardized form. We found that 75% of the pregnancies were planned, while 7% were the result of contraceptive failure. 35% of the women smoked during pregnancy, compared with 43% before pregnancy. However, in relation to the early period of pregnancy the amount of tobacco consumed and the percentage of smokers increased slightly towards the end of pregnancy. Women who smoked were hospitalized during pregnancy more often than non-smokers. 91% of the women used some kind of medication during pregnancy including iron and vitamins.

Alcohol Drinking↗
PubMed1990

[Mastitis in general practice. Is bacteriologic examination useful?].

For a period of 22 months, postpartial women in Oslo were asked to consult one of several specific general practitioners in the event of mastitis. Clinical symptoms, bacteriological findings in breast milk and treatment were recorded in 43 patients. Patients with a favourable (n = 35) and with an unfavourable outcome (n = 8) defined as abscess, relapse and/or relief of symptoms after more than seven days, were compared. Unfavourable outcome was characterized by higher score of clinical symptoms and a higher isolation frequency of Staphylococcus aureus. The occurrence of fever did not differ between the groups. Bacteriological findings in milk from both breasts were compared with the findings from 100 milk donors. Staphylococcus aureus was more frequently isolated in milk from affected breasts than from unaffected and control breasts (17/40 versus 4/40 versus 4/100). Most of the Staphylococcus aureus strains (70%) were betalactamase producers. Coagulase negative staphylococci were a frequent finding in all milk samples, whereas Gram-negative bacteria were frequent only in the controls. The presence of pathogenic bacteria, as well as high bacterial counts, were associated with a higher number of symptoms. However, the predictive value of the bacteriological examination was low. Our study indicates that bacteriological examination of breast milk is justified only in patients with severe, acute symptoms and recurrences when betalactamase producing Staphylococcus aureus are suspected.

Family Practice↗
PubMed1990

Drug utilization in breast-feeding women. A survey in Oslo.

In a retrospective questionnaire survey of 885 women who had given birth 3-5 months before, fewer of those who were still breast-feeding at 4 months (n = 645) were using drugs than those who had stopped breast-feeding before 4 months (n = 240), during the 2 week period preceding registration. The average number of doses (Defined Daily Doses/1000 women/day) was 166 and 307, respectively, in that period. The number of doses taken was significantly associated with the use of oral contraceptive agents (p less than 0.005) and young maternal age (p less than 0.05). Most of the variation in drug use between breast-feeding and not breast-feeding mothers was probably due to the greater use of contraception by the latter. The number of drugs used per mother in the 4 month period seemed to be best predicted by her and her infant's disorders. Long-term medication in breast-feeding women included many drugs for which there is incomplete or no data about milk transfer, e.g. salbutamol, clemastine, dexchlorpheniramine, phenylpropanolamine, cromoglycate and levomepromazine. The disorders most extensively treated with drugs in this period were dyspepsia, haemorrhoids and inflammation of the breast. The finding that smoking was associated with early weaning and consumption of alcohol with prolonged breast-feeding calls for further investigation. More information on these drug and health issues to the breast-feeding mother is highly desirable.

Adult↗
PubMed1990

The excretion of zopiclone into breast milk.

1. The excretion of zopiclone into breast milk was studied in 12 lactating women in the early postpartum period following the oral administration of a single zopiclone tablet (7.5 mg). 2. The milk/plasma AUC ratio of zopiclone was 0.51 +/- 0.09 (mean +/- s.d.). Individual mean milk/plasma concentration ratios of zopiclone showed significant interindividual variation (range 0.41-0.70). 3. A comparison of pharmacokinetic parameters in the postpartum women with those reported previously in non-pregnant women, showed significantly higher Cmax values in the lactating mothers; tmax occurred later in milk than in maternal plasma. 4. Assuming a daily milk intake of 0.15 l kg-1 and 100% absorption the average infant dose of zopiclone in milk would be 1.4% of the weight adjusted dose ingested by the mother.

Azabicyclo Compounds↗
PubMed1990

Midazolam and nitrazepam in the maternity ward: milk concentrations and clinical effects.

1. In a randomized study of 22 patients in a maternity ward, the residual concentrations of two hypnotics, midazolam 15 mg p.o. and nitrazepam 5 mg p.o., in early breast milk and plasma were measured 7 h after intake on day 2 to day 6 postpartum. Milk pH, milk fat and binding to plasma proteins were also investigated. Sleep variables were scored on questionnaires. 2. No measurable (less than 10 nmol l-1) concentrations of drug in milk were found in the group receiving 15 mg midazolam at night, either after the first night or after the fifth night. Additional investigations in two mothers demonstrated that midazolam and its hydroxymetabolite disappeared rapidly from milk with undetectable levels after 4 h. The mean (s.d.) milk to plasma ratio for midazolam was 0.15 (0.06) in six paired samples. It may be assumed that practically no midazolam is transferred via early milk to the baby if the baby is nursed more than 4 h after tablet intake. 3. Milk nitrazepam concentrations increased significantly from the first (30 nmol l-1) to the fifth morning (48 nmol l-1) in the group receiving 5 mg nitrazepam at night. The mean (s.d.) milk to plasma ratio of nitrazepam after 7 h was 0.27 (0.06) in 32 paired samples, and did not vary from day 1 to day 5. Plasma protein binding of nitrazepam in puerperal women was found to be lower than that in plasma of healthy controls. The average amount of nitrazepam received by the breast-fed baby in the morning was calculated to increase from 1 to 1.5 micrograms 100 ml-1 breast milk, from days 1 to 5. In the mothers nitrazepam was associated with better hypnotic effect, but a higher incidence of complaints than midazolam. 4. Milk pH, assuming anaerobic conditions, was found in 10 women to average 6.91 +/- 0.09 (s.d.) on days 2-6 postpartum, which is less than previously reported. 5. It is concluded that both hypnotics may be used safely for a few days in the maternity ward. However, possible long-term effects in the suckling infant of small doses of benzodiazepines ingested with breast milk remain to be investigated.

Adult↗
PubMed1990

Fat content and xenobiotic concentrations in human milk: validation of an enzymatic assay of milk fat.

This study reports the validation of an automatic assay for milk triglycerides, as well as the association between milk xenobiotic concentrations and milk triglycerides. The correlation between this assay and a gravimetric reference method for total fat was good (r = 0.997). Triglycerides and xenobiotics were measured in breast milk sampled from one mother. She received two water-soluble drugs, tetracycline and doxycycline in two courses. The levels of organochlorines (DDE, PCB) were also measured and related to those of fat in milk samples from this mother. These and previous results indicate that milk triglyceride variations influence the concentrations of lipophilic xenobiotics in milk.

Dichlorodiphenyl Dichloroethylene↗
PubMed1989

[Drugs for the mother and infant in the maternity ward. A study of 5 Norwegian university hospitals].

Hospital records were used to record, all drugs prescribed in the maternity ward, delivery characteristics and complications in both mother and infant at five university hospitals. The retrospective survey comprised 970 women and represented 10% of all vaginal deliveries in these hospitals in 1980, and 2% of all annual births in Norway. In total 90% of the women received drugs, excluding laxatives, oxytocics and long-term medication, vitamins and iron. Large variations were found between hospitals in respect of hypnotics (41-86%) and analgesics (65-95%). Of newborns 4-23% were treated with a drug. The large variation was largely due to frequent administration of naloxone at one of the hospitals. Drug utilization post partum was significantly higher in primipareas and in mothers who underwent interventions such as epidural anaesthesia, oxytocin drip, forceps delivery and tears. 98% of the babies were breast-fed on discharge and thus received milk potentially containing drugs. The frequent use of hypnotics indicates that breast-feeding mothers were treated like hospital patients in general. For the majority of the drugs used as a routine in the maternity wards there was no data or insufficient data on excretion in breast milk. The large discrepancy between hospitals as regards prescription of hypnotics and oxytocics to the mother and naloxone to the newborn was considered not to reflect rational prescription criteria and should therefore be reassessed.

Adult↗
PubMed1989

[Disorders and drug consumption among infants. Does breast feeding have an impact?].

Disorders and drug use were analysed in 885 infants whose mothers responded to a questionnaire approximately four months after birth in Oslo, Norway in 1985. Breast-feeding had no influence on drug use in infants, though a lower incidence of some disorders (diarrhea, constipation, vomiting) was found in infants who were breast-fed for average four months than in infants who were weaned earlier. Use of drugs in infants was positively associated with use of drugs by the mother and with the length of her education. About 75% of the babies had at least one disorder and 60% had received at least one drug during the four month registration period. It was claimed that 85% of the drugs were recommended by a physician or a nurse. Anticolic agents, respiratory agents and dermatologicals were given frequently. The single most used drug was dimethicone. 98% of the 261 infants with colic syndrome were treated with this surface active drug, which has an efficacy similar to placebo. During a two week period preceding registration 12% of all infants and concomitantly 25% of the breast-fed infants were exposed to drugs at least once. The drug intake through breast milk was calculated to be 1/7 of the total drug use (117 infant Defined Daily Doses/1,000 infants/day) in breast-fed babies. Validation of the answers to the written questionnaire by subsequent interview of 96 mothers revealed considerable underreporting in the former; 33% for disorders, 22% for drugs and 18% for infant doses. It is concluded that medication for minor disorders in infancy is quite extensive and often unnecessary. Further informative efforts should be directed at parents, as well as the health workers involved.

Breast Feeding↗
PubMed1989

[Breast feeding. Effects of smoking and education].

A study of 885 women who had given birth in Oslo, Norway in 1985 disclosed that 80% were still breastfeeding three months after delivery. Forty percent of the mothers smoked cigarettes daily. Only 7% had stopped smoking because of pregnancy or lactation. High social class and educational level was positively correlated to prolonged breastfeeding. Smoking was negatively correlated to breastfeeding when the infant was three and four months old. While 93% of non-smokers with an education of 17 or more years still breastfed four months after delivery, this was true of only 6% of heavy smokers with an education of nine years or less. Also within each social group and educational level the prevalence of breastfeeding was lower among the smokers, with a dose/response effect of the number of cigarettes smoked. More smokers than non-smokers stopped breastfeeding because they had "too little milk". Forty percent of infants breastfed by smokers suffered from colic or excessive crying, as compared with 26% of the children of non-smokers.

Breast Feeding↗
PubMed1988

Piroxicam in breast milk after long-term treatment.

The presence of piroxicam in breast milk was determined by HPTLC during initial and long term dosing in 4 women treated for arthritis. Piroxicam appeared in breast milk at about 1-3% of the maternal plasma concentration. No accumulation of piroxicam occurred in milk relative to that in plasma up to 52 days of treatment. Neither piroxicam nor its conjugates were detectable in the urine of one breast-fed infant. The daily dose ingested by the infant was calculated to average 3.5% (maximum 6.3%) of the weight-related maternal dose of piroxicam. It is concluded that a breast-fed infant will be exposed to a very small amount of piroxicam.

Adult↗
PubMed1988

Milk concentrations of flupenthixol, nortriptyline and zuclopenthixol and between-breast differences in two patients.

Flupenthixol (FP), nortriptyline (NT) and zuclopenthixol, (ZCP) were determined in breast milk and plasma from 2 puerperal, lactating women with psychiatric disorders. The milk concentrations were equal to, higher and lower than those in plasma for FP, NT and ZCP, respectively. Variation in milk triglyceride concentration, but not milk pH, could partly explain between-breast differences in the milk concentrations. The study demonstrates the need for appropriate and representative milk sampling procedures. The estimated daily infant exposure averaged 0.5, 2.3 and 0.3% of the corresponding maternal weight related doses of FP, NT and ZCP. FP was also detectable in infant plasma. These drugs are not known to be harmful in small doses to breast-fed infants. However, concern about the effect of dopamine blocking agents on neurobehavioral mechanisms in animals warrants caution. If neuroleptics are required for a long period this risk must be weighed against the benefits of breast-feeding, also considering the psychological effects of the latter.

Adult↗