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Biomedical subjects

J M Maltau

Publications and source records attributed to J M Maltau.

At least 19 recordsLinked to original sources
PubMed1997

[Occurrence of bacterial vaginosis among abortion seekers].

Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical diagnosis is based on three of Amsel's four criteria: thin, grey-white discharge, vaginal fluid pH above 4.5, a fishy odour on addition of 10% potassium hydroxide solution to the vaginal fluid, and the presence of clue cells on a saline wet mount. A probably more sensitive indicator of the diagnosis is based on Gram-stain, where the normal lactobacillus-dominated vaginal flora is changed to the lactobacillus deficient flora of bacterial vaginosis. The condition is probably associated with higher risk of complications in connection with pregnancy and gynaecological surgery. A prospective study of bacterial vaginosis based on microscopy of Gram-stained smears was conducted among 168 women applying for first trimester abortion. The prevalence of bacterial vaginosis was 24% and of Chlamydia trachomatis 8.4%. Four patients (10.3%) in the vaginosis group were treated with antibiotics for certain or suspected postabortal endometritis, as against six patients (5.4%) in the group without bacterial vaginosis.

Abortion Applicants↗
PubMed1996

Laser doppler-recorded reactive hyperaemia in the forearm skin during the menstrual cycle.

OBJECTIVE: By means of laser Doppler flowmetry to describe the changes in resting microvascular perfusion and post-occlusive reactive hyperaemia in skin of the forearm and finger pulp throughout the menstrual cycle. DESIGN: Prospective descriptive study. SETTING: University Hospital of Tromso, Norway. SAMPLE: Fifteen nonsmoking healthy women were studied in the follicular (days 2 to 7) and the luteal (days 19 to 24) phase of the menstrual cycle. RESULTS: Resting perfusion in forearm and finger pulp as well as post-occlusive reactive hyperaemia in finger pulp were unchanged from the follicular to the luteal phase. The peak perfusion value of the reactive hyperaemic response after 1 min of arterial occlusion was significantly reduced from the follicular to the luteal phase (P<0.01) in forearm skin. The repayment for the blood flow debt, which is the hyperaemic response in percentage of the ischaemic build-up, was also reduced (P<0.01). After 3 min of arterial occlusion, significant reductions in peak post-occlusive flow (P<0.01), recovery time, which is the total duration of the hyperaemic response (P<0.01), and the repayment (P<0.01) were observed. A significant correlation was found between the ratio serum oestradiol/progesterone and repayment after 3 min of arterial occlusion in forearm skin (r=0.71,P<0.001). CONCLUSIONS: Vascular reactivity is altered during the menstrual cycle. In the luteal phase, significant reductions in peak perfusion, repayment and recovery time were seen. The mechanisms behind these findings are unclear, but probably involve changes in both serum oestradiol and progesterone levels.

Adolescent↗
PubMed1995

[Pregnancy, births and infants after in-vitro-fertilization in Norway, 1988-1991].

We studied 1,165 pregnancies after in vitro fertilization in six public hospitals in Norway in the years 1988-91. The annual number of pregnancies increased from 158 in 1988 to 365 in 1991. The mean number of replaced embryos was reduced from 3.7 to 2.7. The rate of multiple births was not significantly altered in the same period, 24.3% were twin births and 5.7% triplet births. 19.3% of the pregnancies ended in abortion and 8.4% were ectopic. 782 births were registered in the Medical Birth Registry of Norway and compared with all other births during the period. Gestational hypertension, bleeding and preterm birth were observed more often in pregnancies after in vitro fertilization. The proportion of infants with very low birth weight (> 1,500 g) after in vitro fertilization was 9.7%, and nearly 50% of these were triplets. The relative risk of stillbirth and death during the first year of life, adjusted for maternal age and birth order, was 3.1 (95% CI 2.4-4.0) and 2.3 (95% CI 1.5-3.5) for singletons alone. The proportion of multiple births should be reduced.

Female↗
PubMed1995

Effect of probenecid, verapamil and progesterone on the concentration-dependent and temperature-sensitive human erythrocyte uptake and export of guanosine 3',5' cyclic monophosphate (cGMP).

Elevated extracellular cGMP levels have been observed in various clinical conditions, and the analyte has been proposed as a diagnostic marker of cardiovascular as well as malignant diseases. However, the use of extracellular cGMP as a pathophysiological marker requires detailed knowledge about the cellular biokinetics of cGMP (synthesis, metabolic conversion and export). In the present study the transport of cGMP in human erythrocytes has been further characterized. The uptake of cGMP was dependent on a concentration gradient and was temperature-sensitive, compatible with passive diffusion. The cGMP export was temperature-sensitive, saturable (Km = 3.4 +/- 1.0 mu mol l-1), inhibited by probenecid and verapamil and stimulated by progesterone. The results show that human erythrocytes possess a cGMP transport system similar to that found in other cells and that extracellular levels of cGMP are dependent on intracellular levels, membrane transport and influenced by physiological factors and pharmacological agents.

Biological Transport↗
PubMed1994

[Transcervical resection of the endometrium. An alternative to hysterectomy in dysfunctional uterine hemorrhage].

Transcervical electroresection of the endometrium was performed in 104 patients with dysfunctional uterine bleeding which did not respond to conservative treatment. Transcervical resection was offered as an alternative to abdominal hysterectomy. Re-resection was performed in 17 women (16%) because the initial section did not have the desired effect. Altogether 122 resections were performed. 79% of the women were satisfied after the initial resection and 93% when the procedure was repeated. During a follow-up period of six to 28 months after treatment, a hysterectomy was performed in 18 (17%) patients, but unacceptable uterine bleeding was the indication in only five of these cases. One major complication occurred, a small bowel perforation which required intestinal resection. Three uterine perforations occurred without any damage to neighbouring organs. Except for transient headache in a few patients, no clinical symptoms of glycine toxicity were seen. It is concluded that transcervical endometrial resection seems to represent an additional option for surgical treatment of dysfunctional uterine bleeding, but the procedure is not without risk. The long-term results of this procedure must be compared with those achieved by traditional abdominal hysterectomy.

Adult↗
PubMed1993

Progesterone reduces sympathetic tone without changing blood pressure or fluid balance in men.

There is scant information on the effects of progesterone on circulation. Changes in catecholamine levels, blood pressure and transcapillary fluid balance were measured in 12 men before and during administration of natural progesterone (Utrogestan). Before administration, systolic blood pressure was significantly correlated with venous adrenaline (r = 0.67, p = 0.01). There was a significant decrease (p = 0.004) in venous noradrenaline during progesterone administration, and systolic blood pressure was significantly correlated with the arteriovenous difference for noradrenaline (r = 0.66, p = 0.02). Serum progesterone, which attained levels similar to those found in women during the luteal phase, did not significantly alter blood pressure, body weight or intra- to extravascular fluid shift. It is concluded that progesterone may have a direct action by increasing the uptake of noradrenaline from the synaptic cleft or by decreasing the nerve firing rate. Interestingly, the pretreatment finding of a significant correlation between blood pressure and adrenaline was less evident during progesterone administration.

Adult↗
PubMed1993

Evidence for altered transcapillary fluid balance in women with the premenstrual syndrome.

Redistribution of body fluids has been suggested as a possible pathophysiological mechanism for the premenstrual syndrome (PMS). To elucidate this hypothesis, transcapillary fluid balance was studied in ten women with well defined PMS. Wick-methods were used for measuring colloid osmotic and hydrostatic interstitial pressures on the thorax and on the leg. The capillary filtration coefficient was measured by strain gauge plethysmography. From the follicular to the luteal phase the interstitial colloid osmotic pressure on the leg was significantly reduced (mean 3.6 mm Hg, p = 0.005), whereas the interstitial colloid osmotic pressure on the thorax remained constant. The capillary filtration coefficient increased 30% (mean 5.3 x 10(-4) ml/min/100 gm/mm Hg, p = 0.04) from the follicular to the luteal phase. No change was observed in body weight. These findings indicate an instability of vascular regulation in women with premenstrual syndrome, and lend support to the hypothesis that redistribution of fluid, rather than water retention, is responsible for the subjective symptoms such as bloatedness, in the premenstrual syndrome.

Adult↗
PubMed1992

[Streptococci group B and pregnancy. Need for routine check-ups?].

Group B streptococci are a major cause of perinatal infections and affect 1-5 infants out of every 1,000 live births. Maternal vaginal colonization with these bacteria is common (5-25%), and has been associated with late abortions, foetal growth retardation, early rupture of membranes and premature delivery. Colonization with group B streptococci may be observed in more than 70% of neonates born to mothers with the bacteria in their vaginal tracts at delivery. A high number of bacteria in the maternal urogenital tract during pregnancy may predispose to early-onset disease in neonates. The estimated attack rate in colonized neonates is 1-2%. A high specific IgG antibody concentration in the mother may protect the infant, but probably not before 32 weeks of gestation. Colonized women who are unable to produce such antibodies risk having affected offspring. Neonatal infection with group B streptococci frequently results in death or permanent neurologic morbidity; especially from the early-onset type (case-fatality more than 50%) which is most often vertical transmitted. Four cases with early-onset disease illustrate the severity of perinatal group B streptococcal infections. The severity and outcome of the disease may be moderated by screening for group B streptococci during late pregnancy. This screening must be combined with special attention to irregularities in pregnancy or perinatal complications.

Adult↗
PubMed1992

Increased capillary permeability for plasma proteins in oral contraceptive users.

The transcapillary fluid balance was examined in eleven women before administration of a monophasic oral contraceptive (desogestrel 0.15 mg, ethinylestradiol 0.03 mg), and after three and six months of use. The interstitial colloid osmotic pressure was measured by the "wick" method, and the interstitial hydrostatic pressure by the "wick-in-needle" method in subcutaneous tissue on thorax and leg. During the six-month observation period, the following changes were observed: Plasma colloid osmotic pressure decreased (mean 1.8 mmHg, p = 0.047), as well as serum albumin (mean 5.1 g/l, p = 0.0006), total protein concentration (mean 2.8 g/l, p = 0.0006), hemoglobin (mean 0.5 g/dl, p = 0.014) and hematocrit (mean 1.8%, p = 0.047). Blood pressure and body weight remained unchanged, but foot volume showed a significant increase. The colloid osmotic pressure gradient (plasma-interstitium) was significantly reduced. The results indicate an increase in plasma volume in addition to an increased capillary permeability to plasma proteins during oral contraceptive use. We suggest that the observed changes in transcapillary fluid balance is caused by the estrogen component of the oral contraceptive pill.

Adolescent↗
PubMed1991

[Conservative treatment of ectopic pregnancy].

During the last decades the incidence of ectopic pregnancy has been steadily rising. The chosen therapy has usually been unilateral salpingectomy. Recently, different conservative (tube-preserving) treatment-modalities have been introduced in clinical practice. We have tried conservative treatment by local injection of prostaglandin F2a (total dose 2-4 mg) directly into the tubal pregnancy and, if feasible, also into the corpus luteum graviditate. The treatment was successful in 13 out of 16 patients. In one patient laparotomia was performed because of pain, and revealed a haematoma in fossa Douglasi. Reinjection of prostaglandin was necessary in one patient because of rising HCG titres. One patient was hospitalized for four days because of nausea and pain. The treatment was otherwise successful. The method may be useful as a non-surgical alternative in haemodynamically stable patients without tubal rupture. Further studies are needed to evaluate the outcome in terms of future fertility.

Chorionic Gonadotropin↗