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Biomedical subjects

J M Ubachs

Publications and source records attributed to J M Ubachs.

At least 19 recordsLinked to original sources
PubMed1995

The effects of continuous combined transdermal oestrogen-progestogen treatment on bleeding patterns and the endometrium in postmenopausal women.

Fifty postmenopausal women requiring hormone replacement therapy for the treatment of climacteric symptoms were recruited in six centers. All patients received a new combined norethisterone acetate (NETA)/oestradiol (E2)-TTS, (Estragest TTS, Ciba-Geigy Ltd), delivering 0.25 mg NETA and 50 micrograms E2 per day, continuously for 12 calendar months. Bleeding occurred in 38 (76%) of the 50 patients at any time during the 1 year treatment. The percentage of patients without bleeding increased gradually each month, from 24% in the second month to a relatively stable level of approximately 80% in month 7 and thereafter. Twenty-seven patients (54%) did not complete the whole trial period; 15 of which discontinued the treatment within the first few months due to irregular bleeding. In patients who remained in the trial, a clear decrease in the frequency and intensity of the bleeding was observed with time. Bleeding was mostly light or consisted of spotting only. None of the post-trial biopsies showed proliferation or hyperplasia of the endometrium. The treatment resulted in a substantial decrease of climacteric symptoms (Kupperman index) within 4 months and was well tolerated. It was concluded that the continuous NETA/E2-TTS treatment is an effective and safe alternative for the treatment of climacteric symptoms in selected patients.

Administration, Cutaneous↗
PubMed1995

Obstetric antecedents of surgically treated obstetric brachial plexus injuries.

OBJECTIVE: To determine whether the anatomy of an obstetric brachial plexus lesion (OBPL) is causally related to the preceding obstetric history. DESIGN: Anatomical classification of the OBPL during reconstructive neurosurgical treatment in consecutive infants who had surgery for OBPL between 1986 and 1994 and relating these findings with the characteristics of the preceding birth. SETTING: De Wever Hospital, Heerlen, The Netherlands. SUBJECTS: All infants who had surgical treatment for OBPL between 1 April 1986 and 1 January 1994 (n = 130). RESULTS: An Erb's C5-C6 injury was preceded more frequently by a difficult breech birth (19/26 cases or 73%). In contrast, the more extensive forms of Erb's palsy classified as a C5-C7 injury or a total palsy with a C5-T1 injury were observed more frequently after complicated cephalic birth (52/59 or 88%, and 43/45 or 96%, respectively). The extent of anatomical damage as expressed by the incidence of an avulsion of one or more spinal nerves was 18/26 (69%) in Erb C5-C6, 13/59 (22%) in Erb C5-C7 and 21/45 (47%) in total C5-T1 palsy. CONCLUSION: The Erb's C5-C6 palsy, occasionally bilateral and/or complicated by phrenic nerve injury, was the most frequent form of OBPL after a breech birth. The more extensive form of Erb's palsy and the total palsy were observed more frequently after delivery in a cephalic presentation. The pure form of Erb's palsy and the total palsy were characterised by a higher incidence of nerve avulsions than the extensive form of Erb's palsy.

Birth Weight↗
PubMed1995

The reticulocyte count and its subfractions in smoking and non-smoking pregnant women.

UNLABELLED: Our objective was to compare the reticulocyte count and its subfractions in smoking and non-smoking women at different stages of normal pregnancy. STUDY DESIGN: In 247 non-smoking and 123 smoking healthy pregnant women the reticulocyte count and its subfractions were compared at four different stages of pregnancy: 0-10, 11-20, 21-30 and 31-40 weeks. Exclusion criteria were a diastolic blood pressure > or = 90 mmHg, an endocrine disease or a coagulation disorder. Women in the smokers group smoked more than 4 cigarettes a day. Non-smokers were defined as women reporting no smoking at all. Blood samples were run on the Sysmex R-3000 reticulocyte counter. RESULTS: The absolute reticulocyte count was lower in the smoking group throughout pregnancy, but this was only significant in the last ten weeks of gestation (71.9 x 10(9)/l versus 78.8 x 10(9)/l). There was no difference between the low fluorescence, the medium fluorescence and the high fluorescence proportions in the non-smoking and the smoking group. Both groups behaved similarly during pregnancy; there was a decrease of mature reticulocytes and a significant increase of more immature reticulocytes. CONCLUSION: These data show a moderate measurable effect of cigarette smoking on the reticulocyte count and the absence of an effect on the reticulocyte subsets.

Adult↗
PubMed1995

Platelet count and platelet indices at various stages of normal pregnancy in smoking and non-smoking women.

UNLABELLED: Our objective was to compare the platelet count and platelet indices of smoking and non-smoking women at different stages of normal pregnancy. STUDY DESIGN: In 247 non-smoking and 123 smoking healthy pregnant women the platelet count, the mean platelet volume, the platelet distribution width and the plateletcrit were compared at 0-10, 11-20, 21-30 and 31-40 weeks of pregnancy. Exclusion criteria were a diastolic pressure > or = 90 mmHg, an endocrine disease, a coagulation disorder, acetylsalicylic acid or phenprocoumon use. A women was considered a smoker if she smoked more than 4 cigarettes a day. Non-smokers were defined as women reporting no smoking at all. Blood samples were run on the Sysmex NE-8000. RESULTS: There was no significant difference between the platelet count in the two groups. In the non-smoking group, the platelet count showed a significant decrease with gestational age (287 x 10(9)/l to 258 x 10(9)/l). This was not the case in the smokers group. The mean platelet volume of the smokers was significantly lower than that of the non-smokers in the last ten weeks of pregnancy (10.4 fl versus 10.7 fl). The platelet distribution width and the plateletcrit did not change under the influence of cigarette smoking. CONCLUSION: Smoking during pregnancy does not significantly affect platelet count or platelet indices.

Adult↗
PubMed1992

Assessment of whole-blood spontaneous platelet aggregation during pregnancy using an impedance particle counter.

The slide test method of Velaskar and Chitre for determining platelet aggregation in whole blood after induction of aggregation was modified for spontaneous platelet aggregation and evaluated. The reproducibility was satisfactory (CV 1-3%). The results obtained with this method and the method of Velaskar were not significantly different. The Spearman rank correlation was 0.75 (p less than 0.0001). We established reference values for the particle counter method and Velaskar's method in pregnant and non-pregnant women; no significant change in spontaneous platelet aggregation was seen throughout pregnancy. In order to estimate the clinical value of the test in pregnancy, we followed up a number of pregnant patients with primary enhanced spontaneous whole-blood platelet aggregation before and after treatment with low-dose acetylsalicylic acid. The test was found to be suited for the detection of spontaneous whole-blood platelet aggregation and for the follow-up after treatment with acetylsalicylic acid. Further studies are necessary, however, to assess the predictive value of an aberrant test result during pregnancy.

Adolescent↗
PubMed1992

Coagulation and fibrinolysis markers in seminal plasma of patients under evaluation for involuntary childlessness.

Semen specimens from four groups of patients were evaluated for coagulation and fibrinolysis factors: a group of patients with infertile semen and involuntary childlessness (n = 35), a group with fertile semen and involuntary childlessness (n = 39), a group with fertile semen and proven fertility before vasectomy (n = 34) and a group with infertile semen after vasectomy (n = 147). The third patient group with proven fertility before vasectomy was considered as a control group. Only small amounts of fibrinogen, factor VIII:c, plasminogen, antithrombin III, fibrin monomers and plasminogen activator inhibitor-1 were detected in seminal plasma. The thrombin-antithrombin III, D-dimer and tissue plasminogen activator regular concentrations were measured and the D-dimer/thrombin-antithrombin III ratios calculated. The reference ranges were assessed and the quantities were compared in the different patient groups. Significant differences were demonstrated between the prevasectomy group (= control group) and both the postvasectomy and the infertility groups with respect to D-dimer and D-dimer/thrombin-antithrombin III ratio. We conclude that both coagulation and fibrinolysis play a part in coagulum formation and liquefaction of seminal plasma. The balance between coagulation and fibrinolysis (expressed as D-dimer/thrombin-antithrombin III ratio) was significantly different between the control group and the three patient groups. The coagulation/fibrinolysis balance was impaired in the semen from post vasectomy patients and from those with involuntary childlessness and the D-dimer/thrombin-antithrombin III ratios in both these patient groups were very similar.

Antithrombin III↗
PubMed1991

Clinical and pathological aspects of benign and malignant squamous epithelium of the corpus uteri; a report of two cases.

Two patients with primary squamous cell carcinoma of the uterus are described. In both patients, the disease was at an advanced stage when the diagnosis was made. Although endometrial malignancies with squamous elements account for 10-30% of endometrial carcinomas, primary squamous cell carcinoma of the uterus is extremely rare. Up to now fewer than 30 cases have been reported. The pathogenesis, morphogenesis and aetiology of squamous epithelium in the corpus uteri is discussed. Finally, some clinical aspects of the primary squamous cell carcinoma of the corpus uteri are reviewed.

Aged↗
PubMed1991

Blood coagulation and fibrinolysis during normal pregnancy.

Fifty-six pregnant women (gestational age 6-40 weeks) were evaluated for their coagulation activation (fibrin monomers and thrombin-antithrombin III complex) and for their fibrinolysis profile by determining tissue plasminogen activator, plasminogen activator inhibitor, plasminogen, alpha 2-antiplasmin and D-dimer. Fibrin monomers and thrombin-antithrombin III complexes were found to be significantly increasing with gestational age. All the fibrinolytic parameters showed a steady growth with the progress of the pregnancy, with the exception of tissue plasminogen activator which showed a significant decrease with gestational age, but mainly within the reference range. These results suggest a stimulation of the coagulation system and an activation of fibrinolysis with ongoing pregnancy, although the increasing alpha 2-antiplasmin and plasminogen levels and the decreasing tissue plasminogen activator concentrations do not conform to this trend.

Antithrombin III↗
PubMed1987

Effect of Bellergal Retard on climacteric complaints: a double-blind, placebo-controlled study.

The effect of Bellergal Retard (BR) on climacteric complaints was evaluated versus a placebo in an 8-wk double-blind study, followed by a 4-wk open study in which only BR was used as medication. There was a marked decrease in complaints in both the BR and the placebo groups. Statistically significant differences were observed between the groups after 2 and 4 wk of treatment, indicating superior results with BR. After 8 wk of study however, these differences were no longer apparent. It was concluded that studies on medication for climacteric complaints should not only be placebo-controlled, but also be of at least 8 to 12 wk duration for proper evaluation.

Belladonna Alkaloids↗
PubMed1977

Clinical experience in nonstressed antepartum cardiotocography.

The condition of the fetus during pregnancy was assessed by 1,763 antepartum cardiotocograms made in 386 patients with the use of fetal movements and physiologic uterine contractions. There appeared to be a significant correlation between the cardiotocograms and the obstetric outcome.

Apgar Score↗