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Biomedical subjects

M Eronen

Publications and source records attributed to M Eronen.

58 records · Page 4Linked to original sources
PubMedDate not supplied

Congenital complete heart block in the fetus: hemodynamic features, antenatal treatment, and outcome in six cases.

Congenital heart block (CHB) can result in intrauterine cardiac failure leading to fetal or neonatal loss. To establish perinatal hemodynamic factors which might predict adverse outcome, six fetuses with CHB diagnosed between 20 and 30 gestational weeks were examined by echocardiography at 2-week intervals. Neonatal morbidity and outcome in infancy are detailed. The fetuses showed a significant decrease in ventricular rate (VR) with advancing gestation (60 +/- 7 vs 51 +/- 4 beats/min, p = 0.03). Cardiac decompensation defined as hydrops or pericardial effusion was associated with VR of lower than 55 beats/min in two fetuses. Three mothers had a therapeutic trial with a sympathomimetic and digoxin. Salbutamol increased VR 10% in one of three fetuses treated. Digoxin decreased pericardial effusion in one hydropic fetus with autoimmune myocarditis. In this fetus, poor left ventricular fractional shortening (LVFS) was accompanied with high umbilical artery resistance index (RI). High amniotic fluid erythropoietin indicated severe hypoxia preceding death. Pacemaker was indicated in all the newborns. At the age of 2 weeks all the surviving infants had tricuspid regurgitation and a shunt through foramen ovale due to asynchronized atrioventricular contraction. During the 12-month follow-up two of five surviving infants had no symptoms. One had symptomatic neonatal lupus. Two infants had patent ductus arteriosus, one with dilated cardiomyopathy. In conclusion, poor fetal outcome was associated with low VR, low LVFS, and high RI. Despite early pacing, morbidity was high in infancy due to cardiomyopathy and associated heart defects. Regular echocardiographic monitoring during pregnancy and after delivery is required in order to optimize care and timing of any interventions.

Adult↗
PubMedDate not supplied

Prostacyclin treatment for persistent pulmonary hypertension of the newborn.

To study the effect of prostacyclin treatment on pulmonary arterial pressure (PAP), systolic pressure (BP), and systemic oxygenation, eight infants with persistent pulmonary hypertension of the newborn (PPHN) born between 34 and 42 weeks' gestation and having a birth weight of 2540-4130 g were studied using Doppler echocardiography. At a mean age of 19 hours (range 3-32 hours), despite maximal ventilator therapy and an FIO2 of 1.0, the mean PaO2/PAO2 was 0.07 (range 0.04-0.09) and the AaDO2 was 616 mmHg (range 521-654 mmHg). After volume correction and during inotropic medication with dopamine and dobutamine, the mean PAP by echocardiography was 68.6 +/- 6.5 mmHg and the mean BP 59.8 +/- 4.8 mmHg. Prostacyclin infusion was then started at a dose of 20 ng/kg/min and increased stepwise to a mean dose of 60 ng/kg/min (range 30-120 ng/kg/min) over 4-12 hours, at which time PAP decreased to 49.2 +/- 3.5 mmHg (p = 0.0005) and BP to 53.2 +/- 9.1 mmHg (p = 0.17); the PAP thereafter remained below the BP. After 72 hours of prostacyclin infusion, PAP was 49.6 +/- 18 mmHg, BP 66.1 +/- 5.4 mmHg, PaO2/PAO2 0.14 +/- 0.12, and AaDO2 428 +/- 189 mmHg at FIO2 0.65. The median duration of prostacyclin infusion was 3.6 days and of respirator treatment 7.0 days. All patients survived without extracorporeal membrane oxygenation. At 6-12 months, none of the patients had severe central nervous system complications, but two had bronchopulmonary dysplasia. These findings indicate that prostacyclin is able to reverse the right-to-left shunt in PPHN by decreasing PAP, and that systemic hypotension can be prevented with adequate volume correction and inotropic medication.

Apgar Score↗
PubMedDate not supplied

Violent women, blame attribution, crime, and personality.

BACKGROUND: The attribution of blame for criminal act has an impact, both on the way the offender must come to terms with the offence and on the risk of recidivism. Blame attribution has been found to be related to the type of crime and personality. AIMS: This study examined the relationship of blame attribution and feelings of guilt in violent female offenders, according to factors related to crime, background and personality. METHODS: The Gudjonsson Blame Attribution Inventory (BAI) and the Defense Style Questionnaire (DSQ) were administered to 58 violent female offenders. The Hare Psychopathy Checklist-Revised (PCL-R), Structured Clinical Interview II for DSM-IV (SCID II) and clinical interviews were used for assessment. RESULTS: Lower scores of guilt feelings were found in women than has been reported for men. The feelings of guilt were higher in homicide than in other violent crimes, but lower in the cases where women had committed prior violent crimes. No differences were found between psychiatric patients and prisoners. The duration of hospitalisation and incarceration did not result in differences in blame attribution and guilt, but when the victims survived, guilt feelings seemed to increase with the passing of the time. External attribution was related to motives of crime, but traumatic experiences did not have a crucial impact upon blame attribution. The attribution of blame and the amount of guilt feelings were found to be related to personality. Women scoring high on psychopathy reported less guilt than women with low scores. The corresponding result was not obtained in the group of women with antisocial personality disorder, who, however, showed an unexpectedly low use of external attribution. CONCLUSION: The results suggest that it might be difficult for women to cope with the violent offence and that the characteristics of psychopathy seems to have a crucial impact on the guilt feelings and consequently on coping with the crime in female offenders.

Adaptation, Psychological↗