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Biomedical subjects

M Gummerus

Publications and source records attributed to M Gummerus.

At least 19 recordsLinked to original sources

Comparison of enoxaparin, a low-molecular-weight heparin, and unfractionated heparin, with or without dihydroergotamine, in abdominal hysterectomy.

The effects of administration of low-molecular-weight heparin (enoxaparin 20 mg) once a day, of unfractionated heparin (5000 IU twice a day, and of unfractionated heparin (2500 IU) plus dihydroergotamine (0.5 mg) twice a day were assessed in 100 patients undergoing abdominal hysterectomy. The test medications were given subcutaneously 2 hours before operation and for 3 days thereafter. There were no thromboembolic complications. Intraoperative blood loss, wound haematomas and blood loss via drains during four days after operation were similar in the three groups. None of the 37 patients receiving enoxaparin experienced major postoperative bleeding. Six out of 31 patients receiving unfractionated heparin without dihydroergotamine and two out of 32 patients receiving dihydroergotamine in addition experienced major bleeding necessitating re-operation and/or blood transfusion, (P < 0.05). Enoxaparin caused less major bleeding than unfractionated heparin with or without dihydroergotamine in patients undergoing hysterectomy.

Dihydroergotamine

Prophylactic long-term oral tocolysis of multiple pregnancies.

After admission to hospital for bed rest, 200 women with multiple pregnancies were randomly allocated to receive either 4 mg of salbutamol orally five times daily, or to receive no drug. After an average of 6 weeks treatment, no difference between the experimental groups could be detected with respect to duration of gestation, birthweight or any other of the outcomes of pregnancy observed.

Albuterol

[Ectopic pregnancy].

In Finland there were 3 193 ectopic pregnancies registered during the years 1973-1976 (1,25% of the newborns) and 4 856 ectopic pregnancies (1,91%) during the years 1977-1980. Also in the State Maternity Hospital Helsinki the ectopic pregnancy rate rose from 0,8% to 1,4%. During the years 1977-1980 241 women were operated on. From 112 patients without postoperative contraception 48% gave birth, 33% remained infertile, 10% had a recurrent ectopic pregnancy and 9% had an abortion. The best results were achieved in the salpingectomy group. In cases of conservative operations expression was more favorable than salpingotomy. With the development of better diagnostic methods the possibility of conservative operations, partial resection of the tube, respectively, later followed by microsurgical anastomosis, will be increased.

Adolescent

Optic neuritis during lactation.

The condition called "lactation optic neuritis" has been previously considered a clinical entity of its own. Four women, who developed optic neuritis within 1-12 months while breast-feeding their infants, were investigated ophthalmologically and neurologically in order, to find specific clinical features for this condition. The course of the disorder was similar to classic optic neuritis without lactation. The clinical history and laboratory findings in three of the four patients suggested a demyelinating disorder. It is possible that the decreased immunosuppressive activity just after pregnancy induces the manifestation of an underlying demyelinating disease. The existence of "lactation optic neuritis," however, is questioned as a separate entity of its own. Lactation together with decreased immunosuppression may merely act as a provocateur in the onset of optic neuritis, which in many cases is the first clinical manifestation of incipient multiple sclerosis.

Adult

Serum salbutamol concentrations during oral and intravenous treatment in pregnant women.

The serum concentration of salbutamol was determined in 29 pregnant women during oral treatment (4 mg five times per day) and in seven during intravenous infusion (6-30 micrograms/min) because of premature labour. The concentration of salbutamol was determined by combined gas-liquid chromatography mass spectrometry. The mean concentration of serum salbutamol was twice as high during intravenous treatment (24; SD 9 ng/ml), than during oral treatment (12; SD 3 mg/ml). During oral treatment, the salbutamol levels were not correlated to maternal height, weight or the incidence or severity of side-effects. The serum concentrations of salbutamol in patients with twin pregnancies did not differ from those with singleton pregnancies. After stopping intravenous treatment, serum salbutamol levels remained high for several hours and oral treatment can be started 4-6 h after stopping intravenous infusion.

Administration, Oral

Best criterion for the assessment of efficacy of tocolysis and choice of most suitable betasympathomimetic.

Over a period of 10 years, 645 patients were treated with six different betasympathomimetics because of threatening premature labor during the 24-36 weeks of gestation. Some 603 comparable patients were analysed with various parameters to find the most suitable criterion for assessing the efficacy of tocolysis and the best tocolytic agent. Delivery after 37 completed weeks proved clinically a sufficient criterion of a successful therapeutic outcome. The various scores did not essentially facilitate comparison of various tocolytics. The combination buphenin (DilaverR) + verapamil (IsoptinR) proved to be the most suitable medication.

Birth Weight

[Tocolysis with hexoprenalin and salbutamol in a clinical comparison].

140 patients with a threatening premature birth at the greater than or equal to 24-less than 37 week of gestation were in this study randomly treated with hexoprenalin or salbutamol. In 77% in the hexoprenalin and in 74% in the salbutamol group the weight of the newborn was greater than or equal to 2500 g. In 66% in both study groups the birth occurred after the completed 37 weeks of gestation. During infusion of hexoprenalin tachycardia in mothers occurred statistically highly significantly less than during salbutamol. 11% of the mothers in the hexoprenalin group had side-effects during infusion compared to 30% in the salbutamol group. The correlation between the tocolysis-index (Baumgarten) and the prolongation-index (Richter) given by the regression lines facilitates in some measure the comparison of different tocolytic drugs concerning its tocolytic effect.

Albuterol

[Beta-sympathicomimetics, premature birth, and perinatal mortality (author's transl)].

A group of 658 patients hospitalised throughout one year was examined in the 24th to 36th weeks of pregnancy, with the view to finding out, if prematurity and perinatal mortality could be reduced by systematic beta-mimetics therapy of imminent premature birth. Patients with beta-mimetics treatment for imminent premature birth accounted for 112 cases. The proportions of infants with low birth-weight and of perinatal deaths along with beta-mimetics treatment declined with significance by comparison to another review which covered a period between 1968 and 1970.

Adrenergic beta-Agonists

[Treatment of premature labour and antagonization of the side effects of tocolytic therapy with verapamil (author's transl)].

167 cases of threatened premature birth were treated with Fenoterol, Fenoterol + Verapamil and Ritodrine. In 70-79% of cases a newborn of over 2500 g was achieved. In 70-76% it was possible to prolong the pregnancy for over 7 days and in 61-64% a gestation age of 37 weeks and more was reached. Special attention was paid to the facts as to whether the general side effects of Fenoterol can be antagonized with Verapamil.

Abortion, Threatened

Treatment of imminent premature labour.

In this study, 194 imminent premature deliveries were treated. The pregnancies were in the 28th to 36th week. Uterine contractions were demonstrable in all patients and amniotic membranes were intact. All patients were treated with bedrest. Two betasympathomimetics were used in a double-blind study: Nyldrin hydrochloride (43 cases) and Isoxuprine hydrochloride (60 cases). A placebo was given to 41 patients, and ethyl alcohol to 50 patients. Intravenous and intramuscular treatment given in the hospital was continued with oral administration at home, and follow-up examinations were repeated at short intervals. Taking a minimum birth weight of 2500 g as the criteria of successful treatment, the success rate in the placebo group was 71%, in the Nylidrin hydrochloride group 86%, the Isoxuprine hydrochloride group 75% and the alcohol group 70%. When premature delivery was postponed 7 days, the pregnancy advanced., to the 37th week or later in 73, 77, 62 and 56% in their respective groups. The beta-sympathomimetics, especially the Nylidrin hydrochloride, were in every respect more efficient than placebo or alcohol. The therapeutic effect of alcohol was no better than that obtained with placebo. From the fetal point of view, the drugs used in the present study showed no adverse-effects.

Birth Weight

[Prevention of premature birth with nylidrin and verapamil (author's transl)].

108 cases of threatened premature birth were treated with i.v. drip-infusion, followed by oral treatment with Dilatol and Isoptin. This was successful in 81% of cases. A birth-weight of over 2500 g was considered a positive result. In 14% of cases there were side effects. The results are compared with earlier investigations.

Birth Weight