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Biomedical subjects

O A Viegas

Publications and source records attributed to O A Viegas.

At least 73 records · Page 4Linked to original sources

Comparative study of a two dose schedule of PGE2 3 mg pessary and 1700 micrograms film for induction of labour in nulliparae with poor cervical score.

Efficacy of a two dose schedule of 3 mg pessary or 1700 micrograms film of PGE2 for induction of labour was compared in nulliparae with poor cervical score. Patient characteristics in the two groups (43 in 3 mg and 40 in 1700 micrograms group) were comparable in age, period of gestation, indications for induction of labour and in their initial cervical score. The number of patients who started labour with a two dose schedule 4 hours apart were similar in each group. The improvement of cervical score, length of labour, mode of delivery and the neonatal outcome were not different in the two groups. There was no advantage of using a film preparation over that in the form of a pessary and the use of 3 mg dose did not give significantly better results compared with the 1700 micrograms dose, in terms of obstetric or neonatal outcome.

Adult↗

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant acceptors: metabolic changes.

In this longitudinal study involving 100 Singaporean acceptors, the effects of Norplant on metabolic function was evaluated. With respect to liver function, the results at the end of two years still indicate the presence of possible hepatocellular dysfunction. Despite a 4.5% decrease in serum bilirubin during the second year, the mean serum bilirubin still remained significantly raised (p less than 0.001). Furthermore there was a significant fall in total proteins and globulin during the period under review (p less than 0.001). However mean levels of all three parameters remained within the normal clinical range. As regards lipid metabolism, the total triglycerides and total cholesterol still remained significantly decreased at the end of two years (p less than 0.001). The LDL-cholesterol, which was significantly decreased at the end of one year, increased by 2.2% during the second year. However, this rise in LDL-cholesterol was not significant and was still below the preinsertion level. The HDL-cholesterol levels returned to their preinsertion levels after a significant increase in the first year. The HDL-cholesterol/Total cholesterol - HDL-cholesterol ratio returned to its preinsertion value at the end of two years while the LDL-cholesterol/HDL-cholesterol ratio was still significantly lower than the preinsertion ratio (p less than 0.05). As we have not incorporated a simultaneous non-steroid treated control group, the observed changes in lipoprotein lipids could be attributed to extraneous factors such as diet, exercise or other environmental changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilirubin↗

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant acceptors: haemostatic changes.

A longitudinal study of coagulation parameters was carried out on 100 Singaporean acceptors using Norplant for contraceptive purposes. At the end of 2 years of use, results from this ongoing study indicate that these acceptors continue to have an increased predisposition to thrombosis as evidenced by significant increases in platelet count and aggregability. The shortened but stable prothrombin time and activated partial thromboplastin time and increase in certain coagulation factors indicate that Norplant acceptors still have a possible potential for hypercoagulation at the end of two years of use.

Blood Coagulation↗

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant-2 rod acceptors: metabolic changes.

In this longitudinal study involving 100 Singaporean acceptors, the effects of Norplant-2 rods on metabolic function was evaluated. The mean serum bilirubin during the second year remained significantly raised from its preinsertion value (p less than 0.001). Furthermore the total proteins and globulin were still significantly decreased (p less than 0.001). Thus with respect to liver function, the results still indicate possible dysfunction at the end of two years. As regards lipid metabolism, the serum triglycerides, total cholesterol and LDL-cholesterol still remained significantly decreased at the end of two years when compared to preinsertion values. The HDL-cholesterol levels which showed no significant change during the first year of use decreased significantly during the second year of use. As a result the HDL-cholesterol/Total cholesterol - HDL-cholesterol decreased significantly and was 12.0% lower than the pre-insertion ratio (p less than 0.01). Similarly the LDL-cholesterol/HDL-cholesterol increased during the second year of use and was 2.6% higher than its preinsertion ratio. However, this increase was still not statistically significant. As we have not incorporated a simultaneous non-steroid treated control group, the observed changes in lipid metabolism could be attributed to extraneous factors such as diet, exercise or other environmental changes. Nevertheless, the findings at the end of two years, though speculative, still indicate Norplant-2 use to be non-contributory to cardiovascular risk in this population. The use of Norplant-2 was not associated with any significant effect on glucose tolerance after two years of use.

Bilirubin↗

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant-2 rod acceptors: haemostatic changes.

A longitudinal study of coagulation parameters was carried out on 100 Singaporean acceptors using Norplant-2 rods for contraceptive purposes. At the end of 2 years of use, results from this study show a return of platelet count to preinsertion level while platelet aggregation remained significantly enhanced. Thus the net effect of these two changes on an increased tendency for thrombosis needs further evaluation. The PT and APTT continued to remain persistently shortened during the period of use. There was also a general fall in fibrinogen and most other coagulation factors during the two years of use. Thus, again, the net effect of these two changes on the exposed potential for hypercoagulation at the end of the first year needs further evaluation throughout the five years of Norplant-2 use.

Blood Coagulation↗

A plasmin generation method for the determination of tissue plasminogen activator (t-PA) activity in blood.

A plasmin generation method to determine tissue plasminogen activator (t-PA) activity in plasma is described. A protein solution of homogenized fibrin was used as a stimulator in the presence of plasminogen and the plasmin generated was measured by the release of para-Nitroanilide (p-NA) from the chromogenic substrate S-2251. Plasmin generation by 5 iu/mL t-PA in the presence of 1 CU/mL of plasminogen and 850 micrograms/mL of fibrin solution reaches a peak at about 5 h incubation whilst in plasma, plasmin generation peaks after about 16 h incubation. The highest t-PA activity in plasma was determined using an assay involving 18 h incubation. In the 21 subjects studied by this method the t-PA activity at rest ranged from 0.34 to 0.92 iu/mL with a mean of 0.57 +/- 0.15 iu/mL of plasma whilst in the post-occlusion state the activity ranged from 1.12 to 18.0 iu/mL, with a mean of 5.25 +/- 4.49 iu/mL of plasma. We also found that subjects who developed petechiae during occlusion had significantly higher t-PA activity both at pre- and post-occlusion when compared with those who did not develop petechiae. The t-PA activity of acid-treated plasma stored at -70 degrees C showed no significant changes in activity after 12 weeks of storage when compared with the t-PA activity of the same plasma tested prior to storage.

Adult↗

Malignant melanoma of the cervix.

Primary malignant melanoma of the cervix was diagnosed in a 52-year-old woman. Extended hysterectomy and partial vaginectomy were performed. A vulval recurrence was treated with wide excision and total vaginectomy. She subsequently underwent radiotherapy for metastatic lesions in the pelvis and para-aortic nodes, but succumbed to widespread metastatic disease 2 years after initial diagnosis. Diagnosis, therapy, and prognosis for malignant melanoma are discussed.

Combined Modality Therapy↗

Bleeding patterns and acceptability among Norplant users in Singapore.

Norplant contraceptive implants are silastic implants containing levonorgestrel. This study describes our experience with 100 acceptors of NORPLANT implants in Singapore. No pregnancies occurred during the first year of use. The majority found the method's ease of use to be the most attractive feature. Disruption of menstrual rhythm appeared to be the least liked feature. However the incidence of these menstrual irregularities appeared to diminish with time. Implant users have tolerated this early disruption of their menstrual rhythm well and the continuation rate at the end of the year was 97%. Thus it appears that Norplant is a safe, effective and acceptable method of contraception.

Adolescent↗

Balance in family planning.

Family planning has been so effective in Singapore that a risk exists of there being too few young people to sustain the country's economy in the twenty-first century. Relaxation of birth control policies and immigration laws offers hope that this problem will be averted.

Family Planning Services↗

Norplant contraceptive subdermal implants: one year experience in Singapore.

Norplant contraceptive implants are silastic implants containing levonorgestrel. This study describes our experience with 100 acceptors of Norplant implants in Singapore. There were no infections at the site after the implants were inserted. No pregnancies occurred during the first year of use. Disruptions of menstrual rhythm was the main complaint. However, the incidence of menstrual irregularities appeared to diminish with time. Implant users have tolerated this early disruption of their menstrual rhythm well and the continuation rate at the end of the year was 96.6 percent. Thus, it appears that Norplant contraceptive implants offer a highly effective means of contraception which should become well accepted in the near future.

Adolescent↗

Norplant-2 rods: one year experience in Singapore.

Norplant-2 contraceptive implants consist of two silastic rods in which levonorgestrel has been incorporated with the polymer. This study describes our experience with 100 acceptors of the Norplant-2 rods in Singapore. No pregnancies occurred during the first year of use. Menstrual irregularities was the main complaint associated with the use of Norplant-2. However, the incidence of menstrual irregularities appeared to diminish with time and the continuation rate at the end of one year was 95.0 per cent. Thus, it appears that the Norplant-2 rod systems offer a highly effective, convenient means of contraception which should be well accepted in future.

Adult↗

The effects of Norplant-2 rods on clinical chemistry in Singaporean acceptors after 1 year of use: haemostatic changes.

A longitudinal study of coagulation parameters was carried out on 100 Singapore acceptors using the levonorgestrel subdermal implants Norplant-2 rods for contraceptive purposes. At the end of 1 year of use, results from this on-going study indicates that these acceptors have an enhanced potential for hypercoagulation with a significant shortening of their prothrombin time and activated partial thromboplastin time. They also have an increased predisposition to thrombosis as evidenced by significant increases in platelet count and aggregability. A number of other parameters achieved statistically significant differences by the end of one year but since the results were within the normal accepted range, they were therefore unlikely to be of much clinical importance.

Adult↗

The effects of Norplant-2 rods on clinical chemistry in Singaporean acceptors after 1 year of use: metabolic changes.

In this longitudinal study involving 100 Singaporean acceptors, the effects of Norplant-2 rods on metabolic function was evaluated. With respect to liver function, the results indicate possible hepatocellular dysfunction. There was a significant rise in mean serum bilirubin from 0.54 mg/dl to 0.85 mg/dl after 12 months of use (p less than 0.001). Furthermore, there was also a significant fall in total proteins from 7.37 gm/dl to 7.12 gm/dl (p less than 0.001) and serum globulin from 3.18 gm/dl to 2.84 gm/dl (p less than 0.001). As regards lipid metabolism, we have demonstrated significant decreases in mean serum triglycerides (1.04 mmol/l to 0.83 mmol/l), p less than 0.001; total cholesterol (5.04 mmol/l to 4.64 mmol/l), p less than 0.001; and LDL-cholesterol (3.36 mmol/l to 3.10 mmol/l), p less than 0.001 after one year of use. There was a small fall in the HDL-cholesterol (1.21 mmol/l to 1.16 mmol/l) after 12 months of use; this fall was not significant. Despite this, there was a rise in the HDL-cholesterol/Total cholesterol - HDL-cholesterol ratio (0.258 cf 0.244; p less than 0.05) after 1 year of use. As we have not incorporated a simultaneous non-pill treated control group, the observed changes in lipoprotein lipids could be attributed to extraneous factors such as diet, exercise or other environmental changes. Nevertheless, the findings, though speculative, indicate Norplant-2 use to be non-contributory to cardiovascular risk and indeed it may be a protective factor against such risks in this population. The use of Norplant-2 rods was not associated with any significant effect on glucose tolerance after 12 months of use.

Adult↗

The effects of Norplant on clinical chemistry in Singaporean acceptors after 1 year of use: metabolic changes.

In this longitudinal study involving 100 Singaporean acceptors, the effects of NORPLANT on their metabolic function was evaluated. With respect to liver function, the results indicate possible hepatocellular dysfunction; there was a significant rise in mean serum bilirubin from 0.55 mg/dl to 0.87 mg/dl after 12 months of use (p less than 0.001). This rise could not be attributed to a skewed distribution of mean value as the difference achieved statistical significance using the paired 't' test as well as the Wilcoxon signed rank test using the median distribution. In terms of the effects of NORPLANT on lipid metabolism, we have demonstrated a significant rise in HDL-cholesterol (1.08 mmol/l +/- 0.34 to 1.13 mmol/l +/- 0.24; p less than 0.05) with significant decreases in mean serum triglycerides (1.21 mmol/l +/- 0.74 to 0.89 mmol/l +/- 0.45; p less than 0.002) and total cholesterol (5.05 mmol/l +/- 1.02 to 4.64 mmol/l +/- 0.81; p less than 0.001) after one year of use. There was also a significant rise in the HDL-cholesterol/total cholesterol ratio after 1 year (0.225 +/- 0.086 cf 0.250 +/- 0.059; p less than 0.001). As we have not incorporated a simultaneous non-pill treated control group, the observed changes in lipoprotein lipids could be attributed to extraneous factors such as diet, exercise or other environmental changes. Nevertheless, the findings though speculative indicate NORPLANT use to be non-contributory to cardiovascular risk and indeed it may be protective factor against such risks in this population. The use of NORPLANT was not associated with any significant effect on glucose tolerance after 12 months of use.

Adult↗

The effects of Norplant on clinical chemistry in Singaporean acceptors after 1 year of use: I. Haemostatic changes.

A longitudinal study of coagulation parameters was carried out on 100 Singaporean acceptors using the levonorgestrel subdermal implants NORPLANT for contraceptive purposes. At the end of 1 year of use, results from this on-going study indicate that these subjects may have an increased predisposition to thrombosis as evidenced by significant increase in platelet count and aggregability. The results also show that NORPLANT acceptors may have an enhanced potential for hypercoagulation - with a significant shortening of their Prothrombin Time and Activated Partial Thromboplastin Time and increases in Factors V and X. As previously documented, mean values for haemoglobin and haematocrit were significantly elevated by the end of 1 year. A number of other parameters achieved statistically significant differences by the end of 1 year but these were probably due to the large sample size involved and were therefore not likely to be of much clinical importance.

Adult↗

Risk factors for low birthweight in Singapore: strategies for prevention.

An analysis of 9399 consecutive singleton births delivered at this unit is presented. The incidence of low birthweight (less than 2500 g) was 7.4%. Further analysis of the 698 low birth weight babies indicated that a variety of socio-demographic risk factors are operational in the etiology of low birthweight. Many of these are preventable before pregnancy so that the implementation of preventive Public Health measures utilising appropriate technology at least in developing countries may be socially and economically preferable to continued financial investment in intensive perinatal services.

Educational Status↗

Successful outcome of pregnancy in a subfertile patient with severe aortoarteritis (Takayasu's disease).

This report describes the successful outcome of pregnancy in a 27-yr-old subfertile Chinese nullipara with severe Takayasu's disease. Pregnancy was achieved following ovulation induction with clomiphene. Blood pressure was controlled with propranalol and fetal growth was monitored by serial ultrasound fetal anthropometry. Pregnancy was terminated at 38 weeks of pregnancy by elective caesarean section. A live female infant weighing 2420 g was delivered.

Adult↗