Biomedical subjects

R Tuimala

Publications and source records attributed to R Tuimala.

At least 73 records · Page 4Linked to original sources

PubMed1985

Serum vitamin A and E levels in patients with lichen sclerosus and carcinoma of the vulva--effect of oral etretinate treatment.

Serum vitamin A and E concentrations were determined in six patients with vulvar epithelial carcinoma and in 25 patients with lichen sclerosus and atrophicus (LSA) of the vulva. No difference could be found in these levels between the two groups. LSA patients received oral etretinate for two months at least; improvement was observed in 93% of the patients. Etretinate therapy had no effect on the serum levels of vitamins A or E.

Adult↗

PubMed1985

The effects of long-term anticonvulsant drug therapy on vitamin D metabolites and mineral homeostasis in pregnant epileptic women and their newborns.

Serum concentrations of 25-hydroxyvitamin D (25(OH)D), (24,25(OH)2D), 1,25-dihydroxyvitamin D (1,25(OH)2D), total calcium, protein, phosphorus, magnesium and alkaline phosphatase (ALP) were measured in 21 epileptic and 20 healthy control mothers. Serum samples were collected in the third trimester of pregnancy and at delivery, when also mixed blood from the umbilical cord was drawn. 25(OH)D concentrations were similar in both groups and different anticonvulsant drugs had no effects on values. There were small alterations in dihydroxylated vitamin D metabolites. 24,25(OH)2D values were decreased and 1,25(OH)2D concentrations increased. The difference was significant (p less than 0.05) in maternal 1,25(OH)2D values at delivery. Other alterations were statistically almost significant. There was no difference between the diphenylhydantoin and carbamazepine groups. Calcium concentrations were significantly higher in the control than in the epileptic group (in the third trimester p less than 0.01 and at delivery p less than 0.001). Magnesium and phosphorus concentrations were similar in both groups. ALP concentrations were higher in epileptics than in control subjects. Though there were differences in maternal values between epileptics and controls, the fetal concentrations of the analyzed parameters were quite similar in both groups, except for ALP values, which were significantly higher (p less than 0.05) in epileptics than in controls. It was found only slight alterations in vitamin D metabolites. These changes cannot explain hypocalcaemia and osteopenia found often in these patients.

Adolescent↗

PubMed1985

Maternal blood haemostatic-fibrinolytic balance and intrauterine growth retardation.

In order to study the association between haemostatic-fibrinolytic balance during late pregnancy and retarded foetal growth, 22 mothers with suspected intrauterine growth retardation were studied by blood haematocrit and platelet count, plasma fibrinogen and serum fibrinogen degenerating products (FDP) in late pregnancy. Fifteen mothers with undisturbed foetal growth served as controls. No statistical differences could be found between these two groups of mothers in any of the studied blood parameters. It is thus concluded that a defect in the haemostatic-fibrinolytic balance seems not to play any very important role in the etiology of intrauterine growth retardation.

Adult↗

PubMed1985

Clonidine in the treatment of hypertension during pregnancy.

Eighty two hypertensive pregnant patients were treated with clonidine during the last trimester of pregnancy. Clonidine was effective hypotensive agent in all groups treated; in essential hypertension (N 31), in mild pre-eclampsia (N 7), in severe pre-eclampsia (N 19) and in superimposed pre-eclampsia (N 24). The drug was well tolerated by the mothers. One fetus died in utero in severe pre-eclampsia group for hypoxia and another infant died at the age of 1 day for sepsis. If antihypertensive treatment is needed during pregnancy, clonidine is one choice.

Adult↗

PubMed1985

Vitamin A and vitamin E in umbilical artery and vein.

Vitamin A and vitamin E concentrations were measured in 27 umbilical arterial and venous plasma samples obtained from 24 singleton pregnancies and one triplet pregnancy. The levels of both vitamins were similar in arterial and venous plasma (mean +/- S.D. vitamin A 209 +/- 41 micrograms/l and 220 +/- 51 micrograms/l; vitamin E: 2.31 +/- 0.74 mg/l and 2.31 +/- 0.76 mg/l, respectively), but individual differences were observed in some cases. A significant relationship (p less than 0.001) existed between the arterial and venous levels of both vitamins. However, when arterial vitamin A levels were plotted against venous levels, the slope of the regression line (0.61) was significantly (p less than 0.01) different from unity, which suggests that the placental transfer or fetal storage has an effect on the arterial-venous ration of this vitamin. The vitamin A values from the triplet pregnancy were quite low, but comparable with each other.

Female↗

PubMed1985

Low serum oestriol and Cushing's syndrome during pregnancy.

Previously in world literature there have been reports of 40 pregnancies in women with untreated Cushing's syndrome. The perinatal mortality in these series has been 12.9%. This paper reports on a case in which low serum oestriol excretion was the first abnormal laboratory value in a patient with only a few signs of Cushing's syndrome habitus and adrenal adenoma.

17-Ketosteroids↗

PubMed1985

Pregnancy and esophageal varices.

Successful pregnancy in patient after four operations for portal hypertension with severe esophageal varices is presented. Vaginal delivery assisted by vacuum extractor or forceps to shorten the second stage of delivery is recommended.

Adult↗

PubMed1984

Hormonal changes during the perinatal period: FSH, prolactin and some steroid hormones in the cord blood and peripheral serum of preterm and fullterm female infants.

Fetoplacental endocrine function during the last third of gestation, and first 5 days post partum, was studied by hormone measurements of umbilical cord arterial and venous serum in preterm (31-37 weeks gestation) and fullterm (39-42 weeks gestation) female newborn. Furthermore, hormones were measured in peripheral serum of fullterm female infants of 1, 3 and 5 days of age. The data were compared with those obtained previously in corresponding age groups of males. FSH was significantly (P less than 0.05) higher in the cord serum of preterm females (5.4 +/- 1.8 IU/I, SE, n = 30) than in males (1.5 +/- 0.08 IU/l, n = 27), and decreased significantly (P less than 0.05) in preterm females towards fullterm. PRL levels increased in both sexes towards the end of gestation (P less than 0.01), and decreased post partum, but no sex differences could be detected. Testosterone was significantly higher in the male serum samples (P less than 0.01-0.05), but only minor sex differences were seen in cord serum, or post partum, concentrations of the other steroids measured, pregnenolone, progesterone, 17-hydroxyprogesterone and androstenedione. Significant arterio-venous difference (higher in the vein) were seen at term in progesterone and 17-hydroxyprogesterone. The levels of these two steroids also decreased most clearly after birth. Female serum testosterone peaked at d 1 post partum (0.084 +/- 0.014 microgram/l, SE, n = 11), decreased thereafter, but remained at the intrauterine level, suggesting that the low female levels of this steroid are of fetal, rather than placental/maternal origin. The same seems to be true for androstenedione. Our data suggest that the fetal ovary is quiescent during the last weeks of gestation.

Androstenedione↗

PubMed1984

Vasopressin in fetal cerebrospinal fluid.

Vasopressin concentrations were measured in the cerebrospinal fluid in two hydrocephalic fetuses at 33 and 34 weeks of gestation. The vasopressin concentrations in cerebrospinal fluid were 0.8 and 0.6 pg/ml, and in amniotic fluid 0.4 and 1.0 pg/ml, respectively. Previously measured vasopressin concentrations in amniotic fluid of the normal fetuses have been of the same magnitude.

Female↗

PubMed1984

Can the fetus regulate its calcium uptake?

To investigate the role of the fetus in vitamin D metabolism concentrations of vitamin D metabolites, 25(OH)D, 24,25(OH)2D and 1,25(OH)2D, were measured in human umbilical artery and vein. There were no differences between artery and vein in 25(OH)D and 24,25(OH)2D levels. 1,25(OH)2D concentrations were statistically significantly higher in the artery than in the vein. It has been shown in animal experiments that 1,25(OH)2D is an important factor in the maintenance of the placental calcium gradient. We suggest that the fetus actively produces 1,25(OH)2D and hence has the capacity to control its calcium influx.

24,25-Dihydroxyvitamin D 3↗

PubMed1984

Subtotal hysterectomy in emergency obstetrics.

Emergency obstetric subtotal hysterectomy was performed in 11 women over a 20-year period in the University Central Hospital of Tampere. The incidence of these operations was 1 in 7,623 deliveries. During this period the incidence of uterine rupture was 1 in 13,976 deliveries. The other indications included placenta accreta, atonic postpartum haemorrhage and haemorrhage during caesarean section. There were no maternal deaths or major complications. The authors recommend safe subtotal hysterectomy operation of choice in these emergency cases.

Adult↗

PubMed1983

Placental transfer and hormonal effects of metoclopramide.

In order to study the transplacental transfer of metoclopramide, and its endocrine effects, measurements were made of its concentration in maternal and fetal blood, and in the amniotic fluid, together with maternal and fetal plasma concentrations of prolactin, TSH and oestradiol, during delivery by selective Caesarean section. The drug, 10 mg, was injected i.m. 12 and 2 h and just before the onset of anaesthesia. Metoclopramide was detectable in all the umbilical arterial and venous and amniotic fluid samples, in mean concentrations of 50, 63 and 75 ng/ml, respectively. The mean ratio between the umbilical venous and maternal plasma concentrations was 0.63. Accurate maternal plasma half-lives could not be established but they must have averaged 2 to 4 h. The high amniotic fluid concentrations and relatively high umbilical venous and arterial concentrations soon after administration suggest that metoclopramide equilibrates relatively rapidly between the mother and fetus. Metoclopramide raised the maternal plasma prolactin levels from 315 +/- 128 ng/ml (SD) before therapy to 357 +/- 112 ng/ml at the time birth. No statistically significant difference in cord arterial or venous plasma prolactin levels was seen between the control and metoclopramide-treated groups. Metoclopramide did not affect maternal plasma TSH or oestradiol levels. The only change was a slight but significant increase in TSH level in cord blood taken from the umbilical artery after metoclopramide treatment.

Anesthesia, Obstetrical↗

PubMed1983

Comparison of megestrol acetate and clomiphene citrate as supplemental medication in postmenopausal oestrogen replacement therapy.

In a prospective clinical trial lasting one year, 35 postmenopausal women with severe climacteric symptoms were cyclically treated with conjugated oestrogens (1.25 mg daily). This oestrogen replacement therapy was randomly supplemented with 10 mg of megestrol acetate daily (18 women) or 50 mg of clomiphene citrate (17 women) for 10 days four times a year. Both treatment regimens significantly alleviated climacteric symptoms. At the end of the oestrogen-megestrol acetate treatment no endometrial proliferation or hyperplasia was seen, while at the end of the oestrogen-clomiphene citrate treatment the endometrium was proliferative or hyperplastic in two women and atrophic in the other 15. Regular uterine bleeding occurred in each woman after megestrol acetate but never after clomiphene citrate administration. Break-through bleeding during the oestrogen treatment periods appeared in the megestrol and clomiphene groups in five and eight women, respectively. There were no clinically adverse hormonal or metabolic changes during megestrol acetate or clomiphene citrate treatment periods. Our results provide further evidence that in addition to progestins postmenopausal oestrogen replacement therapy can safely be supplemented with antioestrogen and thereby avoid the bleeding which occurs regularly after progestin withdrawal.

Climacteric↗

PubMed1983

Factors related to an improved outcome for twins.

We observed that perinatal mortality among the 220 twins born at our hospital in 1977-78 (3.6%) was significantly lower than for the 210 twins born in 1975-76 (11.0%). At the same time the frequency of postpartum asphyxia had decreased significantly. An analysis of factors related to the diagnosis and therapy revealed that during the later period both the diagnosis of twins and bed rest in hospital had been initiated significantly earlier than during the former period. The duration of pregnancy, length of stay in hospital, use of beta-adrenergic drugs or glucocorticoids, duration and type of delivery and birthweight of the infants were similar in both groups. Early diagnosis permits the greatest degree of readiness for both the mothers and the obstetrical and pediatric personnel in order to meet the possible complications commonly associated with a twin pregnancy and birth.

Asphyxia Neonatorum↗

PubMed1983

Comparison between oral ketoconazole and topical miconazole in the treatment of vaginal candidiasis.

Oral ketoconazole and topical miconazole were compared in the treatment of vaginal candidiasis, in an open trial. One group (n = 49) received of ketoconazole, 400 mg per day for 3 days, another group (n = 42) ketoconazole 200 mg per day for 6 days and the third (n = 49) miconazole vaginal tablets (100 mg) one per day for 14 days. One week after conclusion of the treatment the mycological cure rates (67%, 78% and 81%) were not statistically different from each other. The recurrence rates assessed one month after the treatment were also of same order (7%, 7% and 15%) and did not differ significantly from each other. Those patients who had previous had candidiasis showed lower cure rates than patients with their first vaginal candidiasis., following both miconazole and ketoconazole therapy. No adverse reactions attributable to the drugs were recorded. The advantages of ketoconazole in the treatment of vaginal candidiasis are: oral route of administration, short duration of the therapy (3-6 days), high therapeutic effectiveness and lack of any significant side effects.

Administration, Oral↗

PubMed1983

Endocrine and metabolic effects of low-dose estrogen-progestin treatment in climacteric women.

In a double-blind clinical trial with 31 premenopausal women suffering from climacteric symptoms, 16 (group A) were treated with an estrone (sodium estrone sulfate 1.5 mg)-norethisterone (5 mg) combination, and 15 (group B) were treated with an estrone-megestrol acetate (5 mg) combination. These treatments effectively alleviated climacteric symptoms without causing any bleeding disorders or pathological changes in the cytology of the uterine cervix or endometrium. In groups A and B, respectively, postovulatory progesterone concentrations above 5 nmoles/liter were found in six and five patients before, in five and seven patients during, and in two and four patients after the treatments. Serum levels of luteinizing and follicle-stimulating hormones decreased significantly and testosterone decreased slightly during both treatments. Serum cholesterol (P less than .01) and high-density lipoprotein cholesterol(P less than .001) in group A decreased during the treatment; only the high-density lipoprotein cholesterol values (P less than .05) decreased in group B. Because of the minor endocrine and metabolic changes without any significant difference between the progestins, both norethisterone acetate and megestrol acetate seem to be suitable for estrogen-progestin combinations aimed at alleviating climacteric symptoms.

Adult↗

PubMed1983

Prevention of posthysterectomy infection with a combination of preoperative vaginal and perioperative intravenous administration of metronidazole.

In a prospective double-blind study 58 patients received 1000 mg of metronidazole vaginally 12--16 hours preoperatively and 500 mg intravenously during abdominal hysterectomy while 54 patients were treated with placebo. The lack of all operative site infections in the metronidazole group in comparison with 9 infections (17%) in the placebo group (P less than 0.01) proved the combined short-term vaginal and intravenous use of metronidazole to be efficacious in the prevention of posthysterectomy infections.

Adult↗

PubMed1983

The effect of parturition on umbilical blood plasma levels of norepinephrine.

The norepinephrine concentration in 77 umbilical, arterial, and venous plasma samples, and in 31 simultaneous maternal plasma samples, was measured. The mean (+/- SEM) of 8.7 +/- 1.9 ng/ml in the umbilical artery was higher (P less than .001) than that of 3.6 +/- 0.9 ng/ml in the umbilical vein. In paired fetal-maternal venous samples the norepinephrine concentration of 3.8 +/- 1.7 ng/ml in the fetus was higher (P less than .05) than that of 0.3 +/- 0.1 ng/ml in the mother. Among the different types of vaginal deliveries the umbilical arterial norepinephrine concentrations were: 5.8 +/- 2.1 ng/ml in uncomplicated vaginal deliveries; 16.4 +/- 2.1 ng/ml in breech deliveries (P less than .05 as compared with uncomplicated vaginal deliveries); 8.8 +/- 2.5 ng/ml in vacuum extraction deliveries; and 0.8 +/- 0.3 ng/ml and 11.3 +/- 7.7 ng/ml in twin A and twin B deliveries, respectively. All these values were higher (P less than .001) than those after elective cesarean section, except that for twin A, which was lower (P less than .01) than that for twin B, indicating that labor and vaginal delivery induced activation of the fetal sympathoadrenal system.

Adult↗