Biomedical subjects

Tadeusz Laudański

Publications and source records attributed to Tadeusz Laudański.

17 recordsLinked to original sources

PubMed2006

Effect of short-term, low-dose treatment with tamoxifen in patients with primary dysmenorrhea.

Current treatment of painful periods and other symptoms related to primary dysmenorrhea (PD) is usually commenced with non-steroidal anti-inflammatory drugs or oral contraceptives, which fails in about 10% of affected patients. Tamoxifen, a selective estrogen-receptor modulator (SERM), has been demonstrated to directly inhibit uterine contractions, causing improvement in uterine blood flow. It could be considered for application in selected groups of dysmenorrheic patients, for instance carriers of breast cancer-associated antigen (BRCA) genes, breast cancer survivors or women with advanced endometriosis. Thus the aim of the present study was to investigate the effect of short-term treatment with tamoxifen on PD and PD-related symptoms, as well as its direct effect on parameters of intrauterine pressure during the painful menstruation, in a group of dysmenorrheic patients. After two cycles of administration of tamoxifen we noted a significant decrease in bleeding together with reductions in the severity of menstrual cramps, diarrhea, headache, fatigue and anxiety. In intrauterine pressure assessments, tamoxifen significantly decreased propagation of uterine contractions. In conclusion, SERMs such as tamoxifen may constitute a therapeutic option in selected groups of patients, improving dysmenorrheic symptoms. Additionally to its receptor-mediated effects, tamoxifen was shown to exert a direct influence on uterine contractile activity that may explain the decrease of menstrual pain and cramps noted in the studied group.

Adolescent↗

PubMed2006

[B lynch suture for post partum heamorrhage due to uterine atony].

Uterine atony and concomittant massive haemorrhage is one of the most dangerous complications of labour. Conventional, conservative treatment approach comprising of oxytocics such as oxytocin, methergin or prostaglandins may fail in some cases, mandating surgical techniques, including hysterectomy. B Lynch compression uterine suture may be a safe and effective method of treatment in post partum heamorrhage and in most of cases may replace more complicated techniques. In this article, together with referring the technical aspects of this procedure, we present a case of successful treatment.

Adult↗

PubMed2006

[Comparison between computerized cardiotocography analysis in triplet and singleton pregnancies].

OBJECTIVES: Triplet pregnancies have higher perinatal morbidity and mortality rates than singleton pregnancies. In modern perinatology computer cardiotocography is one of the best methods of fetus state assessment. DESIGN: The research was based on computer analysis of cardiotocograph printouts. MATERIALS AND METHODS: The studies were made on 39 pregnant women in 27-36 week of gestation. The women were hospitalized in the Clinic of Perinatology I Department of Gynecology and Obstetrics, Medical University of Lodz and divided into two groups. First consisted of 30 singleton, second of 9 triplet pregnancies. RESULTS: Computer analysis of cardiotocograph printouts was performed and compared between the triplet and singleton pregnancy groups and presented in forms of tables. CONCLUSIONS: In the studded group of triplet pregnancy statistically significant higher number of high episodes, accelerations, fetal movements and signal loss were observed. The Apgar score and arterial cord pH was not different between the both groups.

Cardiotocography↗

PubMed2006

[Monitoring of labour and delivery in the presence of meconium stained amniotic fluid by pulse oximetry].

OBJECTIVES: Evidence of meconium-stained amniotic fluid during labor suggests implementation of close monitoring of fetal well-being. DESIGN: Our purpose was to compare fetal oxygen saturation between cases with normal and meconium stained amniotic fluid. MATERIALS AND METHODS: Fetal oxygen saturation was continuously recorded with use of Nellcor N-400 fetal pulse oximeter in 30 control cases of term labour of normal, and 30 cases of meconium stained amniotic fluid. Distribution of fetal oxygen saturation values during 5 periods of labour was analyzed and compared between the examined groups, and presented in forms of Tables, together with neonatal umbilical artery pH values, Apgar score, birth weight and percentage of caesarian sections performed. RESULTS: No significant differences in fetal oxygen saturation, neonatal umbilical artery pH, birth weight and caesarian sections rate were observed between analyzed groups. Newborns 1-th minute Apgar score (mean value) and base excess was lower in meconium group compared to control group. CONCLUSIONS: Our data demonstrate, that fetal oxygen saturation trends to decrease during labour in fetuses in both groups.

Amniotic Fluid↗

PubMed2004

[The impact of low-dose aspirin therapy on umbilical and middle cerebral artery blood flow in pregnancy complicated by idiopathic intrauterine growth restriction].

AIM: Intrauterine growth restriction and its treatment still constitute a major clinical problem in perinatology. Since low doses of aspirin could improve the utero-placental circulation (by shifting the prostacyclin/thromboxane A2 balance), we have evaluated the impact of low-dose aspirin treatment of IUGR during pregnancy on umbilical (UA) and middle cerebral artery (MCA) blood flow. MATERIAL AND METHODS: The study comprised 32 pregnant women with idiopathic fetal intrauterine growth restriction (IUGR) diagnosed during pregnancy on the basis of ultrasound examination of biometric parameters (BPD, FL, AC). All the patients were treated only by low-dose aspirin (1.5 mg/kg) for 8-14 days. The: fetal biometry and calculation of blood flow indices (S/D, RI, PI) in umbilical and middle cerebral artery were performed before and after treatment. RESULTS: Mean values of all biometric parameters of the fetuses measured before and after treatment did not show statistically important differences (AC-borderline significantly). Umbilical artery blood flow indices calculated after the treatment were slightly lower and MCA indices slightly higher, as compared to those before the treatment. Cerebro-placental ratio changed from 1.37 to 1.63 (borderline significantly). CONCLUSIONS: IUGR treatment by low-dose aspirin had beneficial but non-significant impact on umbilical and middle cerebral artery blood flow. Since the number of subjects in this study was relatively small, further clinical studies are necessary to evaluate the effectiveness of IUGR treatment by low dose aspirin.

Adult↗

PubMed2003

[Usefulness of the examination of fetal blood oxygen saturation (FSpO2) and fetal heart rate (FHR) as a prognostic factor of the newborn outcome].

OBJECTIVES: Cardiotocography has become the standard for fetal monitoring in labor. False-positive findings during electronic fetal heart rate monitoring may were not associated with neonatal acidemia. Because of the poor specificity of fetal heart rate monitoring in predicting fetal distress, new methods are being investigated as a way to improve the accuracy of assessing the infant's condition during labor. DESIGN: The aim of this study was to determinate the efficiency of fetal blood oxygen saturation (FSpO2) and computer analysis of the fetal heart rate (Co-CTG) in the late 1-st stage of labor as a prognostic factor of newborn acidemia. MATERIALS AND METHODS: Total 62 subjects were studied. During labors and deliveries fetal oxygen saturation was continuously recorded, with use of Nellecor N-400 fetal pulse oximeter and continous CTG were performed by Hewlett Packard 50A. Transdermal fetal oxygen saturation measurements and CTG results obtained during the labors was analyzed using MONAKO system (ITAM Zabrze). The results were compared with the values of pH and base deficit in the umbilical artery measured just after delivery. RESULTS: The sensitivity, specificity, negative, positive predictive values and Youden factor based on FHR and FSpO2, for prognosis of neonatal acidosis were: 65%, 80%, 16%, 97.5% 60% and 0.135 respectively FHR; and 100%, 60%, 100%, 96.8% and 0.968 respectively FSpO2. CONCLUSIONS: 1. The examination of fetal blood oxygen saturation in the labor is a useful prognostic factor of the newborn outcome. 2. The best predictive value for intrapartum fetal asphyxia with metabolic acidosis was found when fetal pulse oximetry is added to cardiotocography.

Acidosis, Respiratory↗

PubMed2003

[The evaluation of prevalence and the impact of pathological microflora of the lower genital tract among women at early pregnancy on the risk of preterm delivery].

The main aim of this prospective study was to determine the prevalence and an association between pathological microflora of the lower genital tract diagnosed at early pregnancy and the risk of preterm delivery. The study group comprised 179 randomly selected pregnant women from Lodz region, between 8 and 16 week of pregnancy. For the qualitative and quantitative assessment of biocenosis of the lower genital tract vaginal and cervical swabs were collected from the pregnant women under study. The C. trachomatis antigen was detected by direct immunofluorescence assay. The vaginal swabs were tested for aerobic and anaerobic bacteria. Bacterial vaginosis was diagnosed by Gram stain according to Spiegel's criteria. To evaluate the risk factors odds ratios were calculated using EPI INFO software. 21 (11.7%) women delivered before 37th week of pregnancy. Bacterial vaginosis was diagnosed among 51 (28.5%) pregnant women while intermediate microflora was diagnosed by Gram stain in 62 (34.6%) women. The shortest mean gestational age at delivery was noted among women with BV. The rate of preterm delivery in BV group was 15.7% comparing to 9.1% among women with normal microflora. Among women with preterm delivery BV was diagnosed in 38.1% (OR = 1.86). Based on culture results only 84 (46.9%) women had normal microflora at early pregnancy. The pathological culture was associated with slightly increased preterm delivery rate (12.6%) as compare to 10.7% in control group. Positive culture for Bacteroides and Mobiluncus was connected with nonstatistical rise in the risk of preterm delivery. No association between C. trachomatis infection at early pregnancy and elevated risk of preterm delivery was found. Early pregnancy diagnosis of bacterial vaginosis and its treatment should lower the rate of prematurity in Poland.

Chlamydia trachomatis↗

PubMed2002

Socioeconomic and environmental risk factors of bacterial vaginosis in early pregnancy.

The main aim of this prospective study was to determine the socioeconomic, demographic and environmental factors that may be associated with the occurrence of bacterial vaginosis at early pregnancy in an indigent population from Central Poland. A group of 196 pregnant women was selected randomly from the patients of 10 district maternity units in the Lodz region, Central Poland. Only singleton pregnancies between 8 and 16 week of gestation were qualified for inclusion in the survey. A standard questionnaire covering medical, socioeconomic, demographic, constitutional and environmental items was administered to every subject and was verified with medical records. Cervico-vaginal swabs were collected from the women under study and tested for bacterial vaginosis (BV) according to Spiegel's criteria. Based on the results of Gram stain, BV was diagnosed in 51 women (28.5%), grade I microflora among 66 (36.9%) and grade II among 62 women (34.6%). In the univariate analysis, only single marital status proved to be an important risk factor associated with BV during pregnancy, this was confirmed in the multivariate analysis. Pregnant women who present risk factors for abnormal cervico-vaginal microflora should be covered by comprehensive prenatal surveillance, which enables early detection and treatment of this pathology. Research that identifies the causal pathways and mechanisms through which social disadvantage leads to a higher risk of preterm birth may help to reduce current socioeconomic and demographic disparities and improve pregnancy outcome.

Adult↗

PubMed2002

[Use of oxi-cardiotocography in twin delivery].

The intrapartum management of multiple gestation continues to challenge the obstetrics profession. Electronic fetal heart rate monitoring and fetal pulse oximetry are used in clinical research to assess fetal well-being during labor. The objective of this study was to establish values of fetal arterial oxygen saturation (FSpO2) and some other parameters by dint of computerised analysis of cardiotocogram during twin delivery. 5 cases of vaginal twin deliveries as the Clinic of Perinatology of the Institute of Gynecology and Obstetrics Lodz Mecical University over the years 1988-1999 were reviewed. In four cases vertex-vertex twins were delivered vaginally, while in one case an assisted breech extraction was conducted on vertex-non vertex twins. The foetus was monitored continually with a Oxford S 8000 systems and pulse oximeter Nellcor N-400. the medium parameters of computerised analysis of CTG and FSpO2 during progressive stages of labour were shown. Twin delivery needs modern fetal monitoring tools to provide the obstetrician information on well-being of the foetus. It is possible to monitor fetal oxygen saturation and CTG parameters in both of the twins during labour The ability to measure fetal oxygen saturation especially during the second stage of twin labor adds critical information about fetal status and refines the interpretation of abnormal FHR patterns. Only after examining a large number of twin fetuses we can assess whether pulse oximetry in useful in management of labor.

Cardiotocography↗

PubMed2002

[Evaluation of fetal oxygen saturation (FSpO2) during the course of underwater labor].

During controlled, randomized prospective trials, fetal arterial hemoglobin saturation (FSpO2) was estimated during 25 underwater labors and compared to results obtained from 34 classical deliveries. Mean fetal hemoglobin saturation during the first stage of labor was similar in both groups while a gradual decreasing trend in fetal FSpO2 was noticed throughout the progress of labor. In the second stage of labor higher mean FSpO2 values were observed in the group of fetuses born underwater. The author emphasized in discussion that underwater labor constitutes delicate and mild procedure particularly for the fetus.

Delivery, Obstetric↗

PubMed2002

[Fetal arterial oxygen saturation (FSpO2) during the second stage of labor after training for childbirth].

OBJECTIVE AND DESIGN: The aim of the research was to determine the effects of participating in training program for childbirth in Maternity School in Lódź on the state of the fetus. In the above research, the authors presented the foetal oxygen saturation (FSpO2) during the second stage of labour among the women participating in Maternity School as well as a control group. Our study analysed the neonatal outcome too (umbilical arterial blood pH and 5 min. Apgar score). MATERIAL AND METHODS: The test group consisted of eighty seven (87) healthy primigravidas of whom forty two (42) participated in classes in the Maternity School and forty fifth (45) made up the control group. Validity of the correlation was assessed by means of t-Student's table of N--2 degree of freedom. RESULTS: The medium parameters of FSpO2 values and duration of the second stage of labor in both groups were shown. Statistically significant differences between the groups were found in duration the second stage of labour--in Maternity School group being shorter. Statistically significant differences in FSpO2 values between groups were not observed.

Adolescent↗

PubMed2002

[The effect of umbilical cord encirclement on fetal arterial oxygen saturation values].

AIM: Our purpose was to study fetal arterial oxygen saturation trends by continuous pulse oximetry during labour in subjects with and without umbilical cord encirclement. MATERIAL AND METHODS: The study was carried out in 46 pregnant women in the 38.9 +/- 1.4 weeks of pregnancy and the 15 of them with umbilical cord encirclement, established respectively after delivery. The fetus was monitored continuously with an Oxford S 8000 system and pulse oximeter Nellcor N-400. The medium parameters of FSpO2 values during progressive stages of labour in both groups were shown. The importance of the correlation was assessed using the t-Student's table of N--2 degree of freedom. RESULTS: In those two groups no significant difference between FspO2 value in first stage of labour was found. In second stage of labour our study showed tendency for higher oxygen saturation values in foetuses without umbilical cord compression.

Female↗

PubMed2002

[Smoking in pregnancy--long term effect].

OBJECTIVES: The data review on the cancer risk in children exposed to tobacco smoke in utero. MATERIALS AND METHODS: The analysis was based on databases available in Medline, Cancerlit and Cochrane. RESULTS: The reviewed data confirm that the risk of developing malignancy after the exposure to maternal smoking is low. Nevertheless, some publications point to a higher risk of having brain tumors or leukemias. CONCLUSIONS: Together with facts that fetus is jeopardized with toxic metabolites of tobacco smoke which cause genotoxic effects or DNA adducts give additional arguments the necessity of introducing smoking cessation programs in perinatal care.

Brain Neoplasms↗

PubMed2002

[Modulation of hypothalamo-pituitary axis by stress during labor].

OBJECTIVES: The present study is aimed to investigate the function of hypothalamo-pituitary-adrenal axis of women during late pregnancy and term labor. DESIGN: Levels of hormones were measured in blood of 34 women undergoing spontaneous labor and elective cesarean section, 2 days before and after delivery, and during labour. Additionally, blood from the umbilical vein and artery was also collected. MATERIALS AND METHODS: We have evaluated changes in corticotropin releasing hormone (CRH), adrenocorticotropin (ACTH) and dehydroepiandrosterone (DHEA) in vein blood of 34 subjects. The concentrations of hormones were measured by dint of RIA method. RESULTS: No significant correlation was found between hormone measurements and fetal outcome. CRH level in the umbilical vein was higher than in the umbilical artery, suggesting the placental origin of hormone. Prepartum CRH concentration was significantly higher in the group of spontaneously delivered patients. There were no correlations between CRH levels and ACTH and DHEA concentration in mother's blood plasma. In fetuses, higher prepartum CRH concentrations resulted in elevated levels of ACTH. No changes were found in DHEA concentration, in both mother and fetus. CONCLUSIONS: These results suggest that placental CRH may modulate a fetus's pituitary but not mother's. The observed high levels of this hormone play an important role mainly in preparation of mother and fetus for delivery.

Adrenocorticotropic Hormone↗

PubMed2002

Permeability of human skin to selected anions and cations--in vitro studies.

Among the many factors influencing the human body every day, metal cations and anions are some of the most important and are constantly present in atmospheric fallout. Some of them such as sulfate or nitrate anions along with different detergents may cause pathological changes within the skin. The aim of this study was to estimate whether sulfate (SO4(2-)) and nitrate anions (NO3-) as well as metal cations, magnesium (Mg2+) and calcium (Ca2+) are able to pass through isolated patches of human skin and to investigate the dynamics of ion diffusion. Concentrations of the substances corresponded to those observed in the atmospheric fallout in two regions of Poland with low (Białowieza) and high (Katowice) pollution rate. Ion chromatography method was used to determine cations and anions levels. In vitro, we found human skin to be permeable to magnesium and calcium ions as well as sulfate and nitrate anions at concentrations observed in the atmospheric fallout in two regions of Poland having different levels of pollution. Diverse influence of sodium lauryl sulfate (SLS) detergent on the grade of metal ion permeability (acceleration in the first 10 hours of experiment) and anion permeability (lack of SO4(2-) influence) suggest the presence of different routes of ions penetration through the skin. It is also supported by different transportation characteristics of individual ions through the skin over time.

Adult↗

PubMedDate not supplied

Do microbiological factors account for poor pregnancy outcome among unmarried pregnant women in Poland?

OBJECTIVE: Being unmarried is a well-known risk factor for poor pregnancy outcome such as preterm delivery and intrauterine growth restriction. The aim of this prospective study was to assess the prevalence and risk of bacterial vaginosis (BV) and selected bacteria isolated from the lower genital tract and to determine the socioeconomic and microbiological characteristics that might be responsible for poor pregnancy outcome observed among unmarried pregnant women. METHODS: The study population comprised 196 pregnant women attending 10 randomly selected outpatient maternity units in the Lodz region, central Poland. Cervicovaginal samples were obtained between 8 and 16 weeks of gestation. Based on Spiegel's criteria, gram-stained vaginal smears were examined for BV and the BV-associated flora was sought by culture. To evaluate the risk factors, relative risk ratios were calculated using EPI INFO software. RESULTS: Among 196 pregnant women, 40 (20.4%) were unmarried. BV was diagnosed among 55 (28.1%) women studied. In the univariate analysis, unmarried pregnant women were characterized by younger age, primary educational level, poor economic situation and excessive smoking during pregnancy, as compared to married women. The unmarried status was a borderline risk factor for BV (OR = 1.83, 95% CI 0.94-4.9) after adjustment for age, smoking and education. An analysis of the microbiological culture from the lower genital tract revealed that unmarried pregnant women had a higher risk for several types of pathological microflora, as compared to married women. However, this finding was significant only for Mycoplasma hominis. The independent risk factors of M. hominis were the young age of the subject and a low concentration of Lactobacillus spp. CONCLUSIONS: The observed socioeconomic, demographic and microbiological differences between unmarried and married women could be responsible for the poor pregnancy outcome among unmarried pregnant women in Poland. Unmarried pregnant women should be covered by comprehensive medical care even before pregnancy. Further studies taking into account the role of psychological stress, patterns of sexual behavior and substance abuse during pregnancy could help identify the factors responsible for adverse pregnancy outcome among unmarried pregnant women.

Adult↗

PubMedDate not supplied

Fractal analysis of the uterine contractions.

The fractal dimension D may be calculated in many ways, since its strict definition, the Hausdorff definition is too complicated for practical estimation. In this paper we perform a comparative study often methods of fractal analysis of time series. In Benoit, a commercial program for fractal analysis, five methods of computing fractal dimension of time series (rescaled range analysis, power spectral analysis, roughness-length, variogram methods and wavelet method) are available. We have implemented some other algorithms for calculating D: Higuchi's fractal dimension, relative dispersion analysis, running fractal dimension, method based on mathematical morphology and method based on intensity differences. For biomedical signals results obtained by means of different algorithms are different, but consistent.

Algorithms↗