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PubMed1984

Pituitary and ovarian function and clinical performance during the use of a levonorgestrel-releasing intracervical contraceptive device.

A levonorgestrel-releasing intracervical device (ICD) was inserted postmenstrually to twenty-one voluntary women. Eight subjects gave blood samples twice a week during the initial three months of use of the ICD and during the seventh and twelfth months of use. Clinical performance was studied; plasma concentrations of levonorgestrel were measured by radioimmunoassay and the effects of the treatment on pituitary and ovarian function were determined by assaying plasma concentrations of LH, FSH, estradiol and progesterone. The results of the first year are presented. Dysmenorrhea, menstrual flow and the number of days of bleeding decreased during the first treatment year. Three spontaneous expulsions occurred; two at the very beginning of the treatment and one after six months of use. Side-effects were few. The plasma level of levonorgestrel remained fairly constant during the observation time of 12 months. Thirty-one of the 36 cycles were ovulatory as judged by plasma progesterone elevations. No pregnancies occurred during the study period of one year.

Adult↗

PubMed1993

Effect of the intrauterine contraceptive device on protein components of human uterine fluid.

The albumin, immunoglobulin G (IgG), immunoglobulin A (IgA), lysozyme, lactoferrin, alpha 1-antitrypsin, alpha 1x-antichymotrypsin, and neutral proteinase levels of uterine fluid and serum of IUD-bearing women were studied in relationship to the phase of the menstrual cycle, the length of IUD implantation and the presence of reported side effects. Selection of these proteins was based on their potential importance in IUD-induced contraceptive action and/or side effects. Generally, only small differences were found in the serum levels of these proteins during the cycle, with different length of implantation or between patients with and without side effects. However, transudation of proteins (albumin, IgG, alpha 1-antitrypsin, alpha 1x-antichymotrypsin) from blood into the uterine cavity was enhanced by the IUD, especially during the postmenstrual and premenstrual periods. The IUD enhanced the local secretory response even more, i.e., the increased release of proteins from the endometrium (lysozyme, neutral proteinase, IgA) and from leukocytes (lysozyme, lactoferrin). Protein changes occurred as the period of insertion increased. These changes in the uterine milieu may account in part for the contraceptive action of the IUD. The secretory proteins rather than the transudation products differed between patients who showed IUD-associated side effects vs. those who did not, implying that IUD-related pathology is primarily associated with changes in local secretory response. The possible role of each protein in the mechanism of IUD action is presented in view of the present findings.

Adult↗

PubMed1994

Background EEG activity in preterm infants: correlation of outcome with selected maturational features.

The aim of this study is to identify normal EEG patterns of preterm infants, characteristic of early postmenstrual ages (PMAs). Quantitative features of EEG background activity have been examined in records from 83 preterm infants within the first 2 weeks of life at a PMA of 27-34 weeks. These subjects presented different cranial ultrasound findings and different outcomes. EEG quantitative data have been compared to the subsequent neurological evolution. We supposed that the features of EEG background activity which were associated with a favourable outcome should be considered as indexes of "normality" of the tracing for that specific PMA. At 27-30 weeks of PMA a high incidence of "temporal sawtooth," a particular rhythmic theta activity detectable in temporal regions, relates to a favourable evolution, therefore it can be assumed that this activity is a normal feature of EEG tracings at this age. On the contrary, a significant correlation between a high incidence of "temporal sawtooth" and an abnormal outcome is observable at 33-34 weeks and leads us to deduce that this pattern should disappear at this time. After 31 weeks other parameters (such as the incidence of 8-20 Hz activities, the length of the intervals and burst duration) show a significant correlation with the outcome.

Brain↗

PubMed1994

Management of early ectopic pregnancy.

OBJECTIVE: Management of early ectopic pregnancy was investigated in a multicenter, prospective study. METHODS: Serum beta-hCG levels were monitored after therapy and correlated to the type of management, gestational age, and initial serum beta-hCG levels in 119 patients with ectopic pregnancies detected at 5-7 postmenstrual weeks. RESULTS: Salpingectomy was performed in 16 patients. No post-operative complications were reported. After conservative laparoscopic surgery of 51 ectopic pregnancies, 9 (18%) had delayed decrease or an increase of serum beta-hCG levels. Re-operations were performed in 4 (7%) patients. Similar findings were noted in 2/6 patients after conservative operations performed by laparotomy. Intrachorionic injection treatment was successful in 17/18 ectopic pregnancies, and expectant management in 7/8 patients with initial serum beta-hCG levels below 250 mIU/ml. CONCLUSIONS: Persistence of trophoblastic activity is a potential complication of conservative surgical treatment of ectopic pregnancy. A detailed diagnosis as early as 6-7 post-menstrual weeks may be the key for future non-surgical management of ectopic pregnancy.

Abortifacient Agents↗

PubMed1994

Metabolic control, food intake and mood during the menstrual cycle in patients with insulin-dependent diabetes.

The impact of menstruation on metabolic control was studied among 20 insulin-dependent diabetics (IDDM) and 20 healthy controls during two menstrual cycles. No systematic fluctuation in glycated protein, blood glucose levels, food intake, intake of mono- and disaccharides, body weight, or mood could be seen during different weeks in the menstrual cycle. A tendency towards menstruation-related variations in the number of insulin reactions and amount of extra injected insulin was observed in the patient group. Levels of glycated protein were significantly (P < 0.05) higher during the premenstruational than during the postmenstruational week, although the difference was small in absolute terms. A poorer mood during the premenstruation weeks (indicating premenstruation syndrome) was associated with a high number of hypoglycemic events (P < 0.01) and frequent changes in insulin doses (P < 0.01). Thus, taken as a group diabetic women do not experience great changes in food intake or metabolic control during the menstrual cycle. This does not exclude the possibility that a small proportion of women have major menstruation related difficulties in controlling their diabetes.

Activities of Daily Living↗

PubMed1995

Hypoalbuminaemia in surgical neonates receiving parenteral nutrition.

The aim of this study was to define the prevalence of hypoalbuminaemia (HA), its predisposing factors, and its effect on outcome in infants. Fifty-six consecutive infants receiving parenteral nutrition (PN) for gastrointestinal disease were divided into two groups according to their lowest measured serum albumin level. The reference range (27.9 to 50.9 g/L) for serum albumin was derived from measurements taken in 37 (22 term and 15 preterm) normal enterally fed newborn infants. HA group (serum albumin < 27.9 g/L) included 15 infants (27%); NA group (serum albumin > or = 27.9 g/L) included 41 infants (73%). HA infants received more albumin than NA infants (median 66 versus 14 mL/kg; P = .005). There was no significant difference between HA and NA groups in gestational age, postmenstrual age at time of start of PN, composition of PN, nor mean weight gain. HA was unrelated to biochemical signs of liver dysfunction, C-reactive protein elevation, septicaemic episodes, or time from operation. HA occurred within the first week of starting PN in 10 infants and returned to normal values within 5 days. HA was a recurrent phenomenon in three patients. Mortality was higher in the HA group (33.3%) than in the NA group (4.9%; P = .02) but was apparently causally unrelated to the low serum albumin level. Hypoalbuminaemia is a common finding in neonates on PN despite the administration of exogenous albumin. Monitoring serum albumin levels in surgical infants on PN seems to be of little clinical value.

Albumins↗

PubMed1987

Female sexual behavior: fluctuations during the menstrual cycle.

This longitudinal prospective study was designed to examine the influence of menstrual cycle phase on female sexuality. Sixty-nine normally cycling women monitored their sexual behavior including both heterosexual and autosexual activities and their basal body temperature daily over two or three consecutive menstrual cycles. Temperature charts were used to ascertain five cycle phases (menstrual, postmenstrual, ovulatory, luteal and premenstrual) and data were analyzed using analyses of variance with repeated measures. The results supported a significant cyclic fluctuation in sexual behavior with both female-initiated and male-initiated sexual activities peaking in the ovulatory phase. Moreover, the findings indicated that women experienced increased sexual arousal and sexual pleasure as they progressed from the menses to the premenstruum. These data suggest that human sexual behavior may be influenced by hormonal fluctuations and cognitive factors associated with the menstrual cycle.

Adolescent↗

PubMed1988

Mood, sexuality, oral contraceptives and the menstrual cycle.

4112 women completed a retrospective questionnaire indicating when during their last menstrual cycle they felt their well-being and sexual interest to be at their best and worst. The commonest pattern was for well-being to be lowest during the premenstrual and highest during the postmenstrual week. Sexual interest was strongly associated with well-being, suggesting that variations of well-being have a powerful effect on sexuality in the majority of women. Oral contraceptive users, though broadly similar in their reported pattern, were less likely to show peaks and troughs of well-being and highs and lows of sexual interest. This was most evident in the subgroup of monophasic pill users who showed the least tendency to variations in both well-being and sexual interest, and a greater tendency to show either peaks or troughs of well-being during menstruation. Triphasic pill users were intermediate between monophasic and non-pill users.

Adult↗

PubMed1993

The impact of oral contraceptives on the experience of perimenstrual mood, clumsiness, food craving and other symptoms.

Two-hundred and seventy-six oral contraceptive (o.c.) users (171 combine o.c. and 105 triphasic o.c.) were compared with 276 non-o.c. users. All women regarded themselves as PMS sufferers, and the groups were matched for age, parity and marital status. Each woman rated severity of 27 symptoms during the premenstrual, menstrual and postmenstrual phases of their last menstrual cycle. The o.c. users reported significantly less menstrual pain and premenstrual breast tenderness. When controlling for the severity of premenstrual depression, there were no differences between the three groups in the timing or severity of perimenstrual food craving or clumsiness. When controlling for the severity of menstrual pain, the o.c. users showed significantly less improvement in negative mood during the menstrual phase, compared with non-users. The apparent tendency for o.c. users to show either a delayed or more prolonged pattern of perimenstrual negative mood deserves further study.

Adolescent↗

PubMed1984

Doppler assessment of the fetoplacental circulation in normal and growth-retarded fetuses.

The Pulsatility Index (PI) of Doppler flow signals from umbilical arteries was used to study flow resistance of the placental villous circulation. A preliminary reference curve of PI values in normal pregnancy was composed from 23 healthy women examined every 2 wk from the 16th postmenstrual week until delivery. The gestational age-related decrease of PI values reflects a reduction of flow resistance in the placental villous circulation. In small-for-date fetuses significantly increased PI values were found, indicating that this simple technique may permit an early diagnosis of compromised fetoplacental circulation, even several weeks to months before fetal growth retardation is clinically presumed.

Blood Flow Velocity↗

PubMed1984

Immediate postabortion insertion of an IUD.

Conception may occur as early as 10 days postabortion. Therefore, immediate postabortum insertion (IPI) of an IUD reduces the danger of exposure to an unwanted pregnancy in the interval and offers better protection against repeat abortion than delayed insertion. Patient motivation to use contraception appears to be highest at the time of termination of an unwanted pregnancy. Complication and pregnancy rates of IPI are comparable with postmenstrual insertion. No serious complications are on record in the world literature; particularly, no cases of infection or perforation have been reported. These facts make IPI not only an acceptable but a highly advisable technique of family planning. In 1977, the American Food and Drug Administration rescinded its earlier prohibition and approved the IPI method. Nulliparous women should be inserted with a copper device, parous women with a Lippes loop.

Abortion, Therapeutic↗

PubMed1983

Acute alcohol intoxication, mood states and alcohol metabolism in women and men.

The course of alcohol absorption and elimination was investigated in seven women and nine men administered a moderate (0.66 ml/kg) dose of 95% ethanol. Women were tested during the postmenstrual phase (Day 6-7), when levels of estrogen and progesterone were estimated to be relatively low. Data reflecting alterations in physical sensations, perceived levels of intoxication, and positive and negative mood states were also collected. Women reached significantly higher peak blood alcohol concentrations (BAC's) than men (p less than 0.01). However, differences in peak BAC's between men and women could be explained by differences in body water content between the sexes. When the raw data on BAC's were corrected for differences in body water content between men and women, no difference in the amount of alcohol metabolized, or in the length of time necessary to metabolize that amount of alcohol, could be found between the sexes. Although women attained higher blood and, presumably, brain levels of ethanol, men did not differ from women in perceived levels of intoxication, physical sensations and mood states. Acute alcohol intoxication appeared to elevate positive mood states during the ascending limb of the BAC curve, but was associated with increased negative affect during the descending limb.

Adult↗

PubMedDate not supplied

Premenstrual changes: patterns and correlates of daily ratings.

Daily ratings of 20 measures of mood, behavior, and physical condition made by 64 women for one menstrual cycle were analysed to determine patterns of covariance between the pre- and postmenstrual periods. Five discriminantly different dimensions of premenstrual change were identified. They were found to be differentially related to a lifetime diagnosis of affective disorder. These results, and others, support the recommendation that research should be focused upon diversified premenstrual changes rather than a single premenstrual syndrome.

Adult↗

PubMedDate not supplied

The relationship between premenstrual dysphoria and daily ratings dimensions.

This study assessed the relationship between premenstrual dysphoria reflected in the Premenstrual Assessment Form (PAF) and the Daily Ratings Form (DRF) dimensions of dysphoric mood, physical discomfort, energy levels, consumption and levels of alcohol, sex and activity. Reports of 59% of women with PAF Major Depressive Syndrome were confirmed by their DRF dysphoric mood score, compared with 27% of women with PAF Minor Depressive Syndrome. Women with confirmed premenstrual dysphoria (PMS + group) had significantly higher levels of mood dysphoria, physical discomfort and lower energy levels than the control group at the premenstrual phase. Higher levels of consumption overall were reported premenstrually than postmenstrually. There were no significant differences between groups on the dimension of more alcohol, sex and activity. Implications for future assessment are discussed.

Adult↗

PubMed1995

Correlates of premenstrual dysphoria in help-seeking women.

Comparisons were made between the premenstrual changes reported by nontreatment-seekers (NTS) (n = 32) and those of treatment-seekers (TS) (n = 52). The Premenstrual Assessment Form Luteal Phase and Follicular Phase versions were completed and the Beck Depression Inventory, the Automatic Thoughts Questionnaire and the State-Trait Anxiety Inventory were completed at both the luteal and follicular phases. Prospective daily ratings were made for two treatment cycles on the Daily Ratings Form and TS were screened for a mood-disorder history. Using the commonly cited 30% decrease in dysphoric levels from the pre- to postmenstrual phases as the criterion of prospective confirmation, women with prospectively confirmed dysphoria (PMD +) were not significantly more symptomatic than those without prospective dysphoric confirmation (PMD -). However, TS were more symptomatic than NTS on measures of depression, anxiety and frequency of negative automatic thoughts but not on mood behaviour and physical changes reflected in the PAF scales. No demographic differences were found between TS and NTS. Results did not support the issue of requiring 'confirmation' of self-reports within a help-seeking group or the use of the 30% criterion in particular. Findings further suggest that the 95-item PAF may be inadequate in differentiating TS from others.

Adult↗

PubMed1983

The maturation of visual acuity in neurologically normal and abnormal newborn infants.

The maturation of visual acuity was studied in 162 neurologically normal and 96 neurologically abnormal newborn infants. Ninety-five percent of the neurologically normal infants developed an acuity of 80 min arc by 35 weeks postmenstrual age (PMA) but only 50% developed an acuity of 40 min arc by 40 weeks PMA. Neurologically abnormal infants, and in particular those with periventricular haemorrhage (PVH), had a delay in the development of acuity. There was a close correlation between the development of 80 min arc acuity and the appearance of the first positivity of the flash visually evoked potential (VEP).

Cerebral Hemorrhage↗

PubMedDate not supplied

Somatosensory evoked potentials in the term newborn.

Median nerve somatosensory evoked potentials (SEPs) were recorded from surface electrodes in 40 healthy term infants (range 36.5-43 weeks postmenstrual age). Electrical stimulation at 5 Hz was used, averaging the response to several runs of 1024 stimuli to each median nerve, bandpass 10-3000 Hz, sweeptime 100 msec. Identifiable potentials were collected over the cervical cord on all runs in all 40 infants and from the cortex in at least some runs in 39 out of 40 infants. The cervical response showed little variation and consisted of a clear negative wave with up to 3 peaks, mean latency of the largest 10.2 +/- 0.7 msec, followed by a positive deflection. The cortical response was very variable in form and latency between infants and to a lesser degree within infants. Four types of cortical wave form were found, symmetrical, asymmetrical, plateau and M shaped, of increasing complexity. In 11% of trials the response was absent or indistinct but could usually be uncovered by alteration in stimulus frequency or intensity. In the whole group, the mean latency for N1 was 30.0 +/- 6.8 msec and for the central conduction time 19.8 +/- 6.5 msec. Significant differences were found between the 4 cortical wave forms in the main variables measured, which gave support for form S being the most primitive and form M the most mature response.

Electric Stimulation↗

PubMed1995

Establishment of normal values for flash visual evoked potentials (VEPs) in preterm infants: a longitudinal study with special reference to two components of the N1 wave.

To establish normal values for flash visual evoked potentials (VEPs) in the preterm period, we analyzed 356 records from 63 neurologically normal infants (26-35 weeks gestation) followed longitudinally. Using both sleep and drowsy state recording within the same session and a mean of 5.7 weekly recording sessions per infant, we hypothesized that the prominent negative wave (N1) consisted of 2 negative components, N1a (early) and N1b (late). This hypothesis could explain the previously reported variability in VEP indices. With a precise definition of the N1a peak, we were able to establish reference ranges for N1a peak latencies at various postmenstrual ages (PMA) which, unlike those previously reported, are narrow enough to be clinically useful. From a cross-sectional analysis we found that the N1a peak latency decreased with maturation at about 4.6 msec/week between 30 and 40 weeks PMA (P < 0.001). We also analyzed the N1 wave form and demonstrated its developmental maturation during this period. There were significant decreases in the amplitudes of both the N1a and N1b peaks with maturation (P < 0.001), but the decrease of the N1a amplitude was steeper than that of N1b. The N1 wave form changed from a wave in which the early peak (N1a) was higher than the late peak (N1b) into the reverse with N1b higher than N1a. This wave change may be related to developmental processes in the visual system. Longitudinal follow-up revealed that extra-uterine life may accelerate the maturation of the N1 wave form but has no effect on the decrease of the absolute values of peak latencies.

Electroencephalography↗