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At least 289 records · Page 16Linked to original sources
PubMed2003

The clientele of traditional birth homes in rural southeastern Nigeria.

Although it is widely documented that traditional birth homes (TBHs) do more than deliver babies, little is known about the other functions in addition to child delivery, which TBHs perform. Drawing on in-depth individual interviews with 13 traditional birth attendants (TBAs) and 147 users of TBHs, we profile the characteristics and health conditions of the clientele of TBHs in four rural communities in southeastern Nigeria. We found that TBHs provide their clients, who are mainly less educated women and girls, health services that range from child delivery, child sex selection, and abortion to family planning and cures for vaginal bleeding. Women are attracted to TBHs because the services are low cost, the women require privacy about their conditions, the TBHs are close by, and the women are confident in the abilities of TBHs. Rural women are bound by poverty, culture, and local values in their choices of services. We assert that health interventions to local people will need to be couched within frameworks that are responsive to their socioeconomic and cultural sensitivities if they are to deliver their expected impact.

Adolescent↗
PubMed1993

Cutaneous manifestations associated with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome: a case-control study.

OBJECTIVE: To study the association of a variety of dermatological manifestations related to vascular abnormalities with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome. METHOD: Case-control study. Consecutive patients referred to the coagulation and haemostasis service of a general hospital for the first determination of antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) and newly diagnosed disorders (for example, thrombocytopenia, thrombotic disorders, and unexplained repeated abortions) were selected. Patients were examined by two dermatologists according to predefined criteria, and information about general characteristics and relevant dermatological and medical histories were collected using an ad hoc questionnaire. The study was limited to patients without evidence of systemic lupus erythematosus. A total of 35 patients was examined; 13 subjects were positive for lupus anticoagulant or anticardiolipin antibodies, or both (cases), and 22 were negative (controls). RESULTS: Moderate to severe livedo reticularis and acrocyanosis were significantly associated with antiphospholipid antibodies, with relative risks of 13.1 (95% confidence interval 1.1 to 149.0) and 8.6 (95% confidence interval 1.1 to 65.1). Capillaritis was also associated with the antibodies. Histories of Raynaud's phenomenon and superficial thrombophlebitis were more common in cases than controls. CONCLUSIONS: This study provides quantitative evidence of the association of antiphospholipid antibodies with several cutaneous diseases in which vascular abnormalities seem to play a major part. The study suggests that these manifestations might appear early in the development of the antiphospholipid syndrome.

Adult↗
PubMed1981

The influence of strain, maternal age, and method of maturation on mouse oocyte aneuploidy.

The chromosome complement of metaphase II oocytes matured by different methods was determined. These oocytes were collected from young and old Swiss-Webster random bred and CBA inbred mice. The results from the two strains were remarkably similar. Superovulation caused no increase in aneuploidy frequencies; however, in vitro maturation resulted in increased hyperploidy rates for oocytes from younger females of both strains. Of the six possible comparisons regarding a maternal age effect, there were no significant increases in hyperploidy. The absence of a maternal age effect on the first meiotic division of oocytes, while such an effect does exist for mid-gestation mouse fetuses, suggests that the maternal age effect on aneuploidy may be due to a decreased ability to select against (abort) aneuploid embryos/fetuses as a function of increasing maternal age.

Aneuploidy↗
PubMed1997

Factors influencing the reliability of oral contraceptives.

BACKGROUND: The reliability of oral contraceptives (OC) is high but several known factors can potentially induce failures. The dose of estrogen (EE) has been reduced through the years. Interaction with concomitant use of other medicine is wellknown and gastroenteritis can reduce the uptake of EE. To further characterize and quantify these factors we have performed this study. METHODS: Among patients admitted for legal abortion we selected those who had taken OC (only combined preparations; gestagen-only preparations were excluded) according to the prescription but nevertheless became pregnant. Various parameters were noted. RESULTS: Among 8058 women 70 women were found. Twenty-nine used three-phased and 25 used low-dose OC while the rest used high-dose, two-phased or unknown OC (four, five and seven patients respectively). Five patients used other medicine concurrently (salbutamol, astemizol, mianserin, chlorcyclizin, paradryl, carbamazepin, lithium, chlorprotoxin and imipramin). Sixteen patients had symptoms of gastroenteritis at the time of conception. Forty-nine patients had failure without any known influencing factors. There was no significant difference between the various OC used by the patients compared to sales of them in Denmark. About two-thirds of the patients wanted to continue with OC as future prevention. CONCLUSIONS: Failure of OC is a rare event but can occur in case of concurrent gastroenteritis or use of other medicine but in many cases, however, no definite cause can be determined. The EE-content of the various OC was not found to have any influence. Although OC-failure had occurred two-thirds of the patients wanted to continue the use of OC.

Adolescent↗
PubMed1999

Surgical treatment of morbid obesity with vertical banded gastroplasty: a comparison between TA90-4.8 and TA90-B.

BACKGROUND: In this study, we wanted to determine the results of vertical banded gastroplasty for morbid obesity and compare the results of using the TA90-4.8 with using the TA90-B instrument. METHODS: Patients with body weight over 100% of or 45 kg above their ideal body weight, body mass index (BMI) over 40 kg/m2, or BMI over 35 kg/m2 with osteoarthritis, venous stasis, sleep apnoea, or frequent abortion were selected for surgical intervention. They were purposely divided into two groups. Vertical banded gastroplasty was performed in group A with two applications of TA90-4.8 (N = 26) and in group B with one application of TA90-B (N = 24). The outlet of the gastric pouch was 10 to 12 mm and reinforced with a 1.5 cm strip of Marlex to give a circumference of 5.5 cm. The follow-up body weight, BMI, and percentage of weight in excess of the ideal weight were compared between the two groups. The results were classified as excellent (0 to 25% excess weight), fair (26 to 50% excess weight), good (51 to 75% excess weight), poor (76 to 100% excess weight), and worse (> 100% excess weight). A failure was defined as a body weight of greater than 76% excess weight and a repeated operation being needed regardless of the ultimate outcome. RESULTS: There were no differences between the two groups regarding age, gender, preoperative body weight, BMI, and excess weight. The operative time was longer for group A (175 +/- 39 min) than for of group B (140 +/- 23 min) (p < 0.0001). In the follow-up period, the postoperative body weight, BMI, and excess weight showed no differences between the two groups. Four patients in group A had poor results, three due to staple disruption and one due to sweet-eating. One patient in group B had stenosis of the stomach pouch and needed another operation to release the stenosis. Thus, five failures (10%) were found in this study. CONCLUSION: Vertical banded gastroplasty is an effective modality for treating morbid obesity. Two applications of TA90-4.8 are not recommended because they result in frequent staple disruption.

Adult↗
PubMed2001

[Anesthetic management of parturients with Marfan syndrome].

Ten pregnancies and 7 deliveries in 5 patients of Marfan syndrome were managed at our institution. Three patients were delivered with a cesarean section under general anesthesia, and one was delivered under epidural anesthesia. Three underwent vaginal delivery with epidural anesthesia. Two patients selected induced abortion, and one had a spontaneous abortion. Six of 7 neonates and all 5 mothers survived without any sequela. One had intrauterine fetal death due to dissection of aortic aneurysm. Simultaneous cesarean section and cardiovascular operation under cardiopulmonary bypass were performed in one case. In the parturient without progress of cardiovascular complication during pregnancy, painless labor under epidural anesthesia is our first choice to minimize hemodynamic derangement. Invasive arterial blood pressure and central venous pressure were monitored in all cases of vaginal delivery for tight hemodynamic control. Epidural anesthesia is also preferred in cases of elective cesarean section for obstetric indication. Emergency cesarean sections are performed in the cases of progressive dissection and urgent obstetric indication. General anesthesia was induced with fentanyl and midazolam to minimize cardiovascular response to tracheal intubation. We emphasize that evaluation of cardiovascular status and multidisciplinary approach are the key in the anesthetic management of parturients with Marfan syndrome.

Adult↗
PubMedDate not supplied

Does family interaction prevent adolescent pregnancy?

This study uses data from the 1982 National Survey of Family Growth to ascertain whether family interaction can avert adolescent sexual activity, pregnancy, childbearing and parenthood. The results obtained from using logistic regression procedures indicate that the family may be effective in increasing adolescents' use of contraceptives and selection of abortion or adoption as alternatives to parenthood. Family interaction, however, was not associated with forestalling adolescent sexual activity or with providing for the well-being of the adolescent and her child and it is unlikely that a policy based solely on family interaction will be effective. Characteristics associated with effectiveness in preventing adolescent pregnancy included race, religion, residence, mother's education, the adolescent's age and family income.

Abortion, Legal↗
PubMed1983

Pure yeast RNA polymerase B (II) initiates transcription at specific points on supercoiled yeast DNA.

Pure yeast RNA polmymerase B (II) can selectively initiate abortive transcription on a supercoiled recombinant plasmid DNA carrying yeast DNA in the presence of low concentrations of ribonucleoside triphosphates and Mn2+. Five major products ranging between 60 and 150 nucleotides were characterized by hybridization. Three of them originate from the vector pBR322 and two from the yeast DNA insert. Based on a RNA primer extension reaction with recombinant M13 DNAs as template, a method allowing the mapping of the short abortive RNA products has been developed. An initiation site within the yeast DNA insert has thus precisely been mapped. The DNA sequence in this region was determined and showed several relevant features. The in vitro initiation site is preceded by a potential TATATATA box at -40 base pairs and at -105 by the sequence GTTAATCT similar to the consensus sequence GCTCAATCT usually found around 80 base pairs upstream from the cap site. Large blocks of alternated purine pyrimidine residues are found in this region as for several known yeast promotors. The 5' end of the RNA initiated from this site contains several potential signals for the initiation of translation. The possibility that a B to Z transition of DNA could be important for the interaction of the RNA polymerase with its template is discussed.

Base Sequence↗
PubMed1978

Monitoring care in abortion clinics.

Medical directors of clinics must monitor three aspects of service to ensure high-quality care in abortion clinics: (1) physician training and selection, (2) patient selection, and (3) abortion outcome monitoring as a means of providing an ongoing audit of clinic performance standards. Methods and criteria for monitoring and evaluating these parameters are discussed, and the importance of such monitoring is emphasized.

Abortion, Induced↗
PubMed1994

[Ethical observations concerning the limitations of medical duty to treat in severely handicapped neonates].

The author places the new treatment options of neonatal intensive care units into the framework of modern medicine in general. Paradoxical situations emerge. In one section of the hospital, premature newborn babies are treated in the intensive-care unit, and in another section others are selected for abortion. A late interruption is often an early labour and delivery. The right to live for every person is formulated in the text. The problems concerning viability and perspectives for life of premature or handicapped newborn babies makes it impossible to formulate a list of situations in which the duty to treat can be disregarded. The only treatment limit is complete brain-death. The parents of the child are the ones most affected by its disabilities; therefore, they must be included in the process of decision-making. There is no right for a healthy child, but a right of the child for acceptance and appropriate care by parents and a stable society.

Child Advocacy↗