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Incidence of actinomycetes infection in women using intrauterine contraceptive devices.

Pancervicovaginal smears taken from 350 women using an intrauterine contraceptive device (IUD) were screened for the presence of actinomycetes organisms. Of the 12 cases in which actinomycetes-like organisms were seen in Papanicolaou-stained smears, the presence of actinomycetes organisms was confirmed by immunofluorescence in 10 cases. The prevalence of actinomycetes infection was thus 2.8% (10 of 350 cases) in the IUD users. Eight (4.3%) of 173 symptomatic subjects had actinomycetes infections. Two of the positive cases were asymptomatic. Eight of the ten patients with confirmed actinomycetes infection were using the Cu T device while two were wearing the Lippes Loop IUD. Seven of the ten patients had been using an IUD for more than two years. The time of insertion of the IUD (postpuerperal, postmenstrual or after medical termination of pregnancy) did not show any correlation with the presence of actinomycetes infection. Actinomyces israelii was responsible for the infection in eight cases while Arachnia propionica was seen in two cases. The organisms could not be grown in culture.

Actinomyces↗

Evaluating premenstrual symptoms in medical practice.

Essential diagnostic criteria for evaluating premenstrual syndrome (PMS) symptoms are marked change in intensity of symptoms measured on postmenstrual and premenstrual days and documentation of changes for at least two cycles. Four symptom evaluation methods in a PMS treatment program are compared and discussed: physician interview, menstrual symptom questionnaire, daily symptom ratings, and the Hopkins symptom checklist. Data from 241 patients who met the criteria for marked change in symptoms show that premenstrual symptom levels are severe, a subgroup has moderate symptoms continuing in the follicular phase, and that emotional symptoms are predominant. Diagnostic evaluation needs to distinguish menstrually related disorder from undiagnosed physical or psychiatric illness. Further research is needed to identify a classification system of multiple subtypes of menstrual disorders.

Adult↗

[Histochemical examination of the endometrium following laparoscopic follicle puncture for the collection of ovocytes].

The ovarian follicles of six normocyclic women were laparoscopically punctured and aspirated on the eleventh or twelfth postmenstrual day of the cycle. Ovocytes and follicular fluid are characterised. Endometrial biopsies were taken of the patients concerned, after two days or so had been allowed to pass.--On histochemical evaluation, the abraded material seemed to exhibit early signs of beginning secretion as a "normal" endometrial response to artificial follicular rupture. The findings are discussed with reference to unanswered questions regarding in vitro fertilisation of human probands.

Endometrium↗

[Physical fitness during pregnancy].

In a study of longitudinal section 25 primigravidae were examined during pregnancy on the bicycle ergometer. A group of 10 non-pregnant women in their postmenstrual phase was used as controls. Blood glucose, cholesterol, triglyceride and lactic acid were analysed parameters in addition to cardiorespiratory. The reaction of the cardiovascular system to submaximal load in healthy pregnant women is economic. The metabolic system reacts with an intensified availability of energy via fat-metabolism and a diminished utilisation of glucose. Pregnancy is a physical stimulus for the female organism.

Adult↗

The relationship of selenium status to respiratory outcome in the very low birth weight infant.

OBJECTIVE: To examine the relationship between plasma and erythrocyte selenium and glutathione peroxidase (GPx) levels in premature infants and outcome measures. DESIGN: Prospective observational longitudinal study. SETTING: Two regional neonatal intensive care units in the South Island of New Zealand, an area with low soil selenium. PATIENTS: Seventy-nine infants with birth weights less than 1500 g or gestation less than 32 weeks admitted within 48 hours of birth from November 1992 through November 1993. MAIN OUTCOME MEASURES: Oxygen requirement at 28 days (chronic lung disease), or 36 weeks postmenstrual age and for all or most of the time from birth (bronchopulmonary dysplasia), total days in oxygen, retinopathy of prematurity, periventricular hemorrhage, or ventricular dilatation. RESULTS: Initial infant plasma selenium and GPx levels were about two thirds of maternal levels and fell a further 30% in 28 days. In contrast to adults, there was a poor correlation in infant plasma between selenium and GPx at birth and 28 days. Plasma selenium at 28 days was significantly lower in infants with chronic lung disease and bronchopulmonary dysplasia. After controlling for gestational age and age when fully fed orally, 28-day plasma selenium was significantly associated with the log of total days of oxygen requirement, each drop of 0.1 mumol/L in 28-day selenium being associated with a 58% increase in days of oxygen dependency. No significant associations of other parameters of selenium status and respiratory outcome were found, and there were no significant associations of any parameters of selenium status with other outcome measures. CONCLUSIONS: This study demonstrates for the first time in human infants that low plasma selenium levels are significantly associated with an increased respiratory morbidity. Whether selenium deficiency is etiologically important in determining the respiratory outcome or the result of sickness in the infant should be investigated in a randomized, controlled trial.

Bronchopulmonary Dysplasia↗

[Optimal (screening) time for detection of therapy-relevant stages of retinopathia praematurorum].

Screening tests for retinopathy of prematurity (ROP) focus on the detection of children in whom the progression of ROP may require therapy. The stages needing therapy must be detected reliably and in time. The frequency of examinations should be limited to the amount needed. We tried to determine whether or not there is a specific time point that can be recommended for the first examination. From 1987 to 1991 we examined 343 children who had been premature or term babies. Only among the 178 immature children with a birth weight of < or = 1500 g were severe stages of ROP found. Of 51 children, 1 child (2%) with a birth weight of between 1500 and 1250 g showed ROP stage 3; 4 children had ROP stage 2 (8%). The birth weight was under 1250 g in 127 prematures. Among these children, ROP progression to stage 2 was found in 119 (15%) and stage 3 in 9 (7%) cases. Independent of the highest stage, stage 2 first occurred 4-24 weeks postnatally, stage 3 between 4 and 20 weeks postnatally. If the highest stage did not occur before menstruation age, stage 2 did not occur before week 34 and stage 3 not before 35 weeks. In comparison to the postnatal age, calculation based on the postmenstrual age allows better individual comparability regarding the onset of ROP stages requiring therapy. Our results suggest that the first ophthalmological examination should be between 32 and 34 weeks after the start of menstruation. Unnecessary examinations of very immature children can be avoided without missing the development of ROP requiring therapy.

Birth Weight↗

[Posture in preterm infants is not a good indicator of brain damage].

The development of posture during the prenatal period was studied longitudinally in 12 matched pairs of low-risk and high-risk preterm infants. The gestational age of the infants in both groups ranged from 28 to 36 weeks. The two members of each pair had the same gestational age at birth and the video recordings were performed at the same postmenstrual age. They were filmed more than three times during the prenatal period, each video recording lasting 1 h. Time of occurrence and duration of each posture were analyzed from replay of the video recordings. No age-specific preference posture described in the literature was found from birth until the term age between two groups. There was no age-related tendency in duration and frequency of postures between two groups. There was a clear-cut dominant head position to the right side from 31 weeks onward. Asymmetrical tonic neck postures (ATN) were very inconsistently present before the term age. And there was no significant difference in the occurrence of ATN postures between two groups. We could not find any specific abnormal postures in the high-risk group. Our study suggested that posture in preterm infants is not a good indicator of brain damage in the prenatal period.

Brain Injuries↗

[Ovarian cycle and school-notes (scores) (author's transl)].

Girls 14 to 16 years of age, menstruating regularly and with a stabile cycle, were tested every school-day by a dictation in their slovakian language. Mistakes were counted and analysed statistically. The girls were interviewed about their cycle. Their capacity to write down the text correctly was different in the four phases of the cycle (P less than 0,001). Most mistakes were made in the premenstrual phase, results were found in the four days of the menstruum. Divided in terziles according to their capacity, the girls of the best terzile had their optimum in the postmenstrual phase, whereas the girls in the medium and in the lower tezile had their optimum during the menstruation.

Adolescent↗

[Evaluation of published recommendations for screening studies of retinopathy of prematurity].

PURPOSE: Evaluation of different and partially contradictory guidelines for screening for retinopathy of prematurity published in Germany. PATIENTS: The data on 1219 preterm infants examined in Bern (n = 900) and Berlin (n = 319) were analyzed. A total of 680 preterm infants (56%) had a birth weight below 1500 g. The remaining infants were examined because oxygen had to be supplied or surgery done before or around the estimated delivery time. RESULTS: Stage 3 retinopathy was found in 88/1219 (7.2%) preterm infants. Only 5/88 infants weighed more than 1500 g at birth. Three of these infants had a birth weight below 2000 g and needed supplemental oxygen for a prolonged period of time. The other 2 infants had birth weights of more than 2000 g and were severely ill. Of 1219 preterm infants, 37 (3%) developed threshold retinopathy (according to the criteria of the multicenter trial); 35/37 infants weighed less than 1230 g at birth. The remaining 2 children (1650 g and 2185 g birth weight) were severely ill. CONCLUSIONS: Preterm infants should be screened for retinopathy of prematurity: (1) if the birth weight is below 1500 g; (2) if the birth weight is below 2000 g and oxygen supply was necessary for more than 30 days; (3) if infants are very sick or must undergo multiple surgery before term. The first examination should be scheduled for the 6th week postnatal and not before 31 weeks postmenstrual age.

Berlin↗

[Premenstrual symptomatology in rural and urban zones].

The objective of this study was to stablish the prevalence and severity of premenstrual symptoms in mexican women who live in a rural zone (n = 50) and in other group who live in a urban zone (n = 50). The Menstrual Distress Questionnaire (MDQ) was applied during the premenstrual and postmenstrual phases of one menstrual cycle. The 97% of the sample presented at least one premenstrual physical symptom, and the 95% of the women presented one psychological-behavioral symptom. There were not differences according with the severity of the physical symptoms between both groups of women. However, women in the urban zone reported more severe psychological-behavioral symptoms then the ones who live in the rural zone.

Adolescent↗

Ocular fundus morphology in preterm children. Influence of gestational age, birth size, perinatal morbidity, and postnatal growth.

PURPOSE: To determine the influence of gestational age, birth size, perinatal morbidity, and postnatal growth on fundus morphology in preterm children using digital image analysis of fundus photographs. METHODS: Thirty-nine preterm children (mean postmenstrual gestational age, 29.1 weeks; range, 24.6 to 32) were included in the study. Thirty-nine healthy children, born at term, were used as control subjects. Fundus photographs were obtained at a mean age of 4.8 years (preterm) and 6.1 years (control subjects). RESULTS: There was no difference in optic disc, excavation, or peripapillary crescent area between the two groups. In the group of preterm children, a large optic disc size was associated with a low birth weight (rs = -0.29, P = 0.07), duration of assisted ventilation (rs = 0.43, P = 0.006), and number of blood transfusions (rs = 0.33, P = 0.04). The girls born prematurely showed a negative relation between the length of gestation and the area of the optic disc (r2 = 0.28, P = 0.009). No such relation was found in boys. The preterm children had increased tortuosity of retinal vessels (P < 0.001 and P < 0.002 for arteries and veins, respectively) and reduced number of vascular branching points (P < 0.001) compared with those of the control subjects. There were no associations between these vascular abnormalities and the perinatal and postnatal variables studied. CONCLUSIONS: No difference in optic disc morphology between preterm children and control subjects was found. However, preterm birth seems to affect the retinal vascular pattern close to the optic disc, independently of retinopathy of prematurity. Among the girls born preterm, optic disc size was negatively correlated to gestational age.

Birth Weight↗

Lysine clonixinate in the treatment of primary dysmenorrhea.

The efficacy and tolerance of Lysine Clonixinate (LC), a NSAID with prostaglandin synthesis inhibiting mechanism was studied in 24 patients with primary dysmenorrhea according to a double-blind randomized crossover Placebo (P) controlled design with patients serving as their own controls. Treatment consisted in administering 1 tablet of LC or P q6h as from onset of menstrual pain during 5 days and 6 menstrual cycles. Patients were controlled monthly as from the 5th day of the cycle, rating changes in pain intensity according to a 4-point scale, presence of pain during pre-, post- and menstrual periods; possible intracycle changes, amount of bleeding, tolerance and related total and general signs and symptoms. Intensity of baseline menstrual pain amounted to 2.9. Menstrual, intramenstrual and postmenstrual pains were observed in 19 out of 24, 24/24 and only 2 out of the 24 patients, respectively. Concomitant symptoms consisted in headache (12), mastalgia (14) and discomfort (12). Results were obtained by averaging the data from the treatment periods with each drug. Menstrual pain was reduced from 2.9 +/- 0.7 to 1.9 +/- 0.7 with P administration and to 0.66 +/- 0.4 with the administration of LC, a highly significant difference between treatments (p < 0.0001). Premenstrual pain was reduced nonsignificantly from 0.79% to 0.58% with P administration and significantly to 0.29% with administration of LC (p < 0.001). Intramenstrual pain affecting all patients at baseline was reduced significantly by 9% with P and also significantly by 50% with LC (p < 0.001). No differences were encountered in concomitant symptoms during P treatment periods while the incidence was significantly reduced with LC (p < 0.0001). No changes in cycle duration or amount of bleeding were observed between treatments. No adverse events were reported.

Adult↗

[Response of the functional system of respiration to the cyclic changes of the hormonal state in women].

Examinations of the respiration, blood flow, blood respiratory function, oxygen intake, mental and physical performance of 116 female athletes going in cyclic and acyclic sports during a menstrual cycle significantly altering the female status ascertained that the status of the respiratory system varied with these changes. High economic benefits of respiratory function and oxygen regimens of the body, high breathing reserves in the postmenstrual and postvalutional phases of a menstrual cycles were found to make the female athletes show higher working capacities in these phases. In addition to instrumental determinations, computer-aided simulation of the body's oxygen regimens and respiratory functional system was used to calculate oxygen parameters and the magnitude of respiratory functional changes during a menstrual cycle.

Computer Simulation↗

Relationship of estradiol and progesterone levels to uterine blood flow during early pregnancy.

The purpose of this study was to examine the relationship of uterine blood flow to serum estradiol and progesterone during early pregnancy. Recumbent uterine artery average velocity, diameter, blood flow volume and uterine and spiral artery resistance were measured using vaginal Doppler ultrasound 118 times in 43 patients during gestational (postmenstrual) weeks 5 to 16. Relationships to serum progesterone and estrogen were analyzed before and after week 10, when intervillous circulation begins, by multiple linear regression analysis and analysis of covariance (ANCOVA) to correct for the effect of gestational age. After correction for gestational age, estradiol was negatively related to uterine artery flow volume (p < 0.05), diameter (p < 0.05), pulsatility index (p < 0.05) and resistance index (p < 0.01) for weeks 5-16 and to diameter (p < 0.05) after week 9. Progesterone was positively related to volume (p < 0.05) and velocity (p < 0.01) for weeks 5-16 and to volume (p < 0.05) for weeks 5 to 9. Spiral artery indices of resistance were unrelated to hormone levels. These results indicate that before the 10th gestational week, uterine blood flow volume is related to progesterone, but not estradiol levels, and suggest that high estradiol levels during and after the 10th week may be associated with decreased uterine blood flow volume.

Adult↗

Pre-discharge outcomes of 22-27 weeks gestational age infants born at tertiary care centers in Connecticut implications for perinatal management.

There is a lack of regional data on survival and morbidity of extremely premature infants born and resuscitated at tertiary care centers. This study analyzes such data from three tertiary care perinatal centers in Connecticut and provides a paradigm for its use in developing guidelines for evidence-based ethical considerations in infants at the threshold of viability. Outcomes of inborn infants 22 to 27 weeks gestation (based on obstetric estimates) who were actively resuscitated at three regional perinatal tertiary-care centers (representing 80% of such infants from Connecticut) were studied retrospectively. Survival and cumulative major morbidities at discharge, stratified by gestational age, were analyzed. Of the 405 infants studied, 278 (69%) survived to discharge. There were no survivors beyond three days at 22 weeks gestational age. Unfavorable outcome defined as death or major morbidity (> or = grade 2 intraventricular hemorrhage, periventricular leukomalacia, > or = Stage 3 retinopathy of prematurity, necrotizing enterocolitis > or = Stage 2, and severe bronchopulmonary dysplasia at 36 weeks postmenstrual age.) was seen in > 85% of 23 and 24 weeks gestation infants. At 25 weeks approximately equal to 30% of infants were discharged without an unfavorable outcome. At 26 and 27 weeks gestation 43% and 61% respectively escaped unfavorable outcomes with > 85% rates of survival. Current regional data such as these would help in developing guidelines for the perinatal management of premature infants at the threshold of viability.

Chi-Square Distribution↗

MR features of developing periventricular white matter in preterm infants: evidence of glial cell migration.

PURPOSE: MR imaging of the brain is increasingly used in the investigation of the newborn, but little information is available on the normal appearance of the developing brain. We scanned a series of newborn infants in an attempt to define the normal appearance of developing periventricular white matter and to assess how pathologic conditions may modify this appearance. METHODS: Sixty-eight newborn infants, median postmenstrual age (PMA) 34 weeks (range, 24 to 42 weeks), were subdivided into two groups: group A (n = 33), which included those with normal clinical and sonographic examinations, and group B (n = 35), which contained those with evidence of neuroabnormality detected prior to the MR study, either clinically or by cerebral sonography. Images were acquired in two planes on a 1.5-T imager using turbo spin-echo pulse sequences. RESULTS: Symmetric periventricular bands of reduced signal intensity were noted in the frontal periventricular white matter on T2-weighted images in 98% of group A infants and in 97% of group B infants. The number of bands was inversely related to PMA. The reduction in number of bands with increasing PMA was delayed in group B infants. CONCLUSION: The uniform appearance of periventricular bands in a population of healthy infants and their relationship to the infants' maturity is consistent with the results of previous histologic studies. These studies demonstrate the presence of migrating glial cells within the periventricular white matter of infants beyond 20 weeks' gestation, when neuronal migration to the cortex is complete. We postulate that the bands seen on T2-weighted images represent groups of migrating glial cells, providing a further marker of cerebral maturation.

Brain↗

[Coping with anger and the premenstrual syndrome].

OBJECTIVE: Investigations in recent years confirm the importance of "anger coping-behaviour" for women suffering from different diseases such as migraine, high blood pressure and coronary heart disease. The hypothesis for this investigation was that "anger-in" coping (anger-suppression) is a possible causal factor in the premenstrual syndrome. METHODS: Data analysis was undertaken on 38 patients (average age 32 years) fulfilling the inclusion criteria. The Menstrual Distress Questionnaire (MDQ) was used for measuring the intensity of premenstrual symptoms. As a result of a cluster analysis of MDQ scores, the 38 patients were divided into 3 subgroups (group 1: mild symptoms, n = 16; group 2: moderate symptoms, n = 10; groups 3: severe symptoms, n = 12). The 3 groups were compared by using different questionnaires regarding the variables anger, attitudes to menarche and menstrual bleeding, anxiety and depression. Additionally, sociodemographic data were obtained and a daily record taken for 2 days premenstrually and 5 day postmenstrually of subjective replies to a standardized protocol. RESULTS: Contrary to our expectations the results showed no significant differences for "anger coping" between the 3 subgroups. Increased daily stress (professional and familial double load) statistically significantly influenced the intensity of premenstrual symptoms. Additional significant factors were a general tendency towards somatization disorder, a negative attitude toward menarche and menstrual bleeding, as well as a tendency to depressive mood in patients with severe premenstrual symptoms. CONCLUSION: Emotional disorders (anger, anxiety) showed less influence on the premenstrual syndrome in the investigated women than daily stress and medical anamnesis.

Adaptation, Psychological↗

Timing of the IUD insertion.

The relationship between the time in the menstrual cycle when a TCu-200 or Cu-7-200 is inserted and subsequent IUD-related events was evaluated. For women who had either TCus or Cu-7s inserted, the pregnancy, expulsion and medical removal rates were similar for insertions performed at any time of the menstrual cycle.

Aging↗