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PubMed2003

Investigation on the efficacy of meloxicam in sows with mastitis-metritis-agalactia syndrome.

The efficacy of meloxicam in the treatment of sows with mastitis-metritis-agalactia syndrome was investigated in comparison with flunixin. Basic therapy comprised administration of an antibiotic and oxytocin. A total of 200 sows and litters were examined in a double-blind clinical study with observations up to 8 days after the first treatment. The primary parameter, the clinical index score on day 2, consisting of rectal temperature, feed intake, general demeanour, respiratory rate, vaginal discharge, degree of inflammation of mammary glands, milk flow and nursing behaviour, revealed a significant (P < or = 0.05) non-inferiority of meloxicam in comparison with flunixin implying equal efficacy of both drugs. No significant differences were noted in the distribution of clinical efficacy scores within both groups at each day of examination. The differences in litter weight and daily weight gain per piglet were not significant between the two test groups. The mortality rates until day 8 of the study were without significant difference between groups. In piglets of diseased litters, however, the mortality rate was 50% lower in the meloxicam group in comparison with the reference group, this difference reaching statistical significance (P < or = 0.05).

Animals↗
PubMed1997

Stroke and pregnancy.

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Antibodies, Antiphospholipid↗
PubMed2006

Factors associated with postpartum physical and mental morbidity among women with known HIV status in Lusaka, Zambia.

The objective of our study was to investigate factors associated with postpartum physical and mental morbidity among women in Lusaka, Zambia with particular reference to known HIV status. Our study was part of the Breastfeeding and Postpartum Health (BFPH) longitudinal cohort study conducted between June 2001 and July 2003. Women were recruited at 34 weeks gestation and followed up to 16 weeks postpartum. Data on maternal health were collected at 3, 7, 10, and 14 days and at 3, 4, 5, 6, 9, 12, and 16 weeks postpartum. Maternal mental health data were collected from April 2002 onwards at recruitment and at seven days and six weeks postpartum. Data on physical morbidity were collected for 429 women (218 HIV-negative, 211 HIV-positive) and data on mental morbidity were collected for 272 women (134 HIV-negative, 138 HIV-positive). Multivariate logistic regression was used to examine factors associated with postpartum physical or mental morbidity. Postpartum physical morbidity was associated with HIV status, parity > or =5 and age < 20 years. Neither antenatal nor postpartum mental morbidity, as indicated by a self-reporting questionnaire 20-item (SRQ-20) score > or =7, were associated with HIV status or with postpartum physical morbidity in this population. Larger comparative studies are required to corroborate or contest these findings.

Adolescent↗
PubMed2000

Postpartum headache after epidural blood patch: investigation and diagnosis.

Use of an epidural blood patch to treat spinal headache after accidental dural puncture is well recognized. The high success rate associated with this practice has been questioned and it is not uncommon for patients to suffer recurring headaches after a supposedly successful blood patch. We describe a patient in labour who suffered accidental dural puncture, and whose headache was treated twice with an epidural blood patch. Despite this, the headache persisted. The case highlights the difficulty in the diagnosis of headache in the postnatal period in patients who have had regional analgesia and the importance of considering an alternative pathology, even if epidural blood patching has been successful. In this case, a diagnosis of cortical vein thrombosis was made. The incidence, presentation, aetiology and treatment of this rare condition is described.

Adult↗
PubMed1986

Susceptibility to drug-induced hypotension in post-partum psychosis.

Three consecutive cases of post-partum psychosis, admitted to a specialist unit, developed severe postural hypotension during treatment with standard doses of antipsychotic drugs. Post-partum patients may be particularly vulnerable to this side-effect, and the possible role of alpha-adrenoceptors in mediating this increased susceptibility to hypotension is discussed. It is suggested that antipsychotic drugs with relatively selective dopamine-blocking activity may be specifically indicated in the treatment of post-partum psychosis.

Adult↗
PubMed2004

Hemicrania continua postpartum.

Hemicrania continua is a common, but unrecognized headache disorder. We describe two patients with hemicrania continua whose symptoms started in the postpartum period, coined as hemicrania continua postpartum.

Adult↗
PubMed1995

Anemia and insufficient milk in first-time mothers.

Insufficient milk is a poorly understood problem that is often identified as a major reason for early discontinuation of breastfeeding. This study explored the relationship between anemia and insufficient milk in 630 first-time mothers. The frequency of anemia (postpartum hemoglobin < 10 g/dL) was 22 percent. Anemic mothers reported a higher level of symptomatology associated with insufficient milk and were more frequently classified as having insufficient milk syndrome. Mothers with the syndrome reported a shorter period of full breastfeeding, and weaned at an earlier age. They identified not having enough milk, baby nursing too often, and baby not gaining enough weight as the main reasons for discontinuing breastfeeding, compared with baby's disinterest and conflicts with school or work as main reasons among mothers not reporting symptoms related to insufficient milk syndrome. The study results suggest that anemia is associated with the development of insufficient milk, which in turn, is related to duration of full breastfeeding and to age at weaning.

Adolescent↗
PubMed1991

Etiopathogenesis and prognosis of cerebral ischemia in young adults. A survey of 155 treated patients.

Etiology and long-term prognosis were prospectively investigated in 155 consecutive patients (96 men and 59 women), aged 16 to 45 years, referred to our Neurosurgical Unit with cerebral transient ischemic attacks or infarction during the period 1978-1988. All patients underwent neurological and medical-cardiological evaluation, cerebral computerized tomography scanning, electrocardiogram, and laboratory tests. Two-dimensional echocardiography was performed in 123 cases (79%), cerebral angiography in 147 (95%). Atherosclerosis was the leading etiology occurring in 48 patients (31%). A cardioembolic disorder was considered the probable cause of ischemia in 8 cases (5.1%). Further possible etiologies were contraceptive pill assumption (5.8% of the total, but 15.3% within the female group), spontaneous arterial dissection (4.5%), migraine (4%), puerperium (2.6%), cervical trauma (2.6%), and other, more uncommon conditions. Despite extensive evaluation, the cause of cerebral ischemia remained unknown in 40% of cases. All patients received antiplatelet medication and 16 underwent surgery. The long-term outcome at a mean follow-up of 5.8 years was favorable: 91% of subjects resumed their work on a full or part-time basis.

Adolescent↗
PubMed1987

Psychotropic drugs.

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Anti-Anxiety Agents↗
PubMed2001

The use of psychotropic medications during breast-feeding.

OBJECTIVE: The authors reviewed the risks and benefits regarding the use of psychiatric medications during breast-feeding as they relate to the health and well-being of mothers and their infants. Strategies are discussed to limit infant exposure to a medication while effectively treating the nursing mother. METHOD: A MEDLINE search of the literature since 1955 was conducted to determine the use of psychotropic medications in breast-feeding women. Search items included each of the categories of psychopharmacologic agents as well as each of the agents in association with nursing, breast-feeding, postpartum, lactation, and breast milk. RESULTS: No controlled studies on the safety of psychotropic medications in nursing mothers were found. Case reports and small case series for each of the different psychotropic medications serve as the basis for suggested treatment guidelines for the management of psychiatric illnesses in breast-feeding women. Thus, each case needs to be considered on an individual basis, with a thoughtful analysis of the risks and benefits of nursing and exposure of the infant to medication. The baseline clinical status of the infant should also be reviewed. CONCLUSIONS: Women are vulnerable postpartum to psychiatric disorders and frequently face the need to decide whether to take psychotropic medications while breast-feeding. Should psychiatric medication be indicated, the parents should be provided with the available information regarding the effects of these medications on the neonate. In this way, an informed decision can be made. When psychotropic medication is used during breast-feeding, it is strongly recommended that the infant's pediatrician be involved in monitoring the infant.

Breast Feeding↗
PubMed1975

The mental content of puerperal psychoses.

The mental concept of puerperal psychoses is considered as having important determinants in body image disturbances. A case is presented of a woman who had had postpartum psychiatric disorders after the birth of each of her two daughters, and who suffered a relapse in identification with her parturient younger daughter.

Body Image↗
PubMed1984

Guidelines for treatment of psychosis during pregnancy.

Treatment of the acutely psychotic pregnant woman presents therapeutic problems for the psychiatrist and the inpatient unit. Controlled studies of the comparative efficacy of therapeutic modalities during pregnancy are lacking, and the literature on the morphological and behavioral teratogenicity of somatic treatments does not lead to definitive conclusions about their safety in pregnancy. The authors review studies in those areas, focusing on the use of psychotropic drugs. Guidelines for treating psychotic pregnant patients in the last six months of pregnancy and the immediate postpartum period are outlined.

Abnormalities, Drug-Induced↗
PubMed2003

Outpatient psychotherapy for mothers--first empirical results.

MOTHERHOOD is a vulnerable phase in the life of any woman, one that may be associated with an increased risk of mental illness. Despite the major clinical significance of this patient group, only a few psychotherapeutic treatment programs are tailored to the needs of mothers of infants. Even when treatment is urgently needed, many mothers of infants reject inpatient psychotherapy so as not to be separated from their children. The outcome may be chronification of disorders, in some cases with a negative impact on their children's development. A new psychotherapeutic outpatient treatment program adapted to the special needs of mothers and offering a substitute to inpatient treatment is presented. First empirical results show that the presented treatment concept led to significant improvements in the symptoms, whose stabilization continued up to the follow-up two years after the start of therapy.

Adult↗
PubMed1997

A benign form of isolated angiitis of the central nervous system in puerperium: an identical disorder to postpartum cerebral angiopathy?

A case of isolated angiitis of the central nervous system (IACNS) in puerperium with a clinical presentation of bilateral frontal lobe hemorrhage is described. Her symptoms and arteriographic abnormalities were resolved by institution of corticosteroid. After cessation of steroid treatment she showed no evidence of relapse. This case indicates that there appears to be a benign form of IACNS, although the etiology of postpartum IACNS is not known. The postpartum cerebral angiopathy described in the literature may be an identical disorder, since there are no clinical points of specific distinction between them.

Adult↗
PubMed1992

Cocaine use and post partum psychiatric symptoms.

The association of mental health symptoms with cocaine use was studied among post partum women. Gestational cocaine use was determined by confidential interview or urine assay. A structured Psychiatric Symptom Index was used to measure mental health symptoms. Among 155 women, 24 (15%) used cocaine. Cocaine-using women had less education, higher parity, less weight gain during pregnancy, and used more cigarettes, marijuana, and opiates in pregnancy than nonusers. High frequency of symptoms (standardized Psychiatric Symptom Index score greater than or equal to 20) was found in 71% of women for the Total Index score, 81% on depression, 61% on anxiety, 36% on cognitive disturbance, and 75% on anger. No differences in Psychiatric Symptom Index Total or factor scores were associated with cocaine use.

Adult↗