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Results for “Postmenstruation”

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At least 127 records · Page 7Linked to original sources

PubMed2006

Early provision of parenteral amino acids in extremely low birth weight infants: relation to growth and neurodevelopmental outcome.

OBJECTIVE: To determine if postnatal growth failure exerts an adverse effect on subsequent growth and neurodevelopment. STUDY DESIGN: A secondary analysis of 1018 infants who were enrolled in a randomized, clinical trial of glutamine supplementation was performed to determine whether early provision of parenteral amino acids (AA) is associated with better growth and neurodevelopmental outcomes. Infants were stratified by whether they were provided > or =3 g/kg per day of AA at < or =5 days of life (early; n = 182) or not (late; n = 836). RESULTS: At 36 weeks' postmenstrual age, significant differences were found in weight, length, and head circumference in favor of the infants who received early AA; the odds of having weight less than the 10(th) percentile for age was 4-fold higher for infants in the late group. At 18 months' CA, there were no differences in weight, length, or measures of neurodevelopment between the groups; however, male infants in the late group were twice as likely to have head circumference less than the 10(th) percentile. CONCLUSIONS: Early AA were associated with significantly better growth outcomes at 36 weeks' postmenstrual age, and fewer infants who received early AA were found to have suboptimal head growth at 18 months' CA.

Body Height↗

PubMed1997

Successful treatment of fetal megavesica in the first half of pregnancy.

OBJECTIVE: Our goal was to assess fetal kidney function in fetuses with megavesica diagnosed during the first half of pregnancy before treatment. STUDY DESIGN: In a prospective interventional study 9 fetuses with megavesica diagnosed during the first half of pregnancy underwent vesicocentesis. Fetal urine biochemical markers (urine electrolytes, osmolarity, and beta 2-microglobulins) were determined after diagnostic vesicocentesis of the fetal megavesica. RESULTS: Surprisingly, in four fetuses who underwent sampling at 13 to 18 postmenstrual weeks, vesicocentesis proved both diagnostic and therapeutic. Pregnancy proceeded with normal amniotic fluid volume, a normal-sized urinary bladder with normal dynamics, and normal postnatal renal function. A fifth fetus had trisomy 18. In three of the remaining four fetuses in whom sampling was performed at 16 to 20 postmenstrual weeks, biochemical markers indicated a poor prognosis. In the remaining fetus marginal results of biochemical studies prompted intrauterine treatment, but death from respiratory problems ensued after premature delivery at 31 weeks. CONCLUSIONS: Fetal megavesica in the first half of pregnancy is an indication for an immediate diagnostic vesicocentesis. This is the first report emphasizing early diagnosis of fetal megavesica with subsequent fetal vesicocentesis and demonstrating that this minimally invasive procedure can be life-saving if performed in early pregnancy.

Abdominal Muscles↗

PubMed1984

Correlation of neurologic assessment in the preterm newborn infant with outcome at 1 year.

A prospective study was undertaken of the outcome at 1 year in 129 preterm infants of less than 34 weeks gestation (range 27 to 34 weeks) who underwent detailed neurologic assessment and ultrasound scanning in the neonatal period and again at 40 weeks postmenstrual age, and an independent neurodevelopmental assessment at 12 months chronologic age. Of the 129 infants, 37 (29%) had ultrasound evidence of periventricular hemorrhage. At 40 weeks postmenstrual age the infants were classified as neurologically normal, abnormal, or borderline on the basis of the neurologic examination. Of the 62 infants considered normal at 40 weeks, 57 (91%) were assessed as normal at one year, compared to only 14 (35%) of the 39 infants considered abnormal (P less than 0.001). Ten (85%) of the 12 normal infants with associated periventricular hemorrhage were normal at 1 year, compared to 47 (94%) of the 50 normal infants without periventricular hemorrhage, whereas 5 (25%) of 20 abnormal infants with associated periventricular hemorrhage and 9 (47%) of the 19 without periventricular hemorrhage were normal at 1 year. There was no direct correlation in individual cases between the severity of neurologic deficit and the presence or severity of periventricular hemorrhage. Infants with a cluster of abnormal signs were more likely to have later dystonia or cerebral palsy than those with marked hypotonia but no other abnormality.

Cerebral Hemorrhage↗

PubMed1995

Effect of pulse dexamethasone therapy on the incidence and severity of chronic lung disease in the very low birth weight infant.

We conducted a prospective, randomized, double-blind trial to assess the efficacy and safety of pulse doses of dexamethasone on survival without supplemental oxygen in very low birth weight infants at high risk of having chronic lung disease. Seventy-eight infants with birth weights < or = 1500 gm who were ventilator dependent at 7 days of postnatal age were randomly assigned to receive pulse doses of dexamethasone, 0.5 mg/kg per day, divided twice daily (n = 39), or an equivalent volume of saline solution placebo (n = 39), for 3 days at 10-day intervals until they no longer required supplemental oxygen or assisted ventilation, or reached 36 weeks of postmenstrual age. At study entry, the groups did not differ by birth weight, gestational age, or severity of lung disease. At 36 weeks of postmenstrual age, there was both a significant increase in survival rates without oxygen supplementation (p = 0.03) and a significant decrease in the incidence of chronic lung disease (p = 0.047) in the group that received pulse therapy. Supplemental oxygen requirements were less throughout the study period in the group that received repeated pulse doses of dexamethasone (p = 0.013). The total numbers of deaths and the durations of supplemental oxygen, ventilator support, and hospital stay did not differ between groups. Recorded side effects in the pulse therapy group were minimal and included an increase in the use of insulin therapy for hyperglycemia (p < 0.05). We conclude that in this population of very low birth weight infants, treatment with pulse doses of dexamethasone resulted in improvement in pulmonary outcome without clinically significant side effects.

Adult↗

PubMed1998

Mechanisms of gastroesophageal reflux in healthy premature infants.

OBJECTIVES: The aim of this study was to characterize the motor events responsible for gastroesophageal reflux (GER) and esophageal acid clearance in a cohort of healthy preterm infants. STUDY DESIGN: Esophageal motility was recorded for 2 to 3 hours after a feeding in 24 preterm infants, 31 to 38 weeks' postmenstrual age, by using a sleeveside hole micromanometric assembly incorporating a pH probe. RESULTS: Sixty acid GER episodes were recorded by pH probe, and 133 non-acid GER episodes were recorded manometrically by the presence of esophageal common cavities. Of the 193 GER episodes, 159 (82%) were associated with transient lower esophageal sphincter relaxation (TLESR). TLESRs were significantly longer in duration than single swallows (15.1 seconds vs 5.6 seconds, P < .001) and had lower nadir pressures (0.8 mm Hg vs 2.3 mm Hg, P < .001). A total of 3216 esophageal body pressure waves were analyzed; 70% of swallow-induced pressure waves were peristaltic in sequence compared with 5% of swallow-unrelated pressure waves. During periods of esophageal acidification (pH below 4), peristaltic esophageal body pressure wave sequences cleared acid refluxate more effectively than nonperistaltic pressure wave sequences. CONCLUSIONS: In healthy preterm infants, TLESRs are the predominant mechanism underlying GER, and esophageal clearance mechanisms are well developed by at least 31 weeks' postmenstrual age.

Cohort Studies↗

PubMed1998

Side effects of 2 different dexamethasone courses for preterm infants at risk of chronic lung disease: a randomized trial.

OBJECTIVE: We hypothesized that a pulsed course of dexamethasone would result in better linear growth than a 42-day reducing course in preterm infants at risk for chronic lung disease of prematurity. STUDY DESIGN: Forty infants with a birth weight of < or =1,250 g who required mechanical ventilation at 7 days of age were randomly assigned to a repeatable 3-day pulse course of dexamethasone commencing immediately or a 42-day (long) course commencing at 14 days of age if they still required mechanical ventilation and supplemental oxygen. The primary outcome measure was linear growth at 36 weeks' postmenstrual age measured by knemometry. RESULTS: There was no difference in lower leg length at 36 weeks' postmenstrual age. Infants receiving the pulse course had lower rises in blood pressure, less myocardial hypertrophy, and less adrenal suppression. However, more infants required supplemental oxygen at 28 days' postnatal age (14/18 vs 8/21, P < .05) and 36 weeks' PMA (8/16 vs 5/20, P = .12). CONCLUSION: In preterm infants at risk for chronic lung disease, a pulsed course of dexamethasone has fewer side effects than a long course but may be less effective at preventing chronic lung disease.

Administration, Inhalation↗

PubMed1999

Lower esophageal sphincter position in premature infants cannot be correctly estimated with current formulas.

OBJECTIVES: Strobel's formula (Esophageal length = 5 + 0.252 x Height) is frequently used as a guide for determining the distance from the nares to the lower esophageal sphincter (LES) in term infants. The aim of this study was to examine this relationship in premature infants. STUDY DESIGN: The distance from nares to LES was manometrically determined in 156 premature infants (26-40 weeks' postmenstrual age; body weights of 610-3050 g). The ability of body weight, height (body length), head circumference, and postmenstrual age to predict the manometrically determined LES position was evaluated with linear and non-linear regression analyses. RESULTS: Body weight and body length were the most predictive of distance from nares to LES (r(2) = 0.848 and 0.802, respectively). These relationships were non-linear and, in the case of body length, deviated substantially from Strobel's model. CONCLUSIONS: In premature neonates, a different formula is needed for prediction of the distance between nares and LES than that applied to term infants and children.

Anthropometry↗

PubMed1998

Salivary cortisol in women with and without perimenstrual mood changes.

An increase in the activity of the hypothalamic-pituitary-adrenal axis (HPA axis) is frequently associated with major depression. During the premenstrual phase of their reproductive cycle some women experience depressive mood changes that are proposed to be of similar intensity to that experienced during periods of major depression. This study examined the secretion of cortisol, the end-product in the HPA axis, at different stages of the menstrual cycle in women with and without premenstrual depression. Women who experienced only mild physical and emotional changes in the premenstrual phase of their cycle had a significantly higher cortisol secretion on a premenstrual day (measured hourly) compared to a postmenstrual day. Those who were significantly more depressed premenstrually showed the opposite pattern of cortisol secretion with significantly lower levels on the premenstrual day compared with the postmenstrual day. Across the menstrual cycle, women who were significantly more depressed premenstrually also had lower evening cortisol levels in their premenstrual phase. The results of this study indicate that, unlike major depression where the underlying neurological changes are manifest as overactivity of the HPA axis, premenstrual depressive changes are associated with reduced HPA axis activity. Premenstrual depression may, therefore, be similar neurologically to seasonal affective disorder, which is associated with underactivity of the HPA axis.

Adult↗

PubMed2002

Replication of a premenstrual decrease in right-ear advantage on language-related dichotic listening tests of cerebral laterality.

Five fused dichotic word tasks measured perceptual asymmetry in 30 women at 4 weekly intervals. The five tasks varied according to whether the stimuli presented were word-word pairs or nonsense word-pairs, or whether they consisted of neutral words paired with positive emotion-evoking words (e.g. hug-tug), neutral words paired with negative emotion-evoking words (e.g. till-kill), or neutral words paired with neutral words (e.g. bean-dean). Overall right-ear advantage (REA) decreased in the premenstrual week relative to the postmenstrual week, replicating previous results using identical measures. In addition, REA scores were similar at menstrual, postmenstrual and midcycle weeks. Additional data from 12 men suggests sex differences in task performance were small or non-existent. In both women and men, there were no effects of repeated testing on REA, but emotional proclivity indices, defined as the tendency to recall words of positive or negative affective tone, increased across the four test sessions. As found previously, there was a trend for women to hear fewer positive words during the premenstrual week. These data are consistent with other research suggesting that a progesterone-mediated decrease in functional asymmetry occurs in the luteal phase. Future research manipulating task demands (e.g. memory load) or the affective valence of the stimuli may be useful in understanding the observed changes in hemispheric advantage.

Adolescent↗

PubMed1992

Light and the neonatal eye.

The lighting environment where the baby born prematurely is placed is different from that experienced in utero. As early exposure to light may affect the immature visual system we have attempted to quantify the neonatal ocular light dose. Lighting surveys performed in 7 neonatal units (NNUs) suggested that mean unit illuminance was 470 lux (range 192-890 lux) and intensive care areas within the NNU were significantly brighter than their corresponding low dependency nurseries. The spectral power distribution of fluorescent lights in NNUs was weighted towards the blue end of the spectrum. Datalogging studies demonstrated that between about 30% and 98% of environmental light was incident on the eyelid, which acts as a predominantly red-pass filter, permitting 21% transmission at 700 nm with less than or equal to 5% transmission at 580 nm. Eye-lid opening frequency was quantified: 45% less than or equal to 26 weeks gestational age and decreasing to 7% at 28 weeks gestational age. The onset of the pupillary reflex to light was between 30 and 34 weeks postmenstrual age, the mean diameter was 3.46 mm before this event and 3.02 mm afterwards. Retinal irradiance values calculated from these data show that it is a function of postmenstrual age. Further studies are required to determine its effect on the immature visual system.

Eye↗

PubMed1999

The development of preterm infants' breastfeeding behavior.

Extensive scientific data are available on the development of sucking in term infants, but corresponding knowledge about preterm infants has been lacking. The aim was to describe the development of preterm infants' behavior at the breast, according to postmenstrual and postnatal age. Mothers co-operated as data collectors using the Preterm Infant Breastfeeding Behavior Scale for observations. Seventy-one singletons (born after 26.7-35.9 gestational weeks) were studied prospectively. Mothers received regular advice about breastfeeding and guidance about interaction and appropriate stimulation. Breastfeeding was initiated at a postmenstrual age (PMA) of 27.9-35.9 weeks. Mothers provided 4321 records of infants' behavior, 70% of the total breastfeeding sessions during the infants' hospital stay. Irrespective of PMA, the infants responded by rooting and sucking on the first contact with the breast. Efficient rooting, areolar grasp and latching on were observed at 28 weeks, and repeated bursts of > or = 10 sucks and maximum bursts of > or = 30 sucks at 32 weeks. Nutritive sucking appeared from 30.6 weeks. Sixty-seven infants were breastfed at discharge. Fifty-seven of them established full breastfeeding at a mean PMA of 36.0 weeks (33.4-40.0 weeks). Their early sucking behavior is interpreted as the result of learning, enhanced by contingent stimuli. We therefore suggest that guidelines for initiation of breastfeeding in preterm infants should be based on cardiorespiratory stability, irrespective of current maturity, age or weight.

Adolescent↗

PubMed1980

Longitudinal developmental course of electrical activity of brain.

Different phases of brain growth precede maturation as indicated in the developmental course of brain electrical activity. This can be illustrated by EEG and evoked potentials recorded from the scalp from a postmenstrual age of 24 weeks. A description of electrical patterns according to postmenstrual age is valid because of the strong relationship between electrical activity and brain maturation, regardless of "gestational" age at birth and birthweight. For evaluation of the electrical activity of the brain especially in preterm infants and during the first year of life sleep studies have been invaluable. In the first year of life the EEG is characterized by appearance and disappearance of special patterns and by an increasing synchronization between hemispheres. Later during childhood and adolescence especially before and in the course of puberty there is an intense maturation which is seen in the EEG by the appearance of rhythmic and paroxysmal patterns related to age and sex. The slowly increasing frequency of the background occipital rhythm and the response to photic stimulation with increasing frequency of photic driving are sensitive indicators of brain maturation. In adolescence there are fewer differences in regard to age and sex dependence which may be an expression for a tapering off of the maturation process. This is in accordance with the general concept of the terminal ordinary growth in man. Developmental changes of evoked responses are also in accordance with the morphological maturation. Measurement of evoked potentials is especially useful in newborns where cerebral maturation can be studied and evaluated.

Adolescent↗

PubMed1998

Decreased expression of microtubule-associated protein 5 (MAP5) in the molecular layer of cerebellum in preterm infants with olivocerebellar lesions.

The changes in microtubule-associated protein 5 (MAP5) expression in the cerebellum with olivocerebellar degeneration (OCD) were investigated by means of immunohistochemical method, compared with gestational age-matched controls. In controls of 24-33 postmenstrual weeks, the molecular layer was diffusely immunoreactive. However, in cases of olivocerebellar degeneration (25-35 postmenstrual weeks), MAP5 immunoreactivity was reduced in the inner half of the molecular layer, especially in a portion where Purkinje cells were absent. The ratio of the density in the outer half of the molecular layer to that in the inner half was also determined with an image analyzer, and increased significantly in Purkinje cell-negative areas. Because MAP5 was believed to be expressed mainly on growing axons in the early fetal period, the reduction of MAP5 immunoreactivity in OCD cases suggested that normal interaction of Purkinje cells and climbing fibers is vulnerable to ischemia and hypoxia in developing stage and that retrograde transynaptic degeneration of the inferior olivary nuclei is secondarily induced.

Brain Diseases↗

PubMed1996

Hysteroscopic Correction of Cesarean Section Scars in Women with Abnormal Uterine Bleeding

Abnormal postmenstrual uterine bleeding may occur in women with history of cesarean section. To study the etiology of this anomaly, transvaginal ultrasound (TVU) was performed during follicular phase in 20 such patients, and hysteroscopy in 7. The TVU revealed the presence of fluid in the isthmus in relation to the cesarean section scar, where a kind of pouch or bursa was observed. Cervical introduction of a catheter showed that the fluid was blood. The TVU observation was confirmed in women in whom hysteroscopy was performed. Resection of ring-shaped fibrotic tissue on the inferior part of the scar stopped abnormal bleeding. Four women were infertile and two conceived, probably because stopping postmenstrual bleeding could interfere with the quality of cervical mucus. These findings suggest that abnormal uterine bleeding in women with an abnormal uterine scar could be resolved by minimally invasive endoscopic surgery, and TVU is a valuable diagnostic tool.

Journal Article↗

PubMedDate not supplied

The influence of the menstrual cycle in postdural puncture headache.

BACKGROUND AND OBJECTIVES: We performed a preliminary study to analyze the influence of the menstrual cycle on the incidence of postdural puncture headache (PDPH). METHODS: One hundred sixty female patients with regular menstrual cycles who received spinal anesthesia were observed. Based on the day within the menstrual cycle that they received the puncture, the patients were classified into period A (perimenstrual) or period B (postmenstrual). The possible relationship among headaches, lifestyle habits, and anesthetic technique, and the presence of PDPH were analyzed, as were the levels of female sex hormones with PDPH in comparison with a control group. RESULTS: Seven cases of PDPH (4.3%) were observed--one within the perimenstrual group and six in the postmenstrual group. No significant differences were observed between the two periods or were there any differences in relating PDPH to the other variables analyzed. CONCLUSIONS: According to our results, the menstrual cycle and hormonal levels may not have any influence on the appearance of PDPH in female patients, although a larger series is required to validate these results.

Adult↗

PubMed2005

Neurobehavioural profile of low-birthweight infants with cystic periventricular leukomalacia.

Twenty-three low-birthweight infants (17 males, six females) diagnosed with cystic periventricular leukomalacia (PVL; median gestational age 30 wks, postmenstrual age range 25 to 36 wks; median birthweight 1365 g, range 680 to 2010 g) were evaluated and compared with 209 comparison infants (117 males, 92 females; median gestational age 33 wks, postmenstrual age range 25 to 39 wks; birthweight 1771 g, range 670 to 2460 g). There were three assessment times: 36 to 38 weeks (preterm), 40 to 42 weeks (term), and 44 to 46 weeks (post-term); the Neonatal Behavioral Assessment Scale (NBAS) was used for assessment. Outcome at 2 years was assessed on the basis of a neurological examination, magnetic resonance imaging, computerized tomography, electroencephalography, and the Mental and Psychomotor Development Indices of the Bayley Scales of Infant Development. All infants in the PVL group were found to have evidence of cerebral palsy, whereas all infants in the comparison group were normally developing. Infants with PVL performed more poorly on all elements of the NBAS examination at all three assessment times compared with the comparison group. They demonstrated poorer motor control, less responsiveness to environmental stimuli, less regulatory capacity, and more abnormal reflexes compared with the comparison group. These results suggest that LBW infants with PVL show dysfunction and/or disorganization in their neurobehavioural systems in the neonatal period. Assessment of neonatal neurobehavioural characteristics using the NBAS may assist clinicians in identifying LBW infants with PVL, and in formulating plans for the developmental care of these infants.

Age Factors↗

PubMed1991

Blunting of neuroendocrine responses to infusion of L-tryptophan in women with perimenstrual mood change.

The neuroendocrine response to L-tryptophan infusion was measured at two stages of the menstrual cycle, premenstrually and postmenstrually, in 13 women with and 13 women without premenstrual depression (the MC and NMC groups respectively). Previous studies have shown that in non-depressed women, this challenge test results in an increase in circulating prolactin and growth hormone. In depressed women both responses are blunted. In this study the growth hormone and cortisol responses were smaller in the MC group than the NMC group on both occasions. The prolactin response was blunted premenstrually compared with postmenstrually in both groups. These findings suggest that women who experience premenstrual depression may have neuroendocrine abnormalities throughout the cycle. The neurotransmitter abnormalities reflected in these altered endocrine responses appear to interact with neuroendocrine changes that normally occur premenstrually resulting in a vulnerability to depression at that phase of the cycle.

Adolescent↗

PubMed2000

Tobacco withdrawal in women and menstrual cycle phase.

Because negative mood is a characteristic of both tobacco withdrawal and menstrual discomfort, withdrawal may vary by menstrual cycle phase. Tobacco withdrawal, mood, and menstrual discomfort were assessed in premenopausal women who quit smoking during either the follicular (Days 1-14 postmenstrual onset; n = 41) or luteal (Day 15 or longer postmenstrual onset; n = 37) phase of the menstrual cycle and maintained biochemically verified smoking abstinence during the postquit week. Women quitting during the luteal phase reported significantly greater increases in tobacco withdrawal and self-reported depressive symptoms than women quitting during the follicular phase. These results indicate that selecting a quit-smoking day early in the follicular phase may attenuate withdrawal and negative affect in premenopausal female smokers.

Adult↗