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Biomedical subjects

A Tollan

Publications and source records attributed to A Tollan.

33 records · Page 2Linked to original sources
PubMed1993

Writing a scientific paper as part of the medical curriculum.

The curriculum at the Medical School, University of Tromsø reserves 23 weeks for optional studies, including a period of 12 weeks at the end of the fifth year when the students carry out an independent study and write a short thesis. Of the first 417 doctors (graduation year 1979-89) from Tromsø 84.6% answered a postal questionnaire asking them to evaluate this part of the curriculum. These postgraduates report high levels of satisfaction with and benefit from this part of the curriculum. A total of 26.8% started working on their thesis before the final 12-week period, 32.6% had also published their study, half of these in international journals, and 75.6% found that the skills acquired during the final optional period had been useful in their subsequent work, irrespective of specialty. In conclusion, postgraduates consider their work in preparing a scientific paper as an important and integral part of medical studies.

Curriculum↗
PubMed1993

Progesterone reduces sympathetic tone without changing blood pressure or fluid balance in men.

There is scant information on the effects of progesterone on circulation. Changes in catecholamine levels, blood pressure and transcapillary fluid balance were measured in 12 men before and during administration of natural progesterone (Utrogestan). Before administration, systolic blood pressure was significantly correlated with venous adrenaline (r = 0.67, p = 0.01). There was a significant decrease (p = 0.004) in venous noradrenaline during progesterone administration, and systolic blood pressure was significantly correlated with the arteriovenous difference for noradrenaline (r = 0.66, p = 0.02). Serum progesterone, which attained levels similar to those found in women during the luteal phase, did not significantly alter blood pressure, body weight or intra- to extravascular fluid shift. It is concluded that progesterone may have a direct action by increasing the uptake of noradrenaline from the synaptic cleft or by decreasing the nerve firing rate. Interestingly, the pretreatment finding of a significant correlation between blood pressure and adrenaline was less evident during progesterone administration.

Adult↗
PubMed1993

Evidence for altered transcapillary fluid balance in women with the premenstrual syndrome.

Redistribution of body fluids has been suggested as a possible pathophysiological mechanism for the premenstrual syndrome (PMS). To elucidate this hypothesis, transcapillary fluid balance was studied in ten women with well defined PMS. Wick-methods were used for measuring colloid osmotic and hydrostatic interstitial pressures on the thorax and on the leg. The capillary filtration coefficient was measured by strain gauge plethysmography. From the follicular to the luteal phase the interstitial colloid osmotic pressure on the leg was significantly reduced (mean 3.6 mm Hg, p = 0.005), whereas the interstitial colloid osmotic pressure on the thorax remained constant. The capillary filtration coefficient increased 30% (mean 5.3 x 10(-4) ml/min/100 gm/mm Hg, p = 0.04) from the follicular to the luteal phase. No change was observed in body weight. These findings indicate an instability of vascular regulation in women with premenstrual syndrome, and lend support to the hypothesis that redistribution of fluid, rather than water retention, is responsible for the subjective symptoms such as bloatedness, in the premenstrual syndrome.

Adult↗
PubMed1993

Effects of ovarian stimulation on blood pressure and plasma catecholamine levels.

Effects of ovarian stimulation for in vitro fertilization on blood pressure and plasma catecholamine levels were studied in 10 women. The examinations were carried out before hormonal treatment with human menopausal gonadotropin (day three of the menstrual cycle, mean serum oestradiol concentration 0.2 nmol l-1, and on the day after ovulation induction with human chorionic gonadotropin (cycle days 10-12, mean serum oestradiol concentration 7.4 nmol l-1). Systolic and diastolic blood pressures (mean +/- SD) decreased 6.7 +/- 8.6 mm Hg, p = 0.049, and 5.3 +/- 4.7 mm Hg, p = 0.009, respectively), and venous plasma noradrenaline increased (42 +/- 44 pg ml-1, p = 0.02) during ovarian stimulation. No significant change was observed in either arterial noradrenaline, arterial adrenaline or venous adrenaline. After stimulation a positive correlation was observed between systolic blood pressure and arterial adrenaline (r = 0.73, p = 0.027), and between systolic blood pressure and the arterial-venous difference for adrenaline (r = 0.81, p = 0.007). The increased venous noradrenaline levels may be a reflex-mediated activation of the sympathetic nervous tone due to a decrease in blood pressure, or may indicate reduced neuronal re-uptake of released noradrenaline. The mechanisms behind the strong correlation between adrenaline and blood pressure are unclear, but may be induced by the supraphysiological oestradiol levels. Thus, adrenaline seems to be more important for blood pressure control in this particular setting.

Adult↗
PubMed1992

[Perinatal listeriosis].

Human listeriosis is a rare disease. It may be foodborne. Listeric infection during pregnancy may give a fatal fetal outcome, caused by transplacental passage of organisms from the maternal gastrointestinal tract. We describe a case of perinatal listeriosis which resulted in preterm stillbirth. Perinatal listeriosis should be considered when flue-like symptoms are presented during pregnancy. Early diagnosis and treatment may improve the outcome.

Adult↗
PubMed1992

Increased capillary permeability for plasma proteins in oral contraceptive users.

The transcapillary fluid balance was examined in eleven women before administration of a monophasic oral contraceptive (desogestrel 0.15 mg, ethinylestradiol 0.03 mg), and after three and six months of use. The interstitial colloid osmotic pressure was measured by the "wick" method, and the interstitial hydrostatic pressure by the "wick-in-needle" method in subcutaneous tissue on thorax and leg. During the six-month observation period, the following changes were observed: Plasma colloid osmotic pressure decreased (mean 1.8 mmHg, p = 0.047), as well as serum albumin (mean 5.1 g/l, p = 0.0006), total protein concentration (mean 2.8 g/l, p = 0.0006), hemoglobin (mean 0.5 g/dl, p = 0.014) and hematocrit (mean 1.8%, p = 0.047). Blood pressure and body weight remained unchanged, but foot volume showed a significant increase. The colloid osmotic pressure gradient (plasma-interstitium) was significantly reduced. The results indicate an increase in plasma volume in addition to an increased capillary permeability to plasma proteins during oral contraceptive use. We suggest that the observed changes in transcapillary fluid balance is caused by the estrogen component of the oral contraceptive pill.

Adolescent↗
PubMed1991

[Conservative treatment of ectopic pregnancy].

During the last decades the incidence of ectopic pregnancy has been steadily rising. The chosen therapy has usually been unilateral salpingectomy. Recently, different conservative (tube-preserving) treatment-modalities have been introduced in clinical practice. We have tried conservative treatment by local injection of prostaglandin F2a (total dose 2-4 mg) directly into the tubal pregnancy and, if feasible, also into the corpus luteum graviditate. The treatment was successful in 13 out of 16 patients. In one patient laparotomia was performed because of pain, and revealed a haematoma in fossa Douglasi. Reinjection of prostaglandin was necessary in one patient because of rising HCG titres. One patient was hospitalized for four days because of nausea and pain. The treatment was otherwise successful. The method may be useful as a non-surgical alternative in haemodynamically stable patients without tubal rupture. Further studies are needed to evaluate the outcome in terms of future fertility.

Chorionic Gonadotropin↗
PubMed1990

[Contraception guidance in general practice. A questionnaire study in Nordland, Troms and Finnmark].

239 (75%) of 318 general practitioners in the three northernmost counties of Norway were asked by mailed questionnaire to report the frequency of consultations on contraception, and what kind of contraception they usually recommended. 85% informed the women about at least three different alternatives; oral contraceptives, intrauterine devices and condoms. Almost 50% would ordinate an intrauterine device to a woman who never had been pregnant. 60% informed the woman about other alternatives even if she had already decided upon method prior to the consultation. The physician often brought up the subject of contraception, but as many as 15% did not, as a routine, mention birth control when a woman consulted them for a first trimester abortion. Almost 50% did not know how to fit the diaphragms.

Adult↗
PubMed1990

[Do male and female physicians give the same contraception guidance?].

A questionnaire on their practice regarding ordination of contraceptive methods was answered by 239 (75%) of the general practitioners in the three northern most counties of Norway. The female doctors reported a higher frequency both of female patients and of consultations for birth control, and were more active in these consultations than their male colleagues. Female doctors suggested more methods to their patients, and had a more positive attitude to barrier methods. 61% of the male doctors and 27% of the female doctors had no experience of fitting diaphragms.

Adult↗
PubMed1990

[The decision process in induced abortion].

This study describes the pattern of decision as reported by women undergoing elective abortion. The results are based on interviews with 45 of 67 women admitted to the Department of Obstetrics and Gynecology, University Hospital of Tromsø, during a two month period in 1988. All women had informed, and most often consulted, at least one person before making the decision, usually their partner and/or a female friend. The majority of the persons consulted supported her, whatever her decision. According to the women, they made the women, the final decision themselves. Two women were persuaded by their partner to decide to have an elective abortion.

Abortion, Induced↗
PubMed1990

Transcapillary fluid dynamics during ovarian stimulation for in vitro fertilization.

Transcapillary fluid dynamics were studied in 10 women during ovarian stimulation for in vitro fertilization. The examinations were done on the first day of stimulation (day 3 of the menstrual cycle, mean serum estradiol concentration 0.2 nmol/L), and the day before oocyte aspiration (day 10 to 12, mean serum estradiol concentration 6.8 nmol/L). Interstitial colloid osmotic pressure was measured on the thorax at heart level by the "wick" method, and interstitial hydrostatic pressure by the "wick-in-needle" method. Plasma colloid osmotic pressure decreased (mean, 2.0 mm Hg; p less than 0.002) and interstitial colloid osmotic pressure increased (mean, 1.0 mm Hg; p less than 0.02) during hormonal stimulation. This implies a reduced transcapillary colloid osmotic gradient (plasma colloid osmotic pressure--interstitial colloid osmotic pressure), probably because of increased capillary permeability to plasma proteins. Hemoglobin and hematocrit were significantly reduced, and body weight and foot volume significantly increased. These results demonstrate that during ovarian stimulation there are both water retention and augmented filtration of fluid from the vascular to the interstitial compartment. This may be of significance for the pathophysiologic condition in the ovarian hyperstimulation syndrome.

Adult↗
PubMed1990

Antepartum to postpartum changes in transcapillary fluid balance.

During the puerperium significant changes occur in the body volume homeostasis. In the present study the transcapillary fluid balance was examined antepartum in nine healthy women. The interstitial colloid osmotic pressure was measured by the 'wick' method, and interstitial hydrostatic pressure by the 'wick-in-needle' method in subcutaneous tissue on the thorax and at the ankle. From antepartum (gestational week 37-40) to postpartum (5th day), the following changes were observed: A significant increase in the colloid osmotic pressure both in plasma (mean 1.8 mmHg, P = 0.027) and in the interstitial fluid at the ankle (mean 2.9 mmHg, P = 0.008). Neither colloid osmotic pressure gradient (plasma-interstitium), interstitial hydrostatic pressure, nor haemoglobin and haematocrit changed. The observed rise in the interstitial colloid osmotic pressure must be caused by mobilization of fluid from the interstitium, probably due to a reduced capillary hydrostatic pressure. The increase in plasma colloid osmotic pressure is most likely caused by an increased albumin synthesis and/or transport of interstitial proteins back to the vascular compartment.

Adult↗
PubMed1987

Transcapillary fluid dynamics during the menstrual cycle.

Transcapillary fluid dynamics in the follicular and luteal phase in women without symptoms of premenstrual syndrome were studied. Interstitial colloid osmotic pressure was measured by the "wick" method and interstitial hydrostatic pressure by the "wick-in-needle" method in subcutaneous tissue on the thorax and ankle. From follicular to luteal phase, the following changes were observed: Colloid osmotic pressures were significantly reduced, both in plasma (mean 2.5 mm Hg) and in the interstitium (thorax mean 1.9 mm Hg and ankle mean 2.0 mm Hg). The interstitial hydrostatic pressures did not change. There were no significant changes in serum albumin, hemoglobin, or hematocrit. A slight, but significant, weight gain was observed (mean 0.7 kg). The reduced plasma and interstitial colloid osmotic pressures in the luteal phase may be due to water retention, but the observed reductions in colloid osmotic pressures are probably not fully explained by simple dilution. A reduction in total protein mass in the luteal phase is suggested.

Adult↗