Biomedical subjects
B Andersch
Publications and source records attributed to B Andersch.
Clomipramine effectively reduces premenstrual irritability and dysphoria: a placebo-controlled trial.
Forty nondepressed women displaying severe premenstrual irritability and/or dysphoria and fulfilling the DSM-III-R criteria of late luteal phase dysphoric disorder were treated daily for 3 menstrual cycles with either the potent serotonin reuptake inhibitor clomipramine (25-75 mg; flexible dosage) (n = 20) or placebo (n = 20). In both treatment groups premenstrual irritability and dysphoria (as rated daily by the patients using a visual analogue scale) were significantly reduced as compared with the rating during 2 pretreatment reference cycles; however, in the placebo group this reduction was only about 40% whereas, in the clomipramine group, the symptom decrease was greater than 80%. At all 3 treatment cycles, patients on clomipramine displayed significantly lower symptom rating than controls. Also with respect to the rating of global improvement, the results obtained with clomipramine were considerably and significantly better than those obtained with placebo. It is concluded that low doses of clomipramine effectively reduce premenstrual irritability and dysphoria with a response rate close to 100%. The possible role of serotonin in the pathophysiology of the premenstrual syndrome is discussed.
A longitudinal study of contraception and pregnancy outcome in a representative sample of young Swedish women.
The prevalence of contraception and pregnancy history in the same women, aged 19 and 24 years, was assessed in a longitudinal cohort study by means of a postal questionnaire. A one-in-four random sample of all the women born 1962, resident in the city of Göteborg in 1981, was obtained from the population register (n = 656). The response rate was 91%. Respondents from 1981 were re-assessed in 1986 (response rate: 83%). The respondents from 1986 (n = 488) represent 74% of the original sample from 1981. Contraceptive usage in the same women aged 19 and 24 years (in brackets) was as follows: Oral contraception (OC) 47% (51%); intrauterine device 3% (11%), p less than 0.01; barrier methods 11% (11%); depot gestagen 0 (0.2%); no contraception 39% (26%), p less than 0.05. OCs were being taken or had been taken by 89%. Reasons given for cessation of OC were as follows: Contraception not required 10% (15%); fear of OC 26% (29%); menstrual disorder 17% (14%); weight increase 18% (10%), p less than 0.05; mental side effects 15% (9%); desire to become pregnant 7% (17%), p less than 0.01. Pregnancies (n = 362) were reported by 194 (43%) of the women. 44% of the pregnancies terminated in legal abortion. The medical complication rate following legal abortion was 15%. Thus, despite the availability of effective contraception, the ratio of legal abortions to live births was high. Fear of side effects was the commonest reason for discontinuing OC.
A comparison of flurbiprofen, tranexamic acid, and a levonorgestrel-releasing intrauterine contraceptive device in the treatment of idiopathic menorrhagia.
Treatment with flurbiprofen (100 mg twice a day for 5 days), tranexamic acid (1.5 gm three times a day for 3 days and 1 gm twice a day for another 2 days), and an intrauterine contraceptive device releasing 20 micrograms levonorgestrel per day was compared in women with idiopathic menorrhagia. The menstrual blood loss during two control periods in 15 women subsequently treated with flurbiprofen and tranexamic acid was 295 +/- 52 ml and 203 +/- 25.2 ml in the 16 women later fitted with a levonorgestrel-releasing intrauterine contraceptive device. Menstrual blood loss was reduced by all three forms of treatment. The reduction in menstrual blood loss expressed as a percentage of the mean of two control cycles for each form of treatment was as follows: flurbiprofen, 20.7% +/- 9.9%; tranexamic acid, 44.4% +/- 8.3%; levonorgestrel-releasing intrauterine contraceptive device after 3 months, 81.6% +/- 4.5%; levonorgestrel-releasing intrauterine contraceptive device after 6 months, 88.0% +/- 3.1%; levonorgestrel-releasing intrauterine contraceptive device after 12 months, 95.8% +/- 1.2%. The reduction in menstrual blood loss achieved by the levonorgestrel-releasing intrauterine contraceptive device was greater than that recorded with flurbiprofen (p less than 0.001) and tranexamic acid (p less than 0.01), and was greater for tranexamic acid when compared with flurbiprofen (p less than 0.05). The levonorgestrel-releasing intrauterine contraceptive device was the only form of treatment to reduce mean menstrual blood loss below 80 ml per menstruation, the upper limit of normal menstrual blood loss.
[Treatment of bacterial vaginosis--an acid gel as an alternative to antibiotic treatment].
Explore the source record for details and available documents.
[Treatment of discharge. Self care is recommended in temporary vaginal problems].
Explore the source record for details and available documents.
[The female life cycle. An attempt to complete deficient information].
Explore the source record for details and available documents.
The influence of different combined oral contraceptives on the prevalence and severity of dysmenorrhea.
The influence of different oral contraceptives (OC) on the prevalence and severity of dysmenorrhea was investigated longitudinally (from age 19 to 24 years) in a representative sample of young women from an urban Swedish population. The women were grouped according to the type of OC used at the time of assessment: monophasic OC with low gestagen activity; progestogen-dominated monophasic OC; triphasic OC; neither OC nor an intrauterine device (IUD). At the age of 19 years, the severity of dysmenorrhea was lower in users of monophasic OCs with low gestagen activity (p less than 0.05) and users of progestogen-dominated monophasic OCs (p less than 0.001) compared to women who used neither OC nor an IUD. At 24 years of age, the severity of dysmenorrhea was lower in users of monophasic OCs with low gestagen activity (p less than 0.001), users of progestogen-dominated monophasic OCs (p less than 0.001) and users of triphasic OCs (p less than 0.001), compared to women who used neither OC nor an IUD. The severity of dysmenorrhea in women who did not use an OC or IUD when 19 years old was reduced in the same women who used OCs when 24 years old, compared (p less than 0.001) to women who still used neither an OC nor an IUD. There were no significant differences in the prevalence and severity of dysmenorrhea between the users of monophasic OCs, irrespective of progestagen activity, and users of triphasic preparations.
Pre-eclampsia, hypertension and the premenstrual tension syndrome.
A total of 261 of 17,000 pregnancies were complicated by pre-eclampsia/hypertension in pregnancy. Seven to twelve years later 237 were available for follow-up together with 33 women, who had a normotensive pregnancy in 1969-1973. The association between pre-eclampsia/hypertension and the premenstrual tension syndrome has been studied. Women with present hypertension complained significantly (P less than 0.05) more of premenstrual sadness than the normotensive women. However, women with previous pre-eclampsia/hypertension in pregnancy did not have more premenstrual symptoms than women in general, on the contrary, women with a history of severe pre-eclampsia had less symptoms.
Factors influencing the prevalence and severity of dysmenorrhoea in young women.
Factors influencing the prevalence and severity of dysmenorrhoea were assessed longitudinally in a representative sample of young women born in 1962. The prevalence of dysmenorrhoea was lower (P less than 0.01) at 24 years of age than at 19 years of age. At 24 years of age, 67% of the women still experienced dysmenorrhoea; 10% reported dysmenorrhoea which limited daily activity. The severity of dysmenorrhoea (linear analogue scale) was lower (P less than 0.001) at 24 years of age (3.4, SD 2.8) than at 19 years (4.1, SD 3.2). The prevalence and severity of dysmenorrhoea were reduced (P less than 0.05) in women who were parous in 1986 and nulliparous in 1981, but was unchanged in women who were still nulliparous or women who had had a miscarriage or abortion. Dysmenorrhoea was reduced (P less than 0.001) in oral contraceptive users. The severity of dysmenorrhoea was significantly associated with the duration of menstrual flow, menarcheal age and cigarette smoking. The severity of dysmenorrhoea was not associated with age as an isolated factor, nor with height, weight, length of menstrual cycle or frequency of physical exercise.
Effect of clomipramine on premenstrual syndrome.
Clomipramine (25-50 mg) was administered daily for 5 consecutive menstrual cycles to 5 nondepressed women with severe premenstrual irritability and sadness. All subjects reported a dramatic reduction in premenstrual complaints.
Bacterial vaginosis and the effect of intermittent prophylactic treatment with an acid lactate gel.
Intermittent treatment with an acid lactate gel (Lactal, ACO, Sweden) reduced symptoms of bacterial vaginosis (BV) and promoted the reestablishment of the normal vaginal flora of lactobacilli. Forty-two women seriously affected by recurrent BV were initially given acid gel (lactate gel, pH 3.8, 5 ml) to be inserted into the vagina daily for 7 consecutive days. Thereafter they entered into a double blind clinical trial and were treated prophylactically 3 days monthly for 6 months with either lactate gel or a placebo gel. Women treated with the lactate gel were clinically improved, i.e. no signs of BV in 88% compared to 10% in the placebo group (p less than 0.001). The vaginal lactobacilli flora was reestablished in 83% of the lactate group and in 16% of the placebo group. Local intermittent application of lactate gel was found to be free of side effects and is a preferable alternative to repeated treatments with antibiotics in patients with recurrent BV.
A double-blind cross-over study comparing flurbiprofen with naproxen-sodium for the treatment of primary dysmenorrhea.
The efficacy of flurbiprofen (100 mg, twice daily) and naproxen-sodium (500 mg, twice daily) for the treatment of primary dysmenorrhea was evaluated in a double-blind cross-over study. All the women (n = 57) complained of severe (23%) or very severe (77%) dysmenorrhea which interfered with their daily life. Frequent absenteeism due to dysmenorrhea was reported by 39% of the women. The severity of pain was reduced (p less than 0.001) during treatment with both flurbiprofen and naproxen-sodium compared with the pain severity before the first dose. There was, however, no significant difference in mean pain relief achieved by the two drugs studied. During the study period, absenteeism was reported by only 6 (11%) and 3 (5%) women when treated with flurbiprofen or naproxen-sodium respectively. More than 60% of the women reported no or only mild interference with daily activities during treatment. No serious side effects were reported and none of the patients was obliged to terminate treatment because of side effects. Flurbiprofen and naproxen-sodium, at the dosages indicated, were both shown to be effective in relieving pain in patients suffering from severe primary dysmenorrhea and markedly improved their capacity for normal activities during menstruation.
Prediction of sepsis neonatorum following a full-term pregnancy.
The aim of the present study was to identify obstetrical factors predicting sepsis neonatorum following a full-term pregnancy. In 1982 26 infants out of 2,977 full-term pregnancies had septicemia. For comparison 42 women of corresponding age were randomly selected. A stepwise regression analysis was performed in order to evaluate the association between seven different variables and sepsis neonatorum. We found that prolonged rupture of the membranes (p less than 0.003) and primary amniotomy (p less than 0.02) were the most important factors predicting sepsis neonatorum (r2 = 0.22). Factors such as cervical ripening, vaginal examinations, intrauterine monitoring devices, prolonged labor and prolonged pregnancy did not add to the predicted power of the analysis.
An objective evaluation of flurbiprofen and tranexamic acid in the treatment of idiopathic menorrhagia.
The effect of flurbiprofen (100 mg x 2 for 5 days) was compared with tranexamic acid (1.5 g x 3 for 3 days, 1 g x 2 days 4 and 5) in the treatment of 15 women with idiopathic menorrhagia. The mean blood loss during two medication-free periods was 295 +/- 52 ml. A significant (p less than 0.01) reduction in menstrual blood loss was recorded during treatment with both flurbiprofen and tranexamic acid. The menstrual blood loss was significantly (p less than 0.01) lower during treatment with tranexamic acid (155 +/- 33 ml) than with flurbiprofen (223 +/- 44 ml). Various side effects were recorded by 7 of 15 women during treatment with tranexamic acid and by 4 women of 15 during treatment with flurbiprofen. Many women with menorrhagia suffer simultaneously from dysmenorrhea. Thus although tranexamic acid was generally more effective in reducing menstrual blood loss, flurbiprofen provides an important therapeutic alternative to antifibrinolytic agents, especially in patients with concomitant dysmenorrhea.
The effect of flurbiprofen and naproxen sodium on intra-uterine pressure and menstrual pain in patients with primary dysmenorrhea.
The effects of flurbiprofen (100 mg) and naproxen sodium (500 mg) on intrauterine pressure and menstrual pain were assessed in 8 women with primary dysmenorrhea using a double-blind parallel study technique. Intrauterine pressure was recorded with a microtransducer catheter for 4 h and resting pressure, active pressure, frequency of pressure cycles, and the area under the curve were analysed in 30 min periods. Prior to medication all the patients displayed signs of uterine hyperactivity as judged by a high resting pressure 55.3 +/- 3.8 mm Hg, high active pressure 175.0 +/- 6.1 mm Hg and a high frequency of pressure cycles 12.3 +/- 0.7 contractions per 0.5 h. Oral administration of flurbiprofen and naproxen sodium significantly suppressed uterine activity and was associated with a significant reduction in pain intensity. However no significant differences were recorded between the two drugs regarding their effects on intrauterine pressure and pain intensity.
Rupture of renal arterial aneurysm in pregnancy. Case report.
The case is described of a patient at term of her second pregnancy with spontaneous rupture of a renal arterial aneurysm, successfully delivered by caesarean section with primary repair of the renal artery. Sixteen cases have previously been reported, but only one was dealt with in a similar way. The literature is reviewed and the aetiology of pregnancy-related arterial aneurysm is discussed.
Histochemical investigation of cervical intraepithelial neoplasia.
An enzyme histochemical method and histomorphological examination were applied in the cases of 37 patients with cytological atypia. Good agreement was found between the presence of aberrant glucose-6-phosphate dehydrogenase (G-6-PD) activity (metabolic atypia) and histopathologically demonstrable dysplasia. Only three women with metabolic atypia showed a normal histopathological picture. The results suggest that enzyme histochemistry may also be a valuable supplement to histopathology in the diagnosis of cervical neoplastic changes.