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Biomedical subjects

I Milsom

Publications and source records attributed to I Milsom.

At least 145 records · Page 8Linked to original sources
PubMed1985

Ibuprofen and naproxen-sodium in the treatment of primary dysmenorrhea: a double-blind cross-over study.

The efficacy of ibuprofen and naproxen-sodium for the treatment of primary dysmenorrhea was evaluated in a double-blind cross-over study in 57 otherwise healthy women. The severity of pain reported by the patients was significantly (P less than 0.01) reduced during treatment with both ibuprofen and naproxen-sodium compared to the severity of pain before the first dose. The mean pain relief during treatment with ibuprofen was significantly (P less than 0.05) greater than during treatment with naproxen-sodium in the dosages indicated.

Adolescent↗
PubMed1985

Maternal haemodynamic changes during caesarean section: a comparison of epidural and general anaesthesia.

Haemodynamic measurements were performed on 20 healthy women before and during elective caesarean section under epidural (10 women) or general anaesthesia (10 women). The influence of the two anaesthetic techniques on the haemodynamic changes associated with operative delivery was compared. The following haemodynamic variables were studied: cardiac output (CO), stroke volume (SV) determined non-invasively with impedance cardiography, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure, mean arterial pressure (MAP) and total peripheral vascular resistance (TPR). During epidural anaesthesia, SV was largely unchanged before delivery but increased (P less than 0.05) following delivery. However, CO increased (P less than 0.05) prior to delivery due to an increase (P less than 0.01) in HR. A further increase (P less than 0.05) in CO was recorded following delivery. SBP, DBP, MAP and TPR decreased (P less than 0.01) during epidural anaesthesia. In the patients undergoing general anaesthesia, SV decreased (P less than 0.05) prior to delivery. However, CO remained largely unchanged due to an increase (P less than 0.01) in HR. Following delivery, CO (P less than 0.05) and SV (P less than 0.01) increased whereas HR decreased (P less than 0.01). SBP, DBP and MAP increased (P less than 0.01) prior to delivery, returning to the same level as prior to induction of anaesthesia following delivery. TPR was largely unchanged prior to delivery but decreased (P less than 0.01) following delivery.

Anesthesia, Epidural↗
PubMed1984

Factors influencing aortocaval compression in late pregnancy.

The circulatory effects of postural change in late pregnancy were investigated in 20 healthy pregnant women. Maximum stroke volume (93.2 +/- 11.9 ml) was recorded with the subject in the left lateral position and was significantly (p less than 0.001) reduced in the supine, right lateral, and lithotomy positions, but was largely unchanged in the standing motionless position (89.9 +/- 12.6 ml). Diastolic, systolic, and mean arterial blood pressures and total peripheral vascular resistance were significantly (p less than 0.001) increased in the supine, right lateral, lithotomy, and upright motionless positions when compared to the same variables in the left lateral position. The following factors were found to be significantly correlated to the hemodynamic response to the supine recumbent position: maternal age (p less than 0.05), the position of the fetus in the uterus (p less than 0.05), and systolic (p less than 0.001) and diastolic (p less than 0.001) blood pressures measured with the subject in the left lateral position. The implications of the present findings for modern obstetric delivery care and the etiology of the supine hypotensive syndrome are discussed.

Adult↗
PubMed1984

Effect of ibuprofen, naproxen sodium and paracetamol on intrauterine pressure and menstrual pain in dysmenorrhoea.

The effects of ibuprofen (400 mg), naproxen sodium (250 mg) and paracetamol (500 mg) on intrauterine pressure and menstrual pain was assessed in 12 women with dysmenorrhoea in a double-blind parallel study. 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. Ibuprofen, in a single oral dose of 400 mg, significantly reduced resting pressure, active pressure, the frequency of pressure cycles and the area under the curve and this was associated with a significant reduction in pain intensity. Neither paracetamol nor naproxen sodium effected significant changes in intrauterine pressure or pain score.

Acetaminophen↗
PubMed1984

Effect of various oral contraceptive combinations on dysmenorrhea.

The influence of different oral contraceptives on the prevalence and severity of dysmenorrhea was investigated in a representative sample of 19-year-old women from an urban Swedish population. The prevalence and severity of dysmenorrhea were significantly (p less than 0.01) reduced amongst users of progestogen-dominated oral contraceptives compared to a control group of women who used neither oral contraceptives nor an intrauterine device. However, there was no significant difference in the prevalence and severity of dysmenorrhea between users of oral contraceptives with low progestogen activity and the same control group. Thus, the relative progestogen activity of the oral contraceptive used appears to be of importance for the effective treatment of dysmenorrhea. Possible reasons for the superior therapeutic efficacy of progestogen-dominated oral contraceptives are discussed. Further studies are, however, necessary to evaluate the importance of the progestogen activity of oral contraceptives in the treatment of dysmenorrhea.

Absenteeism↗
PubMed1983

Primary adenocarcinoma of the uterine cervix. A clinical study.

In a retrospective clinical study, 67 matched cases of primary adenocarcinoma and squamous cell carcinoma of the cervix were compared. The mean age, weight, and menopausal age of women with adenocarcinoma of the cervix were in excess of the corresponding figures for squamous cell carcinoma. There was a significantly (P less than 0.05) larger number of diabetics and nulliparous women amongst the patients with adenocarcinoma of the cervix. Blood group A was significantly (P less than 0.05) more frequent in patients with cervix cancer. Treatment choice was independent of the tumors histological type. The five-year survival rates for adenocarcinoma of the cervix were 83.3% (Stage IB), 60.0% (Stage IIA), and 45.5% (Stage IIB). The corresponding five-year survival rates for squamous cell carcinoma were 90.0%, 73.3%, and 40.9%. There were indications that adenocarcinoma of the cervix was less radiosensitive than squamous cell carcinoma. Estrogen substitution following treatment of adenocarcinoma of the cervix did not adversely affect the outcome.

Adenocarcinoma↗
PubMed1983

Measurement of cardiac stroke volume during cesarean section: a comparison between impedance cardiography and the dye dilution technique.

Simultaneous determination of cardiac stroke volume by impedance cardiography and the dye dilution technique was compared in ten women undergoing elective cesarean section performed under general or epidural anesthesia. The influence of delivery and the anesthetic procedures used on stroke volume determination by the two methods was evaluated and compared. The correlation coefficients for measurements performed before and during anesthesia showed little variation and were largely unchanged after delivery of the child (r = 0.90-0.97). Mean stroke volume determined by impedance cardiography was significantly (P less than 0.001) lower than mean stroke volume calculated from the dye dilution technique. However, there was no significant difference between the mean change in stroke volume determined by the two techniques during serial measurements. Impedance cardiography was found to be a safe, reliable, non-invasive technique for the measurement of changes in stroke volume during cesarean section. The ability of the impedance method to determine changes in stroke volume was unaffected by the anesthetic procedures employed or by delivery of the child.

Anesthesia, Epidural↗
PubMed1983

Measurement of cardiac stroke volume by impedance cardiography in the last trimester of pregnancy.

Simultaneous determination of cardiac stroke volume by impedance cardiography and the dye dilution technique was compared in 10 women during the last trimester of pregnancy. Measurements were performed in different body positions to investigate the influence of body position on stroke volume. The correlation coefficient for all measurements was 0.87. Mean stroke volume determined by impedance cardiography was significantly (p less than 001) lower than mean stroke volume calculated by the dye dilution technique. There was no significant difference between the mean change in stroke volume determined by the two techniques during serial measurements. The reproducibility of individual impedance-determined stroke volumes (6.1 ml) did not differ significantly from individual values obtained by dye dilution (9.3 ml). Maximum mean impedance-determined stroke volume was recorded in the left lateral position (83.8 +/- 4.0 ml). Mean stroke volume was significantly (p less than 0.01) reduced in the supine position (17.9%). A smaller (14.4%) reduction was registered in the right lateral position. These changes in stroke volume according to body position were equally evident by both methods. Impedance cardiography is a safe, reliable, non-invasive technique for the measurement of changes in stroke volume during late pregnancy. The ability of impedance cardiography to determine changes in stroke volume was unaffected by changes in body position.

Adult↗
PubMed1982

An epidemiologic study of young women with dysmenorrhea.

The prevalence of dysmenorrhea was studied in a random sample of 19-year-old women from an urban Swedish population. Dysmenorrhea was reported by 72% of the women. Fifteen percent suffered from dysmenorrhea which limited daily activity and was unimproved by analgesics. Dysmenorrhea occurred significantly (p less than 0.01) more often in women not using oral contraceptives. A significant correlation (p less than 0.01) was found between early menarche and an increased severity of dysmenorrhea. There was a significant correlation (p less than 0.01) between the severity of dysmenorrhea and the amount of menstrual flow. Parous women had significantly (p less than 0.01) less dysmenorrhea than women who had never been pregnant or women who had experienced a legal or spontaneous abortion. Smokers as compared to nonsmokers had significantly (p less than 0.01) less dysmenorrhea. The severity of dysmenorrhea was not affected by height, weight, or regularity of the menstrual cycle. Absenteeism as a result of dysmenorrhea was evaluated.

Absenteeism↗
PubMed1982

Contraception and pregnancy among young women in an urban Swedish population.

The reproductive history and use of contraception in a representative sample of 19-year-old women from the city of Göteborg is reported. Oral contraceptives (OC) were taken by 47%, 4% had an intrauterine device and 12% used a barrier method while 37% practiced no form of contraception. The type of OC used and reasons for discontinuation are presented. The duration of OC use was one year or less for 46% of the women and exceeded 3 years in only 10%. Major causes of discontinued OC were the result of side effects attributed by the woman to OC, or a fear of OC. There were 93 pregnancies reported in the population sample, resulting in the birth of 34 infants. Pregnancy was terminated by legal abortion in 51% of the reported pregnancies. The ready availability of a return visit to discuss possible side effects and fears resulting from the chosen method of contraception may improve continuity, thus reducing the number of legal abortions.

Abortion, Legal↗
PubMed1982

Measurement of stroke volume with impedance cardiography.

Simultaneous determination of stroke volume with impedance cardiography and the dye dilution technique was compared in 11 healthy men before and after exercise. The correlation coefficient for all measurements was 0.82. Mean stroke volume determined by impedance cardiography was significantly (P less than 0.001) lower than mean stroke volume calculated by the dye dilution technique. However, there was no significant difference in the mean change in stroke volume determined by the two techniques during serial measurements. The reproducibility of single impedance-determined stroke volumes (6.9 ml) was not significantly different from single values obtained by dye dilution (7.3 ml). Impedance cardiography was found to be a safe, reliable, non-invasive method for the measurement of changes in stroke volume in healthy individuals before and after exercise. At present, direct estimation of absolute values of stroke volume is not recommended using impedance cardiography. Calibration of the impedance technique against other established techniques in a given application is necessary.

Adult↗
PubMed1982

Treatment of vaginal candidosis with a single 500-mg clotrimazole pessary.

In a double-blind study the therapeutic efficacy of a single 500-mg clotrimazole pessary was compared with that of a 200-mg clotrimazole pessary inserted once daily for three days in 72 patients with vaginal candidosis confirmed by culture. On clinical assessment four weeks after completion of treatment with the single-dose pessary the cure rate was 86% compared with 92% after the three-day regimen. There was no significant difference in the eradication rate between the single-dose (94%) and three-day regimens (89%). Four weeks after completion of treatment the recurrence rates by culture were 18% with the single-dose and 24% with the three-day regimen. The former treatment was well tolerated and as effective as the three-day clotrimazole regimen.

Adult↗
PubMed1982

A study of parental attitudes after donor insemination (AID).

Artificial donor insemination (AID) is important in the treatment of infertility when the couples' wish for a family is denied because of male sterility. However, very little is known regarding the continued development of AID families and their attitudes to insemination after the child is born. The study is based on a questionnaire anonymously completed by 92 couples returning to obtain a second child by insemination. None of the parents regretted his or her decision regarding insemination and the majority were prepared to recommend the method to other couples in the same situation. Apart from one couple the parents intended to withhold the truth from the child regarding its origin. The majority of parents chose not to inform anyone else regarding the child's conception. The parents were therefore anxious that case notes and details concerning insemination were treated with the utmost discretion and confidentiality. The parents in this study clearly indicated they preferred insemination to adoption. A large proportion of the parents who already had a child as a result of insemination returned to the clinic for a second child.

Adult↗
PubMed1979

An evaluation of a post-operative vacuum drainage system.

The effectiveness of a plastic bottle vacuum drainage system ('Steritex vacu-drain') was evaluated in 50 randomly selected patients undergoing major surgery. The incidence of post-operative wound infection was 6%. The drainage system was found to be effective and acceptable to both patients and personnel involved in its management.

Adult↗
PubMedDate not supplied

An evaluation of the acceptability of incontinence aids used by 85-year-old men and women.

An evaluation of the acceptability of incontinence aids was performed in incontinent 85-year-old men and women (n = 355) resident in the city of Göteborg. Incontinence aids were used more often (P < 0.001) by incontinent women (67.9%) than men (42.9%) living in the community, and were used by 86.4% of the incontinent men and 91.5% of the incontinent women living in an institution. Pads were the commonest form of incontinence aid used, irrespective of whether the men (26.6%) and women (67.9%) lived in the community or in an institution (men, 59.1% and women, 86.2%). Urinary leakage and odour as a result of urinary incontinence limited daily life for many men (22.4% and 30.6%, respectively) and women (14.7% and 27.4%, respectively), and meant that 24% of the men and 18% of the women were dependent on another person. At the primary assessment 38.8% of the men and 26.8% of the women living at home were dissatisfied with their present form of incontinence aid. An individual assessment of the patients' requirements regarding incontinence aids was then performed by a urotherapist. Following intervention there was an increase in the number of men (61.2%, P < 0.01) and women (75.3%, P < 0.05) using incontinence aids. There was also an increase (P < 0.01) in the acceptability of the incontinence aids used as judged by the men (dissatisfied: before, 38.8%; after, 14.3%) and women (dissatisfied: before, 26.8%; after, 6.8%) living at home who were already using some form of incontinence aid at the primary assessment.

Journal Article↗
PubMedDate not supplied

Selecting the correct incontinence pad in nursing home patients by pad weighing.

The aim of this study was to identify which types of absorbent pads were being used by the inhabitants of two nursing home wards and to determine to what extent the pads were adapted to the patient's leakage volume. An objective assessment of urinary leakage was performed in all the men (age 80.2 +/- 8.0 years) and women (age 84.8 +/- 6.5 years), from the two wards, who used incontinent aids (n=41). Subjects were assessed by weighing all incontinence aids on a precision weight scale before and after use during a period of 7 days. The number of patients experiencing wetting of external clothing or bedding was recorded. During the assessment period 1146 pads were used and the mean urinary leakage per patient during the day was 260 +/- 212 ml and during the night 413 +/- 230 ml. Wetting of external clothing or bedding occurred during the day time in 16% and in 40% at night time despite the use of pads. Only 22% of the pads were adapted to the patients degree of urinary incontinence. Many of the nursing home inhabitants were using larger pads than necessary. If the pads had been adapted to the patient's urinary leakage volume, costs for incontinence aids would have been reduced by 31%.

Journal Article↗
PubMedDate not supplied

The influence of dementia on the prevalence of urinary and faecal incontinence in 85-year-old men and women.

The influence of dementia on the prevalence of urinary and faecal incontinence was investigated in a random sample (n = 485) of the total population of 85-year-olds from the city of Gothenburg, Sweden. The subjects were assessed by a psychiatric interview, physical examinations, computed tomography of the head and analysis of cerebrospinal fluid. Urinary and faecal incontinence were assessed by a urotherapist. Dementia, urinary and faecal incontinence were defined according to strict, internationally accepted criteria. The prevalences of urinary and faecal incontinence, and dementia were 38%, 17% and 29% respectively. Demented men (50%) and women (60%) were more often urinary incontinent than non-demented men (18%) and women (36%). Faecal incontinence was more prevalent in demented (34.8%) than non-demented subjects (6.7%). Both urinary and faecal incontinence were more prevalent in women (43% and 20% respectively) than men (27% and 11%, respectively). The prevalences of urinary and faecal incontinence, and dementia were higher in residents of a nursing home or hospital (74%, 51% and 92%, respectively) than in subjects living at home (32%, 9% and 18%, respectively). Of the demented subjects resident in an institution, 78% were incontinent compared with 37% living at home. Incontinence aids were used by 18% of the men and 33% of the women, and their use increased with increasing severity of dementia. Dementia influenced the prevalence of urinary incontinence, and both conditions independently of each other strongly influenced the need for institutional care.

Journal Article↗