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Biomedical subjects

L E Edwards

Publications and source records attributed to L E Edwards.

At least 19 recordsLinked to original sources
PubMed1997

The effects of cigarette smoking and gestational weight change on birth outcomes in obese and normal-weight women.

OBJECTIVES: The associations of infant birth outcomes with maternal pregravid obesity, gestational weight gain, and prenatal cigarette smoking were examined. METHODS: A retrospective analysis of 1343 obese and normal-weight gravidas evaluated the associations of cigarette smoking, gestational weight change, and pregravid body mass index with birthweight, low birthweight, and small- and large-for-gestational-age births. RESULTS: Smoking was associated with the delivery of lower-birthweight infants for both obese and normal-weight women, and gestational weight gain did not eliminate the birthweight-lowering effects of smoking. Women at highest risk of delivering lower-birthweight infants were obese smokers whose gestational gains were less than 7 kg and normal-weight smokers whose gestational gains were less than 11.5 kg. CONCLUSIONS: To balance the risks of small and large-size infants, gains of 7 to 11.5 kg for obese women and 11.5 to 16 kg for normal-weight women appear appropriate.

Birth Weight↗
PubMed1996

Pregnancy complications and birth outcomes in obese and normal-weight women: effects of gestational weight change.

OBJECTIVE: To compare the pregnancy course and outcomes in obese and normal-weight women and their associations with gestational weight change. METHODS: Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes in a retrospective study of 683 obese and 660 normal-weight women who delivered singleton living neonates. RESULTS: Compared with normal-weight women, obese women gained an average of 5 kg (11 lb) less during pregnancy and were more likely to lose or gain no weight (11% versus less than 1%). Obese women were significantly more likely to have pregnancy complications, but the incidence of complications was not associated with weight change. Compared with obese women who gained 7-11.5 kg (15-25 lb), obese women who lost or gained no weight were at higher risk for delivery of infants under 3000 g or small for gestational age infants, and those who gained more than 16 kg (35 lb) were at twice the risk for delivery of infants who were 4000 g or heavier. CONCLUSION: Gestational weight change was not associated with pregnancy complications in obese or normal-weight women. To optimize fetal growth, weight gains of 7-11.5 kg (15-25 lb) for obese women and 11.5-16 kg (25-35 lb) for normal-weight women appear to be appropriate.

Birth Weight↗
PubMed1996

Photodynamic therapy of rat endometrium sensitized with tin ethyl etiopurpurin.

STUDY OBJECTIVE: To evaluate endometrial ablation in the rat using photodynamic therapy and the photosensitizer tin ethyl etiopurpurin (SnET2). DESIGN: Laboratory research. SETTING: A pharmaceutical and device manufacturing company. MATERIALS: Forty-five healthy female rats (age 8-10 wks). INTERVENTIONS: Groups of three to five rats were given SnET2 by either intrauterine or intravenous administration. Light treatment was given at either 3 or 24 hours after SnET2 administration at a light dose of 75, 150, or 200 J/cm. MEASUREMENTS AND MAIN RESULTS: A fluorescence detection system was employed to determine relative drug uptake of SnET2 into uterine tissue. The highest levels of SnET2 were detected at 3 hours. After light treatment, responses of uterine tissues were evaluated histologically. The best endometrial ablation was seen when SnET2 was given by intrauterine administration with light treatment at 150 J/cm 24 hours later. A consistent transmural response was seen with this route of administration at 200 J/cm. Intravenous SnET2 gave inconsistent responses. In light-only controls, all light doses caused no tissue response. The depth of necrosis in tissues treated with photodynamic therapy were light-dose dependent. CONCLUSION: With either route of SnET2 administration, drug uptake was confirmed and a light-dose-dependent response in the walls of rat uterine horns was demonstrated.

Animals↗
PubMed1985

Transurethral resection of the prostate and bladder neck incision: a review of 700 cases.

Transurethral resection (TUR) is regarded as the treatment of choice for relief of outflow tract obstruction in the male, but bladder neck incision (BNI) is an acceptable alternative when the gland is small. Seven hundred cases of TUR/BNI have been reviewed (TUR = 388; BNI = 312). BNI was performed when the gland was less than 35 g and where there was no clinical suspicion of malignancy. The operative details of our single incision technique are given. While the patients in the BNI group were younger, catheter stay was shorter, there was less infection, a significantly reduced need for blood transfusion and a satisfactory outcome in terms of control and need for further surgery. BNI is a technically simpler procedure than TUR and is easy to teach and learn. Results show it is safe and effective for patients in acute retention as well as those treated electively and it is the operation of choice for small benign prostates.

Adult↗
PubMed1984

Effect of insulin and transferrin in the maintenance of the activated state of the T-lymphocyte induced by allo-antigen.

Insulin is an immuno-modulating molecule enhancing cytotoxic T-cell function and supporting intermediary metabolism in activated lymphocytes. Insulin also maintains the activated state of mitogen-stimulated lymphocytes. Because of the importance of allo-antigen response of diabetic patients for infections and transplant immunity, we explored the role of insulin in the allo-activated state of lymphocytes. Allo-stimulation was provided in one-way mixed lymphocyte reactions, with Balb/C mouse lymph node cells responding to irradiated spleen cells of C57BL/6 mice, in culture under conditions which permitted evaluation of hormonal modulation. Mixed lymphocyte reactions established in fetal calf serum, insulin-depleted by passage over antibody affinity columns, were of equal magnitude to those in insulin-replete serum. A weak but positive mixed lymphocyte reaction can be effected with an artificial serum substitute containing no additional hormone. Provision of insulin (10 nmol/l) restored a full mixed lymphocyte reaction response which was mimicked by addition of transferrin. The insulin-transferrin combination was not additive. In conclusion, insulin and transferrin maintain the allo-activated state of the mouse lymphocyte, transferrin alone being sufficient when full antigenic stimulation is provided. If the same applies to human lymphocytes, insulin-deficient diabetic patients will respond to full allo-antigen challenge, and so should be fully capable of mounting a transplant immune response.

Animals↗
PubMed1983

Post-catheterisation urethral strictures. A clinical and experimental study.

Seventeen patients who developed urethral strictures following catheterisation have been studied; 14 of these (82%) were catheterised for standard monitoring purposes during and after major heart surgery, which was a coronary artery bypass graft (CABPG) in 12 cases. The possible aetiological mechanisms for the development of this complication are discussed. Animal experiments were designed and carried out to compare the effects of different catheter materials on the urethral mucosa. Silicone catheters provoked the least inflammation and rubber the most. A further experiment determined the flow rates through catheters of different sizes. From our results, we suggest that the careful insertion of a small silicone catheter, distally fixed, is least likely to induce stricture formation.

Adolescent↗
PubMed1983

School-based prenatal services: can similar outcomes be attained in a nonschool setting?

The purpose of this study is to evaluate whether enhancement of hospital-based prenatal care of adolescents results in pregnancy outcomes comparable to those found in adolescents receiving care at school-based clinics. An initial study comparing hospital clinic and school clinic programs administered by the St. Paul Maternal and Infant Care Project (MIC) from 1973-1976 indicated that delivered teens from the high school clinics had earlier and more frequent prenatal visits and fewer low birth weight babies than delivered adolescents who received care at hospital based clinics. After the initial study of 1976, MIC hospital based services for the adolescents were enhanced to include additional educational and support services. A follow up study, (1976-1979) was subsequently conducted, using criteria similar to the previous study, to compare the results of hospital and school-based programs for pregnant teens. The follow up data demonstrated that the School Group initiated care much earlier and had significantly more prenatal visits than the Comparison Group, but the Comparison Group demonstrated a dramatic improvement in both areas when compared to the first study. Rates of obstetrical complications and infant outcomes were more similar for both groups than in the initial study, supporting the premise that while the school provides a superior setting for provision of prenatal services, similar services at nonschool sites can be greatly enhanced and can demonstrate significant improvement in obstetrical outcomes.

Adolescent↗
PubMed1980

Adolescent contraceptive use: experience in 1,762 teenagers.

Retrospective analysis was done on 1,762 adolescent family planning patients who used the St. Paul Maternal and Infant Care Project Teen Clinic from 1969 through June 1979. Factors evaluated included method of contraception, demographic data, and continuation rates calculated by Life Table Method. A further comparison was done on 403 of these patients who initiated their family planning care at a project satellite clinic located within a local high school.

Adolescent↗
PubMed1980

Teaching human sexuality in junior high school: an interdisciplinary approach.

A pilot educational program in human sexuality designed for junior high age adolescents was conducted jointly by the St. Paul, Minnesota Maternal and Infant Care Project and the St. Paul Public Schools. This program encompassed two courses which presented a comprehensive view of young men and women as sexual beings. The goal was to affect primary prevention of adolescent pregnancy and other problems related to adolescent sexuality. Pre- and posttest scores demonstrated a statistically significant increase in student knowledge, and weekly evaluations revealed consistent interest in subject matter presented.

Adolescent↗
PubMed1979

Pregnancy in the underweight woman. Course, outcome, and growth patterns of the infant.

The obstetric performance and pregnancy outcome of 354 underweight patients were compared with matched control subjects of normal weight. The growth patterns of their infants were also compared. The underweight women had significantly higher rates of cardiac/respiratory problems, anemia, PROM, and endometritis but were less prone to develop pre-eclampsia. Prematurity and low Apgar scores were significantly more frequent in the infants of underweight women. There was no difference in the frequency of IUGR and in perinatal mortality rates. The mean birth weight of the infants of underweight women was 231 grams less than that of infants of control subjects. Underweight women, particularly if they were anemic, had a higher incidence of low-birth-weight infants despite adequate weight gain. AGA infants of underweight women were more likely to be below the twenty-fifth percentile for weight correlated with length by 12 months of age.

Adolescent↗