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Biomedical subjects

N S Pattison

Publications and source records attributed to N S Pattison.

At least 37 records · Page 2Linked to original sources
PubMed1991

Cofactor dependent and cofactor independent anticardiolipin antibodies.

Two distinct types of anticardiolipin antibodies are described, one of which requires the presence of a serum factor (cofactor) to bind cardiolipin in ELISA and liposome affinity systems. The second type does not require this cofactor. The requirement of a cofactor for the binding of some but not all anticardiolipin antibodies provides an explanation for the confounding variability of the results of assays for these antibodies. It also explains why blocking agents such as BSA and gelatin do not produce consistent results in this assay.

Adult↗
PubMed1991

Recurrent miscarriage--outcome after supportive care in early pregnancy.

One hundred and thirty three couples were investigated at a recurrent miscarriage clinic. In their next pregnancy 42 women (Group 1) with unexplained recurrent miscarriage were managed with a programme of formal emotional support and close supervision at an early pregnancy clinic. Two women were seen in 2 pregnancies (44 supervised pregnancies); 86% (38 of 44) of these pregnancies were successful. Four of the 6 miscarriages had an identifiable causal factor. Nine women (Group 2), also with unexplained recurrent miscarriage, acted as a control group. After initial investigation they were reassured and returned to the care of their family practitioner and did not receive formal supportive care in their subsequent pregnancy; 33% (3 of 9) of these pregnancies were successful (p = 0.005; Fishers Exact Test). Whilst acknowledging that there is a significant spontaneous cure rate in this condition, emotional support seems to be important in the prevention of unexplained recurrent miscarriage, giving results as good as any currently accepted therapy.

Abortion, Habitual↗
PubMed1991

Separation of lupus anticoagulant from anticardiolipin antibodies by ion-exchange and gel filtration chromatography.

Separation of lupus anticoagulant from anticardiolipin antibodies in the serum of a patient containing both antibodies is described. A simple two-step procedure utilizing diethylaminoethylcellulose ion-exchange chromatography followed by Sepharose CL-4B gel filtration chromatography allowed the separation of IgM from IgG isotype. Lupus anticoagulant was found to be exclusively IgM, whilst anticardiolipin antibodies were IgG. This is apparently the first report that anticardiolipin antibodies and lupus anticoagulant can be different isotypes and adds to the increasing evidence that they are separate entities.

Abortion, Habitual↗
PubMed1990

Obstetric risk factors: can they predict fetal mortality and morbidity?

An antepartum fetal risk score was developed and applied to 29,101 pregnancies which delivered at National Women's Hospital between January 1983 and April 1988. Twenty-one past and current obstetric and medical factors available at the onset of pregnancy or labour were weighed to obtain a risk score. The scoring system developed compared favourably with international systems. An antepartum fetal risk score of three or more was chosen to select a high risk group. These 10,859 women, 37% of the total population, identified 90% of those who had a fetal or neonatal loss. The perinatal mortality rate was 34.7/1000. Twenty-eight percent of this group had a caesarean section and 23% gave birth to a low birth weight infant. Women who had an antepartum risk score of seven or more had a perinatal mortality rate of 200/1000. The remaining women, a low risk group of 18,242 (63%), had a perinatal mortality rate of 4.1/1000. However 60% had a complicated pregnancy including 8.2% who required a caesarean section and 2.7% who gave birth to a low birth weight infant. The antepartum fetal risk score clearly identified the population at risk of fetal or neonatal loss. In addition significantly more medical intervention was provided to the high risk group. It is important to note that 60% of the low risk group had a complicated pregnancy leaving only 24% of the total population whose pregnancy was normal.

Adult↗
PubMed1990

Pregnancy in women with diabetes mellitus, twenty years experience: 1968-1987.

This paper reviews 1528 pregnancies in women with diabetes mellitus between 1968 and 1987 at National Women's Hospital; 571 had established diabetes and 957 had gestational diabetes. During this period the perinatal mortality rate for women with established diabetes fell from 15.2% to 2% and for those with gestational diabetes from 6.7% to 0.5%. This improvement was probably related to changes in management which included a team approach to perinatal care and a concentration on lowering blood glucose levels during pregnancy. The outstanding problem is the high incidence of congenital abnormalities in women with established diabetes. Two to three percent of these pregnancies ended in a perinatal death due to congenital anomaly. Improved prepregnancy and early pregnancy blood glucose control must be the aim to reduce the congenital abnormality rate.

Blood Glucose↗
PubMed1989

Fetal liver length in normal and isoimmunized pregnancies.

The length of the right lobe of the fetal liver was measured by means of ultrasound examined on 53 occasions in 21 isoimmunized pregnancies. Fetal blood samples were taken in all patients within 24 hours. Comparisons were made with 350 measurements of liver length in normal pregnancies. A good correlation was found between liver length and fetal hemoglobin level (r = 0.794, p less than 0.001) and between liver length and reticulocyte count (r = 0.721, p less than 0.001). At the time of first sample, all fetuses with a hemoglobin of less than 100 gm/L had a liver length that was greater than the ninetieth percentile. Liver length measurement seems to be a useful indicator of the degree of fetal anemia in isoimmunized pregnancies.

Cell Count↗
PubMed1989

Transdermal oestrogen for postmenopausal women: a double blind crossover comparative study with ethinyl oestradiol.

A double blind crossover study of transdermal oestradiol (50 micrograms/day) and ethinyl oestradiol (20 micrograms/day) was conducted with 25 postmenopausal women. Transdermal oestradiol increased circulating levels of oestradiol and oestrone. Both preparations favourably improved patients' symptoms and vaginal cytology, lowered gonadotrophin levels and urinary calcium loss and gave a satisfactory menstrual pattern. Transdermal oestradiol had no effect on measures of hepatic function whereas oral ethinyl oestradiol significantly altered levels of sex hormone binding globulin, plasma renin substrate and lipoproteins. Transdermal oestradiol has a comparable beneficial effect on postmenopausal symptoms to ethinyl oestradiol without the adverse effects on hepatic proteins.

Administration, Cutaneous↗
PubMed1987

Anticardiolipin antibodies: their presence as a marker for lupus anticoagulant in pregnancy.

A solid phase ELISA was developed to investigate the association between anticardiolipin antibodies and lupus anticoagulant in pregnancy. Twenty-seven pregnant women with a history of recurrent fetal losses or systemic lupus erythematosus (SLE) were tested for the presence of lupus anticoagulant, anticardiolipin antibodies, antinuclear antibodies (ANA) and anti-single-stranded DNA antibodies. Nineteen women with a total of 49 previous unsuccessful pregnancies were found to have lupus anticoagulant and anticardiolipin antibodies. Three women who had suffered four fetal deaths from six pregnancies had anticardiolipin antibodies without lupus anticoagulant. Cardiolipin antibodies were not detected in the remaining five patients. This assay for measuring anticardiolipin antibodies appears to provide a simple and inexpensive method of identifying women at risk of fetal death from the adverse effects of lupus anticoagulant.

Abortion, Habitual↗
PubMed1987

Cone biopsy of the cervix: does surgical technique influence cytological follow-up?

A 10-year experience of cone biopsy of the cervix was reviewed to determine whether the surgical method used delayed the diagnosis of recurrent disease. Although there is a trend to selective ablation of cervical intraepithelial neoplasia, cone biopsy is a necessary adjunct to the colposcopist and remains the technique used by many gynaecologists. Two surgical techniques were compared; 1) Sturmdorf sutures, where the denuded cervical stump was covered by squamous epithelium 2) Interrupted vertical sutures, where the cervical epithelium was not covered. There was a 15% incidence of recurrent disease which was related to the completeness of initial excision and the age of the patient. The surgical technique employed did not influence the future cytological follow-up nor delay the diagnosis of recurrent disease.

Adult↗
PubMed1986

Fetal hydrothorax in the second trimester of pregnancy: successful intra-uterine treatment at 24 weeks gestation.

Two cases of fetal hydrothorax were diagnosed during ultrasound examination in asymptomatic women in the second trimester of pregnancy. One recognized at 19 weeks gestation increased in size. Thoracentesis at 24 weeks followed by continuous drainage for 7 days relieved the condition. The other diagnosed at 15 weeks resolved over the next month without interference. Each pregnancy resulted in a normal term infant. Aspiration of fetal hydrothorax should be performed when the condition appears progressive and is not associated with a major structural abnormality.

Drainage↗
PubMed1985

Myometrial activity in first trimester human pregnancy after Epostane therapy. Effect of intravenous oxytocin.

The effect on myometrial activity of Epostane, a competitive inhibitor of the 3 beta-hydroxy steroid dehydrogenase enzyme system (3 beta-HSD) has been studied in 20 women awaiting termination of pregnancy. The women were randomly allocated by a double-blind procedure into two groups. In the Epostane-treated group there were significant falls in serum progesterone and oestradiol concentrations after 3 days of treatment. The placebo-treated group showed a small but significant decline in serum progesterone concentration. Insertion of an intrauterine balloon catheter for pressure measurements produced significantly greater uterine activity in the Epostane-treated group. The oxytocin response was variable and there was no significant difference between the two groups. A small rise in the peripheral plasma concentration of a prostaglandin F2 alpha metabolite (PGFM) was observed in the placebo group following oxytocin injection. There was a significant inverse correlation between post treatment progesterone values and uterine activity. Epostane appears to sensitize the myometrium to endogenous oxytocics and this probably results from progesterone 'withdrawal'. This effect may prove useful in potentiating the action of exogenous myometrial stimulants, such as prostaglandins, and may have a role in the termination of early pregnancy.

3-Hydroxysteroid Dehydrogenases↗