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Biomedical subjects

S W Lindow

Publications and source records attributed to S W Lindow.

At least 19 recordsLinked to original sources
PubMed2006

The prevalence of emotional abuse in gynaecology patients and its association with gynaecological symptoms.

AIM: To determine the lifetime prevalence of emotional abuse in a population of women attending a gynaecology outpatient clinic and also to investigate whether women who reported emotional abuse were more likely to complain of certain gynaecological symptoms. SETTING: A gynaecology outpatient clinic in a North of England Hospital. METHODS: Anonymous confidential questionnaire given to women. RESULTS: Nine hundred and twenty consecutive women were included, 825 questionnaires were returned (90% response rate). The prevalence of emotional abuse was 24% (198/825). Emotional abuse is four times less common in women over 50 years old. Of the fifteen presenting symptoms reported by the women, referral for termination of pregnancy, cervical smear abnormality, worry about cancer and urinary incontinence were significantly more common in the group who reported emotional abuse. The women with emotional abuse also had significantly more consultations; however, the duration of their symptoms was not significantly different. CONCLUSION: The prevalence of emotional abuse in a group of women attending the gynaecology outpatient clinic in a North of England Hospital was 24%. Women who are subjected to emotional abuse tend to have more consultations and are more likely to complain of certain symptoms.

Domestic Violence↗
PubMed2006

The development of a scoring system for symphysis pubis dysfunction.

Based on a review of the literature, a questionnaire was developed to create a scoring system for pregnancy-related symphysis pubis dysfunction (SPD) and completed by 150 (100 without SPD and 50 with SPD) peri-partum women. The questionnaire was tested for reliability in a sub-set of 21 women. Symptoms that were significantly associated with SPD were identified and used in a scoring system in order to diagnose patients with SPD. SPD was reported by 12% of patients in the first trimester, 34% in the second trimester and 52% in the third trimester. Significant symptoms in patients with SPD were: pubic bone pain on walking, turning over in bed, climbing stairs, standing on one leg, and previous damage to back or pelvis. Using a score of 1 for each of the above symptoms, a score of 2 and above was considered diagnostic of SPD. There was 1 false positive score. As SPD is a clinical condition with no definitive diagnostic test, there is a need for a scoring system that will allow patients to be assessed in terms of their symptoms. This system has the potential to facilitate screening, diagnosis and management of SPD as well as allow monitoring of the patient and assessment of the success of various interventions.

Arthralgia↗
PubMed2006

Should obstetrics and gynaecology be separate specialities? A survey of Yorkshire trainees.

A questionnaire was given to trainees attending the Yorkshire Modular training programme to determine their views on separating obstetrics and gynaecology. A total of 73 questionnaires were collected; 34% of participants were junior grade (SHO), 65% were middle grade (SpR, LAT, SSHO) and 30% of participants were male. A total of 42% of participants wanted to work in gynaecology only; 28% of participants wanted to work in obstetrics only; and only 23% wanted a combined practice. The primary reasons to prefer gynaecology was more job satisfaction than in obstetrics and better social hours of work (100%). All of the 28% of participants who wanted to work in obstetrics only, thought it is more rewarding and 100% enjoyed the challenge. In conclusion, perhaps separating obstetrics and gynaecology will make both specialties more attractive, as individuals would not be compelled to practice both. There is a possibility that this might result in better recruitment and retention in both specialities.

Adult↗
PubMed2006

How competent are obstetric and gynaecology trainees in managing maternal cardiac arrests?

The recent Confidential Enquiry (2000-2002) has emphasised 'emergency drills for maternal resuscitation should be regularly practised in clinical areas in all maternity units'. It was therefore planned to assess the knowledge of airway management and ventilation among obstetrics and gynaecology trainees in the Yorkshire Deanery (Training Region). Questionnaires were given to trainees attending the Modular Training Programme and were collected on the same day. A total of 71 questionnaires were collected which represents 62% of the 113 trainees in Yorkshire region. Replies were received from 39 registrars, 27 Senior House Officers (SHO), four Senior SHOs (SSHO) and one clinical fellow. MRCOG Part 1 was passed by 52% and 36% of trainees had MRCOG Part 2. A total of 69% of trainees did not know that chin lift opens the airway in some 70 - 80% of patients; 50% of trainees were not aware why jaw thrust is preferred over chin lift; 76% of the trainees knew the most common cause of airway obstruction in a patient with an altered level of consciousness--the tongue falls back and obstructs the pharynx ('swallowing the tongue'). Knowledge of the main cause of airway obstruction was good among obstetrics and gynaecology trainees, but their understanding of how to manage this was found to be relatively poor. Attendance at a local Basic Life Support course should be compulsory for obstetric and gynaecology trainees early in their career.

Education, Medical↗
PubMed2006

The effect of maternal methadone use on the fetal heart pattern: a computerised CTG analysis.

Using a computerised analysis, the cardiotocograph (CTG) from women who use methadone (n= 25) when compared with women who do not use methadone (n= 25) showed a significant reduction in the fetal heart baseline rate, with a significant reduction in number of accelerations and episodes of high variation. The short-term variation, number of decelerations and episodes of low variation were not different between the two groups. The time taken to meet the standardised criteria was not different, and it is possible that a computer-assisted CTG analysis could be more accurate than a naked eye interpretation.

Adult↗
PubMed2005

Pregnancy outcome in women who use opiates.

BACKGROUND: Opiate use in pregnancy is on the increase. There are a number of complications associated with this problem but current data from UK centres are sparse. DESIGN: A retrospective study. SETTING: A North of England Hospital. METHODS: Maternal and neonatal case records were studied and a standard data set completed. MAIN OUTCOME MEASURES: Maternal and neonatal outcomes were classified by the woman's drug usage at the end of pregnancy. RESULTS: One hundred and ten babies born to 108 women were studied and 41% had evidence of previous exposure to the hepatitis C virus. Women who took heroin in later pregnancy were significantly more likely than women who were stabilised on methadone to have a baby who needed morphine (40% versus 19%), had higher mean maximum neonatal abstinence scores (NAS) (5.8 versus 4.7) and stayed in the neonatal unit significantly longer (mean 17.2 days versus 11.8 days). There were two neonatal deaths and the overall rate of prematurity was 29%. CONCLUSIONS: The outcome for pregnancy in women who use opiates is complicated by high rates of prematurity and neonatal death. Women who used heroin in later pregnancy had babies who developed more severe NAS and needed a longer hospital stay than women who used only methadone.

Adult↗
PubMed2005

Somatostatin receptors 2 and 5 are preferentially expressed in proliferating endothelium.

Angiogenesis is characterised by activation, migration and proliferation of endothelial cells and is central to the pathology of cancer, cardiovascular disease and chronic inflammation. Somatostatin is an inhibitory polypeptide that acts through five receptors (sst 1, 2, 3, 4, 5). Sst has previously been reported in endothelium, but their role remains obscure. Here, we report the expression of sst in human umbilical vein endothelial cells (HUVECs) in vitro, during proliferation and quiescence. A protocol for culturing proliferating and quiescent HUVECs was established, and verified by analysing cell cycle distribution in propidium-iodide-stained samples using flow cytometry. Sst mRNA was then quantified in nine proliferating and quiescent HUVEC lines using quantitative reverse transcriptase-polymerase chain reaction. Sst 2 and 5 were preferentially expressed in proliferating HUVECs. All samples were negative for sst 4. Sst 1 and 3 expression and cell cycle progression were unrelated. Immunostaining for sst 2 and 5 showed positivity in proliferating but not quiescent cells, confirming sst 2 and 5 protein expression. Inhibition of proliferating cells with somatostatin analogues Octreotide and SOM230, which have sst 5 activity, was found (Octreotide 10(-10)-10(-6) M: 48.5-70.2% inhibition; SOM230 10(-9)-10(-6) M: 44.9-65.4% inhibition) in a dose-dependent manner, suggesting that sst 5 may have functional activity in proliferation. Dynamic changes in sst 2 and 5 expression during the cell cycle and the inhibition of proliferation with specific analogues suggest that these receptors may have a role in angiogenesis.

Antineoplastic Agents, Hormonal↗
PubMed2005

Women with nausea and vomiting in pregnancy demonstrate worse health and are adversely affected by odours.

The objectives of this study were (1) to determine aversive stimuli that are related to nausea and vomiting in pregnancy (NVP); (2) to determine food and fluid intake in early pregnancy; and (3) to explore relationships between aversive stimuli and health measures. A total of 273 women in an antenatal setting completed a questionnaire survey, incorporating the Nausea and Vomiting in Pregnancy Instrument (NVPI); the General Health Questionnaire (GHQ); measures of perceived mood and illness; food and fluid intake; and open-ended questions relating to perceived aversive and helpful stimuli. Data was subjected to quantitative and qualitative analysis. A total of 57% of women reported aversive stimuli. Of these, the primary sense implicated was olfaction, with 72% reporting food smells. A number of women were affected by the odours of drinks (26%) and other products (31%). Women who were adversely affected by odours had higher severities of NVP, perceived illness and psychopathology scores on the GHQ. In conclusion, odour appears to be an important stimulus related to NVP, with perceived aversive smells related to the severity of nausea. Women severely affected by NVP demonstrated worse health. The role of olfaction in pregnancy and specifically in sufferers of severe NVP should be evaluated further.

Female↗
PubMed2005

Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003.

OBJECTIVE: To establish the risk of serious complications from severe pre-eclampsia and eclampsia in a region using a common guideline for the management of these conditions. DESIGN: A five-year prospective study. SETTING: Sixteen maternity units in Yorkshire. POPULATION: All women managed with severe pre-eclampsia and eclampsia. METHODS: A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data. MAIN OUTCOME MEASURE: Incidence of the conditions and serious complication rates. RESULTS: A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty-seven women were diagnosed with severe pre-eclampsia or eclampsia (5.2/1000). One hundred and fifty-one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty-five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty-five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug. CONCLUSION: A regional guideline for severe pre-eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.

Anticonvulsants↗
PubMed2004

24 hour rhythm in the timing of pre-labour spontaneous rupture of membranes at term.

OBJECTIVE: To study the timing of pre-labour spontaneous rupture of membranes (SROM) in term pregnancies. DESIGN: Prospective cohort. SETTING: A maternity hospital in the United Kingdom. SAMPLE: Women who were more than 37 weeks gestation with confirmed spontaneous rupture of membranes and not in labour after 4 h. METHODS: Women who were admitted into labour ward with a diagnosis of spontaneous rupture of membranes after 37 weeks of gestation were included. The women's demographic details were recorded and inquiries about whether they had sexual intercourse in the preceding 12 h. The final outcome of their pregnancy was recorded and analysed. MAIN OUTCOME MEASURES: (1) The exact time of spontaneous rupture of membranes, (2) the time of onset of spontaneous labour, (3) delivery details. RESULTS: One hundred and ninety-six women were studied. A 24 h rhythm in the timing of spontaneous rupture of membranes was found with 33.2% occurring between 00:00 and 04:00 h. When contractions representing the onset of labour occurred there was no diurnal rhythm to the timing of onset of contractions. CONCLUSIONS: There is a 24 h rhythm in the timing of spontaneous rupture of membranes in term gestations. The physiological reasons for this rhythm are not understood at the present time.

Adult↗
PubMed2004

Psychological health in early pregnancy: relationship with nausea and vomiting.

The psychological health of women in early pregnancy was investigated in a sample of 273 women (mean gestational age 12.8 weeks, SD=2.8) using the General Health Questionnaire (GHQ) and mood and illness perception visual analogue scales, and compared with the prevalence and severity of nausea and vomiting as measured using the Nausea and Vomiting in Pregnancy Instrument (NVPI). Using a cut-off of 4/5 for the GHQ, 50.5% of pregnant women were found to have potential psychiatric problems. However, perceived mental health and physical illness was significantly better than anticipated. The severity of nausea and vomiting correlated independently with GHQ subscales for somatic symptoms, social dysfunction, anxiety/insomnia and severe depression. The contradiction between high GHQ scored and high perceived wellbeing might be explained through cognitive processing. Nausea and vomiting in early pregnancy is associated with psychiatric morbidity. The causal relationship between the two conditions has not been established.

Adolescent↗