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Biomedical subjects

T Lind

Publications and source records attributed to T Lind.

At least 181 records · Page 10Linked to original sources

Effect of normal pregnancy upon the glycosylated haemoglobins.

In this cross-sectional study total glycosylated haemoglobin (Hb AIa+b+c) has been measured in 20 healthy non-pregnant women and in five groups of 20 healthy women at various times during pregnancy. A statistically significant decrease occurs in these minor haemoglobin fractions by about 20 weeks gestation and this reduced level is maintained throughout the rest of pregnancy. If diabetic patients are to have their control assessed during pregnancy by determination of these fractions this fact might be relevant.

Adult↗

Red cell mass during and after normal pregnancy.

Red cell mass, derived from plasma volume and haematocrit, was calculated serially in 45 healthy women during pregnancy and 4 to 6 months after delivery. Compared to the non-pregnant, postpartum value there was a reduction of approximately 100 ml at 12 weeks gestation. An increase in red cell mass occurred thereafter: at 36 weeks gestation values 180 ml greater than the non-pregnant were found. Iron and folic acid supplements almost doubled this increment to 349 ml of red cells.

Adult↗

A prospective, controlled trial of six forms of hormone replacement therapy given to postmenopausal women.

This study was undertaken to investigate the effect of various forms of hormone replacement therapy (HRT) upon postmenopausal women while controlling as many variables as possible. It was felt that the age, duration of amenorrhoea and the general health of the patients should be as comparable as possible and that each patient should provide her own pretherapy and post-therapy control data. In addition, it was felt that any placebo effect should be investigated and the patients were therefore randomly allocated to placebo tablets or one of six available forms of HRT. The age/sex registers of two large general practices were scrutinized and all women between 49 and 54 years of age were asked to cooperate; for a variety of reasons only 56 women were suitable and willing to take part in the project, yielding 8 women for each of the seven possible therapy groups. Blood samples were taken at 7-day intervals three times before therapy was given and the mean of the three values was used as the control value. The women returned on day 21 of each subsequent therapy cycle for six consecutive months and finally three months after discontinuing therapy. From the data the following broad conclusions can be drawn: (i) some women have classic symptoms of hot flushes and sweating despite high endogenous oestrogen concentrations; (ii) vaginal cytology is a relatively poor indicator of endogenous oestrogen status; (iii) while follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations are reduced on HRT neither is decreased to anywhere near premenopausal values while prolactin is unaffected; (iv) plasma cholesterol levels are reduced on HRT, the pulse rate is slower and both systolic and diastolic blood pressure are reduced to a small but significant extent; (v) there is no adverse effect upon blood clotting; and (vi) most women experience significant or complete relief of symptoms on all forms of HRT as do some women taking a placebo. The combined preparations containing an oestrogen and progestogen produced vaginal bleeding in only 80 per cent of the women. Thus protection by regular endometrical shedding may not be afforded to all women. As vaginal bleeding is unacceptable to most women if they can achieve the same symptomatic relief without inducing menstruation, it is suggested that women have a low dose oestrogen preparation prescribed cyclically for 6 to 12 months. If therapy is to be maintained for a longer time, uterine curretage should be undertaken at regular intervals to exclude the possibility of endometrial carcinoma developing.

Climacteric↗

Metabolic changes in pregnancy relevant to diabetes mellitus.

The alterations in carbohydrate metabolism during pregnancy are discussed and possible mechanisms for these changes are put forward. It is stressed that the raised levels of plasma glucose, the enhanced response to insulin and the decreased tissue sensitivity to insulin are all features of normal pregnancy. It may be difficult to distinguish this from very early forms of diabetes mellitus during pregnancy, the detection of which is briefly considered.

Adult↗

Serum prolactin, gonadotrophin and oestrogen levels in women receiving hormone replacement therapy.

Prolactin, oestrone, oestradiol, FSH and LH concentrations have been determined in postmenopausal women receiving different forms of hormone replacement therapy. While the serum oestrogen levels achieved were sufficient to cause a significant decrease in circulating FSH and LH levels, no significant change in prolactin concentrations was found. Two other findings are of interest: despite the absolute concentrations achieved, the ratio of FSH to LH and the ratio of oestradiol to oestrone did not change significantly on any of the hormone formulations used; and while FSH and LH were both suppressed to a significant degree on therapy neither was suppressed to premenopausal values suggesting the possibility of a 'female inhibin' in the normal regulation of gonadotrophin secretion.

Estrogens↗

Effect of maternal parity and infant sex upon the haematological values of cord blood.

Coulter Counter (Model S) analysis of 400 cord blood samples are presented, together with differential white cell counts for 249 of these. The mean values for haemoglobin and red cell count are somewhat higher than previous values determined by manual methods, while those for haematocrit and mean cell volume are slightly lower. An unexpected finding was that the red cell count, haemoglobin concentration, and haematocrit, are significantly higher in male than in female infants. A parity effect was also demonstrated: infants of both sexes born as second or subsequent births had lower values for total white cell count, haemoglobin concentration and haematocrit, than first-born infants.

Birth Weight↗

Haematological changes during normal pregnancy: iron induced macrocytosis.

Haematological indices in 300 pregnant and 50 non-pregnant women were obtained by Coulter Counter analysis. In 47 women who did not receive iron supplements during pregnancy, haemoglobin concentration fell from a mean of 12-23 g/dl in early pregnancy to 11-04 g/dl at 34 weeks gestation, a level which was maintained until term. In the 153 women to whom iron supplements were given during pregnancy, the initial fall in haemoglobin concentration was less, was arrested by 28 weeks gestation and then rose to a level equivalent to the booking level. This different pattern in iron supplemented pregnancies was due to an increase in the red cell count together with a change in mean cell volume. Although the changed mean cell volume usually remained within the normal range in the group who did not take iron, a few women developed microcytosis which could reflect iron deficiency; a macrocytic change was noted in a small number of the women who received routine iron supplements and this could reflect iron "over sufficiency". The results are discussed in relation to the possible effects of giving routine oral iron to all pregnant women.

Anemia, Macrocytic↗

Changes in the oral glucose tolerance test during the puerperium.

Oral glucose tolerance tests were performed during late pregnancy, on the second and fifth days of the puerperium and finally six weeks after delivery in a group of 12 healthy women. The glucose response showed no significant change from the pregnancy values on the second and fifth days of the puerperium but each woman had returned to 'normal' by the sixth week post partum. In contrast, the insulin response had returned to the non-pregnant value by the second day of the puerperium.

Blood Glucose↗

Planned pregnancy in a renal transplant recipient.

A scheme is described for the investigation and management of a renal transplant recipient before conception, over conception and during the subsequent pregnancy, delivery and puerperium. The patient showed the physiological changes in homeostasis of normal pregnancy. Methods of monitoring maternal, fetal and renal well-being are discussed. The patient was delivered of a live male child and the neonatal problems are described. The puerperium was uneventful.

Adult↗

Cord plasma glucose and insulin concentrations and maternal-fetal relations.

The concentration of glucose and insulin was estimated in 854 samples of umbilical cord blood plasma and 503 concurrently collected maternal blood samples. The mean cord insulin concentration, excluding all infants born to known diabetic mothers, was 7 muU./ml., but the distribution was skewed with 10 per cent of infants having a value of 12 muU./ml. or more. The giving of intravenous sugar-coating fluids to the mother during labor tended to exaggerate the skewness rather than move the whole distribution to the right. Babies born by vaginal route, whatever the presentation of method of delivery, had slightly lower mean insulin values than those born by Caesarean section. It thus seems unlikely that "stress" is a factor causing high cord insulin values at birth. Other data concerning maternal-fetal glucose and insulin relations are discussed.

Blood Glucose↗