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After a short representation of the present possibilities in prophylaxis and therapy of premature infants an information is given about disturbances of metabolism of the liver follow up the treatment with beta-adrenergic substances. Further a first report is given about laying in of pessars in addition to cerclage in cases of insufficiency of the cervix uteri.
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OBJECTIVE: To compare use-effectiveness and side-effects of medical termination of early pregnancy by oral administration of separated doses of mifepristone 150 mg or single dose of mifepristone 200 mg followed by PG05 1 mg vaginally in 4500 healthy pregnant women with amenorrhea < or = 49 days in a phase I multicentre study. METHODS: All subjects were recruited in 30 clinics after obtaining informed consents. RESULTS: The complete, incomplete abortion and continuous pregnancy rates were 88.6%, 8.1%, 1.7% and 92.0%, 5.8%, 0.8% in single dose and separated doses groups, respectively. The efficacy of termination of early pregnancy by mifepristone 150 mg in separated doses was higher than that in single dose of mifepristone 200 mg when both in combination with PG05 1 mg (P < 0.01). One case of allergic rash was noted after administration of mifepristone. No severe side-effects were observed except bleeding problems. 65 cases received emergency vacuum aspiration and 7 of them received blood transfusion due to heavy bleeding. In addition, 2 cases of ectopic pregnancies required blood transfusion as heavy bleeding caused by exfetation disruption. There was no significant difference in to the time to start bleeding and the days of bleeding lasted between two treatment groups. However, there was a significant positive correlation (P < 0.001) between diameters of SAC and the days of bleeding lasted. CONCLUSIONS: Logistic regression analysis suggested that subject's age, gravidity and days of amenorrhea have significant effects on abortion efficacy. 75.2% of subjects are satisfactory in self-assessment of the treatment, and 81.8% of subjects will choose medical abortion method in case they need to terminate undesired early pregnancy in the future.
Generally, clinical symptoms such as abnormal leukorrhea are caused by C. trachomatis, an ordinary bacteria in cervical infection. The effects of levofloxacin administration at a dose of 300 mg/day for 5-14 days were investigated in the subjects (n = 66) after the discussion of cystic cervicitis. The treatment was made in combination with chloramphenicol-solcoseryl tablet for vaginal use. And it was demonstrated that treatment was effective in all subjects. Then, Sero IPALISA, an examination of IgA/IgG antibody was conducted for the screening of Chlamydia infection (n = 258). The rate of antibody-positive case was 48/160 (30.0%) for the non-pregnant women and 26/98 (26.5%) for the pregnant. The occurrence rates for the women singing in 15-24 and 35-39 years of age were 50 and 41%, respectively. The results from the measurement of the antibody titer were as follows: the rate of IgA/IgG positive care was 61/87 for IgA and 56/87 for IgG when the cut-off index was 1.11 or more. The rates for both antibody were 11/87 (12.6%) and 24/87 (27.6%) for the indexes of 1.11-3.00 and 3.01 or more, respectively. Next, one to three courses levofloxacin at 300 mg/day for 14 days were given to 48 non-pregnant subjects infected with Chlamydia and one to two courses of clarithromycin at 400 mg/day for 14 days were given to 26 pregnant subjects. Side effects have not been noted in any care and there was no changes in the IgA/IgG antibody titer depending on these treatments.
UNLABELLED: Post-Caesarean section analgesia can be achieved by morphine infusion. NSAIDs are frequently administered to relieve uterine cramps. This study is aimed at assessing the efficacy of the combination of suppository diclofenac and morphine infusion in post-Caesarean section pain relief. General anaesthesia was given to 60 patients who were randomly allocated into two groups: group A received 100 mg suppository diclofenac before surgical incision and morphine infusion 1.5 mg per hour postoperatively while group B received only morphine infusion 1.5 mg/H postoperatively. Pain assessment was done by an unbiased observer on arrival of the patients in the recovery room, then 6 hours, 12 hours and 24 hours later. Pain relief was found to be better in group A, with group B requiring more supplemental analgesia. Apart from better analgesic effect for wound pain, group A also had more favourable scores for uterine cramping pain. The incidence of nausea or vomiting was similar in both groups. No respiratory depression was observed in both groups. Two cases of increased bleeding (one from each group) were observed, both receiving conservative treatment. THE CONCLUSION: suppository diclofenac improved the analgesic efficacy of morphine infusion in post-Caesarean analgesia.
A number of vaginal and urethral devices have recently been introduced for the treatment of female urinary stress incontinence. Nine recent studies of these were scrutinized. The median corrected subjective cured/improved rate was 63% for the vaginal and 43% for the urethral devices. The latter group have a high percentage of side-effects with related drop-outs. Urinary tract infection and migration of the device into the bladder are particularly worrying. The vaginal devices currently available compete favourably with other non-surgical forms of therapy for stress incontinence in terms of efficacy and safety.
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UNLABELLED: Estrogen replacement therapy is used in postmenopausal women with symptoms of urogenital atrophy. The aim of this study was to detect differences in efficacy of a low-dose estradiol-releasing vaginal ring and a placebo ring in the relief of symptoms of estrogen deficiency and reduction of urogenital atrophy (pH and vaginal mucosal maturation) in postmenopausal women. DESIGN: This was a multicentre double-blind, placebo-controlled study. PATIENT SAMPLE: 84 postmenopausal women, of whom 67 completed the full 24 weeks of treatment. RESULTS: Vaginal pH decreased significantly (p = 0.0006) in the estradiol group compared with the placebo group. Similarly, in the estradiol group the mean maturation value increased significantly (p = 0.0004), while incidence of pallor and friability were significantly reduced. Patients in the estradiol group reported significantly greater relief of dyspareunia. CONCLUSION: The results indicate that the estradiol-releasing vaginal ring is effective and well tolerated in the treatment of local estrogen deficiency.
OBJECTIVE: To critically assess the world literature on the efficacy and safety of the vaginal ring estradiol delivery system for the local treatment of urogenital atrophy due to hypoestrogenism. STUDY DESIGN: Published data over the past decade on the vaginal ring delivery system were reviewed. RESULTS: Data from comparative clinical trials indicate that the vaginal ring delivery system is comparable in efficacy, safety and tolerability to other vaginal delivery systems and may enhance compliance because of its ease of use. CONCLUSION: The vaginal ring delivery system offers an alternative to other vaginal delivery systems with the advantages of accurate and sustained dosing and minimal need for patient intervention.
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