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- Forsberg, L, et al.
(author)
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Long-term consequences after exposure to antiepileptic drugs in utero
- 2011
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In: Therapeutic advances in drug safety. - : SAGE Publications. - 2042-0986 .- 2042-0994. ; 2:5, s. 227-34
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Journal article (peer-reviewed)abstract
- Most pregnant women with epilepsy need pharmacological treatment during pregnancy. Children exposed to antiepileptic drugs have an increased risk of being born with major malformations. Some antiepileptic drugs seem to have negative effects on psychomotor or cognitive development in children exposed during foetal life. Neither carbamazepine nor lamotrigine in monotherapy seem to affect the cognition of exposed children. Several studies have shown negative effects on the long-term neurodevelopment of children prenatally exposed to valproic acid or polytherapy (two or more antiepileptic drugs during pregnancy). For most of the newer antiepileptic drugs there are insufficient data regarding long-term outcome.
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- Ingemarsson, Ingemar, et al.
(author)
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Effects of isradipine, a new calcium antagonist, on postpartum uterine activity
- 1989
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 68:8, s. 725-730
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Journal article (peer-reviewed)abstract
- The effects of a new calcium antagonist, isradipine (PN 200-110) on postpartum uterine activity and the maternal cardiovascular system were investigated. Uterine activity was recorded by a microtip transducer catheter inserted transcervically within 45 min of normal vaginal delivery. 0.5 mg of isradipine was given as a bolus injection during 5 min to 7 women with spontaneous uterine activity and 1 mg was given during a 15-min period to another 8 women with oxytocin-stimulated uterine activity. Matched controls with similar pre-injection activity (+/- 5%) but not given the drug were selected for comparison. The effects of the drug in 3 women (given 1 mg of isradipine) were compared with those in matched controls and in women given 0.25 mg of terbutalin i.v. as a bolus injection. Isradipine had a marked inhibitory effect on both spontaneous and oxytocin-stimulated uterine activity. The inhibitory effect of 1 mg of isradipine seemed comparable to that of 0.25 mg of terbutalin. The inhibition occurred within 1-2 min after the injection and was sustained throughout the study period (2 h). A transient reduction of the systolic (mean maximum decrease 10-15%) and diastolic blood pressure (mean maximum decrease 15-20%) was seen, particularly during the injection period. Hypotension (systolic blood pressure less than 80 mmHg) was not recorded. A moderate increase in pulse rate (mean maximum increase 22-27%) was seen in all cases. The results show that isradipine given as a bolus injection can inhibit early postpartum uterine activity, with minimal side effects.
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| 17. |
- Linder, C, et al.
(author)
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A LC-MS/MS method for therapeutic drug monitoring of carbamazepine, lamotrigine and valproic acid in DBS
- 2015
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In: Bioanalysis. - : Future Science Ltd. - 1757-6199 .- 1757-6180. ; 7:16, s. 2031-2039
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Journal article (peer-reviewed)abstract
- Background: Therapeutic drug monitoring of antiepileptic drugs in children with epilepsy assists for personalized drug therapy but require numerous patient visits for venous blood sampling. DBS is an alternative matrix applicable to home sampling which can save time and reduce stress for this patient group. Results: A fast LC–MS/MS method for quantification of carbamazepine, lamotrigine and valproic acid based on DBS sampling was developed. The method showed linearity in therapeutically relevant concentration ranges and compatible with unknown volume sampling and expected hematocrit range of the patient group. Conclusion: A LC–MS/MS method for the three most commonly used antiepileptic drugs has been fully validated and clinically applied on DBSs from patients at the neuropediatric clinic at Karolinska University Hospital.
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- Lindström, Jan K., et al.
(author)
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Intersubjectivity at the counter : Artefacts and multimodal interaction in theatre box office encounters
- 2017
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In: Journal of Pragmatics. - : Elsevier BV. - 0378-2166 .- 1879-1387. ; 108, s. 81-97
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Journal article (peer-reviewed)abstract
- The present study investigates the interplay between language, material and embodied resources in one specific type of service encounters: interactions at theatre box offices. The data consist of video recorded interactions in Swedish at three box offices, two in Sweden and one in Finland. Cases representative of the interactions are selected for a multimodal micro-analysis of the customer--seller interactions involving artefacts from the institutional and personal domain. The study specifically aims at advancing our understanding of the role of artefacts for structuring and facilitating communicative events in (institutional) interaction. In this way, it contributes to the growing research interest in the interactional importance of the material world. Our results show that mutual interactional focus is reached through mutual gaze in strategic moments, such as formulation of the reason for the visit. Artefacts are central in enhancing intersubjectivity and mutual focus in that they effectively invite the participants for negotiation, for example, about a seating plan which can be made visually accessible in different ways. Verbal language can be sparse and deictic in these moments while gaze and pointing to an artefact does more specific referential work. Artefacts are also a resource for signalling interactional inaccessibility, the seller orienting to the computer in order to progress a request and the customer orienting to a personal belonging (like a bag) to mirror and accept such a temporary non-accessibility. We also observe that speech can be paced to match the deployment of an artefact so that a focal verbal item is produced without competing, simultaneous physical activity.
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| 21. |
- Lipworth, L., et al.
(author)
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Maternal pregnancy hormone levels in an area with a high incidence (Boston, USA) and in an area with a low incidence (Shanghai, China) of breast cancer
- 1999
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In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 79:1, s. 7-12
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Journal article (peer-reviewed)abstract
- Characteristics probably associated with the fetal hormonal milieu have recently been shown to increase (birth size indicators, prematurity, neonatal jaundice) or decrease (pregnancy toxaemia) breast cancer risk in the female offspring. However, it is unknown whether differences in pregnancy hormone levels may contribute to the marked geographical variation in breast cancer incidence. We have compared, in a highly standardized manner, pregnancy hormone levels in a population with high incidence and one with low incidence of breast cancer. Three hundred and four pregnant Caucasian women in Boston and 334 pregnant Chinese women in Shanghai were enrolled from March 1994 to October 1995. Levels of oestradiol, oestriol, prolactin, progesterone, human growth hormone, albumin and sex hormone-binding globulin were measured in maternal blood at weeks 16 and 27 of gestation and compared between the two study sites using non-parametric Wilcoxon's rank-sum test. Demographical, anthropometrical and pregnancy characteristics were ascertained through interview, and relevant variables concerning delivery and the newborn were abstracted from medical records and paediatric charts. During the first visit, median serum levels of all studied hormones were statistically significant, and in most instances substantially, higher among Chinese women, who have a low incidence of breast cancer, compared with American women, who have a high incidence of breast cancer. An analogous pattern was evident during the second visit, although the relative differences tended to be smaller. Further research is needed to identify lifestyle or other exogenous determinants of pregnancy hormone levels, as well as possible mechanisms by which they may influence carcinogenic processes in the breast and possibly other organs.
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| 22. |
- Ljunghall, S., et al.
(author)
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Disturbance of basal and stimulated serum levels of intact parathyroid hormone in primary hyperparathyroidism
- 1991
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In: Surgery. - 0039-6060 .- 1532-7361. ; 110:1, s. 47-53
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Journal article (peer-reviewed)abstract
- In patients with primary hyperparathyroidism, measurements were made of basal and stimulated levels of intact parathyroid hormone (PTH). The basal PTH values were elevated in all but six of 89 patients and provided clear separation towards normal individuals (n = 75) and patients with hypercalcemia of other origin (n = 34). The PTH value correlated with the serum calcium concentration in hyperparathyroidism and with the weight of excised parathyroid adenomas but not with that of chief cell hyperplasias. A constant ethylenediaminetetraacetic acid infusion during 60 minutes of induced essentially linear reductions of plasma-ionized calcium concentrations, averaging 0.02 mmol/L/10 minutes, which were associated with swift, curvilinear, elevations of PTH levels that reached a plateau after 10 to 20 minutes. The increment in serum PTH level correlated with the basal PTH value both in patients with hyperparathyroidism and controls. However, in proportion to the much greater glandular mass in the patients with hyperparathyroidism, the secretion of PTH was relatively reduced. The findings support the value of the intact PTH assay in the differential diagnosis of hypercalcemia and show that PTH secretion in vivo is extremely sensitive to hypocalcemic stimulation, that the pathological parathyroid tissue in hyperparathyroidism is characterized by a reduction of hormone release per unit weight, and that the hormone secretion in hyperparathyroidism operates closer to its maximal capacity than under normal circumstances.
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- Wide, K, et al.
(author)
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Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study
- 2004
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In: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 93:2, s. 174-176
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Journal article (peer-reviewed)abstract
- Aim: Antiepileptic drugs (AEDs) are known teratogens. Some specificity between different AEDs has been noted in the literature. The aim was to compare the teratogenic effect of valproic acid (VPA) and carbamazepine (CBZ) in monotherapy. Methods: Infants exposed to AEDs (n=1398) in early pregnancy were identified from the Swedish Medical Birth Registry. The number of infants with congenital malformations and exposed to AED was compared with the expected number estimated from all infants born (n=582656). Results: 90% (1256) of the AED exposed children were exposed to AEDs in monotherapy, 56% were exposed to CBZ and 21% to VPA. The odds ratio (OR) for having a malformation in the AED exposed group was 1.86 [95% confidence interval (95% CI) 1.42-2.44]. Exposure to VPA in monotherapy compared with CBZ in monotherapy gave OR=2.51 (95% CI 1.43-4.68) for a neonatal diagnosis of malformations. However, there is no information available on the number of therapeutic abortions, or the different types of epilepsy or drug dosage in the two treatment groups. Conclusion: There was a small increase in the risk of having a major malformation after exposure to AEDs in monotherapy. Exposure to VPA seems to carry a higher risk than exposure to CBZ.
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| 46. |
- Wuu, J., et al.
(author)
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Correlates of pregnancy oestrogen, progesterone and sex hormone-binding globulin in the USA and China
- 2002
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In: European Journal of Cancer Prevention. - : Ovid Technologies (Wolters Kluwer Health). - 0959-8278 .- 1473-5709. ; 11:3, s. 283-293
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Journal article (peer-reviewed)abstract
- The objective of this study is to examine perinatal correlates of oestradiol (E2), oestriol (E3), progesterone and sex hormone-binding globulin (SHBG) among pregnant women in the USA and China. Three hundred and four Caucasian women in Boston and 335 Chinese women in Shanghai were studied. Levels of E2, E3, progesterone and SHBG were measured in maternal blood at weeks 16 and 27 of gestation, and correlated with maternal, gestational and perinatal characteristics. Height, weight and body mass index (BMI) before pregnancy is inversely associated with E2 and SHBG, whereas E3 is inversely associated with height and progesterone is inversely associated with weight and BMI. A previous live birth is associated with lower E2 and SHBG in the index pregnancy. Total gestation duration is inversely associated with E2, E3 and progesterone, whereas weight gain during pregnancy is inversely associated with progesterone and SHBG. In the US, pregnancies with female fetuses are characterized by significantly reduced progesterone. Pregnancy hormones are associated with several maternal, gestational and neonatal characteristics.
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| 47. |
- Xu, B., et al.
(author)
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Maternal and gestational correlates of pregnancy prolactin and growth hormone in USA and China
- 2003
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In: European Journal of Cancer Prevention. - : Ovid Technologies (Wolters Kluwer Health). - 0959-8278 .- 1473-5709. ; 12:1, s. 35-42
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Journal article (peer-reviewed)abstract
- The objective of this study is to determine correlates of prolactin and growth hormone levels among pregnant women in the USA and China. We studied 304 pregnant Caucasian and 335 pregnant Chinese women. Levels of prolactin and growth hormone were measured at weeks 16 and 27 of gestation, and correlated with maternal, gestational and perinatal characteristics. Both growth hormone and, to a lesser extent, prolactin were inversely associated with pregnancy weight and body mass index, history of a previous live birth and newborn size, whereas educated women had higher levels of both hormones. Growth hormone levels were lower in women who gained more weight, smoked and had nausea and vomiting during pregnancy, whereas prolactin increased with longer total gestation. We found robust associations between maternal and newborn characteristics on the one hand and prolactin and growth hormone during pregnancy on the other.
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