Return of fertility after the removal of Nova T or Copper T 200

The return of fertility after removal of Nova T or Copper T 200 IUDs was studied in 150 women who had a removal for planning pregnancy in a study performed for the comparison of the clinical performance of these IUDs in Denmark, Finland and Sweden. There was no significant difference in the return of fertility of women having used either device. The cumulative probability of pregnancy per 100 women after the removal of the IUD, as a net rate, was 77.3 at one year, 88.9 at two years and 92.4 at three years.The return of fertility was analyzed separately for those women who had used their IUD for less than two years and for two or more years. The duration of the use had no significant effect on the return of fertility. The outcome of pregnancy, the birth weight, the condition at delivery and the sex ratio of the newborns were normal in the participating countries.     

Pituitary and gonadal function during the use of norgestrel-estradiol vaginal rings

Four women used polysiloxane contraceptive rings (CVR) impregnated with d-Norgestrel and estradiol for contraceptive purposes. The treatment was given in three-week cycles, leaving one treatment-free week between the cycles. Subjects were followed by blood sampling twice a week for three or four treatment cycles. Plasma concentrations of d-Norgestrel, estradiol, progesterone, and gonadotropins were determined by radioimmunoassay.The bleeding patterns were very acceptable. One subject experienced acne and weight gain, but no other side-effects were observed. Furthermore, no local irritation was found during the follow-up period of six or seven months.The individual variation in the mean plasma concentrations of d-norgestrel was between 3.2 and 1.1 ng/ml. Apart from one case, the highest individual levels were observed at the beginning of the first treatment cycle. Plasma estradiol was low during the treatment, but in some cases low post-insertion peaks were observed. No ovulatory progesterone values were found.Plasma LH was generally suppressed, but FSH was not. During the treatment-free week increasing concentrations of both LH and FSH were found, indicating an activation of pituitary function.     

Comparison of the analgesic effect of ten nonsteroidal anti-inflammatory drugs

The analgesic effect of 10 anti-inflammatory drugs was compared using a single-blind method in 90 patients with rheumatoid arthritis. Each patient received two different drugs, for three days each and each drug was evaluated in 18 patients. After the trial, the patients considered which of the drugs they preferred. The greatest relief from pain was achieved by diclofenac, indomethacin, naproxen and tolfenamic acid, each of these being preferred by the majority of patients and being significantly (p less than 0.01) better than the least effective drugs ketoprofen and proquazone. Acetylsalicylic acid, azapropazone, carprofen and ibuprofen were considered intermediate in efficacy.     

Low-saturated fat dietary counseling starting in infancy improves insulin sensitivity in 9-year-old healthy children: the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study

OBJECTIVE: Insulin resistance is promoted already in childhood by obesity and possibly by high-saturated fat intake. We examined the effect of infancy onset biannually given dietary counseling on markers of insulin resistance in healthy 9-year-old children. RESEARCH DESIGN AND METHODS: Healthy 7-month-old infants (n = 1,062) were randomized to the intervention (n = 540) and control (n = 522) groups. Each year, two individualized counseling sessions were organized to each intervention family. The purpose of counseling was to minimize children's exposure to known environmental atherosclerosis risk factors. Homeostasis model assessment of insulin resistance (HOMA-IR) index, serum lipids, blood pressure, and weight for height were determined in a random subgroup of 78 intervention children and 89 control children at the age of 9 years. RESULTS: Intervention children consumed less total and saturated fat than the control children (P = 0.002 and < 0.0001, respectively). The HOMA-IR index was lower in intervention children than in control children (P = 0.020). There was a significant association between saturated fat intake and HOMA-IR. In multivariate analyses including saturated fat intake, study group, and other determinants of HOMA-IR (serum triglyceride concentration, weight for height, and systolic blood pressure), study group was, whereas saturated fat intake was not, significantly associated with HOMA-IR. This suggests that the beneficial effect of intervention on insulin sensitivity was largely, but not fully, explained by the decrease in saturated fat intake. CONCLUSIONS: The long-term biannual dietary intervention decreases the intake of total and saturated fat and has a positive effect on insulin resistance index in 9-year-old children.     

Two intrauterine rescue transfusions in treatment of severe fetomaternal hemorrhage in the early third trimester

When massive fetomaternal hemorrhage is diagnosed in the early third trimester of pregnancy, serial fetal intravascular transfusion may be an alternative to immediate delivery.     

Eight years of experience with molecular identification of human enteroviruses

We have successfully typed 1,121 human enterovirus (HEV) isolates during the last 8 years by adapting partial VP1 sequencing to routine identification of HEV isolated from diverse clinical and environmental specimens. The isolates include 48 of the 59 traditional nonpoliovirus HEV serotypes and members of 8 newly discovered types, which would have remained untypeable by neutralization using the conventional cross-sectional pools of antisera.     

Patient satisfaction in the long-term effects of Eustachian tube balloon dilation is encouraging

Object: To investigate the long-term effects of balloon Eustachian tuboplasty (BET) from patient’s perspective and to discover which symptoms of Eustachian tube dysfunction (ETD) benefit the most from BET.

Method: We designed a retrospective postal questionnaire based on the seven-item ETD questionnaire (ETDQ-7). Our questionnaire covered the severity of present ETD symptoms in comparison with the preoperative situation, the severity of current overall ear symptoms, and possible surgical interventions after BET. Forty-six patients treated in our institution between 2011 and 2013 fulfilled the inclusion criteria and 74% (34 patients; total 52 ears treated with BET) returned the questionnaire with a mean follow-up time of 3.1 years (range 1.8-4.6 years).

Results: Pain in the ears, feeling of pressure in the ears, and feeling that ears are clogged had reduced in 75% of the ears that suffered from these symptoms preoperatively. Seventy-seven percent of all the responders felt that their overall ear symptoms were reduced. Altogether, 82% of all the patients stated that they would undergo BET again if their ear symptoms returned to the preoperative level.

Conclusion: Patient satisfaction in the long-term effects of BET is encouraging. These results may help clinicians in preoperative patient selection and counselling.     

Morphological and functional differentiation of the surface epithelium of the bursa Fabricii in chicken

Morphological and functional differentiation of the mucosal surface epithelium of the bursa Fabricii was studied in White Leghorn chicken fetuses and newly hatched chickens. First signs of differentiation towards two types of epithelial cells appeared on the thirteenth day of incubation: The apical cells of the epithelial buds projected towards the lumen, and an increase in the number of Golgi regions was observed in the epithelial cells between the buds. On day 15 the follicle-associated epithelium contained small apically situated vacuoles, and large mucin granules appeared in the interfollicular surface epithelium. Towards the day of hatching both epithelial cell types were arranged to a monolayered or pseudostratified cylindrical epithelium. The follicle-associated epithelium had invaginations and small vacuoles in the apical cytoplasm, whereas the interfollicular surface epithelium had numerous microvilli on its apical surface and large mucin granules in the apical cytoplasm. In functional studies, endocytosis of colloidal carbon was demonstrated in four out of ten 19-day-old fetuses and in all chickens studied immediately after hatching.     

Effects of an intervention on health behaviors of older coronary artery bypass (CAB) patients

Coronary artery bypass (CAB) patients are older increasingly more often than before. Effectiveness of cardiac rehabilitation among the elderly is not yet adequately known about. The purpose was to describe short-term (3-month), intermediate (6-month), and long-term (12-month) effects of health counseling, guidance, and adjustment education in groups on health, health behaviors, and functional abilities among older CAB patients. The study population was randomized to an intervention group (IG=49) and a control group (CG=68). Prior to CAB, intervention included one guidance and counseling group session and four sessions within 12 months following CAB. Intervention had positive effects on exercise activities, use of alcohol, and functional abilities among all participants, and on frequency of eating visible fat, fresh greens and vegetables among men. The intervention was effective with some exercise activities and functional abilities persisting for at least 1 year following CAB. Similar interventions may be arranged for older people. Health care professionals need to guide and encourage older people in their efforts to participate in them.