Abstract:
:According to a London physician, women with epilepsy taking antiepileptic drugs can take combined oral contraceptives (OCs). It is usual to recommend a combined OC preparation containing at least 50 mcg of estrogen (Ovran) from patients taking enzyme-inducing antiepileptic drugs; this can be increased to 60 mcg by taking 2 30 mcg pills, and if necessary to 80 mcg. To ensure that ovulation is inhibited, the blood progesterone concentration can be measured on day 21 of the 1st cycle. The higher doses of estrogen should be accompanied by higher doses of progestogen. The commonest fetal malformations are cleft lip and palate and congenital heart disease, usually septal defects. These abnormalities may be caused by all the major antiepileptic drugs. Phenytoin has been particularly implicated and may cause minor defects in up to 30% of infants and major defects in about 5%. The incidence of cleft palate and heart defects with phenytoin is 1.8% compared with 0.7% in the general population. With sodium valproate, neural tube defects occur in about 1.5% of pregnancies. Present evidence suggests that carbamazepine is the safest drug. Folic acid supplements reduce the risk of neural tube defects in women at risk, therefore women taking antiepileptic drugs who are contemplating pregnancy should be given a small folic acid supplement or a diet rich in folate. To reduce the risk of bleeding in the perinatal period, pregnant women taking enzyme-inducing antiepileptic drugs should be given oral phytomenadione (vitamin K1) 20 mg daily for at least 1 week before delivery. Vitamin K1 should be given to the newborn immediately after delivery. Only phenobarbitone and primidone might be contraindicated for breast feeding. Mothers with uncontrolled major epilepsy should not be left alone with small children. If there is already 1 sibling with epilepsy the risk of inheriting epileptic liability rises to about 10% and if both parent have epilepsy the risk is 15-20%.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
O'Brien MD,Gilmour-White Sdoi
10.1136/bmj.307.6902.492subject
Has Abstractpub_date
1993-08-21 00:00:00pages
492-5issue
6902eissn
0959-8138issn
1756-1833journal_volume
307pub_type
杂志文章,评审abstract:STUDY OBJECTIVE:Comparison of four layer bandage system with traditional adhesive plaster bandaging in terms of (a) compression achieved and (b) healing of venous ulcers. DESIGN:Part of larger randomised trial of five different dressings. SETTING:Outpatient venous ulcer clinic in university hospital. PATIENTS:(a) Pr...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.297.6657.1159
更新日期:1988-11-05 00:00:00
abstract:OBJECTIVES:Confirmation of breakthroughs in three different malaria chemoprophylactic regimens (chloroquine 300 mg weekly and proguanil 100 mg daily; chloroquine 300 mg weekly and proguanil 200 mg daily; proguanil 200 mg daily) and assessment of compliance. DESIGN:Prospective, randomised multicentre trial. SETTING:Fi...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.307.6911.1041
更新日期:1993-10-23 00:00:00
abstract:OBJECTIVE:To determine the prevalence of severe psychological trauma --that is, post-traumatic stress disorder--in children involved in everyday road traffic accidents. DESIGN:12 month prospective study. SETTING:Accident and emergency department, Royal United Hospital, Bath. SUBJECTS:119 children aged 5-18 years inv...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7173.1619
更新日期:1998-12-12 00:00:00
abstract:OBJECTIVE:To assess the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children. DESIGN:Population based cohort study. SETTING:The UK Clinical Practice Research Datalink...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m331
更新日期:2020-02-19 00:00:00
abstract:OBJECTIVE:To evaluate the performance of a rapid test for chlamydia with first void male urine samples as a potential tool for diagnosis and screening of chlamydial infection in men. DESIGN:Evaluation of test performance in prospective cohort study. Settings A young people's sexual health centre (site 1) and a genitou...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b2655
更新日期:2009-07-28 00:00:00
abstract:OBJECTIVE:To assess adjustment practices for primary outcomes of randomized controlled trials and their impact on the results. DESIGN:Meta-epidemiologic study. DATA SOURCES:25 biomedical journals with the highest impact factor according to Journal Citation Reports 2009. STUDY SELECTION:Randomized controlled trials p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f4313
更新日期:2013-07-12 00:00:00
abstract:OBJECTIVE:To determine whether abnormal results for liver function tests are investigated in primary care and findings on full investigation. DESIGN:Retrospective audit and prospective clinical investigation. SETTING:University hospital and surrounding general practices serving around 330 000 people. SUBJECTS:Adults...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7281.276
更新日期:2001-02-03 00:00:00
abstract:OBJECTIVE:To explore the suitability of a screening based intervention for excessive alcohol use by describing the experiences of general practitioners who tried such an intervention in their everyday practice. DESIGN:Qualitative interviews with general practitioners who had participated in a pragmatic study of a comb...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.325.7369.870
更新日期:2002-10-19 00:00:00
abstract:OBJECTIVE:To determine prevalence of HIV infection and drug injecting behaviour among inmates of Glenochil Prison on a specified date a year after an outbreak of hepatitis B and HIV infection. DESIGN:Cross sectional: voluntary, anonymous HIV salivary antibody surveillance and linked self completion questionnaire on ri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6975.293
更新日期:1995-02-04 00:00:00
abstract:OBJECTIVE:To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. DESIGN:Population based cohort study. SETTING AND PARTICIPANTS:1,857,822 live single births in Sweden 1992-2010. MAIN OUTCOME MEASURES:Associations between maternal body ma...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g6572
更新日期:2014-12-02 00:00:00
abstract:OBJECTIVE:To study the association between wheezy symptoms in young children and the presence of bacteria in the airways. DESIGN:Birth cohort study. SETTING:Clinical research unit in Copenhagen. PARTICIPANTS:Children of asthmatic mothers, from age 4 weeks to 3 years, with planned visits and acute admissions to the r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c4978
更新日期:2010-10-04 00:00:00
abstract:OBJECTIVE:To determine whether screening Danish men aged 65 or more for abdominal aortic aneurysms reduces mortality. DESIGN:Single centre randomised controlled trial. SETTING:All five hospitals in Viborg County, Denmark. PARTICIPANTS:All 12,639 men born during 1921-33 and living in Viborg County. In 1994 we include...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38369.620162.82
更新日期:2005-04-02 00:00:00
abstract:OBJECTIVE:To examine the potential effectiveness and efficiency of different guidelines for statin treatment to reduce deaths from coronary heart disease in the Canadian population. DESIGN:Modelled outcomes of screening and treatment recommendations of six national or international guidelines--from Canada, Australia, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38849.487546.DE
更新日期:2006-06-17 00:00:00
abstract:OBJECTIVE:To study the relation between low walking speed and the risk of death in older people, both overall and with regard to the main causes of death. DESIGN:Prospective cohort study. SETTING:Dijon centre (France) of the Three-City study. PARTICIPANTS:3208 men and women aged >or=65 living in the community, recru...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4460
更新日期:2009-11-10 00:00:00
abstract::Ruben Meerman and Andrew Brown explain why the answer might not be what you expect. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7257
更新日期:2014-12-16 00:00:00
abstract:OBJECTIVE:To evaluate dynamic contrast enhanced computed tomography for detecting and localising pancreatic necrosis in acute pancreatitis. DESIGN:Prospective evaluation with blind reporting of scans. SETTING:Single teaching hospital. PATIENTS:60 Consecutive patients with acute pancreatitis suspected to have pancrea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6737.1425
更新日期:1990-06-02 00:00:00
abstract:OBJECTIVE:To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. DESIGN:Randomised controlled trial. SETTING:Home based intervention in heart failure patients. PARTICIPANTS:293 patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39164.568183.AE
更新日期:2007-05-26 00:00:00
abstract:OBJECTIVES:To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. DESIGN:Two year community and hospital based study in three British health districts. SETTING:Health districts of Brighton (population 28...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:
更新日期:1998-04-04 00:00:00
abstract:OBJECTIVE:To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN:Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6756.835
更新日期:1990-10-13 00:00:00
abstract:OBJECTIVE:To compare the rate of moderate to severe exacerbations between triple therapy and dual therapy or monotherapy in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES:PubMed, Embase, Cochrane databases, and clini...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k4388
更新日期:2018-11-06 00:00:00
abstract:OBJECTIVE:To determine long term outcome in children who had a severe acute neurological illness in early childhood associated with pertussis immunisation. DESIGN:Follow up study of cases and matched controls. SETTING:Assessment of children at home and at school throughout Britain. SUBJECTS:Children recruited into t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6913.1171
更新日期:1993-11-06 00:00:00
abstract:OBJECTIVE:To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. DESIGN:Parallel group randomised controlled trial. SETTING:Primary health centre in a deprived, ethnically mixed inner city area. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7394.855
更新日期:2003-04-19 00:00:00
abstract:OBJECTIVE:To develop and validate a prognostic model for early death in patients with traumatic bleeding. DESIGN:Multivariable logistic regression of a large international cohort of trauma patients. SETTING:274 hospitals in 40 high, medium, and low income countries PARTICIPANTS:Prognostic model development: 20,127 t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5166
更新日期:2012-08-15 00:00:00
abstract::The results of the work of the Edinburgh Rehabilitation Medicine Service in one year were evaluated. Over 1400 new patients were seen, of whom 525 were in hospital at the time. Patients most often referred were those who had had cardiovascular accidents, back pain, lower limb amputations, and head injuries and those c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6648.601
更新日期:1988-09-03 00:00:00
abstract:OBJECTIVES:To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN:Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39049.706493.55
更新日期:2007-01-13 00:00:00
abstract:OBJECTIVE:To investigate the relations of maternal diet and smoking during pregnancy to placental and birth weights at term. DESIGN:Prospective cohort study. SETTING:District general hospital in the south of England. PARTICIPANTS:693 pregnant nulliparous white women with singleton pregnancies who were selected from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7206.339
更新日期:1999-08-07 00:00:00
abstract:OBJECTIVE:To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. DESIGN:Multicentre, three group, randomised, double blind, sham controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k2860
更新日期:2018-07-19 00:00:00
abstract::The instrument through which a commissioner purchases health services from a provider is, as in other walks of life, a contract, so considerable importance has been attached by the NHS Executive to the contracting mechanism. A contract should in theory influence the quality of the service provided, but they are in man...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7055.477
更新日期:1996-08-24 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN:Matched cohort study. SETTING:Population based, electronic primary healthcare databases before 31 December 2015 from four European coun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l5367
更新日期:2019-10-08 00:00:00
abstract:OBJECTIVE:To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN:Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelect...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6680.1061
更新日期:1989-04-22 00:00:00