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Biomedical subjects

A Leviton

Publications and source records attributed to A Leviton.

At least 199 records · Page 11Linked to original sources
PubMed1973

Are hypertrophic astrocytes a sufficient criterion of perinatal telencephalic leucoencephalopathy?

To determine if the presence of amphophilic globules (GL) in infant cerebral white matter was a necessary criterion of perinatal telencephalic leucoencephalopathy (PTL), the epidemiological features of infants who had PTL-that is, hypertrophic astrocytes and amphophilic globules (HA·GL)-in their cerebral white matter were compared with those of infants who had hypertrophic astrocytes, but who did not have amphophilic globules (HA·[unk]). Postmortem bacteraemia was seen much more frequently in infants with HA·GL than in infants with HA·[unk] (P<0·05). In addition, infants with HA·GL tended to die at older postnatal ages than infants with HA·[unk]. These observations are in keeping with the view that HA·GL and HA·[unk] are not epidemiologically identical. The operational definition of PTL therefore remains the occurrence of both HA and GL in infant cerebral white matter.

Age Factors↗
PubMed1971

Custering of the morphological components of perinatal telencephalic leucoencephalopathy.

The data upon which the original report of perinatal telencephalic leucoencephalopathy was based have been examined for clustering of the four criteria of neonatal white matter damage. Three clusters have been identified: (1) acutely damaged glia with amphophilic globules, (2) hypertrophic astrocytes and amphophilic globules but without necrotic foci, and (3) hypertrophic astrocytes and amphophilic globules with necrotic foci. The original report of perinatal telencephalic leucoencephalopathy therefore probably included two entities. One was characterized by acutely damaged glia and amphophilic globules and the other by hypertrophic astrocytes and amphophilic globules. The two entities do not occur together significantly more frequently than would be expected on the basis of the independent occurrence of each.

Demyelinating Diseases↗
PubMed1971

Morphologic correlates of age at death of infants with perinatal telencephalic leukoencephalopathy.

The ages at death of neonates with various constellations of those abnormalities of cerebral white matter thought to represent a response to injury have been compared to determine the temporal relationships of the various morphologic expressions of perinatal telencephalic leukoencephalopathy. The maximum risk of hypertrophic astrocytes (HA) without amphophilic globules (GL) preceded the maximum risk of HA with GL. Of all infants with HA and GL, those without necrotic foci (NF) tended to die at a younger age than those with NF. These and other findings have been interpreted as evidence that perinatal telencephalic leukoencephalopathy may consist of several morphologic constellations whose differences may reflect variations in (a) the time of occurrence of an insult, (b) the duration of an insult or (c) the survival after an insult.

Age Factors↗
PubMedDate not supplied

Variation in use of corticosteroids among infants < or = 1,500 grams across hospitals in three states.

We identified factors associated with no antenatal corticosteroid treatment among 1,369 women who delivered infants < or = 1,500 g and < 34 weeks gestation, 1991-1993. At four hospitals, infants weighing 500-1,500 g were enrolled. Information regarding corticosteroid use, maternal characteristics, and perinatal events were obtained. Factors associated with no corticosteroid treatment were examined in unadjusted and adjusted logistic regression models. Overall, 693 (50.6%) women did not receive corticosteroids. Two hospitals had higher rates of no corticosteroid usage (89% and 75%) as compared with the other two (32% and 50%). Black, Hispanic, and poor women were more likely to receive care at the hospitals where the rates of corticosteroid utilization were lower. Factors in the multivariate model included: < 1 or 1 day of hospitalization, vs. delivery on > or = 2 days of hospitalization (21.4: 14.5, 97.2; 4.7: 3.2, 6.9); gestational age < 26 weeks (2.7: 1.8, 4.1) or > 28 weeks (1.8: 1.3, 2.6) vs. 26-28 weeks; < 12 hours of labor vs. > 12 hours (1.7: 1.2, 2.4); delivering at hospital 2, 3, 4 vs. hospital 1 (1.6: 1.1, 2.5; 24.3: 13.6, 43.4; 10.2: 6.8, 15.3). We conclude that variations in hospital practice limit widespread use of this important antenatal treatment.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Very low birthweight Infant's placenta and its relation to pregnancy and fetal characteristics.

Our objective was to relate pathology of the very low birthweight (VLBW) infant's placenta to pregnancy and fetal characteristics. We correlated the pathologic features of 1146 placentas from infants with birth weights of 500-1500 g who were born between 1/1/91 and 12/31/93 to the number of gestations per pregnancy, initiator of preterm delivery, gestational age, birth weight Z score, and duration of rupture of membrane (ROM). Placental correlates of acute inflammation and villous edema were associated with preterm labor (PTL), prelabor premature rupture of membranes (PROM), lower gestational age, and higher birth weight Z score. In PTL pregnancies delivered within 1 h of membrane rupture, 61% of placentas already had membrane inflammation. Placental correlates of pregnancy-induced hypertension (PIH) were seen more commonly with PIH pregnancies, older gestational age, and lower birth weight Z score. We found a more prominent histopathologic signature for singleton than for multiple gestation placentas. The placental pathologic findings associated with the clinical diagnoses of infection, PIH, and low-birth weight Z scores in our VLBW/preterm population are similar to those in the literature regarding term pregnancies. The presence of multiple histologic findings consistent with inflammation in placentas of PTL pregnancies with duration of ROM lasting <1 h suggests that some cases of PTL are precipitated by a more long-standing infection than that previously suspected. Morphologic placental features appear to be correlates of the phenomena leading to premature delivery. Examination of the VLBW infant's placenta provides insight into the etiology and management of VLBW/preterm deliveries.

Adult↗