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Biomedical subjects

A Perez

Publications and source records attributed to A Perez.

216 records · Page 12Linked to original sources
PubMedDate not supplied

Effects of timing of conception on birth weight and preterm delivery of natural family planning users.

OBJECTIVE: Various birth defects and untoward perinatal outcomes have been claimed to be associated with pregnancies conceived by gametes aged in vivo before fertilization. Thus, these outcomes were systematically assessed in pregnancies occurring in natural family planning (NFP) users. Our international multicenter cohort study of NFP pregnancies (n = 877) is by far the largest systematic study designed to assess pregnancy outcome and is of sufficient power to allow us to address the concern of low birth weight (< 2500 g) and preterm delivery (< 37 weeks gestation). STUDY DESIGN: In addition to gathering baseline medical data, evaluation was performed at 16 weeks, 32 weeks and at term. Data were collected in a systematic cohort fashion, verified by the five collaborating international recruiting centers, and analyzed by investigators in the US. Most recruiting center principal investigators are obstetrician-gynecologists and, if not, have integral relationships with such specialists. Standard criteria could thus be applied within and among centers. In our cohort, birth weight was recorded accurately at delivery. Almost all of the deliveries occurred in hospitals; thus, data should be quite reliable. Neonatal examination for anomalies was usually conducted immediately after delivery, when birth weight was recorded. RESULTS: Analysis of risk factors for low birth weight and preterm delivery showed that this population had a low risk profile. Low birth weight infants (< 2500 g) and preterm deliveries were increased among women with a history of either prior low birth weight or preeclampsia in the index pregnancy. However, mean birth weight was unaffected by the timing of conception vis à vis ovulation or pregnancy history. Mean birth weight for the 877 singleton NFP pregnancies was 3349.6 g. The risk of preterm delivery was increased among older women who drank alcohol, but there were no significant effects of timing of conception vis à vis ovulation on preterm delivery. Results held when analysis was stratified according to whether NFP was being used for contraception or to achieve pregnancy. CONCLUSIONS: Our data do not appear to show striking differences between 877 NFP pregnancies and the general obstetric population. The timing of conception vis à vis ovulation does not exert significant effects on the birth weight or preterm delivery of resulting pregnancies, a reassuring finding for NFP users.

Birth Weight↗
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Pregnancy outcome in natural family planning users: cohort and case-control studies evaluating safety.

Conceptions involving aging gametes are of relevance to natural family planning (NFP) because women using NFP to avoid pregnancy abstain from intercourse during the fertile time of the cycle. To help verify the safety of pregnancies occurring among NFP practitioners, our group has, since 1986, conducted a large cohort study involving six experienced NFP centers. Timing of conception was determined from NFP charts, in which women recorded days on which intercourse occurred. The number of days from the most probable conception intercourse to probable day of ovulation was first determined, and used as an estimate of the time gametes remained in the genital tract before fertilization. Several studies have already been completed, cohort as well as case-control in nature.

Abortion, Spontaneous↗
PubMedDate not supplied

Pregnancy complications in natural family planning users.

A multicenter cohort study was designed to assess pregnancy outcome among natural family planning (NFP) users, and provide the opportunity to address complications in NFP users by planning status and by timing of conception with respect to day of ovulation. There were 877 singleton births in this sample. Complications evaluated were abnormal vaginal bleeding, urinary tract infection, vaginal infection, hypertension of pregnancy, proteinuria, glycosuria, and anemia. There was no significant difference in the mean age, number of prenatal visits or birth weight among optimally and non-optimally timed pregnancies or for planned and unplanned pregnancies. There were higher incidences of "parity 2 or more" and current smokers in the non-optimally timed pregnancies and lower incidences of prior pregnancy loss and "currently employed" in the non-optimally timed pregnancies. There was little difference in pregnancy complications with respect to pregnancy timing, with the exception of a significant increased risk of vaginal bleeding late in pregnancy among non-optimally timed conceptions (11.5%) compared to optimally timed pregnancies (5.2%, RR = 2.2, 95% CI 1.3-3.7). More differences were observed in pregnancy complication rates by planning status. Unplanned pregnancies were associated with significantly more late pregnancy bleeding, vaginal infections, proteinuria, glycosuria and medication use than planned pregnancies. Unplanned pregnancies had lower incidences of maternal anemia. Complications of pregnancy were low in this NFP population, irrespective of planned versus unplanned status. Women with planned pregnancies had even fewer complications during pregnancy than women with unplanned conceptions, suggesting that women using NFP to plan their reproduction may be at particularly low risk.

Cohort Studies↗
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A customized instrumentation stand for patient transport.

A customized instrumentation stand is described for use during transport of cardiothoracic or major surgery patients between the OR and a critical care area. The stand attaches to a patient bed and is equipped with a pulse oximeter, ECG/BP monitor, defibrillator/monitor and support module, oxygen tank, supplies, and medications. The design allows maximum visibility and accessibility, easy movement, and quick attachment to and disconnection from a bed. A similar apparatus may benefit surgical programs facing comparable transport needs.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Plasma immunoreactive somatostatin is elevated in diabetic ketoacidosis and correlates with plasma non-esterified fatty acid concentration.

In experimental diabetes and after the administration of beta-hydroxybutyrate and non-esterified fatty acids (NEFA), an increase in circulating immunoreactive somatostatin (IRS) has been described. Both ketones and NEFA are raised in diabetic ketoacidosis. Therefore, we decided to investigate 10 patients in diabetic ketoacidosis by measuring, on admission and throughout the initial 24 hours of therapy, circulating levels of IRS, beta-hydroxybutyrate, acetoacetate, triglycerides, blood glucose, pH and NEFA. Fluids and insulin were administered IV following a previously established protocol. Nine patients showed abnormally high levels of circulating IRS. When compared with a group of controlled insulin-dependent diabetic patients, basal IRS was high (111 +/- 15 vs 28 +/- 3 pmol/l), and remained elevated for at least 24 h despite clear improvement of metabolic status. On admission we also found elevated levels of NEFA (1.04 +/- 0.2 mmol/l), triglycerides (4.7 +/- 1.1 mmol/l), beta-hydroxybutyrate (22.1 +/- 4mmol/l), and acetoacetate (4.8 +/- 1.1 mmol/l). A significant correlation was found initially between IRS and NEFA (p less than 0.01). We conclude that circulating IRS is high in most cases of diabetic ketoacidosis. The mechanism behind this hypersomatostatinaemia could be related to the abnormalities of lipid metabolism which occur in diabetic ketoacidosis.

3-Hydroxybutyric Acid↗
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Prevention of highly emetogenic chemotherapy-induced vomiting: a double blind, randomized crossover study to compare pancopride (LAS 30451) and pancopride plus dexamethasone.

AIMS: Pancopride (PNC) is a new 5HT3 receptor antagonist which has demonstrated complete protection from nausea and vomiting in 25-73% of patients treated with highly emetogenic chemotherapy. A double-blind, randomized crossover study was carried out to assess whether the addition of dexamethasone (DXM) to PNC increases the antiemetic efficacy. METHODS: PNC (0.2 mg/kg. i.v. 30 min before chemotherapy) plus placebo (PLC) was compared with PNC (same dose and schedule) plus DXM (20 mg. i.v. immediately before PNC). In the second cycle, patients received the alternative antiemetic treatment. Eighty patients were included in the study (PNC + DXM = 39, PNC + PLC = 41), 29 of whom were women and 51 men. Fifty-four percent of the patients in the PNC + DXM group and 59% of those in the PNC + PLC group received chemotherapy containing cisplatin. Seventy-seven patients completed the first cycle and 70 the second. RESULTS: Complete protection was obtained in 19/16 patients (50/46%) with PNC + PLC and in 32/22 (82/63%) with PNC + DXM (P < 0.001). Latency was significantly longer in the PNC + DXM group. The efficacy of both treatments was unaffected by the order of administration. Side effects were mild in both groups. CONCLUSIONS: The combination of PNC + DXM is more efficacious than PNC + PLC in protection against highly emetogenic chemotherapy-induced vomiting.

Antiemetics↗
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[Community participation and appropriate technology in the early diagnosis of human hydatidosis].

The basic strategy for development of hydatid struggle programs is in the actuality: Primary Attention of Health. In the present work and in this instance, it's arm a precocious detection system of hydatid disease, fixed in immunologic diagnostic by means of ELISA technical beginning with blood capillary samples, taken in filter paper by teachers and sanitary agents from official services of Rio Negro Province. 177 teachers and 45 sanitary agents were trained, correspondent to 25 schools, 3 lodging schools and 9 Hospitals all of them from rural area. 890 blood samples during the training were obtained. Lastly, the trained personal armed the system and they obtained 728 samples in the beginning of the Program. It hadn't statistical differences in the reactivity of both samples. The serological prevalence found was 1.32%. The activity displayed by teachers and sanitary agents permitted to detect 21 new cases it was the 20% of new cases diagnosed in this area in the period of work. The viability and the importance of the incorporation of non traditional effectors into the Hydatid Control Programs is discussed.

Community Participation↗
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Hantavirus pulmonary syndrome in the Province of Rio Negro, Argentina, 1993-1996.

Early in 1995 the first case of Hantavirus Pulmonary Syndrome was serologically confirmed in El Bolsón (Province of Río Negro, Argentina), corresponding to the third outbreak reported in Argentina. A total of 26 cases of HPS related to the Andean region of Rio Negro Province, were reported from 1993 to 1996, 17 in El Bolsón, 4 in San Carlos de Bariloche, and 5 in Buenos Aires. The incidence rate was 5.03 x 100,000 with a mortality rate of 51.85 x 100. The occurrence of cases was mainly seasonal, with a significantly greater number in the spring, and the persons affected mainly lived in urban or periurban areas. In four cases, the affected individuals were members of a couple, spouses or live-in contacts. Seven cases were Health workers (physicians, nurses or administrative staff). Twelve cases were related among them, due to an outbreak of 80 days. Two of them did not visit the Andean region. A total of 139 rodents were captured and seven of them, Olygoryzomys longicaudatus, were found to be serologically positive. The possibility of infection by contact with rodents or fecal matter is being analyzed and also hypothesis related with interhuman transmission.

Adolescent↗
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Number and DNA content of hypertrophic spermatogonia in normal and cryptorchid human testes.

The number and the DNA content of hypertrophic spermatogonia were studied in normal and cryptorchid testes. The number of hypertrophic spermatogonia in cryptorchid testes is higher than in control testes at the same age. This finding suggests alterations in the spermatogonia of cryptorchid males. The results show a polyploid DNA content in more than 80% of hypertrophic spermatogonia in both normal and cryptorchid testes. There were hypertrophic spermatogonia with a DNA content between 2c and 4c (0.5%) and between 4c and 8c (9%). These spermatogonia might be cells in the S phase of the cell cycle.

Adolescent↗
PubMedDate not supplied

Healing of the resected liver stump: its process and the significance of portal blood flow.

In an effort to investigate the healing process of resected liver stump and the significance of portal and hepatic arterial flow. In addition to hepatectomy in the first group, an arterial and a portal branch were ligated in the second and third groups, respectively. It was demonstrated that portal branch ligation influenced a delay in healing of resected liver stump rather than hepatic arterial branch ligation. It is assumed that portal blood flow is more responsible for liver stump healing as well as hepatic regeneration than is hepatic arterial flow.

Animals↗
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Experimental study of morphological changes after gastroplasty.

Twelve rabbits were sacrificed one and three days, one, two, four and eight weeks after horizontal gastroplasty in order to investigate morphological changes after operation. Histology of the proximal pouch of the stomach showed various degrees of mucosal damage and a close relationship between its severity and high pH of the pouch. This suggested the usefulness of pH measurement of the gastric juice in the proximal pouch as an indicator of mucosal damage after gastroplasty.

Animals↗