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Biomedical subjects

B M Mogilner

Publications and source records attributed to B M Mogilner.

At least 37 records · Page 2Linked to original sources
PubMed1983

Non-aggressive management of post-date pregnancies.

A non-aggressive approach to the management of post-date pregnancies was tested in a clinical trial involving 156 patients who had reached 294 days of amenorrhea and had a pelvic score of 4 or less. Dates had been established with certainty in each case. In half of the patients (the study group) no time limit was imposed on the pregnancy, but the women were checked at frequent intervals for any increase in pelvic score and for changes in any of the following: fetal movement count recorded daily by the mother, an oxytocin challenge test, and amnioscopy. The pregnancy ended either through spontaneous contractions or through surgical induction carried out because of a change in any one of the parameters or an increase above 4 in the pelvic score. In the 78 control patients labor was induced surgically on day 294, even if the pelvic score was low. In the study group, labor started spontaneously in 52 patients; labor was induced in 17 women after they showed an elevated pelvic score, in 7 because of a pathologic parameter and in one because a mild pre-eclampsia developed. There were 7 cesarean sections in the study group compared with 16 in the control group (P less than 0.05). The average duration of labor was 6.7 h in the study group, compared with 9.4 h in the control (P less than 0.01). There was no significant difference between the two groups with regard to meconium staining during labor, pathologic fetal heart rate, or the 5 min Apgar score. In the study group there was one neonatal death as a result of severe congenital heart disease, and in the control group one infant died due to asphyxia. It is concluded that conservative management of prolonged pregnancies, with close supervision, gives better results than routine induction of labor at 42 wk. The importance of the pelvic score as an indication for induction is stressed. A protocol has been developed which can be used in cases of uncertain dates as well.

Clinical Trials as Topic↗
PubMed1983

Unusual parascrotal hernia with ectopic testicle in a neonate. Case report.

A giant indirect inguinal hernia leading to a huge parascrotal mass in a newborn is described. The right scrotum was empty and the ectopic testicle was found in the perineum, close to the anus. To our knowledge this is the first report of the presence at delivery of a parascrotal inguinal hernia in combination with an ectopic testicle.

Hernia, Inguinal↗
PubMed1983

Bisatellited microchromosomes and multiple congenital malformations.

The significance of small additional metacentric chromosomes is still unclear. A patient is reported with multiple congenital malformations involving craniofacial structures, the cardiovascular system and gastrointestinal tract, in whom an extra small bisatellited chromosome was detected. The maternal karyotype revealed a marker number 9 chromosome. These cases present a true diagnostic dilemma in genetic counseling, since chromosomal instability may occur in the presence of parental minor structural chromosomal changes.

Abnormalities, Multiple↗
PubMed1983

Production of the hydroxylated metabolites of vitamin D in a neonate with a single hypoplastic-dysplastic kidney.

The ability to produce dihydroxylated metabolites of vitamin D was studied in a term neonate suffering from severe renal insufficiency. The infant died at age 26 days owing to end-stage renal failure and the necropsy examination showed a single dysplastic kidney weighing 1.5 g. At age 2 weeks the serum levels of the dihydroxylated metabolites of vitamin D were found to be normal and a pronounced increase was noted 24 hours after injection of 100 000 IU vitamin D2. The study suggests that during the neonatal period a small renal mass is sufficient to maintain optimal circulating levels of the dihydroxylated metabolites of vitamin D.

Dihydroxycholecalciferols↗
PubMed1983

Necrotizing enterocolitis associated with rotavirus infection.

Infection has been widely reported as one of the factors usually incriminated in the development of necrotizing enterocolitis (NEC) in a previously ischemic bowel. Gram-negative bacteria have previously been implicated as pathogens in this dangerous entity, for which neonates are at high risk. However, viral infections have rarely been reported in connection with NEC. Rotavirus was identified in the stools of two premature infants who developed the full-blown picture of NEC in the Neonatal Intensive Care Unit (NICU) at Kaplan Hospital, Rehovot. Both cases occurred within a period of 3 months, during the winter season. During that time, rotavirus was diagnosed in the stools of 10 other infants admitted to the NICU. The detection of rotavirus in the stools of the two premature infants with NEC observed by us strongly suggests that rotavirus should be included in the list of infectious agents associated with the development of NEC.

Cross Infection↗
PubMed1983

Comparison between the combination of azlocillin-gentamicin and ampicillin-gentamicin in the treatment of a nursery population.

Newborn, and particularly premature infants are prone to life-threatening infections. The combination of ampicillin-gentamicin (AM-G) has been used extensively in neonatal intensive care units (NICU). Because resistant bacteria emerged, a new drug--an acylureidopenicillin, azlocillin, with a wide antibacterial spectrum--has been developed. A prospective randomized study was performed in order to evaluate the combination of AM-G vs. azlocillin-gentamicin (AZ-G). Thirty neonates received AM-G and 28 received AZ-G. Definite infection was found in 15 AM-G patients and in 10 AZ-G patients. In these patients, the antibiotic regimen was changed in six of the AM-G and in one of the AZ-G patients. In each of the two treatment groups, one very-low-birth-weight baby died due to overwhelming sepsis. In vitro sensitivity to AZ-G was higher than to AM-G, according to azlocillin blood levels obtained. Infants weighting less than 2,350 g had lower clearance and volume of distribution than did infants weighing greater than 2,350 g. The serum half-life was approximately the same in both groups. It appears to be that in the NICU, the combination of AZ-G may be more effective than the AM-G combination.

Ampicillin↗
PubMed1983

Necrotizing enterocolitis--a 5-year experience.

With the increased survival of very-low-birth-weight neonates, necrotizing enterocolitis (NEC) represents one of the most frequent life-threatening conditions for this population. NEC was diagnosed on 24 occasions during a 5-year period (1977-81) at the Neonatal Intensive Care Unit, Kaplan Hospital, Rehovot. These 24 NEC cases, confirmed by radiological, surgical or pathological findings, were analyzed in a retrospective study. The mean weight was 1,450 g and the mean gestational age 32 weeks. Only one of the affected infants was a full-term newborn. The mean age at onset of symptoms was 9.8 days. In one case, NEC developed before feedings were started. The infectious agents--most frequently gram-negative rods--were isolated from the most seriously ill babies. Cultures from blood and gastric aspirate were positive in 10 of the 12 fatal cases. No bacteria were isolated from the blood among the survivors. Rotavirus, the only viral particle detected, was diagnosed in the bloody stools of two of the infants who recovered completely. Prophylactic therapy with oral kanamycin, administered to all premature infants weighing less than 1,500 g born over a 3-year period, did not appear to have a preventive influence. The overall mortality was 50%, with no sequelae observed among survivors. The high incidence of positive cultures among fatal cases suggests that overwhelming infection played a fundamental role in the outcome.

Enterocolitis, Pseudomembranous↗
PubMed1982

The obstetrical management of patients with immunologic thrombocytopenic purpura.

Pregnant women with immunologic thrombocytopenic purpura (ITP) run the risk of complications during pregnancy and labor, mainly due to the possibility of hemorrhage. Antibodies pass through the placenta, causing a transient, but dangerous thrombocytopenia in the fetus and infant. Four women with ITP, having five deliveries, are presented, showing that the modern treatment of these patients includes corticosteroids during pregnancy, thrombocyte transfusion during labor, and splenectomy being or after the pregnancy in selected cases. Cesarean section is not indicated for the disease per se, and fetal scalp blood sampling for thrombocyte count during labor is not necessary. The newborn needs immediate, careful control and, if necessary, thrombocyte transfusion and even steroids. Prolonged follow-up of the infants is necessary.

Adult↗
PubMed1982

Hydrops fetalis caused by maternal indomethacin treatment.

Hydrops fetalis was diagnosed in one of two twins, while the other suffered from cardiac failure. Indomethacin administered to the mother to arrest premature labor, seemed to be the predisposing factor resulting in the hydrops fetalis. The possible relationship between intrauterine closure of the ductus arteriosus and the pathogenesis of hydrops fetalis is discussed.

Adult↗
PubMed1981

Subcutaneous fat necrosis of the newborn.

A case of subcutaneous fat necrosis of the newborn is described. Severe perinatal asphyxia preceded the appearance of the skin lesions. Premature rupture of membranes and the presence of foul-smelling meconium raised the possibility of infection by anaerobes as an additional etiologic factor. The main hypotheses concerning the cause and pathogenesis of this condition are reviewed. The alarming clinical picture that stands in sharp contrast to the benign prognosis is stressed.

Adipose Tissue↗
PubMed1980

Posterior fossa subdural hematoma in a normally delivered, full-term newborn.

A large subdural hematoma of the posterior fossa was diagnosed by computerized tomography in a normally delivered, full-term newborn. This potentially treatable condition has been previously diagnosed in only 13 reported cases during the last 40 years. It is conceivable that the routine use of CT scan in newborns who show progressive neurological dysfunction will facilitate the rapid detection and treatment of similar cases.

Brain↗