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Biomedical subjects

D Farine

Publications and source records attributed to D Farine.

At least 55 records · Page 3Linked to original sources
PubMed1990

Placenta previa--is the traditional diagnostic approach satisfactory?

The accuracy of the diagnosis of placenta previa using transvaginal sonography (TVS) was compared to that of the traditional transabdominal sonography (TAS). Seventy seven women were scanned by both methods and each sonographic diagnosis was compared to the placental location at delivery. TVS was superior to TAS in diagnosing placenta previa and invariably correct in ruling it out. TVS (and TAS) failed to predict the placental location at delivery only in women diagnosed as having marginal placenta previa prior to 35 weeks gestation. The use of the vaginal probe significantly improved the accuracy of the diagnosis of placenta previa.

Abdomen↗
PubMed1990

Magnetic resonance imaging and computed tomography scan for the diagnosis of acute fatty liver of pregnancy.

Magnetic resonance imaging (MRI) and computed tomography were used to diagnose fatty liver of pregnancy in a patient with preeclampsia and thrombotic thrombocytopenia purpura. The clinical course included multiple system failure that necessitated mechanical ventilation, dialysis, and plasmapheresis. The MRI picture is described in this entity for the first time. Both imaging techniques are discussed and compared.

Adult↗
PubMed1989

Is it really a placenta previa?

Transvaginal sonography was compared to the traditional transabdominal sonography for diagnosing placenta previa. There was no vaginal bleeding in the 55 women studied following vaginal examination. The exact location of the internal os was diagnosed in all women by the vaginal route, and only in 36 of the 55 by abdominal scanning. Transvaginal sonography correctly diagnosed 39 out of the delivered 45 women, whereas transabdominal sonography only did so in 20 of the 45 cases. These results suggest that transvaginal sonography for the diagnosis of placenta previa is safe and superior to transabdominal sonography.

False Positive Reactions↗
PubMed1988

Vaginal ultrasound for diagnosis of placenta previa.

Transvaginal sonography was compared with transabdominal sonography in 35 women with suspected placenta previa. The transvaginal sonographic technique did not result in vaginal bleeding in any of the patients. The internal os and its relationship to the location of the placenta were visualized by transvaginal sonography in all patients, but only in 24 patients (69%) by transabdominal sonography. Transvaginal sonography ruled out placenta previa in 13 cases thought to be placenta previa by abdominal sonography. The transvaginal diagnosis in these 13 patients was confirmed at delivery. Thirty-four of the 35 women have been delivered. The diagnosis at delivery confirmed the transvaginal sonographic diagnosis in 29/34 cases and the transabdominal diagnosis in 16/34. Transvaginal sonography did not predict the delivery diagnosis in five patients who were erroneously believed to have placenta previa by both sonographic techniques.

Female↗
PubMed1988

A close look at early embryonic development with the high-frequency transvaginal transducer.

Transabdominal sonography has been, for the past two decades, used as an effective diagnostic and research tool in obstetrics. It is predominantly used in the second and third trimesters of gestation. Its use in the first trimester is relatively limited and mostly diagnostic in nature. The introduction of the higher frequency transvaginal transducer probe, with its higher resolution of the images, opens new possibilities to study early gestation. We studied embryonic development in 38 well-dated and normal pregnancies. A well-defined intrauterine gestational sac could be seen at 4 weeks and 1 to 4 days of menstrual age. The beta-subunit of human chorionic gonadotropin level at this time was 450 to 750 mlU/ml. Structures such as the yolk sac, membranes, ventricular system in the brain, musculoskeletal system, and cord were described and illustrated. Textbooks and atlases were used for comparative purposes. High-resolution transvaginal sonography will facilitate first-trimester perinatology.

Embryo, Mammalian↗
PubMed1988

Endogenous digoxin-like substance(s) associated with uneventful and high-risk pregnancies.

We assessed the existence of endogenous digoxin-like substance(s) (EDLS) in mother-neonate pairs using a routine radioimmunoassay for digoxin. None of those studied had been treated with cardiac glycosides during or before pregnancy. In uneventful pregnancies, cord EDLS levels (0.31 +/- 0.02 ng/ml mean +/- SEM) were significantly higher (p less than 0.001) than both antepartum and postpartum maternal levels (0.14 +/- 0.02 and 0.17 +/- 0.02 mg/ml, respectively). This observation was in contrast with findings in high-risk pregnancies. In general, EDLS levels in the high-risk group were significantly higher than in normal pregnancies (cord 0.94 +/- 0.38 ng/ml; antepartum 1.63 +/- 0.54 ng/ml; postpartum 0.89 +/- 0.73 ng/ml). In the high-risk group there was a remarkably wide range of maternal and cord EDLS concentrations. The present studies suggest that following pregnancies of high risk for a variety of reasons, EDLS determination may be commonly high in the perinatal period and may affect the determination of 'true' digoxin. Consequently, digoxin dosing based on monitoring drug concentration may be futile.

Blood Proteins↗
PubMed1988

Real-time ultrasonic evaluation of the baboon pregnancy: biometric measurements.

Ultrasonic and direct biometric measurements of nine fetal baboons were made during 23 evaluations. Both the femur length and the biparietal diameter were correlated to gestational age. These initial results have facilitated intrauterine surgery. The data presented will help in determining adequate fetal growth and in dating the baboon pregnancy.

Animals↗
PubMed1988

Pregnancy complicated by maternal spina bifida. A report of two cases.

Pregnancy occurred in two women who had undergone corrective surgery for meningomyelocele. Both women had urinary incontinence leading to urinary tract infections and, in one, to vulvitis urinosa. There is limited literature on maternal meningomyelocele and its complications.

Adolescent↗
PubMed1987

Shoulder dystocia: predictors and outcome. A five-year review.

Shoulder dystocia is an uncommon complication of delivery with a high morbidity rate. Ninety-one cases were coded for shoulder dystocia at the Toronto General Hospital from 1980 through 1985. True shoulder dystocia was found in 24 cases, an incidence of 0.23%. There was no significant difference in average weight and percentage of macrosomia between cases of true shoulder dystocia and those merely coded as such. True shoulder dystocia was associated with a neonatal morbidity rate of 42%, consisting of a respiratory arrest and neurological and orthopedic damage. Fundal pressure, in the absence of other maneuvers, resulted in a 77% complication rate and was strongly associated with orthopedic and neurologic damage. Delivery of the posterior shoulder and the corkscrew maneuver were associated with good fetal outcome.

Delivery, Obstetric↗
PubMed1985

Conception rate after gonadotropin therapy in hyperprolactinemia and normoprolactinemia.

The cumulative pregnancy rate after gonadotropin treatment was evaluated in 63 hyperprolactinemic and 242 normoprolactinemic women. All pregnancies in the hyperprolactinemic patients were achieved within four treatment cycles; the cumulative pregnancy was 62% as compared with 29% in normoprolactinemics. The same results were obtained when patients were divided according to endogenous estrogenic activity. These results imply that in bromocriptine failures there is no need to lower prolactin levels to achieve pregnancy with gonadotropins.

Amenorrhea↗
PubMed1985

Maternal mortality in Ontario from 1970 to 1980.

This review describes trends in maternal mortality in Ontario, Canada during 1970 to 1980 inclusive. There has been a significant decline in the total and direct deaths recorded. Anesthetic complications, hemorrhage, obstetric sepsis, and non-obstetric infections are now rare causes of maternal mortality. Toxemia and emboli remain major components of direct obstetric deaths. Collagen vascular disease, cardiac disease, pulmonary emboli, and cerebrovascular accidents are consistently found as causes of indirect maternal deaths.

Eisenmenger Complex↗
PubMed1984

Significance of the endogenous digoxin-like substance in infants and mothers.

Digoxin serum concentrations were measured by a routine radioimmunoassay in 30 neonates not receiving digoxin; nonetheless, digoxin levels were between 0.17 nM and 1.64nM (means = 0.64nM +/- 0.27 nM). There was a negative correlation between gestational age and concentration of an endogenous digoxin-like substance (EDLS). Neonates less than or equal to 32 wk gestational age had higher levels of EDLS than neonates greater than 32 wk old. EDLS concentrations were compared in 22 mothers and their 24 offspring and were higher in all newborn infants (0.34nM +/- 0.09nM and 0.15nM +/- 0.08nM). EDLS was shown to inhibit Na+-K+-adenosinetriphosphatase activity by measurement of 86Rb uptake in erythrocytes exposed to sera samples from 30 infants in the study. EDLS levels greater than 0.6 ng/ml were associated with lesser 86Rb uptake. Simulation kinetics suggest that the presence of 0.6nM EDLS would lengthen the digoxin t1/2 by 64%, reduce the volume of distribution by 23%, and lower clearance by 53% if the peak "true" digoxin level were 2 ng/ml. EDLS concentrations of 1.5 ng/ml would increase the t1/2 by 207% while reducing the volume of distribution by 43% and clearance by 81%. These considerations cast serious doubts on the validity of currently accepted digoxin kinetics and dosing in preterm infants.

Birth Weight↗
PubMed1984

Isolated angiitis of brain in pregnancy and puerperium.

Isolated angiitis of the brain in labor and puerperium is described. Persistent headaches in a preeclamptic patient in the postpartum period usually suggests either persistent preeclampsia or subarachnoid hemorrhage. Isolated vasculitis of the brain, which was diagnosed in the present case, should be considered as it responds to medical (pharmacologic) treatment.

Adult↗
PubMed1983

Prolactinomas in women treated in the past for infertility.

This is a retrospective study on 352 infertile women who were treated with HMG-hCG (Human Menopausal Gonadotropin/human Chorionic Gonadotropin) between 1962 and 1977. The purpose of this study was to search for hyperprolactinemia and prolactinomas in these women. Hyperprolactinemia was found in 75 women (21%). The prevalence of hyperprolactinemia increases with age. Asymptomatic pituitary tumors were found in 29 of 31 women evaluated (94%). Three women had macroadenomas and 26 had microadenomas. We were not able to demonstrate that the HMG-hCG treatment and the ensuing pregnancy had any long-term ill effects on the size of the tumor. These findings suggest that prolactinomas were slow growing. An active search for these tumors must be made in women treated for infertility in the past.

Adenoma↗
PubMed1982

Retrospective evaluation of human menopausal gonadotropin and human chorionic gonadotropin induction of ovulation in galactorrheic and hyperprolactinemic women.

A retrospective study on the success of induction of ovulation with human menopausal gonadotropin and human chorionic gonadotropin (hMG/hCG) in 267 women was performed. Galactorrheic women had a higher pregnancy rate (55%) than nongalactorrheic women (22%). Galactorrhea was a far better indicator of the success of the treatment than hyperprolactinemia at present. The results obtained may suggest that in "bromocriptine failure" it is not mandatory to lower prolactin levels prior to induction of ovulation with hMG/hCG, and these women may be treated with menotropins alone.

Adult↗
PubMed1981

Spontaneous pregnancy and its outcome after human menopausal gonadotropin/human chorionic gonadotropin-induced pregnancy.

The fertility in previously sterile women who conceived at least once following hMG/hCG-induced ovulation is investigated. The study comprises 141 women. The cumulative spontaneous pregnancy rate (CSPR) was calculated using life table analysis and was found to be 30.4% after 5 years. The CSPR for subsequent pregnancies reached 91.3% after 5 years. This figure is similar to that of normal parous women, although the study group (previously infertile women) requires a larger exposure period to attain the figure. The spontaneous abortion rate in the hMG/hCG-induced pregnancies was 29%; whereas in subsequent spontaneous pregnancies this rate was 8.8%. This difference in rate was found to be statistically significant, and the possible reasons are discussed.

Abortion, Spontaneous↗