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Biomedical subjects

E Weiss

Publications and source records attributed to E Weiss.

332 records · Page 19Linked to original sources
PubMedDate not supplied

Family planning in traditional markets in Nigeria.

Operations research on the Ibadan Market-Based Distribution Project in Nigeria investigated the feasibility of a contraceptive distribution system using traders in the traditional markets to sell pills, condoms, and foaming tablets. Two hundred and thirty-five female and male traders were trained and supplied with contraceptives, malaria treatments, and oral rehydration salts to sell at low prices in 39 markets. This article presents findings from qualitative and quantitative research conducted in 1985-89 to determine if the sale of contraceptives in the marketplace is acceptable to participating traders and shoppers and to identify trader and market characteristics associated with sales volume. Sales of contraceptives totaled 18,286 pill cycles, 11,818 packages of four condoms, and 4,429 packages of four foaming tablets. The average monthly sale for each participating trader was 5.3 units. Adaptations of this model are being tested in other Nigerian cities and in Accra, Ghana.

Adult↗
PubMedDate not supplied

[Histologic placenta findings in prolonged pregnancy: correlation of placental retarded maturation, fetal outcome and Doppler sonographic findings in the umbilical artery].

In 253 postterm pregnancies we investigated the correlation between retarded placental maturation, mode of delivery and fetal outcome and tried to answer the question, whether it is possible to estimate placental risk antenatal with pulsed doppler ultrasound of an umbilical artery. Villus maturation was determined by the criteria of Becker and the results were classified into 3 groups: Normal maturity, regionally or disseminated retarded maturation. In the latter group we found the highest rate of cesarean sections for fetal distress and a high neonatal morbidity. The birth weight was lower compared to the cases with normal placental maturity. As an index of placental resistance we determined the (A-B)/A-quotient of an umbilical artery with pulsed doppler ultrasound. The Resistance-Index was increased when the placental maturation was retarded. In 60% of cases with pathological umbilical artery flow velocity waveforms we found disseminated retarded placental maturation, whereas this occurred only in 6% of cases with normal flow.

Birth Weight↗
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[Examination of the reduction of umbilical circulation in fetuses with variable decelerations of heart rate using Doppler sonography of the umbilical artery].

4 patients with ruptured membranes and spontaneous labour showed variable decelerations of the fetal heart rate. Blood flow velocities of the umbilical arteries were measured by means of pulsed Doppler ultrasound. The flow velocity waveforms, being normal between the contractions, showed a rapid change to absent and reverse diastolic flow during uterine contraction. By means of quantitative estimation the forward flow as as high as the measured reverse flow in the umbilical artery, resulting in a stop of placental perfusion. Computer-added reconstruction of the curve of fetal heart frequency revealed the exact temporal relation between reduction of umbilical artery perfusion and deceleration of fetal heart rate as well as the relation between recovery of the fetal heart rate and normalisation of blood flow in the umbilical artery. Using this noninvasive method, we could analyze for the first time the acute changes of umbilical artery perfusion in relation to changes of the fetal heart rate in human fetus. A stop in placental perfusion does not always mean an absence of any movement of the fetal blood column. We could demonstrate that this is due to a systolic forward and diastolic reverse flow in the same extent. The described acute flow alterations are discussed as a model for flow alterations described in high risk pregnancies with abnormal fetoplacental perfusion.

Blood Flow Velocity↗
PubMedDate not supplied

[Doppler sonography of the umbilical artery, mode of delivery and perinatal morbidity in prolonged pregnancy].

130 women with postterm pregnancies (281-297 days of gestation) were examined with pulsed Doppler ultrasound of an umbilical artery. The result was not included in clinical decisions. In the group with abnormal flow a high rate of cesarean sections because of fetal distress (53%) was necessary, whereas only 3% were performed in the group with normal flow. In cases with reduced enddiastolic blood flow velocity the fetal outcome was significantly worse compared with cases with normal flow. The sensitivity of pulsed doppler ultrasound in predicting cesarean section for fetal distress was 71%, the specificity 91% (3 days before delivery). The oxytocin challenge test indicated this with a sensitivity of 58% and a specifity of 82%, whereas the nonstress test is not useful in predicting fetal risk in postterm pregnancy.

Blood Flow Velocity↗
PubMedDate not supplied

Arterial emboli of the upper extremity: a persisting problem.

From 1969 to 1980, 154 emboli of the upper extremities (UEE) were managed in our institution. They occurred in 151 patients, 66 males (44%) and 85 females (56%) aged ranged from 23 to 87 years (mean 68.9). Obstruction level was in the subclavian artery (12 cases), the axillary artery (46), the brachial artery (74 cases), the radial or ulnar artery (22 cases). Cardiac disease was present in 119 cases. Ischemia was severe in 47 cases (30%), and partial in 104 (67%). Peripheral gangrene was already present in 2 cases. 106 patients were operated on within 10 hours after the occurrence of UEE (69%). Associated systemic emboli was noted in 10 cases. The treatment consisted in 140 primary embolectomies and in 11 cases of conservative therapy (heparin 10, thrombolysis 1). Reoperation was done in 11 patients (7%) because of recurrence of UEE and in 4 cases (2%) for post-operative thrombosis. Results were good in 128 patients with clinical improvement and arterial patency.

Adult↗
PubMedDate not supplied

[Late neurologic morbidity of premature infants with intrauterine diagnosis of null- or negative flow of the umbilical arteries].

Absent or reverse enddiastolic flow velocities (AREDFV) of the umbilical arteries are associated with fetal distress and adverse fetal outcome. We studied 68 fetuses with AREDFV with respect to abnormal neurological evaluation up to two years. A control group was matched for gestational age and had normal umbilical artery flow velocity waveforms. Fetuses with AREDFV showed increased abnormal neurological signs, compared with the control group (31% vs. 12%). Our results confirm the significance of AREDFV in growth retarded infants with respect to neurological development in early childhood.

Blood Flow Velocity↗
PubMedDate not supplied

[Doppler sonographic flow measurements of the middle cerebral artery in end-diastolic zero flow in the umbilical arteries in relation to fetal outcome].

Absent or reverse end-diastolic flow velocities (AREDFV) of the umbilical arteries are associated with fetal distress. We studied 74 fetuses with AREDFV with respect to the resistance index of the middle cerebral artery (MCA). The change in the resistance index of MCA was applied to the fetal outcome. The fetuses were retrospectively divided into 3 groups: 1) The fetuses in the first group did not show any changes in the course of observation of the MCA. 2) In the second group a drop followed by an increase in the resistance index of the MCA was confirmed. This is known in literature as "cerebral oedema". 3) The third group showed only a drop in the resistance index, described in literature as "brain-sparing-effect". The increase in the resistance index of the MCA points to a danger for the fetus, since the incidence of fetal acidosis, low birth weight, severe idiopathic respiratory distress syndrome in these fetuses was extremely high. In particular every second fetus in this group showed neurological complications. The change in the cerebral perfusion known as "cerebral oedema" which is extremely dangerous for the fetus has to be avoided.

Adult↗