Decreased tear osmolarity and absence of the inferior marginal tear strip following sleep.
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Adult↗
Biomedical subjects
G R Cohen
Publications and source records attributed to G R Cohen.
Percutaneous balloon mitral valvuloplasty in a pregnant woman with mitral stenosis, sickle cell crisis and acute pulmonary edema. A case report.
A woman with acute congestive heart failure secondary to mitral stenosis and sickle cell crisis was treated successfully with a combination of an exchange transfusion and percutaneous balloon valvuloplasty. That combination provided an alternative to surgical mitral commissurotomy, with its significant risks for both the mother and fetus. The patient was able to undergo an uncomplicated pregnancy course despite the increased risk of cardiac decompensation in the intrapartum and postpartum period.
Adult↗
Hyperkalemia after irradiation of packed red blood cells: possible effects with intravascular fetal transfusion.
Plasma potassium, calcium, and albumin concentrations in irradiated blood, and in fetal blood before and after transfusion, were measured. Dangerously high plasma potassium levels were observed in some units of irradiated packed red blood cells (range, 13.9 to 66.5 mEq/L; mean, 44.7 mEq/L) and could be one possible explanation for the high incidence of fetal arrhythmia associated with fetal intravascular transfusion. There are many factors operative in the preparation of irradiated packed red blood cells that may predispose to high potassium levels: the age of the red blood cells, the number of procedures used to concentrate the blood, the duration of time elapsed from concentration, the duration of time elapsed from irradiation, and the hematocrit. Use of fresh blood, avoidance of multiple packing procedures, limiting the hematocrit in the donor unit to less than or equal to 80%, and minimizing the time between concentration, irradiation and transfusion may minimize the potassium levels, and therefore making an additional washing procedure unnecessary.
Arrhythmias, Cardiac↗
The sequential use of estradiol and prostaglandin E2 topical gels for cervical ripening in high-risk term pregnancies requiring induction of labor.
We compared the safety and efficiency of 200 mg of estradiol valerate prepared as a topical cervical gel as a preripening agent when used 6 hours before the application of 2 mg of prostaglandin E2 gel for the purpose of cervical ripening in 40 high-risk obstetric patients before indicated oxytocin induction of labor. When compared with a placebo prostaglandin E2 dosage, the estradiol had no effect on the change of Bishop score, length of labor, amount of oxytocin required, or the cesarean delivery rate. While no uterine contractions were noted after the application of the estradiol, 85% of patients had recordable uterine activity after the application of prostaglandin E2, suggesting that even at the 2 mg dosage this sequential regimen is not appropriate for local cervical ripening.
Administration, Topical↗
ST segment depression in paired electrocardiograms and serum electrolytes in pregnant women receiving intravenous ritodrine.
Forty-three women admitted for preterm labor had electrocardiograms and serum potassium and glucose levels determined before and two and four hours after the initiation of intravenous ritodrine tocolysis. The ST segment depression found at two and four hours was significant but not dependent upon a fall in potassium or increase in the heart rate or glucose level. Such symptoms as chest pain and dyspnea were also not dependent upon potassium, glucose or heart rate changes. These findings support the concept of an intrinsic drug effect.
Blood Glucose↗
Heparin-induced cutaneous necrosis in a postpartum patient.
A case of heparin-induced cutaneous necrosis resembling necrotizing fasciitis occurred in a post-cesarean section patient. She presented with massive necrosis of the skin and abdominal pannus on the sixth postoperative day after a cesarean section for severe preeclampsia and failed induction. A biopsy showed findings characteristic of heparin-induced cutaneous necrosis, permitting conservative therapy.
Adult↗
A prospective randomized study of the aggressive management of early labor.
The aggressive management of early labor has been suggested as a means to lower the cesarean section rate for dystocia. The aim of our study was to prospectively evaluate a protocol of early intervention in primigravid women with infrequent uterine contractions during early labor in relation to the course of labor, the cesarean section rate, and the perinatal morbidity. In our population the active management of labor did not alter the mode of delivery or the perinatal outcome. Furthermore, the course and duration of labor were not significantly different between the management and control groups.
Adult↗
Uterine hyperstimulation resulting from intravaginal prostaglandin E2. A case report.
Prostaglandin E2 administered intravaginally is an effective method of improving Bishop scores in patients requiring elective induction of labor. We treated a woman for hypertonic uterine contractions that occurred over a five-hour period after application of 5 mg of prostaglandin E2. Sedation and magnesium sulfate were not effective in decreasing the intensity of the contractions, but terbutaline, 0.25 mg subcutaneously, was.
Administration, Intravaginal↗
Alterations in platelet concentration and aggregation in normal pregnancy and preeclampsia.
Platelets were evaluated in normal pregnant women and in pregnant subjects with mild and severe preeclampsia, nonpregnant control subjects, and pregnant subjects with chronic hypertension. The parameters studied included platelet count, presence of circulating platelet aggregates, and in vitro platelet aggregability by means of a variety of agonists of platelet aggregation. When subjects with a normal pregnancy were compared to nonpregnant controls, they demonstrated a significantly lower platelet count and an increase in circulating platelet aggregates and in vitro hypoaggregability. Significant differences among the groups of pregnant subjects could not be found. These studies suggest the occurrence of platelet activation in pregnancy. This activation causes in vivo platelet aggregation followed by exhaustion of platelets.
Adolescent↗
Plasma prostaglandin metabolite levels after use of prostaglandin E2 gel for cervical ripening.
An ideal agent for cervical ripening should produce an increase in cervical scores without stimulating myometrial contractions. Currently used methods of preinduction ripening with prostaglandin E2 are frequently associated with contractions, limiting their use in high-risk patients. To discriminate between a direct effect of absorbed prostaglandin E2 and a triggering of the intrinsic mechanisms of labor, we measured circulating levels of stable metabolites of prostaglandin E2 and prostaglandin F2 alpha. Prostaglandin E2 gel insertion followed by a rise in prostaglandin E2 metabolite but not prostaglandin F2 alpha metabolite implies that contractions are secondary to absorbed prostaglandin E2.
Dinoprost↗
Work-related eye injuries.
Twenty-one patients admitted between 1977 and 1982 to the Medical College of Virginia were studied retrospectively for work-related eye injuries. This group comprised 7.7% of all eye-injury admissions. Patients suffered both blunt and penetrating injuries; penetrating injuries had poorer prognoses. Twenty of the 21 patients had not worn protective eyewear. The average per-patient cost related to ocular injury was $2946, and the average hospital stay was 6.4 days. In contrast, the one patient who had worn protective eyewear had ocular-related costs and hospitalization of only $350 and a one-day stay. Protective eyewear is important in lessening the severity of injury as well as decreasing the financial and psychologic burden to the patient, hospital, and employer.
Adult↗
Clinical significance of transient visual phenomena in the elderly.
To evaluate the significance of transient visual phenomena in the elderly patient, a retrospective study of 43 patients over 40 years of age (mean, 58) presenting between 1971 and 1982 was conducted. Historical, clinical and diagnostic features were collated and analyzed by computer. The study revealed that 31 patients were diagnosed as migraine and 12 as vertebrobasilar insufficiency based on features identified in this review. Follow-up was obtained in 90% of the patients with a mean follow-up of 2.4 years. In general, prognosis proved to be excellent, with two deaths of cardiac origin and an 81% incidence of remission or symptomatic improvement of the visual events. No retinal or cerebral strokes were observed and TIAs occurred in only 9% of the population. This study suggests that transient visual phenomena in the elderly are benign.
Adult↗
Heat production during sleep.
Heat production during sleep was studied by continuous indirect calorimetry with simultaneous electroencephalographic monitoring. Controlling for gross influences on heat production, comparisons of heat production during different sleep stages showed heat production in stage 4 sleep to be significantly lower than in other sleep stages. There appeared to be a gradation in heat production in non-rapid-eye-movement stages of sleep with stage 2 higher and stage 4 lower than stage 3. Heat production in stage 4 was less variable than in any other sleep stage. Both the level and variability of heat production was similar in stage 2 and rapid-eye-movement sleep. Heat production during the night was 9% lower than during resting wakefulness. The average heat production in stage 4 sleep was 14.4% lower than resting wakeful values.
Adult↗
Total alcohol consumption and excessive drinking.
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Alcohol Drinking↗