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Biomedical subjects

H J Landy

Publications and source records attributed to H J Landy.

48 records · Page 3Linked to original sources
PubMed1988

The effect of chronic steroid therapy on glucose tolerance in pregnancy.

We analyzed the records of 26 pregnant patients receiving chronic steroids to assess the combined effect of pregnancy and glucocorticoid administration on glucose tolerance. Five patients (19.2%) developed diabetes mellitus, four of whom required insulin. In a pregnant control group of 1325 patients, 53 patients (4.0%) developed diabetes mellitus, five of whom required insulin. Glucose intolerance was significantly higher in the steroid-treated group (p = 0.003). Comparison with a nonpregnant steroid-treated control group (47 patients, 15% of whom developed diabetes mellitus) showed no significant different (p = 0.23) between the two. All pregnant steroid-treated patients developing diabetes mellitus began steroid therapy after conception, whereas none of the patients receiving steroid therapy before conception developed glucose intolerance (p = 0.012). There does not appear to be an additive effect of steroid treatment and pregnancy on glucose intolerance; however, all patients receiving steroids should undergo periodic glucose screening.

Adult↗
PubMed1987

Genetic implications of idiopathic hydramnios.

The antenatal diagnosis of hydramnios requires a careful search for associated underlying maternal or fetal conditions. Even in pregnancies associated with idiopathic hydramnios in which no underlying condition can be identified, a high perinatal mortality rate exists. Although trisomy 18 has been seen in pregnancies with hydramnios and growth retardation, the association with specific chromosomal disorders and idiopathic hydramnios has not been well defined. A review of pregnancies complicated by hydramnios was undertaken; 99 cases with complete pregnancy and delivery information were identified. Fifty-nine pregnancies were complicated by idiopathic hydramnios, and except for the hydramnios, sonographic evaluation was normal. Delivery information revealed one infant with trisomy 18 and eight infants with structural anomalies not appreciated antenatally. Of the undiagnosed malformations, 25% are frequently associated with trisomy 21. We recommend fetal chromosomal analysis as an adjunct to the evaluation of pregnancies complicated by idiopathic hydramnios.

Chromosomes, Human, Pair 18↗
PubMed1987

Postabortal septic pelvic thrombophlebitis diagnosed with computed tomography. A case report.

Septic pelvic thrombophlebitis is an uncommon complication in obstetrics and gynecology that may be difficult to diagnose clinically. Computed tomography (CT), an accurate and noninvasive modality, has greatly aided in the diagnosis of this disorder. In a case of septic pelvic thrombophlebitis complicating second-trimester pregnancy termination, CT enabled the correct diagnosis to be made and treatment to be initiated.

Abortion, Induced↗
PubMed1987

May-Hegglin anomaly in pregnancy. A case report.

The May-Hegglin anomaly is a rare autosomal dominant platelet disorder that can be associated with significant bleeding. We treated a patient for pregnancy complicated by the May-Hegglin anomaly and a complete placenta previa.

Adult↗
PubMed1986

The "vanishing twin": ultrasonographic assessment of fetal disappearance in the first trimester.

Review of the sonographic findings of 1000 pregnancies with viable gestations in the first trimester revealed a minimum incidence of twinning of 3.29%. Of these, 21.2% demonstrated the "vanishing twin" phenomenon, often with associated bleeding, but with a good prognosis for the remaining fetus. Ovulation induction did not appear to alter these data. The sonographic criteria for "vanishing twin" are discussed. The incidence of multiple gestation is 3.29% to 5.39%, higher than previously believed.

Diagnostic Errors↗
PubMed1982

The vanishing twin.

In general, it has not been recognized that many twin or multiple gestations are lost in utero early in pregnancy. Until the advent of ultrasound, the ability to document early human fetal loss in multiple gestation was difficult. However, recent reports of serial ultrasound examinations of pregnant women have documented the "disappearance" of at least one of two gestational rings. Furthermore, the number of twins observed at delivery was significantly less than the number of twin conceptions originally identified by ultrasound during the first trimester. These observations led to the concept of the "vanishing twin" [8,10,13,15,17,20,22,35,41]. In order to obtain reference and personal data on this subject, we reviewed the literature and corresponded with members of the International Society for Twin Studies and obstetricians affiliated with Northwestern University Medical School, Chicago, Illinois. The nine studies that have documented this phenomenon cite "disappearance" rates ranging from 0% to 78%, depending on patient population and timing of ultrasonography [8,10,13,15,17,20,22,35,41]. Several explanations are offered: physiological mechanisms of "disappearance" (resorption or formation of a blighted ovum or fetus papyraceus), artifactual error, incomplete scanning technique, and poor quality ultrasound equipment. The only complication thus far associated with "disappearance" of a fetus is slight vaginal bleeding.

Abortion, Spontaneous↗
PubMed1978

Controlled clinical study of naltrexone side effects comparing first-day doses and maintenance regimens.

In a controlled double-blind clinical study, 42 patients reported side effects and severity of side effects to naltrexone on three different first-day doses and maintenance dosage regimens. Initiating doses of 25, 100, and 150 mg were administered. The maintenance regimens involved 350 mg of naltrexone per week for 4 weeks with drug administration in Group A, five times weekly; in Group B, three times weekly; and in Group C, twice weekly. All three groups received identical doses for the last dosage administered each week. The first-day doses produced no significant quantitative difference in side effects. Overall, the three groups reported little difference in side effects. Nonetheless, the regimen with the least number of patients reporting side effects daily was that of Group B. In no case, regardless of dose or dosage regimen, did any patient have side effects of such a nature as to require termination of their participation in the study.

Administration, Oral↗
PubMedDate not supplied

Placental abruption associated with cocaine use: case report.

The medical problems associated with cocaine ingestion, most notably cardiovascular side effects, have become evident as its use has become epidemic in the United States. Its effects on pregnancy and the developing fetus are similarly being recognized as more women of childbearing age are abusing cocaine. A case of placental abruption at 33 weeks' gestation following cocaine use is reported. A review of the pharmacodynamics, medical complications, teratogenic potential and effects in pregnancy is included.

Abruptio Placentae↗
PubMedDate not supplied

The vanishing twin: a review.

This article reviews the scientific literature discussing the vanishing twin phenomenon. Information pertaining to frequency, aetiology, and potential complications, as well as the impact of sonographic technology on our growing understanding of the events in early multiple pregnancy is provided.

Diseases in Twins↗
PubMedDate not supplied

Corpus callosotomy for seizures associated with band heterotopia.

Band heterotopia is a severe form of neuronal migration disorder associated with intractable epilepsy and neurologic impairment. Surgical treatment of seizures associated with this malformation has not been reported previously. We report a patient with band heterotopia and poorly controlled atonic seizures causing falls and injury. The patient was treated with anterior corpus callosotomy, with significant postoperative decrease in seizure frequency. Corpus callosotomy is a reasonable alternative to consider in management of patients with cortical heterotopia and intractable seizures.

Adolescent↗