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Biomedical subjects

J J Botti

Publications and source records attributed to J J Botti.

27 records · Page 2Linked to original sources

The frequent occurrence of false-positive results in phleborheography during pregnancy.

In this study, none of 25 pregnant women without any past history of venous thromboembolic disease had a positive phleborheogram sometime during their pregnancy or within six weeks post partum. In contrast, zero of ten nonpregnant women, also screened for venous thrombophlebitis, had a positive test finding during the same time interval. No clinical parameters, including weight gain, leg circumference, leg swelling, development of varicose veins, leg pain or use of support stockings, correlated with the occurrence of a positive test result. While there is conflicting evidence from other studies, our data suggest the need for caution in interpreting a positive phleboroheogram as an accurate indicator of thrombophlebitis in pregnant women.

Adult↗

Variations of biologic activity of low-dose prostaglandin E2 on cervical ripening.

The effect of low-dose prostaglandin E2 vaginal gel specially prepared from commercially available materials, on subsequent indicated oxytocin induction of labor, was investigated in a randomized, double-blind, placebo-controlled clinical trial. The stability of the gel after preparation was documented by radioimmunoassay in vitro. No differences between the treated and placebo groups were noted in subsequent modified Bishop scores, length of labor, use of analgesia or anesthesia, success of induction, mode of delivery, or perinatal outcome. Comparisons of this clinical trial with those previously reported are offered.

Adult↗

Placental microbiology and histology and the pathogenesis of chorioamnionitis.

The present study was undertaken to determine the proportion of cases of chorioamnionitis that was caused by microbiologic agents. Seventy-five placentas were processed to isolate aerobic and anaerobic bacteria and chlamydia. Results were correlated with the presence or absence of histologic and clinical chorioamnionitis. Bacteria were recovered from 72% (18 of 25) of placentas with histologic chorioamnionitis and from nine of 11 cases (82%) of clinical chorioamnionitis, all of which had histologic chorioamnionitis. Bacteria were recovered from only 15% (six of 39) of placentas without histologic chorioamnionitis. Nearly 50% of the bacteria recovered from placentas were anaerobes, often fastidious in their growth requirements. Often two to three such anaerobes were recovered from a placenta. Findings of the present study increase the possibility that bacteria are responsible for most cases of chorioamnionitis.

Chlamydia Infections↗

The clinical significance of placental villous edema.

A study was undertaken to determine why there is such variability in morbidity and mortality in neonates exposed to antenatal chorioamnionitis. Villous edema provides a clue. It was present in 72/83 placentas with chorioamnionitis. The extent and severity of the edema had a strong, positive correlation with cord arterial blood pH values, low Apgar scores, the need to resuscitate vigorously at birth, the subsequent need for assisted ventilation, the frequency of hyaline membrane disease, and neonatal mortality. Most of the difference in morbidity and mortality between preterm and full-term infants was related to the greater severity and extent of villous edema in those born prematurely.

Amnion↗

Portal venous blood flow distribution to liver and ductus venosus in newborn lambs.

Changes in the distribution of portal venous blood flow to the left and right lobes of the liver and through the ductus venosus were determined from before birth through 9 days of age in 25 chronically catheterized fetal and newborn lambs. Blood flow distribution was calculated by means of the radionuclide-labeled microsphere technique. With umbilical cord clamping portal venous blood flow distribution to the right lobe of the liver decreased when compared to that in the term fetus; distribution to the left lobe and ductus venosus increased. More than 50% of portal blood flow was shunted through the ductus venosus during the first hour after birth. Ductus venosus shunts of at least 25% of total portal blood flow were noted in half the lambs between the second and sixth days of life. Portal venous distribution to the right lobe was inversely related to the fraction of portal blood flow shunted through the ductus venosus. The ratio of right lobe weight to total liver weight was significantly correlated with the ratio of right lobe flow to total liver flow (r = 0.73; P less than 0.001). The conclusion is that large and persistent ductus venosus shunts are normal during the first postnatal week in lambs.

Animals↗

Chorioamnionitis and possible neonatal infection associated with Lactobacillus species.

A patient is described with premature labor at 32 weeks of gestation complicated by chorioamnionitis associated with Lactobacillus species, subsequent premature delivery, and possible neonatal infection. Mother and infant did well with antibiotic therapy. The significance of chorioamnionitis and neonatal pneumonia due to this organism group is discussed.

Adult↗

Nonimmunologic hydrops fetalis: a review of 19 cases.

Nineteen cases of nonimmunologic hydrops fetalis occurring during a nine-year period were reviewed. The pregnancies were complicated by hydramnios (78%) and preterm delivery (84%). Hydramnios appears to be the most useful indicator of the pregnancy at risk; its occurrence should prompt ultrasonographic investigation for evidence of hydrops. Modalities available for antenatal diagnosis of underlying fetal abnormalities include amniocentesis, serologic tests, fetal cardiac monitoring, radiography, hemoglobin electrophoresis and glucose tolerance testing. A specific cause for the hydrops may not be detectable (42% of our cases were idiopathic). Management of affected pregnancies is influenced by the frequent occurrence of fetal asphyxia and premature delivery. Outcome is poor: only 32% of the babies survived beyond the neonatal period. Symptomatic treatment for the neonate includes fluid restriction, maintenance of blood sugar, support of ventilation and attention to the complications of asphyxia.

Adult↗

Sequential longitudinal evaluation of cardiac growth and ventricular diastolic filling in fetuses of well controlled diabetic mothers.

Hypertrophic cardiomyopathy and abnormal ventricular diastolic filling in the infant of the diabetic mother is related to poor maternal glycemic control. Evaluation of fetuses of well controlled diabetic mothers has not been examined. Eleven fetuses of nondiabetic mothers (normals) and 9 fetuses of well controlled insulin-dependent diabetic mothers (FODMs) underwent serial evaluation of cardiac growth and ventricular diastolic filling using M-mode and Doppler echocardiography at 20-26 weeks' (period 1), 27-33 weeks' (period 2), 34-40 weeks' (period 3),m and 48-72 hours after birth (period 4). Indices of right and left ventricular diastolic filling included time velocity integral ratios (E/A and %E/E+A). Cardiac growth and birth weight in the two groups were similar consistent with "good" glycemic control. This conclusion was supported by similar maternal glycosylated hemoglobin (%A1C) prenatally and newborn %A1C and C-peptide values postnatally. Heart rate before and after birth and placental resistance prenatally were similar. Both normals and FODMs demonstrated an increase in left ventricular E/A and %E/E+A ratios from period 1 to 4 (p < 0.0001). This shift occurred earlier (by period 2) in normals (p < 0.01). Right ventricular filling ratios increased by period 4 in normals only (p < 0.01). No differences were noted between the groups during any period. Good glycemic control in FODMs results in normal cardiac growth and ventricular diastolic filling. Progression of diastolic filling is abnormally delayed, however, and is presumably more exaggerated in poorly controlled diabetics.

Birth Weight↗