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Biomedical subjects

L G Keith

Publications and source records attributed to L G Keith.

At least 55 records · Page 3Linked to original sources
PubMed1989

Substance abuse in pregnant women: recent experience at the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital.

Drug abuse during pregnancy is associated with adverse perinatal outcome. Patterns of abuse have changed in recent years with the increasing popularity of cocaine. We compared pregnancy outcome data from 137 women receiving prenatal care in the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital with those of matched controls. Among drug-using women, the mean gestational age at delivery and mean birth weight were significantly lower than those of controls. In addition, study pregnancies were more frequently complicated by the need for antenatal hospitalization, preterm delivery, low birth weight (less than 2500 g), and abruptio placentae.

Adult↗
PubMed1988

The Northwestern University triplet study. IV. Biochemical parameters.

Umbilical arterial and venous blood gas indices of 11 triplet pregnancies were reviewed. Ten sets of triplets were delivered by cesarean section and one set was delivered vaginally. Mean 1-minute Apgar scores were significantly lower in the group of infants delivered third than in either of the other birth order groups. There were no statistically significant differences when the mean umbilical arterial or venous pH, PCO2, and base deficit were compared among any one triplet and the other two. Similarly, no significant differences were found when these parameters were compared by birth order in relation to mean 5-minute Apgar scores, mean birth weights, and mean gestational ages at delivery. Birth order did not appear to significantly influence acid-base status, although it may become significant with an increasing time in utero after delivery of the firstborn infant. Further study is necessary to investigate whether there is a critical interval of delivery whereby the infants remaining in utero become acidotic.

Apgar Score↗
PubMed1988

The Northwestern University Twin Study. V: Twin deliveries at Prentice Women's Hospital and Maternity Center, 1978-83.

Two hundred fifty-one twin deliveries between January 1, 1978 and June 30, 1983 at Prentice Women's Hospital and Maternity Center were reviewed. Cases were excluded if birth weight was less than 500 g, if gestational age was less than 26 weeks or if an antenatal fetal demise had occurred. Maternal demographic characteristics, delivery data and infant characteristics are described. The effect of providing care to a high-risk population of mothers in whom approximately 60% either deliver their infants preterm or with a birth weight of less than 2,500 g is discussed in terms of costs of care.

Adolescent↗
PubMed1988

The Northwestern University Twin Study. VII: The mode of delivery in twin pregnancy. North American considerations.

No consensus exists for the optimal mode of delivery for twin fetuses. Opinions vary by type of institution (university medical center vs community hospital), country or continent (North America vs Western Europe) and personal preference of individual physicians. This article lists clinical considerations in arriving at the decision and presents them in the form of a decision tree.

Decision Trees↗
PubMed1988

The Northwestern University Triplet Study. I: Overview of the international literature.

The international literature on triplet births is surveyed. No definitive work on triplet gestations exists. The relatively few articles on this subject are divided into three categories: 1) national data; 2) local, regional or hospital series; 3) case reports. Clinical concerns, such as prematurity, low birth weight, bed rest, and tocolysis, are discussed with specific reference to literature citations.

Bed Rest↗
PubMed1988

The Northwestern University Triplet Study. II: Fourteen triplet pregnancies delivered between 1981 and 1986.

Fourteen triplet deliveries conducted between 1 January 1981 and 30 June 1986 at the principal teaching hospitals of Northwestern University Medical School are reviewed. Maternal demographic characteristics are listed, as are the obstetric outcomes, including mode of delivery, and the fetal outcome. The recent literature of triplet delivery is reviewed. The rate of triplet delivery in our study was 0.37 per 1,000 live births. About two-thirds of the pregnancies resulted from the use of fertility-inducing agents. Ultrasonic confirmation was available in all cases. The majority of women were delivered by cesarean section (85%). No consistent pattern of presentation was seen. The mean weight of all 42 infants was 1,779 g (+/- 594). Unlike-sex triplets accounted for most of the sets (77%). The mean 5-min Apgar score of all infants was 9 and had no association with the order of deliveries. The weight differences by sex regardless of birth order were clinically insignificant. Neonatal mortality was 2.3%.

Adult↗
PubMed1987

Cocaine use during pregnancy: adverse perinatal outcome.

Cocaine use has increased dramatically in the United States during the past decade. The life-threatening cardiovascular and central nervous system complications of cocaine have been well documented; however, few studies have examined the risks of cocaine use during pregnancy. In this report the perinatal outcome data of 70 women receiving care at the Perinatal Center for Chemical Dependence of Northwestern University, whose pregnancies were complicated by cocaine abuse, were compared with those of matched control subjects. The use of cocaine during pregnancy was associated with lower gestational age at delivery, an increase in preterm labor and delivery, lower birth weights, and delivery of small for gestational age infants.

Adult↗
PubMed1987

Economic considerations in the use of laparoscopy for diagnosing pelvic inflammatory disease.

The clinical diagnosis of pelvic inflammatory disease (PID) is associated with an average accuracy rate of 65% when preoperative impressions are confirmed or rejected with laparoscopy. The cost of this error rate should be evaluated when considering the cost and risks of immediate laparoscopy in patients suspected of having PID. This study reviewed selected patient admissions for PID from Northwestern Memorial Hospital for the years 1981-1985. The costs of hospitalization and treatment and the inherent diagnostic error rate were considered concurrently. No significant additional expense would have been incurred if all the women admitted with a clinical diagnosis of PID had had laparoscopic verification of their clinical diagnoses as compared to the cost of treatment with intravenous antibiotics for three to five days. We recommend the early use of laparoscopy in establishing the diagnosis of PID because it ensures a more accurate and definitive diagnosis and does not add significantly to costs.

Chicago↗
PubMed1987

Thermovascular changes associated with in situ and minimal breast cancers. Results of an ongoing prospective study after four years.

A four-year prospective study was conducted on more than 25,000 women, both asymptomatic (59%) and symptomatic (41%), with a view to investigating the thermal and vascular disorders associated with early stages of breast malignancy. All the patients underwent thermographic, mammographic and physical examinations performed under standard conditions and, when indicated, complementary radiographic (spot/magnified pictures), ultrasound and cytologic tests. Of the 294 in situ, microinvasive and nonpalpable cancers diagnosed in this study, 60-70% generated significant thermal anomalies that, in most cases, consisted of distorted thermovascular patterns. A tentative explanation for these clinical observations was formed from intramammary measurements of temperature and blood flow performed on seven patients and was based on recent experimental data on the origin of vascular reactions associated with cancer growth. This study clearly showed that thermography may contribute to the early detection of breast cancer and to the identification of women at high risk of developing breast cancer. Two hundred four (21.3%) of the 958 patients who, on their first visit, had an abnormal thermogram but no findings at physical examination or mammography developed cancer within the next three years (length of follow-up, 4-41 months).

Adult↗
PubMed1986

The Ljubljana IUDs: further observations on surface morphology.

Twelve IUDs that had been worn from 8 years 10 months to 24 years were examined by SEM. Photomicrographs of selected samples are shown, and a discussion of the nature of the surface encrustations is provided. The authors are of the opinion that surface encrustations are generic to different types of IUDs and that their clinical significance is presently unknown.

Adult↗
PubMed1986

The Nordic contribution to the English language twin literature.

This project was inspired by the extensive contribution of Nordic researchers to the English language twin literature. The purpose of the study was to compile a source bibliography of twin literature written at Nordic institutions. The bibliography compiled as a supplement for this paper provides as complete a survey as is possible to obtain in the United States. Our search began with a Medline Computer data base. To make our survey more complete, we cross-referenced and added to this using the Index Medicus, the National Institute of Mental Health Bibliography, Excerpta Medica, specific article references, references provided by Nordic university libraries and Gedda's Estudio dei Gemelli. The full bibliography of 313 references is available at no cost from the Center for the study of multiple Birth, Rm. 476, 333 E. Superior, Chicago, Ill. 60611, U.S.A.

Bibliographies as Topic↗
PubMed1985

Chorionic villus sampling for first-trimester prenatal diagnosis: Northwestern University program.

We present our initial experience in developing a chorionic villus sampling program at Northwestern University. In phase 1, we performed chorionic villus sampling in 58 patients prior to elective first-trimester abortion, assessing the reliability and reproducibility of obtaining adequate villus samples and performing cytogenetic analysis by means of both the direct and culture methods. Specimens were categorized according to quality: class I, multiple identifiable villi (n = 20); class II, few villi or villi mixed with decidua (n = 15); class III, no villi (n = 23). There was a positive trend between operator experience, amount of villi obtained, and quality of cytogenetic preparations. In March, 1984, we received Institutional Review Board approval to perform chorionic villus sampling in continuing pregnancies (phase 2). Among the first 20 cases we found two abnormalities (47,XY, + 13; 45,X). The remaining 18 pregnancies were continuing. Recommendations are made for developing a chorionic villus sampling program.

Adolescent↗
PubMed1985

Energy dispersive spectrophotometric and X-ray diffraction observations in IUDs.

This paper describes preliminary observations of the surface deposits on Lippes Loop, Dalkon Shield, and Saf-T-Coil IUDs removed after periods of time up to 15 years. Rosettes of euhedral rhombic crystals with a columnar prismatic habit were observed on a Lippes Loop that had been in situ for 15 years. All mineral deposits were found to be calcium salts, but the degree of crystallization varied significantly, from almost totally amorphous to the perfect euhedral crystal form. The microenvironment alone or in combination with cyclic changes in the biochemical milieu surrounding the IUD may influence the deposition of specific mineral species.

Crystallization↗
PubMed1985

The Fitz-Hugh-Curtis syndrome revisited. Changing perspectives after half a century.

The Fitz-Hugh-Curtis syndrome is an extrapelvic manifestation of pelvic inflammatory disease. Classically it consists of adhesions between the liver capsule and the diaphragm or the anterior peritoneal surface. Two recent changes have been made in the assessment of this syndrome. One, the syndrome was originally thought to be caused solely by Neisseria gonorrhoeae. Recent studies using tissue cultures and serum antibody titers have documented a major etiologic role for Chlamydia trachomatis as well. Two, the condition has recently been reported to exist in men, whereas previously it was believed to be limited to sexually active women in their reproductive years.

Abdominal Muscles↗
PubMed1985

Role of sexual behavior in the development of pelvic inflammatory disease.

The role of sexual behavior in the development of pelvic inflammatory disease (PID) is not well understood. In general the literature is limited and flawed in the methods used to assess sexual behavior. Good evidence suggests that PID in Western society is a sexually transmitted disease. For number of partners, frequency of intercourse, time of intercourse and sexual life-style the evidence suggests that those variables have a significant role in the development of PID. It is important to assess PID in the context of all its risk factors, including sexual behavior, race, prior history of PID and IUD use.

Adolescent↗
PubMed1985

Problems in the cultivation of cervical bacteria.

Multiple variations in the types, species and prevalence of cervical bacteria are described in the literature. A review of the literature was undertaken to determine the effect of delay on the ability to identify bacteria. Experiments were initiated to elaborate on those observations. The rate of organism isolation was related to the delay in transport to the laboratory.

Adult↗