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Biomedical subjects

M de Jager

Publications and source records attributed to M de Jager.

23 records · Page 2Linked to original sources

Primary care fetal assessment--low-cost fetal arousal testing.

Conventional vibro-acoustic stimulation tests require expensive vibro-acoustic stimulators and electronic monitoring equipment. Attempts to simplify the test have been made using an electric toothbrush and razor but even these simpler devices are not available in most primary care settings. We compared the sound pressure generated by a Corometrics 146 vibro-acoustic stimulator to that of an empty soft-drink can in an in vitro study. The can compared favourably to the conventional vibro-acoustic stimulator.

Acoustic Stimulation↗

Amnioinfusion.

Abnormal amniotic fluid volume may be both the result and the cause of complications at various stages of pregnancy. This review focuses on evidence from randomised trials of the effectiveness of amnioinfusion. Attempts to prevent the development of pulmonary hypoplasia by means of transabdominal amnioinfusion to correct severe oligohydramnios in the middle trimester of pregnancy have not been evaluated by randomised trials. Long-term transcervical amnioinfusion for prelabour rupture of the membranes has shown promising results in prospective studies, but has also not been subjected to randomised evaluation. Transcervical amnioinfusion during labour is a relatively simple procedure. Normal saline is infused through an intrauterine catheter, preferably one with a catheter-tip pressure transducer. Once an adequate volume of amniotic fluid has been achieved, it is maintained by means of a slow continuous infusion or repeated bolus infusions. Amnioinfusion has been used to prevent or treat fetal heart rate (FHR) decelerations thought to be due to oligohydramnios. In several rather small randomised trials, amnioinfusion has been associated with a reduction in FHR decelerations, caesarean sections, low Apgar scores, low umbilical arterial pH values and postpartum endometritis. Amnioinfusion has also been used to dilute thick meconium-staining of the amniotic fluid. In trials for this indication, amnioinfusion has been associated with similar benefits, and in addition a reduction in meconium presence below the vocal cords, meconium aspiration syndrome and the need for neonatal ventilation. Larger trials are needed to determine whether amnioinfusion is associated with an effect on perinatal mortality, and whether complications such as umbilical cord prolapse are increased.

Amnion↗

Influence of weight on removal of co-adhering bacteria from salivary pellicles by different modes of brushing.

This study compared removal of pairs of co-adhering and non-co-adhering oral actinomyces and streptococci from salivary pellicles by manual, rotating/oscillating electric and sonic toothbrushes, applying weights up to 240 g. First, actinomyces were allowed to adhere to a pellicle in a parallel plate flow chamber, after which streptococci suspended in saliva were perfused through the chamber at 33 degrees C. On average, 34-39% of the adhering bacteria were adhering as single organisms. For co-adhering and non-co-adhering pairs, 33 and 10% of the adhering bacteria were involved, respectively, in aggregates comprising more than 10 organisms. Brushing by hand removed 82% at low weight (40 g), which was less than by electric (93%) or sonic (92%) brushing, while for all modes of brushing bacterial removal increased with increasing weight to 95-99%. For a non-co-adhering pair, subsequent exposure of brushed pellicles to a streptococcal suspension yielded only 2-16% of bacteria involved in large aggregates, regardless of the mode of brushing. For the co-adhering pair, however, de novo streptococcal adhesion to hand-brushed pellicles yielded 34-57% of bacteria involved in large aggregates, while electric and sonic brushing left 22-35% of the bacteria involved in large aggregates. De novo streptococcal adhesion for the co-adhering pair increased with increasing weight for the electric and sonic brush in contrast to the manual brush. Since a strong influence of co-adhesion is evident in de novo streptococcal adhesion, despite nearly complete removal of all actinomyces, these observations suggest that the three modes of brushing leave footprints to which streptococci preferentially adhere.

Actinomyces↗