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Biomedical subjects

R C Cefalo

Publications and source records attributed to R C Cefalo.

At least 109 records · Page 6Linked to original sources
PubMed1982

Rocky Mountain spotted fever in pregnancy: differential diagnosis and treatment.

Rocky Mountain spotted fever (RMSF) presents both diagnostic and therapeutic difficulties in the pregnant patient. Early clinical manifestations may be mistaken for normal pregnancy changes. Accurate diagnosis is essential, since several of the disorders in the differential diagnosis may have important obstetric implications. Antibiotics generally used to treat serious infections during pregnancy are ineffective in treating RMSF. Chloramphenicol is the antibiotic of choice. Specific recommendations for evaluating pregnant patients with suspected RMSF are given.

Chloramphenicol↗
PubMed1982

In-hospital maternal mortality in the United States: time trends and relation to method of delivery.

To study time trends in maternal mortality in the United States and to attempt to compare the risk of cesarean with vaginal delivery, information from the Professional Activities Study of the Commission on Professional and Hospital Activities for 3 years-1970, 1974, and 1978-was reviewed. For all deliveries, mortality per 100,000 deliveries declined from 25.7 in 1970 to 14.3 in 1978. For vaginal deliveries, mortality per 100,000 deliveries declined from 20.4 to 9.8. For cesarean deliveries, mortality per 100,000 births decreased more than for vaginal deliveries, from 113.8 to 40.9. Mortality for deliveries with no mention of complications, lacerations, or uterine rupture declined significantly from 1970 to 1978. Mortality for deliveries complicated by dystocia or malpresentation declined significantly from 1970 to 1974, but failed to decline thereafter. Mortality for deliveries complicated by a previous cesarean or by antepartum hemorrhage did not decline significantly from 1970 to 1978. For all complications with a sufficient number of vaginal and cesarean deliveries, except deliveries complicated by malpresentation or antepartum hemorrhage, mortality was at least twice as high in cesarean as in vaginal deliveries. Based on a comparison of mortality after a previous cesarean with mortality for all vaginal deliveries with no complication, the authors conclude that cesarean delivery is probably neither less than 2 nor more than 4 times more hazardous than vaginal delivery.

Adolescent↗
PubMed1982

Paroxysmal tachycardia and cardioversion during pregnancy.

Synchronized direct current (DC) cardioversion was used successfully for treatment of a pharmacologically refractory supraventricular tachycardia during pregnancy. No maternal or fetal complications or ill effects occurred. Although few cases have been reported, a review of the literature supports the use of synchronized DC countershock therapy for the treatment of certain arrhythmias during pregnancy. Thorough knowledge of electrocardioversion techniques and of concurrent fetal monitoring is recommended.

Adolescent↗
PubMed1982

Relationship of fetal limb lengths to both biparietal diameter and gestational age.

Ultrasonic long bone imaging is a potentially valuable index of fetal growth. Reported here are fetal limb measurements in normal pregnancies, produced with readily available ultrasound equipment and described using simple statistical techniques. Lengths of femur, humerus, tibia/fibula, and radius/ulna are related to gestational age. Femur and humerus measurements are also related to biparietal diameter. Linear correlation is high and with few exceptions these results confirm those of other investigators. Comparability between these data and previously published work is examined and the utility of these standards of growth discussed. Long bone imaging is confirmed as being reliable, reproducible, and a viable alternative to the measurement of biparietal diameter in the biophysical assessment of fetal development.

Anthropometry↗
PubMed1981

Fetal toxicity of nitroprusside in the pregnant ewe.

Sodium nitroprusside, a direct-acting vasodilator, has been used to treat the hypertension associated with preeclampsia and eclampsia. Fatal cyanide intoxication has been reported during infusion of nitroprusside. We have investigated placental transfer and fetal toxicity of nitroprusside in the acute pregnant ewe model. A maternal intravenous infusion of nitroprusside solution was maintained at a rate sufficient to decrease mean maternal arterial pressure by 20% for 1 hour. Maternal and fetal levels of nitroprusside were in equilibrium at the 20 minute sample. Five of the eight animals exhibited tachyphylaxis to nitroprusside, and their fetuses died in utero with lethal levels of cyanide. No significant changes were observed in uterine blood flow.

Animals↗
PubMed1981

The role of prostaglandins in endotoxemia and comparisons in response in the nonpregnant, maternal, and fetal models. II. Alterations in prostaglandin physiology in the nonpregnant, pregnant, and fetal experimental animal.

The present study evaluates the response of the nonpregnant ewe, the pregnant ewe, and the fetal lamb with regard to prostaglandin physiology after E. coli endotoxin administration. Baseline levels are reported and response to a stimulator (E. coli endotoxin) and an inhibitor (indomethacin) of prostaglandin synthesis is evaluated. The results reveal that the prostaglandin response to stimulation or inhibition relies upon the baseline levels and that acute alterations of prostaglandin ratios may occur with inhibition of prostaglandin synthesis. The fetus reacts differently than the pregnant and nonpregnant animal and appears to be resistant to the effects of endotoxin, which may be secondary to the elevated baseline fetal prostaglandin levels.

Animals↗
PubMed1981

Histiocytosis X and pregnancy.

Histiocytosis X is associated with a pathologic proliferation of mononuclear histiocytes in the reticular endothelial system. Different clinical manifestations of this group of disorders may occur. Pregnancy and histiocytosis X infrequently occur simultaneously. Four cases previously reported along with 1 new case of histiocytosis X and pregnancy are reviewed in this report. Only chronic histiocytosis X, Hand-Schüller-Christian disease (HSCD), has been reported to occur during pregnancy. The most frequent complication during pregnancy was the onset or exacerbation of diabetes insipidus, as frequently seen with this disorder. The possibility that HSCD may alter pituitary function may contribute to the infrequent occurrence of pregnancy in patients with this disorder.

Adult↗
PubMed1980

The role of prostaglandins in endotoxemia: comparisons in response in the nonpregnant, maternal, and fetal models. I. Prostaglandins and the pulmonary effect of experimental endotoxemia.

The mechanism of respiratory distress in sepsis is unknown. Previous work has shown elevations of prostaglandins during sepsis. This study reveals a correlation between levels of prostaglandins F 2 alpha and E and pulmonary hypertension and other parameters of respiratory distress in oophorectomized ewes subjected to endotoxin. The use of prostaglandin synthetase inhibitors prior to endotoxin prevented the rise in prostaglandins and the development of respiratory distress.

Animals↗
PubMed1980

Clinical applicability of amniotic fluid tests for fetal pulmonic maturity.

Recent advances in the understanding of neonatal respiratory distress syndrome have led to a proliferation of amniotic fluid tests for fetal pulmonic maturity. Clinical application of these tests requires a knowledge of reliability, availability, and cost. This review outlines the major features of the most widely utilized pulmonary maturity tests and allows the clinician to make a comparative assessment.

Amniocentesis↗
PubMed1980

Perinatal risk factors in gravidas with moderate renal impairment.

The coexistence of chronic renal disease and pregnancy leads to an increased risk for mother and fetus. This report retrospectively analyzes a series of patients with moderate renal impairment. Infants of patients who had superimposed preeclampsia showed a significant decrease in birth weight and gestational age at delivery. These patients were characterized by a significantly higher mean arterial pressure at the time of the first clinic visit.

Adolescent↗