Biomedical subjects

R Figueroa

Publications and source records attributed to R Figueroa.

At least 19 recordsLinked to original sources

PubMed2006

A video study of pain relief during newborn male circumcision.

OBJECTIVE: The purpose of this investigation was to compare the effectiveness of dorsal penile nerve block and topical lidocaine-prilocaine anesthesia techniques for pain relief during circumcision. METHODS: In total, 18 healthy term newborn males were divided based on anesthesia. The topical lidocaine-prilocaine group had six males undergoing circumcision and three males undergoing a sham procedure. The dorsal penile nerve block group had six males undergoing circumcision and three males undergoing a sham procedure. The procedures were videotaped and viewed by 90 noninvestigator reviewers who scored the infants' pain using the Neonatal Infant Pain Scale and a numeric pain scale. Statistical analysis utilized a P-value of <0.05 as significant. RESULTS: The median Neonatal Infant Pain Scale and numeric pain scores were significantly lower in the dorsal penile nerve block group than in the topical lidocaine-prilocaine group or the sham group (Neonatal Infant Pain Scale: 1.0 (range 0-6) versus 6.0 (range 2-6) versus 4.0 (range 0-6), P < 0.001, respectively; numeric pain scale: 2.0 (range 0-10) versus 8.0 (range 1-10) versus 4.0 (range 0-10), P < 0.001, respectively). In the sham group, procedures with the dorsal penile nerve block had significantly lower pain scores than those with topical lidocaine-prilocaine (Neonatal Infant Pain Scale: 1.0 (range 0-6) versus 5.0 (range 2- 6), P < 0.001; numeric pain scale: 1.0 (0-8) versus 6.0 (range 0-10), P < 0.001). When reviewers were divided by medical background, gender or parental status, no differences in pain scores were observed. CONCLUSION: The dorsal penile nerve block anesthesia technique for newborn male circumcision was significantly more effective for pain relief than topical lidocaine-prilocaine.

Analysis of Variance↗

PubMed2004

Pregnancy in a woman with unilateral lung agenesis.

Unilateral lung agenesis is a rare congenital condition of unknown etiology. A 33-year-old nullipara with right lung agenesis and scoliosis was admitted to the hospital at 30 weeks of gestation because of oligohydramnios. At 32 weeks she was treated for an upper respiratory tract infection with azithromycin. She went into premature labor at 34 weeks and was delivered by Cesarean for breech presentation. Both mother and infant did well.

Adult↗

PubMed2004

Transmission study of Andes hantavirus infection in wild sigmodontine rodents.

Our study was designed to contribute to an understanding of the timing and conditions under which transmission of Andes hantavirus in Oligoryzomys longicaudatus reservoir populations takes place. Mice were caged in test habitats consisting of steel drums containing holding cages, where seronegative rodents were exposed to wild seropositive individuals by freely sharing the same cage or being separated by a wire mesh. Tests were also performed for potential viral transmission to mice from excrement-tainted bedding in the cages. Andes virus transmitted efficiently; from 130 attempts with direct contact, 12.3% resulted in virus transmission. However, if we consider only those rodents that proved to be infectious, from 93 attempts we obtained 16 infected animals (17.2%). Twelve of them resulted from intraspecies O. longicaudatus encounters where male mice were differentially affected and 4 resulted from O. longicaudatus to Abrothrix olivaceus. Experiments using Abrothrix longipilis as receptors were not successful. Transmission was not observed between wire mesh-separated animals, and mice were not infected from excrement-tainted bedding. Bites seemed not to be a requisite for oral transmission. Genomic viral RNA was amplified in two out of three saliva samples from seropositive rodents, but it was not detected in urine samples obtained by vesicle puncture from two other infected rodents. Immunohistochemistry, using antibodies against Andes (AND) hantavirus proteins, revealed strong reactions in the lung and salivary glands, supporting the possibility of oral transmission. Our study suggests that AND hantavirus may be principally transmitted via saliva or saliva aerosols rather than via feces and urine.

Animals↗

PubMed2003

Uterine rupture associated with castor oil ingestion.

A woman at 39 weeks' gestation with a previous Cesarean delivery had severe abdominal pains and rupture of membranes shortly after ingesting 5 ml of castor oil. Forty-five minutes later, repetitive variable decelerations prompted a Cesarean delivery. At surgery, a portion of the umbilical cord was protruding from a 2-cm rupture of the lower transverse scar.

Administration, Oral↗

PubMed2003

Randomized controlled trial of vaginal misoprostol versus dinoprostone vaginal insert for labor induction.

OBJECTIVE: To compare the safety and efficacy of vaginal misoprostol versus dinoprostone vaginal inserts for cervical ripening and labor induction. METHODS: Two hundred singleton gestations with an indication for cervical ripening and induction of labor were randomized to receive either 50 microg of misoprostol intravaginally every 3 h or a 10-mg dinoprostone vaginal insert every 12 h for a maximum of 24 h. Statistical analysis included Student's t test, the Mann-Whitney U test, chi2 analysis and Fisher's exact test. RESULTS: Ninety-seven women received vaginal misoprostol while 89 women received the dinoprostone vaginal insert. Fourteen women were removed from the study after randomization. The interval from start of induction to vaginal delivery (794.5 +/-408 min vs. 1005.3 +/- 523 min; p < 0.02) was significantly shorter in the misoprostol group. Women receiving misoprostol were more likely to deliver vaginally both in < 12 h (44% vs. 12%; p < 0.0001) and < 24 h (68% vs. 38%; p < 0.001). A non-reassuring fetal heart rate tracing was the indication for 71.4% (20/28) of Cesarean deliveries in the misoprostol group compared to 40% (14/35) in the dinoprostone group (p = 0.03). There were no significant differences in neonatal outcomes. CONCLUSION: Intravaginal misoprostol and dinoprostone are safe and effective medications for use in cervical ripening before labor induction. Misoprostol results in a shorter interval from induction to delivery. However, Cesarean delivery for a non-reassuring fetal heart rate tracing was more common with misoprostol.

Administration, Intravaginal↗

PubMed2003

Intrapartum assessment of fetal well-being: any role for a fetal admission test?

OBJECTIVE: To determine whether the fetal admission test is predictive of intrapartum complications. METHODS: We studied the fetal heart rate tracings of women in spontaneous labor at 37-42 weeks' gestation from 1 November 2001 to 31 March 2002. The study population was subdivided based on reactivity defined as > or = 15 beats/min for > or = 15 s, reactivity redefined as > or = 10 beats/min for > or = 10 s, variability, presence of late and/or variable decelerations, and reassuring fetal admission test; and compared for various labor outcome variables. Student's t test, the chi2 test and Fisher's exact test were used for analysis. RESULTS: A total of 426 women met our inclusion criteria. There were no differences between groups when compared for maternal age, parity, gestational age, birth weight, labor analgesia and length of labor. Irrespective of the definition of reactivity, women with a non-reactive fetal admission test were more likely to be delivered by Cesarean section, to have fetal distress resulting in Cesarean section and to have a longer neonatal hospital stay. In addition, redefining reactivity improved the specificity, positive and negative predictive values, accuracy, relative risk and likelihood ratio with regard to development of fetal distress. Similar results were obtained when variability and decelerations were used as criteria for comparisons. CONCLUSION: The fetal admission test is useful in predicting the absence of intrapartum fetal distress irrespective of the criterion used for evaluation. Redefined reactivity appears to be most predictive of intrapartum fetal distress.

Adult↗

PubMed2003

Posterior uterine rupture in a woman with a previous Cesarean delivery.

A 33-year-old primipara with a previous low transverse Cesarean delivery underwent labor induction at 41 weeks' gestation with a 10-mg dinoprostone vaginal insert. Eleven hours later, with the cervix fully dilated, an emergency Cesarean delivery was performed because of repetitive variable decelerations followed by fetal bradycardia. A posterior uterine wall rupture extending from the fundus to the vagina was repaired in layers. The neonate had an Apgar score of 2 and 4 and expired on the 7th day of life.

Administration, Intravaginal↗

PubMed2003

Comparison of obstetric outcomes in twin pregnancies after in vitro fertilization, ovarian stimulation and spontaneous conception.

OBJECTIVE: To compare the outcomes of liveborn twin gestations conceived after in vitro fertilization (IVF) or ovarian stimulation with spontaneously conceived twin pregnancies. METHODS: A review of all twin gestations delivered at Winthrop-University Hospital from 1 January 1999 to 31 December 2000. Women who underwent fetal reduction or had a demise of one twin were excluded. Maternal demographics, antepartum complications, mode of delivery and perinatal outcome were compared. RESULTS: Sixty pregnancies were conceived after IVF, 34 were conceived by ovarian stimulation and 101 were spontaneously conceived. Women in the IVF group were older (p < 0.001), were more often 35 years or older (p < 0.001) and primiparous (p = 0.005). More women in the ovarian stimulation group had a poor obstetric history (p = 0.04). Spontaneous gestations had a higher incidence of monochorionic placentations (p = 0.002). There were no differences in gestational age at delivery, antepartum complications, or mode of delivery. There were fewer low-birth-weight neonates in the IVF group (odds ratio 0.59, 95% confidence interval 0.35-0.98; p = 0.03) than in the spontaneous group, but the difference disappeared when only the dichorionic pregnancies were compared. Other neonatal outcomes studied were the same among groups. CONCLUSION: Twin gestations conceived following IVF and ovarian stimulation appear to have similar outcomes to spontaneously conceived twin gestations.

Adult↗

PubMed2001

Reference values of amniotic fluid neuron-specific enolase.

OBJECTIVE: Enolase is a dimeric cytoplasmic enzyme whose double gamma isoenzyme, neuron-specific enolase, is predominantly found in neuronal and neuroendocrine tissues. Cell injury causes its release into the blood and cerebrospinal fluid (CSF). Neuron-specific enolase has been measured in the serum and CSF of adults and full-term asphyxiated neonates as a marker of neurological injury. We recently observed an elevation of neuron-specific enolase in the amniotic fluid of women whose neonates subsequently developed intraventricular hemorrhage or periventricular leukomalacia. The purpose of our study was to establish reference values of neuron-specific enolase in the amniotic fluid as a function of gestational age. METHODS: A total of 110 amniotic fluid samples, obtained primarily for genetic studies (16-20 weeks, n = 22), for evaluation of preterm labor (21-35 weeks, n = 66) and for fetal lung maturity studies (36-40 weeks, n = 22), were analyzed for neuron-specific enolase. Samples were from women who subsequently delivered term neonates with normal neurological examinations or who delivered preterm neonates with normal neurosonograms up to the 7th day of life. Descriptive statistics and non-parametric correlations were used for analysis. RESULTS: There was no correlation between gestational age and concentration of neuron-specific enolase (Spearman's r = 0.059, p = 0.63). The overall mean neuron-specific enolase value was 2.5 +/- 1.39 microg/l. The highest value obtained was 6 microgl. Of the 110 women, 105 (95.5%) had neuron-specific enolase values of less than 5 microg/l, while five (4.5%) had values ranging from 5 to 6 microg/l. CONCLUSIONS: The amniotic fluid level of neuron-specific enolase does not change as a function of gestational age. These stable levels may have utility in the evaluation of cases with fetal neurological injury.

Adult↗

PubMed2001

Postpartum angiographic embolization for vulvovaginal hematoma. A report of two cases.

BACKGROUND: Puerperal hematomas can become a life-threatening obstetric emergency. Their incidence is 1 or 2/1,000 deliveries. When mainstay methods of suture and packing fail, arterial embolization becomes an excellent alternative to definitive treatment, laparotomy. CASES: A 32-year-old woman, para 2-0-2-2, developed extreme rectal and vulvar pain one hour postpartum. A 12 x 10-cm vulvovaginal hematoma was identified, drained, sutured and packed. Bleeding continued, blood products were administered, and selective angiographic embolization of the pudendal and inferior gluteal arteries was successfully performed. A 31-year-old woman, para 1-0-1-1, developed a left vaginal hematoma immediately postpartum. She failed vaginal packing and underwent angiographic arterial embolization successfully. The patient was discharged on the fourth postpartum day. At six weeks postpartum, neither patient had evidence of hematoma formation. CONCLUSION: In the setting of a puerperal hematoma refractory to conventional first-line therapy, arterial embolization provides a rational, effective alternative for achieving hemostasis with minimal morbidity.

Adult↗

PubMed2001

[High prevalence of subclinical thyroidal disease among individuals attended in health control].

BACKGROUND: There is no information about the prevalence of thyroidal diseases in the general Chilean population. AIM: To assess the prevalence of thyroidal diseases in individuals attended in occupational health examinations. SUBJECTS AND METHODS: Four hundred seventy two individuals were examined between 1998 and 1999. In all, serum levels of thyroid hormones, TSH and anti thyroidal antibodies (anti microsomal, anti thyroid peroxidase and anti thyroglobulin) were measured. RESULTS: Forty four subjects were excluded from the study due to an incomplete medical record and 18 due to a personal history of thyroidal disease. Abnormal serum levels of thyroid hormones or TSH were detected in 28 subjects (6.8%). Four (1%) had hypothyroidism, 23 a subclinical hypothyroidism (5.6%) and one (0.2%) had hyperthyroidism. In 87 subjects (21.2%) at least one of the antibodies was positive. Positive anti thyroid antibodies were found in 14 of 28 subjects (50%) with abnormal thyroid hormone levels, compared with 73 of 382 subjects (19.1%) with normal thyroid hormone levels. Thyroid dysfunction was twice as frequent in women than in men. CONCLUSIONS: In this sample, a 6.8% prevalence of abnormal thyroid function tests was detected.

Adolescent↗

PubMed2001

[Panic disorder and hyperthyroidism. Report of 2 cases].

In two females aged 27 and 32 years old, an aggravation of their panic disorder coincided with the appearance of clinical signs of hyperthyroidism. The clinical diagnosis was confirmed with the finding of raised thyroid hormone levels and undetectable TSH levels. These two cases highlight the importance of routine thyroid function assessment in patients with panic disorder, mainly in those with partial response to medications or when symptoms aggravate, despite an adequate treatment.

Adult↗

PubMed2000

Telomere erosion varies during in vitro aging of normal human fibroblasts from young and adult donors.

The life span of normal fibroblasts in vitro (Hayflick limit) depends on donor age, and telomere shortening has been proposed as a potential mechanism. By quantitative fluorescence in situ hybridization and Southern blot analysis, we show progressive telomere loss to about 5 kb mean telomere restriction fragment length in fibroblasts from two adult donors within 40 population doublings, whereas in fibroblasts from two infant donors, telomere erosion is reduced, leaving a mean telomere restriction fragment length of approximately 7 kb at senescence (after approximately 60 population doublings). Aging of fibroblasts from both infant and adult donors was not accompanied by chromosomal abnormalities but was correlated with increased telomere repeat-binding factor 2 expression at both the protein and transcriptional level.

Adult↗

PubMed2000

Epidemiologic study of pulmonary obstruction in workers occupationally exposed to ethyl and methyl cyanoacrylate.

The association between pulmonary obstruction (e.g., asthma) and occupational exposure to methyl cyanoacrylate (MCA) and ethyl cyanoacrylate (ECA) was examined in an occupational cohort of 450 persons at an adhesive production facility in Puerto Rico. Employee medical records containing information on physical examinations and pulmonary function tests (PFTs), as well as occupational histories, on each employee over a period of about 17 yr and industrial hygiene measurements were evaluated. The cohort analysis was based on a Cox proportional hazards model. Workers exposed to ECA or MCA were compared to workers unexposed to these chemicals with respect to their risk of becoming an "incident case." An "incident case" was defined as any person whose PFTs were normal at the time of employment, but later demonstrated an obstructive pattern, which was defined as a decline in the ratio of forced expiratory volume exhaled in 1 s to forced vital capacity (FEV1/FVC) below 70%. A separate case-control analysis was also conducted that compared "suspected cases," defined as all those whose PFTs ever demonstrated an obstructive pattern (e.g., asthma), to persons whose PFTs remained within normal limits throughout their employment with respect to their past peak and cumulative exposures to cyanoacrylates. All of these analyses showed no evidence that exposure to average short-term concentrations of ECA or MCA of less than 0.5 ppm and occasional daily peak exposures of at least 1.5 ppm (usually 10 min or less), with occasional higher concentrations during spills, were associated with an increased risk of pulmonary obstruction. However, the study suggested that persons occupationally exposed to cyanoacrylates were more likely to have some reversible eye or upper airway irritation than persons who were unexposed.

Adhesives↗

PubMed2000

High prevalence of thyroid abnormalities in a Chilean psychiatric outpatient population.

The aim of the present study was to establish the prevalence of thyroid disturbances in patients consulting for panic and mood disorders. These data may be relevant because thyroid functional alterations affect the success of treatment in these pathologies. We studied prospectively 268 psychiatric outpatients (204 females and 64 males) diagnosed by DSM-IV criteria. We excluded patients with addictive disorders and major medical disease. We measured TSH, Free T4 (FT4) and antimicrosomal antibodies (AMA). We diagnosed classical hypothyroidism when the TSH value was >10 microUI/ml (NV=0.25-4.3) and subclinical hypothyroidism when the TSH value was between 5-10 microUI/ml. Hyperthyroidism was diagnosed when FT4 >1.4 (NV=0.8-1.4), the TSH suppressed and the radioiodine uptake >20% (NV=5-15). Positive antimicrosomal antibodies (AMA) titres were >1:100 dilution. Hypothyroidism was diagnosed in 26/268 patients (9.7%); 10 cases corresponded to the classical form (38.5%) and 16 cases to the subclinical form (61.5%). Hyperthyroidism was found in 6/268 patients (2.2%). Normal thyroid function with positive AMA was found in 28/268 patients (10.4%). Hypothyroidism was more common in patients with mood disorders, and hyperthyroidism in patients with panic disorders. Patients with panic disorder had significant higher levels of FT4. The prevalence of positive AMA, hypothyroidism and hyperthyroidism was higher in women than men. We found a high frequency of thyroid abnormalities in a psychiatric outpatient population. These data suggests that routine evaluation of thyroid function should be considered in patients consulting for mood and panic disorders.

Adolescent↗

PubMed2000

Amniocentesis for selection before rescue cerclage.

OBJECTIVE: To determine whether diagnostic amniocentesis should be part of evaluations of women under consideration for rescue cerclage. METHODS: We reviewed the obstetric records of 25 candidates for rescue cerclage seen between June 30, 1995, and July 1, 1997. Rescue cerclage was defined as a procedure on a cervix with an internal os dilated at least 2 cm and 50% effaced, with membranes visible at the external os. Transabdominal amniocentesis was offered as part of the preoperative evaluation, and amniotic fluid (AF) was sent for glucose and lactate dehydrogenase level determinations, Gram staining, and culture for aerobic and anaerobic bacteria. Placentas were examined for histopathologic evidence of inflammation. The women were divided into three groups. Eleven women had rescue cerclage after amniocentesis, seven had rescue cerclage after declining amniocentesis, and seven had amniocentesis but were treated conservatively because of AF markers of infection. Analysis of variance and chi(2) statistics were used. RESULTS: The group that had rescue cerclage after amniocentesis had a significantly longer mean admission-to-delivery interval, higher mean gestational age at delivery, higher mean birth weight, and higher neonatal survival rate than did the group that had rescue cerclage without amniocentesis and the group that had no cerclage after amniocentesis (P <.001). CONCLUSION: Amniocentesis before rescue cerclage placement identified women with subclinical chorioamnionitis who would not benefit from cerclage.

Abortion, Spontaneous↗

PubMed2000

Chloroplast division and morphology are differentially affected by overexpression of FtsZ1 and FtsZ2 genes in Arabidopsis.

In higher plants, two nuclear gene families, FtsZ1 and FtsZ2, encode homologs of the bacterial protein FtsZ, a key component of the prokaryotic cell division machinery. We previously demonstrated that members of both gene families are essential for plastid division, but are functionally distinct. To further explore differences between FtsZ1 and FtsZ2 proteins we investigated the phenotypes of transgenic plants overexpressing AtFtsZ1-1 or AtFtsZ2-1, Arabidopsis members of the FtsZ1 and FtsZ2 families, respectively. Increasing the level of AtFtsZ1-1 protein as little as 3-fold inhibited chloroplast division. Plants with the most severe plastid division defects had 13- to 26-fold increases in AtFtsZ1-1 levels over wild type, and some of these also exhibited a novel chloroplast morphology. Quantitative immunoblotting revealed a correlation between the degree of plastid division inhibition and the extent to which the AtFtsZ1-1 protein level was elevated. In contrast, expression of an AtFtsZ2-1 sense transgene had no obvious effect on plastid division or morphology, though AtFtsZ2-1 protein levels were elevated only slightly over wild-type levels. This may indicate that AtFtsZ2-1 accumulation is more tightly regulated than that of AtFtsZ1-1. Plants expressing the AtFtsZ2-1 transgene did accumulate a form of the protein smaller than those detected in wild-type plants. AtFtsZ2-1 levels were unaffected by increased or decreased accumulation of AtFtsZ1-1 and vice versa, suggesting that the levels of these two plastid division proteins are regulated independently. Taken together, our results provide additional evidence for the functional divergence of the FtsZ1 and FtsZ2 plant gene families.

Antibodies, Monoclonal↗

PubMed2000

Alterations in relaxation to lactate and H(2)O(2) in human placental vessels from gestational diabetic pregnancies.

We determined whether alterations in the mechanism of relaxation to H(2)O(2) potentially contribute to the enhanced prostaglandin-mediated contractile response to H(2)O(2) and posthypoxic reoxygenation seen in human placental vessels of pregnancies with gestational diabetes mellitus (GDM). Isolated placental arteries and veins from GDM and uncomplicated full-term pregnancies were precontracted with prostaglandin F(2alpha) (PO(2) 35-38 Torr) and then exposed to lactate (1-10 mM), arachidonic acid (0.01-10 microM), nitroglycerin (1 nM-1 microM), forskolin (0.01-10 microM), or H(2)O(2) (1 microM-1 mM + 10 microM indomethacin). The rates of tissue H(2)O(2) metabolism by catalase and nitrite production were measured. The relaxation to lactate was reduced in GDM placental arteries and veins by 54-85 and 66-80%, and the relaxation to H(2)O(2) was inhibited by 80-94% in GDM placental veins compared with vessels from uncomplicated full-term pregnancies. H(2)O(2) caused only minimal relaxation of placental arteries. Responses to other relaxing agents were not altered in the GDM placental vessels. Diabetic vessels showed rates of nitrite production that were increased by 113-195% and rates of H(2)O(2) metabolism by catalase that were decreased by 44-61%. The loss of relaxation to H(2)O(2) and lactate (mediated via H(2)O(2)), perhaps as a result of the inhibition of catalase by nitric oxide, may explain the previously reported enhancement of prostaglandin-mediated contractile responses to H(2)O(2) and posthypoxic reoxygenation seen in GDM placental vessels.

Adolescent↗