Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Delivery”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1990

Thrombocytopenia at delivery: a prospective survey of 6715 deliveries.

Thrombocytopenia occurred in 513 (7.6%) of 6715 consecutive deliveries that occurred in our hospital over a 3-year interval. The patients with thrombocytopenia could be divided into three groups. The largest group (65.1%) consisted of healthy women whose thrombocytopenia was incidentally detected. The next group of patients (13.1%) was composed of healthy women who had an obstetric or medical condition such as diabetes or premature labor. No mother or infant in either group had excessive bleeding, and no infant had a cord platelet count less than 50 x 10(9) per liter. The last group (21%) was composed of hypertensive patients and patients with immune thrombocytopenia. Two infants in this group had cord platelet counts less than 50 x 10(9) per liter, but neither had bleeding. This study indicates that incidental thrombocytopenia in an otherwise well woman at term is the most frequent type of thrombocytopenia and poses no apparent risk for mother or infant at delivery.

Female↗
PubMed1998

Elective delivery of infants with macrosomia in diabetic women: reduced shoulder dystocia versus increased cesarean deliveries.

OBJECTIVE: We sought to test the hypothesis that elective delivery of infants diagnosed with macrosomia by ultrasonographic studies in diabetic women will significantly reduce the rate of shoulder dystocia without significantly increasing cesarean section rate. STUDY DESIGN: In a prospective study diabetic women with ultrasonographic estimated fetal weight > or = 4250 gm underwent elective cesarean section; women with estimated fetal weight > or = 90th percentile but < 4250 gm underwent induction of labor. Maternal and neonatal outcomes were analyzed and compared for the periods before and after initiation of the protocol. RESULTS: A total of 2604 diabetic patients were included in this study. The rate of shoulder dystocia was significantly lower after instituting the protocol (2.4% vs 1.1%, odds ratio 2.2). The cesarean section rate increased significantly between the two periods (21.7% vs 25.1%, p < 0.04). Ultrasonography correctly identified the presence or absence of macrosomia in 87% of patients. Only 10.6% of diabetic patients at term required intervention under the protocol (6.8% labor induction, 3.8% elective cesarean section). The rate of shoulder dystocia was 7.4% in macrosomic infants delivered vaginally. CONCLUSION: An ultrasonographically estimated weight threshold as an indication for elective delivery in diabetic women reduces the rate of shoulder dystocia without a clinically meaningful increase in cesarean section rate. This practice, in conjunction with an intensified management approach to diabetes, improves the outcome of these high-risk women and their infants.

Adult↗
PubMed1998

Plasmid delivery to muscle: Recent advances in polymer delivery systems.

Preclinical studies involving intramuscular injection of plasmid into animals have revealed at least four significant variables that effect levels of gene expression (i.e., >fivefold effect over controls), including the formulation, injection technique, species and pretreatment of the muscle with myotoxic agents to induce muscle damage. The uptake of plasmid formulated in saline has been shown to be a saturable process, most likely via a receptor-mediated event involving the T tubules and caveolae. Pharmacokinetic studies have demonstrated that the bioavailability of injected plasmid to muscle cells is very low, due to rapid and extensive plasmid degradation by extracellular nucleases. We have developed protective, interactive, non-condensing (PINC) delivery systems designed to complex plasmids and to (i) protect plasmids from rapid nuclease degradation, (ii) disperse and retain intact plasmid in the muscle and (iii) facilitate the uptake of plasmid by muscle cells. PINC systems result in up to at least a one log increase in both the extent and levels of gene expression over plasmid formulated in saline. We have combined the PINC delivery systems with two different muscle-specific expression plasmids. After direct intramuscular injection of these gene medicines, we have shown both local myotrophic and neurotrophic effects of expressed human insulin-like growth factor (hIGF-I) and the secretion of biologically active human growth hormone (hGH) into the systemic circulation.

Journal Article↗
PubMed1997

High efficiency DNA delivery into swine oocytes and embryos by electronic pulse delivery (EPD).

The production of transgenic swine for xenotransplantation has been proposed as an optimal option to overcome the chronic shortage of human organ donors. Generation of genetically engineered swine has been elusive due to the difficulties in gene transfer. In order to achieve effective gene delivery, a key step for the genetic modification, we applied electronic pulse delivery (EPD) technology to introduce H2Kb-DC DNA construct into swine eggs. Using the developed EPD Protocols, we have achieved good viability of the EPD treated oocytes, satisfactory embryonic development of the EPD treated embryos, and stable DNA transfer into the swine embryos with high efficiency. Thus, application of the EPD technology promises to effectively facilitate the generation of large transgenic mammals.

Animals↗
PubMed2006

Nanoemulsions as versatile formulations for paclitaxel delivery: peroral and dermal delivery studies in rats.

Pathogenesis of psoriasis involves the keratinocytes in epidermis as well as the angiogenesis involving deeper skin layers. So, the drug delivery strategy should be customized to localize paclitaxel (PCL) inside both layers. In this investigation, in order to achieve penetration of PCL into deeper skin layers while minimizing the systemic escape, a nanoemulsion (NE) was formulated and evaluated its in vivo pharmacokinetic performance. Further, the same formulation was explored for peroral bioavailability enhancement of PCL. Upon dermal application, the drug was predominantly localized in deeper skin layers, with minimal systemic escape. When orally administered as NE, PCL was rapidly absorbed reaching a steady-state value of 3.5 microg/ml in 30 minutes, and steady-state levels persisted up to 18 hours. This has amounted to an absolute bioavailability of 70.62%. Inhibition of P-glycoprotein efflux by D-alpha-tocopheryl polyethyleneglycol 1,000 succinate and labrasol would have contributed to the enhanced peroral bioavailability of PCL. This investigation provides direct evidence on the localization of large molecular weight, lipophilic drug, PCL, in dermis. Further, the NE formulation has enhanced the peroral bioavailability significantly to more than 70%. The developed NE formulation was safe and effective for both peroral and dermal delivery of PCL.

Administration, Cutaneous↗
PubMed1996

Recurrence risk of low birthweight deliveries among women with a prior very low birthweight delivery.

To estimate the risk of repeat low birthweight deliveries among women whose first child was very low birthweight (less than 1500 g), a retrospective cohort of women who had their first and second children in Washington state between 1984 and 1991 was studied. After adjustment for potential confounding factors, a woman whose first infant was very low birthweight experienced an 11.5-fold increased risk of delivering a low birthweight (less than 2500 g) second infant (relative risk 11.5, 95% confidence interval 5.4 to 24.4). Women with a very low birthweight first infant also had a significantly increased risk of repeat very low birthweight infant (p < 0.0001). Women with a previous very low birthweight delivery are at increased risk of repeat low and very low birthweight infants. This high-risk group may benefit from education regarding recurrence risk and modification of factors associated with low birthweight, as well as good prenatal care.

Adult↗
PubMed2006

Previous preeclampsia, preterm delivery, and delivery of a small for gestational age infant and the risk of unexplained stillbirth in the second pregnancy: a retrospective cohort study, Scotland, 1992-2001.

Women with a previous stillbirth are known to be at increased risk of stillbirth in subsequent pregnancies. However, few studies have addressed the association between other complications of pregnancy and the future risk of stillbirth. Using linkage of national pregnancy and perinatal death registries, the authors performed a retrospective cohort study of 133,163 women having a second birth in Scotland between 1992 and 2001 whose first infant was liveborn. The risk of unexplained stillbirth was increased among women with a previous preterm birth (adjusted hazard ratio (HR) = 2.04, 95% confidence interval (CI): 1.34, 3.11), previous delivery of a small for gestational age (SGA) infant (HR = 2.14, 95% CI: 1.59, 2.87), and previous preeclampsia (HR = 1.68, 95% CI: 1.07, 2.62). The associations were similar after adjustment for maternal age, height, marital and smoking status, and interpregnancy interval. There was a statistically significant positive interaction between previous delivery of a SGA infant and previous preeclampsia (p = 0.01): Women with this combination in their first pregnancy had an approximately fivefold risk of unexplained stillbirth in the second pregnancy (HR = 4.95, 95% CI: 2.63, 9.32). Associations were stronger with SGA unexplained stillbirths. The authors conclude that complicated first births of liveborn infants are associated with an increased risk of unexplained stillbirth in the next pregnancy.

Confidence Intervals↗
PubMed1992

Hemorrhagic hypotension after brain injury causes an early and sustained reduction in cerebral oxygen delivery despite normalization of systemic oxygen delivery.

Morbidity and mortality are doubled when hemorrhagic hypotension (HEM) accompanies a traumatic brain injury (TBI). Hemorrhagic hypotension initiates a "secondary" injury (SI) that has been attributed to ischemia, but this has not been confirmed in the laboratory. All previous studies have been of relatively short duration (less than 6 hours), allowing insufficient time to study the pathophysiology of SI, since maximal intracranial pressure (ICP) elevations may occur 16 to 20 hours after injury. We hypothesized that HEM combined with TBI would reduce cerebral oxygen delivery (cO2del) and cerebral metabolic rate for oxygen (cMRO2) to a greater degree than would occur with TBI alone. In a porcine model of TBI and HEM we recorded systemic oxygen delivery (sO2del), ICP, cerebral blood flow (CBF), cO2del, cMRO2, brain oxygen extraction ratio (cO2ER), and cortical water content (CWC) over a 24-hour study period. Controls (n = 7) were instrumented only, group 1 (n = 14) received a focal cryogenic lesion only, group 2 (n = 21) received a cryogenic lesion plus hemorrhage to 50 mm Hg for 45 minutes. Animals were resuscitated with crystalloid solutions; shed blood in group 2 animals was returned after one hour. Hemorrhagic hypotension following TBI produced a significant and sustained reduction in cO2del associated with a lower cMRO2 and cO2ER, and higher ICP and CWC, than seen with lesion alone. This occurred despite adequate early restoration of sO2del. This confirms that cerebral ischemia is ongoing despite restoration of systemic hemodynamics.

Animals↗
PubMed1982

Response to bronchodilator drug administration by a new reservoir aerosol delivery system and a review of other auxiliary delivery systems.

Response to bronchodilator aerosols delivered by metered dose inhalers (MDI) depends in part upon the amount of drug depositing on the airways. Ideally, the MDI should be actuated during a slow deep inhalation followed by a breathholding pause, an impossible maneuver for many patients. We developed a new reservoir aerosol delivery system (RADS) consisting of a 700-ml collapsible bag in which aerosol could be injected. The mouthpiece-canister was filtered with a reed that vibrated at inspiratory flows greater than 0.3 L/s to produce a noise. Patients were instructed to keep inhalation silent while breathing from RADS. One puff of metaproterenol (650 microgram) administered via RADS (with one breath rebreathed) was compared with one puff of metaproterenol (650 micrograms) from usual MDI using serial measurements of body plethysmography and spirometry. Respiratory inductive plethysmography measured the point of MDI actuation, volume of inhalation, inspiratory flow, and breathholding pause. Ten patients with chronic airflow limitation caused by asthma or chronic bronchitis were given typed instructions on MDI usage and trained shortly before the study. Metaproterenol via RADS produced significantly greater maximal increase in SGaw (195 +/- 52% SE) compared with metaproterenol via conventional MDI (101 +/- 24%, p less than 0.003). Bronchodilator response in 4 patients unable to coordinate actuation of the MDI with inspiration was significantly less than in 6 patients with good MDI technique (p less than 0.005). The mean flow rates were 0.54 +/- 0.16 L/s during inhalation of metaproterenol compared with 0.19 +/- 0.02 L/s and 0.24 +/- 0.03 L/s during the first and second inhalations, respectively, using RADS. This reservoir aerosol delivery system, which was well accepted by the patients, promotes more effective bronchodilation than the conventional metered dose inhaler.

Adult↗
PubMed2006

Delivery of condensed DNA by liposomal non-viral gene delivery system into nucleus of dendritic cells.

In this study, we developed novel double-membranous non-viral gene delivery system modified with SV-40 T antigen-derived nuclear localization signal (NLS-DMEND) for delivery of luciferase plasmid DNA to nucleus of non-dividing mouse bone marrow-derived dendritic cells (BMDC). Intracellular trafficking and gene expression of NLS-DMEND in the BMDC were evaluated. Condensed DNA was observed in the nucleus by confocal laser scanning microscopy, and the NLS-DMEND induced significant luciferase activity in the BMDC. It was suggested that the condensed DNA particle transferred into nucleus via energy dependent manner, since the nuclear transfer was inhibited by metabolic inhibitors. In conclusion, condensed plasmid DNA was delivered into the nucleus of non-dividing BMDC by NLS-DMEND.

Animals↗
PubMed1996

Effect of food intake on the delivery of fluorescein as a model drug in colon delivery capsule after oral administration to beagle dogs.

The effect of food on the release time of a model drug, fluorescein (FL), has been studied after oral administration to beagle dogs in colon delivery capsule in comparison to conventional gelatin capsule and enteric capsules. The dose of FL was 30 mg for each animal. After oral administration of each test preparation in fasted or postprandial condition (100 grams of commercial solid food was given at 30 min before drug administration), blood samples were collected and plasma FL concentrations were measured spectrofluorometrically. Pharmacokinetic analysis was performed with plasma FL concentration vs. time data and the following parameters were determined; Tmax (the time when plasma FL concentration reaches to its maximum concentration), Cmax (peak plasma FL concentration), Tlag (the time when FL appeared at first into the systemic circulation), AUC (area under the plasma FL concentration vs. Time curve) and MRT (mean residence time). For gelatin capsule, mean Tmax appeared at 0.83 +/- 0.33 (S.E.) h after administration and MRT was 2.67 +/- 0.21 h in fasted condition. By feeding, Tmax and MRT increased to 1.50 +/- 0.76 h and 3.09 +/- 0.49 h. For two enteric HPMCP and Eudragit S capsules, MRT were 2.90 +/- 0.48 h and 5.24 +/- 0.32 h in fasted condition, and 11.30 +/- 1.10 h and 12.83 +/- 0.34 h in postprandial condition, respectively. Tlag also increased by postprandial administration. As colon delivery capsule, time-controlled release capsule (TCC) and two types of intestinal inner pressure-controlled release capsules (PCC) (#1 is a separate type and #2 is a seamless one) were tested. MRT of TCC was 4.76 +/- 0.29 h and 6.43 +/- 0.66 h in fasted and postprandial conditions, respectively. This capsule did not receive the effect of food intake. For #1 PCC, MRTs were 5.32 +/- 0.22 h and 12.28 +/- 0.26 h in fasted and postprandial conditions, respectively. For #2 PCC, MRTs were 5.51 +/- 0.26 h and 13.36 +/- 0.84 h in fasted and postprandial conditions, respectively. In addition, the effect of two times feedings was studied with two PCCs and longer MRTs, 28.44 +/- 1.39 h and 26.32 +/- 1.64 h, were obtained. The release time of FL from PCCs increased by postprandial administration. As compared to the results on two enteric capsules, these PCCs are thought to disintegrate in the colon. However, TCC is thought to disintegrate in the stomach after postprandial administration.

Administration, Oral↗
PubMed2001

Different therapeutic outcomes in experimental allergic encephalomyelitis dependent upon the mode of delivery of IL-10: a comparison of the effects of protein, adenoviral or retroviral IL-10 delivery into the central nervous system.

Experimental allergic encephalomyelitis (EAE) is a CNS autoimmune disease mediated by the action of CD4(+) T cells, macrophages, and proinflammatory cytokines. IL-10 is a cytokine shown to have many anti-inflammatory properties. Studies have shown both inhibition and exacerbation of EAE after systemic IL-10 protein administration. We have compared the inhibitory effect in EAE of Il10 gene delivery in the CNS. Fibroblasts transduced with retroviral vectors expressing IL-10 could inhibit EAE. This was not associated with a prevention of cellular recruitment but an alteration in their phenotype, notably an increase in the numbers of CD8(+) T and B cells. In marked contrast, CNS delivery of adenovirus coding for mouse IL-10 or IL-10 protein performed over a wide dose range failed to inhibit disease, despite producing similar or greater amounts of IL-10 protein. Thus the action of IL-10 may differ depending on the local cytokine microenvironment produced by the gene-secreting cell types.

Adenoviridae↗
PubMed1993

Integrated delivery networks. A system for the future. Genesys Health System designs and builds a patient-focused care delivery network.

St. Joseph Hospital, Flint, MI, formed Genesys Health System in 1981, affiliating with five area hospitals and a number of other healthcare organizations. In 1983 the system closed one of the hospitals. Genesys Health System's vision is described as a three-legged stool, with the integrated delivery system as the seat. That system balances on three legs: a strong primary and specialty care physician network; a financing, or insuring, mechanism; and a revolutionary hospital and delivery system with a full continuum of services across a range of institutional and home settings. Genesys has two physician joint ventures that will eventually become one as Genesys member hospitals' medical staffs merge. Member physicians are already linked by a common computer system and risk-sharing mechanisms. The physician-Genesys joint ventures have contractual arrangements with various managed care organizations. The system serves more than 50,000 persons enrolled with HealthPlus of Michigan and virtually all the 10,000 enrolled patients of Blue Care Network, the Blue Cross health maintenance organization. After evaluating the community's needs, Genesys Health System decided to build a new hospital; 439-bed Genesys Regional Medical Center at Health Park is scheduled to open in 1997. The new hospital will be the first in the United States to be designed and built using patient-focused care concepts.

Catholicism↗
PubMed1999

[Comparison of the Bishop score, of sonographic measurement of the cervical length and fibronectin determination in predicting time to delivery and the type of delivery at term].

Our aim was to compare the Bishop score, FNf assays, and the sonographic measurement of cervical length, in order to assess the best marker for time until spontaneous labor at term and risk of cesarean, especially for lack of progress of dilatation. This prospective study included 128 singleton vertex pregnancies with no clinical evidence of membrane rupture or regular contractions and a prenatal consultation between 39 weeks 4 days and 40 weeks 3 days. We successively assayed FNf, determine the Bishop scored, and measured cervical length by transvaginal ultrasound. The end points were the percentage of patients with a spontaneous onset of labor in the week following these tests and the type of delivery. The spontaneous onset of labor within a 7-day period was closely associated with a Bishop score > or = 6 and especially with a cervical length < or = 26 mm, but not with a positive FNf assay. On the other hand, vaginal delivery was significantly associated with the fibronectin assay but not with either the Bishop score or cervical length. Ultrasound measurement of cervical length and the fetal fibronectin assay provide different physiological data useful for different purposes: cervical length is more valuable than the Bishop score for predicting the onset of spontaneous labor within 7 days (when these assessments are performed close to term) and the FNf assay is very useful for evaluating the risk of cesarean.

Adult↗
PubMedDate not supplied

[Assisted spontaneous delivery vs. Bracht manual aid within the scope of vaginal delivery in breech presentation. Late morbidity in children 5-7 years of age].

For judgment of late morbidity we investigated 52 children after vaginal delivery in breech presentation age from 5 to 7 years. This concerned 27 children after assisted spontaneous labour and 25 children after manual expression according to Bracht. All the children were mature and eutrophic and without neonatal distress after delivery. They were explored with help of an voluminous screening programme, concerning not only the intellectual development but also the psychomotoric capacity. The result was an very high intellectual conduct in frame of the test according to Raven (PR greater than 75). The difference in confrontation to the collective after manual expression according to Bracht was statistical significant (p less than 0.05). Neuropsychologic investigations according to Simernitzkaja demonstrated evident differences in disfavour to children after manual expression according to Bracht concerning the visual memory performance for symbols and letters. Further investigations referring to the graphomotoric accomplishment of one hand or both hands reinforced the opinion; that means the visual motoric totality performance in a narrowed sense or the psychomotoric performance in a enlarged sense was statistical significant poorer pronounced (p less than 0.05). The results underline the claim to estimate more critical the manual expression according to Bracht till now.

Brain Damage, Chronic↗
PubMed1986

Delivery of antifibroblast agents as adjuncts to filtration surgery. Part I--Periocular clearance of cobalt-57 bleomycin in experimental drug delivery: pilot study in the rabbit.

Antitumor and antifibroblast agents show promise as adjuncts after glaucoma filtration surgery in reducing postoperative scarring and failure. We used nuclear imaging in rabbits to investigate periocular clearance of one such agent (57Co-bleomycin). Sub-Tenon injection was compared to other delivery techniques. Our results showed that a collagen sponge and a silastic disc implant with a microhole prolonged drug delivery when compared to sub-Tenon injection alone or injection with a viscosity enhancing agent (0.5% sodium hyaluronate). We theorize that if an antifibroblast agent can be delivered in small and sustained amounts after filtration surgery, this may prolong bleb longevity and avoid unnecessary drug toxicity.

Animals↗
PubMed1981

Breech delivery: impact of increasing cesarean section delivery.

We present a retrospective analysis of neonatal outcome and maternal morbidity in the delivery of 192 infants presenting by the breech position, weighing more than 1,000 gm, and exhibiting fetal heart tones upon admission. All of the deliveries occurred between Jan 1, 1975 and Dec 31, 1978. Over the study period the cesarean section rate increased from 35.9% to 73.3%, and maternal morbidity increased from 17.9% to 35.0%. Maternal morbidity in the cesarean section group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies incompatible with life, and the fourth was due to severe respiratory distress syndrome in a markedly premature infant. Traumatic neonatal morbidity occurred almost exclusively in the vaginally delivered group with only one case of traumatic morbidity in the cesarean section group. Apgar scores of the infants weighing less than 2,500 gm were significantly improved in the cesarean section group (P less than .01), but no significant difference was seen in the five-minute Apgar score in the infants weighing more than 2,500 gm.

Apgar Score↗