Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Data 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 343 records · Page 19Linked to original sources
PubMed1991

Maturation of the secretion of thyroid hormone and thyroid-stimulating hormone in the fetus.

BACKGROUND: Data on human fetal thyroid function have largely been derived from histologic studies or studies of cord-blood samples obtained at hysterotomy or delivery. These data may not represent true normal values. Cordocentesis (ultrasound-guided blood sampling from the umbilical cord) is a technique that allows investigation of physiologic processes in fetuses not under stress. METHODS: We measured serum thyroid-stimulating hormone, total and free thyroxine (T4), total and free triiodothyronine (T3), and thyroxine-binding globulin in blood samples from 62 fetuses. The samples were obtained by cordocentesis (n = 58) or cardiocentesis (n = 4) at 12 to 37 weeks of gestation. Maternal serum samples were obtained immediately before fetal blood sampling. RESULTS: Fetal serum thyroid-stimulating hormone, thyroxine-binding globulin, and total and free T4 and T3 concentrations increased significantly with the length of gestation (P less than 0.001). The only significant association among these variables, independent of the length of gestation, was between thyroid-stimulating hormone and free T4 (P less than 0.0001). Maternal serum concentrations of these variables did not change during gestation, and there was no significant relation between fetal and maternal values. Most fetal serum concentrations of thyroid-stimulating hormone were higher, whereas most serum total and free T3 concentrations were lower than the respective values for normal adults. The fetal serum total T4, free T4, and thyroxine-binding globulin values reached the level of the mean adult values at approximately 36 weeks of gestation. CONCLUSIONS: The increases in fetal serum concentrations of thyroid-stimulating hormone, thyroxine-binding globulin, and total and free T4 and T3 during gestation reflect increasing maturation of the pituitary, thyroid, and liver. The finding of increasing fetal serum concentrations of thyroid-stimulating hormone in the presence of increasing thyroid hormone concentrations suggests that the sensitivity of the fetal pituitary gland to negative feedback is limited or is counterbalanced by increasing stimulation by thyrotropin-releasing hormone from the hypothalamus.

Female↗
PubMed1994

The hemispheric cerebrovascular response to hemodilution is attenuated by a focal cryogenic brain injury.

Experimental brain injury attenuates the normal increase in cerebral blood flow (CBF) that accompanies a fall in PaO2, and this may contribute to the well-known detrimental effects of hypoxia following closed head injury. Anemia is also known to adversely affect posttraumatic survival, and it is reasonable to hypothesize that this too may be related to an altered cerebrovascular response. Therefore, to examine this possibility, pentobarbital-anesthetized rabbits were subjected to a left posterior parietal cryogenic cortical injury, followed 90 min later by isovolemic hemodilution with hetastarch. Unlesioned control animals underwent an identical degree of hemodilution. CBF was measured using radioactive microspheres. In control animals, hemodilution was accompanied by a marked increase in CBF in all brain regions. For example, in the left posterior cortex, CBF increased from 30 +/- 14 mL/100 g/min (baseline Hct = 42 +/- 2%, mean +/- SD) to 100 +/- 20 mL/100 g/min at Hct = 12 +/- 1%. By contrast, there was a markedly attenuated response throughout the left (ipsilateral) hemisphere of injured animals, even in cortical regions distant from the injury. For example, in the left posterior cortex, CBF changed from a baseline of 32 +/- 21 mL/100 g/min (baseline) to 40 +/- 14 mL/100 g/min at the lowest Hct. CBF responses to hemodilution were unaltered in the contralateral hemisphere and in the hindbrain. These data indicate that a localized brain lesion can produce widespread ipsilateral alterations in the CBF response to hemodilution, with resultant compromise in cerebral O2 delivery. These data support the argument that the CBF increase produced by hemodilution is an active vasodilatory process rather than a passive response to changing blood viscosity.

Animals↗
PubMedDate not supplied

The effect of rate of infusion on continuous epidural analgesia for labor and delivery.

The authors previously reported that if a loading dose of 50 mg bupivacaine was followed by infusion of 0.0625% bupivacaine (12.5 mg/hr), supplemental doses to achieve satisfactory analgesia for labor and delivery were required in 50% of patients. The current study was done to determine whether increasing the dose from 12.5 to 25 mg/h would eliminate the need for supplemental injections. Twenty-three healthy parturients were randomly assigned to one of two groups--Group I: 0.125% bupivacaine at 20 ml/hr (25 mg/hr); or Group II: 0.25% bupivacaine at 10 ml/hr (25 mg/hr). Taking both groups together, the 50-mg bupivacaine loading dose followed by 25 mg/hr provided adequate analgesia for labor and delivery in 74% of the patients. Two parturients in Group I and three in Group II required supplemental boluses of 4 ml of 0.5% bupivacaine for delivery. Pharmacokinetic data were similar in both groups. Using a dose of 25 mg/hr resulted in 74% of the patients obtaining adequate analgesia for labor and delivery. This improvement over the 50% success rate in the previous study, was achieved without any evidence of toxicity.

Adult↗
PubMedDate not supplied

Intraventricular hemorrhage and fetal heart rate in very low birth weight infants.

OBJECTIVE: This study was designed to investigate the relationship between fetal heart rate patterns before delivery and periventricular-intraventricular hemorrhage in the very low birth weight infant. STUDY DESIGN: The last 30 minutes of electronic fetal heart rate data preceding delivery were analyzed for 84 singleton infants weighing between 700 and 1500 gm. All these infants received serial cranial ultrasonographic examinations commencing within 24 to 48 hours of birth. RESULTS: Thirty-three fetuses had normal heart rate patterns, and 51 had fetal heart rate abnormalities. Periventricular-intraventricular hemorrhage was not associated with fetal heart rate abnormalities. Univariate and multivariate regression analysis demonstrated that only gestational age < 28 weeks was a significant contributing factor to periventricular-intraventricular hemorrhage (odds ratio 2.2, 95% confidence interval [CI], 1.0 to 4.8). CONCLUSION: Fetal heart rate patterns immediately preceding delivery are not predictive of periventricular-intraventricular hemorrhage in the very low birth weight infant.

Adult↗
PubMed2003

Antisense oligonucleotides reach mRNA targets via the RNA matrix: downregulation of the 5-HT1A receptor.

Successful application of antisense oligonucleotides (ODNs) in cell biology and therapy will depend on the ease of design, efficiency of (intra)cellular delivery, ODN stability, and target specificity. Equally essential is a detailed understanding of the mechanism of antisense action. To address these issues, we employed phosphorothioate ODNs directed against specific regions of the mRNA of the serotonin 5HT1A receptor, governed by sequence and structure. We demonstrate that rather than various intracellular factors, the gene sequence per se primarily determines the antisense effect, since 5HT1a autoreceptors expressed in RN46A cells, postsynaptic receptors expressed in SN48 cells, and receptors overexpressed in LLP-K1 cells are all efficiently downregulated following ODN delivery via a cationic lipid delivery system. The data also reveal that the delivery system as such is a relevant parameter in ODN delivery. Antisense ODNs bound extensively to the RNA matrix in the cell nuclei, thereby interacting with target mRNA and causing its subsequent degradation. Antisense delivery effectively diminished the mRNA pool, thus resulting in downregulation of newly synthesized 5HT1A proteins, without the appearance of truncated protein fragments. In conjunction with the selected mRNA target sequences of the ODNs, the latter data indicated that effective degradation rather than a steric blockage of the mRNA impedes protein expression. The specificity of the antisense approach, as described in this study, is reflected by the effective functional downregulation of the 5-HT1A receptor.

Active Transport, Cell Nucleus↗
PubMed2000

The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control study.

OBJECTIVE: To test whether being small for gestational age, defined as having a birthweight less than the 10th centile of intrauterine growth references, is a risk factor for preterm delivery for singleton live births. DESIGN: A case-control study. SETTING: Maternity hospitals in 16 European countries. SAMPLE: Four thousand and seven hundred preterm infants between 22 and 36 completed weeks of gestation and 6,460 control infants between 37 and 40 weeks of gestation. METHODS: Newborn babies are identified as being small for gestational age using customized reference standards derived from models of fetal growth. The impact of being small for gestational age on preterm delivery is estimated using logistic regression. MAIN OUTCOME MEASURE: Spontaneous or induced preterm delivery. RESULTS: Being small for gestational age is significantly associated with preterm birth, although the magnitude of this association differs greatly by type of delivery and gestational age. Over 40% of induced preterm births for reasons other than the premature rupture of membranes are small for gestational age compared with 10.7% of control infants (OR 6.41). For spontaneous or premature rupture of membranes related preterm births, the association is also significant, but weaker (OR 1.51). The relationship between growth restriction and preterm delivery is strongest for preterm births before 34 weeks of gestation. CONCLUSIONS: These findings highlight the phenomenon of abnormal fetal growth in all premature infants and, in particular, infants delivered by medical decision for reasons other than premature rupture of membranes. The observed association between being small for gestational age and preterm delivery among spontaneous preterm births merits further attention because the causal mechanisms are not well understood.

Case-Control Studies↗
PubMed1989

Analysis of 20,291 deliveries in a Turkish institution.

Data of 20,291 deliveries are presented; 6.85% (1389) of the patients were 19 years old or under and 6.24% (1276) were 35 or over; 7352 women had one child (primipara) and 1475 had five or more. Cephalic presentation constituted 94.2% of deliveries. The total induction rate was 9%. The incidence of prematurity and post-term gestation was 13 and 7.2%, respectively. Prolonged labor was encountered in 4% of the patients. Anesthesia was employed in 65.8% of all deliveries. Total and primary cesarean section rates were 9.77 and 7%, respectively. The incidence of fetal mortality was 2.55% and congenital anomalies were seen in 1.53% of the infants. The birth weight was under 2499 g in 9.5% of the newborns. Pregnancy complications of different magnitude were encountered in 23.7% of the cases. Uterine rupture and inversion rates were 0.12% and 0.005% respectively. The maternal mortality rate was found to be 64.06 per 100,000 deliveries.

Adolescent↗
PubMedDate not supplied

A ten-year review of breech deliveries at Ibadan.

An audit of all breech deliveries at the University College Hospital, Ibadan over a ten-year period was done to determine the most important contributors to perinatal morbidity and mortality in breech deliveries. The data were obtained from the birth register and individual case records of patients seen at the hospital during the period. The audit revealed the occurrence of 263 breech deliveries out of a total 9,966 deliveries, giving an incidence of breech presentation of 2.6%. Breech presentation was commonest among primigravidae (32.0%) and decreased with increasing parity. Caesarean section was the commonest mode of delivery (46.1%) at term. The fresh stillbirth rate was 10.5%. Low birthweight and prematurity were noted in 31.0% and 35.2%, respectively. The corrected perinatal mortality rates for pre-term and term breech were 450.0 per 1000 and 62.5 per 1000, respectively. Caesarean section appeared to confer an advantage over vaginal delivery at term. Low birth-weight and prematurity remain significant predisposing factors to the high perinatal morbidity and mortality attending breech births.

Apgar Score↗
PubMed1988

Postdate pregnancy in a network of community hospitals: management and outcome.

The outcome of 116 postdate pregnancies managed by 14 family physicians in small community hospitals is compared with the outcome of term gestations in the same setting. The postdate pregnancies in this relatively unselected population showed an increase in incidence of macrosomia and fetal heart rate abnormalities similar to those reported from referral centers. The increases in incidence of meconium staining and low Apgar scores reported previously were not found. The postdate patients had more frequent induction, augmentation, and amniotomy, as well as a significant increase in primary cesarean section, decreased use of epidural anesthesia, and fewer assisted deliveries. These data suggest that the community physicians were attaining a favorable outcome in the postdate pregnancy by an active approach to induction and management of labor combined with abdominal delivery of the macrosomic infant showing evidence of fetal distress.

Apgar Score↗
PubMed2000

Dominant role of host selective pressure in driving hepatitis C virus evolution in perinatal infection.

The dynamics of the genetic diversification of hepatitis C virus (HCV) populations was addressed in perinatal infection. Clonal sequences of hypervariable region 1 of the putative E2 envelope protein of HCV were obtained from four HCV-infected newborns (sequential samples spanning a period of 6 to 13 months after birth) and from their mothers (all samples collected at delivery). The data show that the variants detected between birth and the third month of life in samples from the four newborns were present in the HCV populations of their mothers at delivery. In the newborns, a unique viral variant (or a small group of closely related variants) remained stable for weeks despite active viral replication. Diversification of the intrahost HCV population was observed 6 to 13 months after birth and was substantially higher in two of the four subjects, as documented by the intersample genetic distance (GD) (P = 0.007). Importantly, a significant correlation between increasing GD and high values for the intersample K(a)/K(s) ratio (the ratio between anoffymous and synonymous substitutions; an index of the action of selective forces) was observed, as documented by the increase of both parameters over time (P = 0.01). These data argue for a dominant role of positive selection for amino acid changes in driving the pattern of genetic diversification of HCV populations, indicate that the intrahost evolution of HCV populations is compatible with a Darwinian model system, and may have implications in the designing of future antiviral strategies.

Amino Acid Sequence↗
PubMed2003

Nurse initiated thrombolysis in the accident and emergency department: safe, accurate, and faster than fast track.

OBJECTIVE: To reduce the time between arrival at hospital of a patient with acute myocardial infarction and administration of thrombolytic therapy (door to needle time) by the introduction of nurse initiated thrombolysis in the accident and emergency department. METHODS: Two acute chest pain nurse specialists (ACPNS) based in A&E for 62.5 hours of the week were responsible for initiating thrombolysis in the A&E department. The service reverts to a "fast track" system outside of these hours, with the on call medical team prescribing thrombolysis on the coronary care unit. Prospectively gathered data were analysed for a nine month period and a head to head comparison made between the mean and median door to needle times for both systems of thrombolysis delivery. RESULTS: Data from 91 patients were analysed; 43 (47%) were thrombolysed in A&E by the ACPNS and 48 (53%) were thrombolysed in the coronary care unit by the on call medical team. The ACPNS achieved a median door to needle time of 23 minutes (IQR=17 to 32) compared with 56 minutes (IQR=34 to 79.5) for the fast track. The proportion of patients thrombolysed in 30 minutes by the ACPNS and fast track system was 72% (31 of 43) and 21% (10 of 48) respectively (difference=51%, 95% confidence intervals 34% to 69%, p<0.05). CONCLUSION: Diagnosis of acute myocardial infarction and administration of thrombolysis by experienced cardiology nurses in A&E is a safe and effective strategy for reducing door to needle times, even when compared with a conventional fast track system.

Emergency Service, Hospital↗
PubMed1997

A regional perinatal database in southern Sweden--a basis for quality assurance in obstetrics and neonatology.

BACKGROUND: In order to ensure as few avoidable adverse outcomes of pregnancy as possible, it is necessary to continuously evaluate the quality of both obstetric and neonatal care. The eleven southernmost hospitals in Sweden have joined together in a project of developing a regional database, with special emphasis on rapid output of information in order to identify changing trends. METHODS: A regional computerized database has been developed, collecting variables and quality indicators agreed upon by all participants. Specific protocols have been designed for obstetric care, neonatal care and autopsy findings. All participating units transfer information on paper forms or via local computerized information systems. The regional database thus receives data on about 20,000 deliveries annually. RESULTS: Data collection started on September 1, 1994. The first results are due in March 1996, and thereafter on a regular basis every 3 months. Special methods for rapid analysis of raw data have been developed with the help of commercially available data analysis tools. CONCLUSIONS: It is possible to construct an information system with different computer platforms and different database tools at each participating facility, as long as the database systems are locally controllable. That a software is commercially available is no guarantee that data transfer to a central database is possible. Experience from participating sites also indicates that a specialized database is needed for registering obstetric data, as general computerized record-keeping systems are unable to cope with an event concerning more than one subject at a time.

Female↗
PubMed1997

Effects of long-term maternal intravenous magnesium sulfate therapy on neonatal calcium metabolism and bone mineral content.

A prospective study was designed to determine whether calcium homeostasis and bone mineral content were affected adversely in preterm infants born to mothers receiving long-term antenatal therapy with magnesium sulfate. Preterm infants born to mothers receiving long-term antenatal therapy with magnesium sulfate and requiring prolonged bed rest for preterm labor were compared with infants of mothers not receiving magnesium sulfate but in whom prolonged bed rest was also required. Serum magnesium, calcium, phosphorus, osteocalcin, and parathyroid hormone were measured in infants at 0, 24, 48, and 72 h after delivery. Bone mineral content of the distal radius was measured 1 week postnatally and at term-equivalent postmenstrual age. Maternal serum mineral status indices obtained near delivery and bone indices were compared with those of their infants. The clinical characteristics and morbidities of the infants were similar between groups. We observed significantly greater serum concentrations of magnesium, phosphorus, and osteocalcin during the 72 h after delivery and a lower serum calcium concentration which normalized by 72 h in preterm infants whose mothers were treated with magnesium sulfate compared with infants whose mothers did not receive magnesium sulfate. Both groups, however, had similar radius bone mineral content measurements and anthropometric indices after delivery. These data suggest that although preterm infants born to mothers treated with magnesium sulfate have delayed clearance of magnesium and phosphorus, they have a normalization of serum calcium by 72 h after delivery and no significant differences in bone mineral content after delivery compared with infants whose mothers do not receive magnesium sulfate.

Adult↗
PubMed1991

Endometrial cancer and age at last delivery: evidence for an association.

Because the role hormonal and reproductive factors play in the etiology of endometrial cancer is incompletely understood, the authors evaluated the risk of this cancer in relation to age at last delivery. The data were obtained in a hospital-based case-control study of 483 women with endometrial cancer (cases) and 693 women with other conditions (controls) conducted in a number of hospitals in the United States and Canada from 1978 to 1985. There was an inverse association between age at last delivery and endometrial cancer risk: Compared with women who last gave birth before age 25 years, the rate ratio was 0.9 (95% confidence interval (CI) 0.5-1.6) for last delivery at ages 25-29 years, 0.6 (95% CI 0.3-1.0) for last delivery at ages 30-34 years, 0.5 (95% CI 0.3-1.0) for last delivery at ages 35-39 years, and 0.4 (95% CI 0.1-0.9) for last delivery at age 40 years or older. The trend of decreasing rate ratio with increasing age at last delivery was statistically significant (p = 0.02). The association was apparent regardless of parity or menopausal status. There was no evidence for an association between age at first pregnancy and risk. These data suggest that women who bear children late in reproductive life may be at lower risk for endometrial cancer than those who complete their families early.

Adult↗
PubMed1988

Selected concepts and controversies in pediatric cardiopulmonary resuscitation.

Although more than 80 years of research in cardiac resuscitation produced many important findings and greatly enhanced our understanding of the arrest state, outcome following pediatric cardiac arrest remains poor. Resuscitation guidelines have recently been published, but they may not reflect optimal therapy. Closed-chest compression-induced cardiac output may be higher in pediatric patients, particularly infants, than that previously reported in adults. To achieve higher cardiac outputs, direct cardiac compression is important; the recommended compression location has therefore been changed based on recent data. The optimal rate of compression, however, is uncertain, so further research is needed. Alternative vascular access sites, such as the endotracheal and intraosseous route for drug administration may permit more rapid drug delivery, but data suggest that a larger epinephrine dose than currently recommended should be used. It may also be helpful to dilute the drug in normal saline before endotracheal administration. Although experimental data suggest that a pure alpha-adrenergic agonist may be beneficial in a cardiac arrest, recent data show that epinephrine remains the drug of choice. Finally, the role of sodium bicarbonate in both the arrest and postarrest setting has become controversial. Recent data suggest that bicarbonate may be detrimental and that therapy of acidosis is best directed at improving perfusion, oxygenation, and ventilation. Alternative forms of therapy for acidosis, such as THAM and dichloroacetate may prove beneficial in the postarrest setting.

Acidosis↗
PubMed2002

Risk factors for birth before arrival at Siriraj Hospital.

OBJECTIVE: To assess the potential risk factors for birth before arrival at Siriraj Hospital. STUDY DESIGN: Prospective case-control study. SETTING: Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. SUBJECTS: The subjects were 320 patients who had delivered at Siriraj Hospital and were divided into two groups. One hundred and sixty patients, who gave birth before admission to the labor room of Siriraj Hospital, were assigned as the study group. The control group consisted of 160 patients who had normal deliveries in the labor room of Siriraj Hospital at the same period of time. INTERVENTION: Information was obtained by interviewing the patients. Both the interviewer and the subjects were blinded to each other. The data were analyzed by using logistic regression model and EpiInfo program. MAIN OUTCOME MEASURE: Information of antenatal care, socio-economic data, past obstetric history and present data of delivery. RESULTS: The six significant risk factors were identified; education level of the patients (odds ratio 6.11), past history of previous delivery (odds ratio 6.18), past history of preterm delivery (odds ratio 4.03), no antenatal care (odds ratio 8.55), unawareness of true labor symptoms (odds ratio 1.89) and present preterm delivery (odds ratio 2.99). CONCLUSION: The risk factors identified from this study were low education level, past history of previous delivery, past history of preterm delivery, no antenatal care, unawareness of symptoms of true labor and present preterm delivery. The risk factors from this study should have further study to get more information that can apply to control birth before arrival.

Adult↗
PubMedDate not supplied

[Increase of births by cesarean section in Campania in 2000].

Cesarean deliveries (CS) are increasing in Italy, especially in the Campania region, where they reached a peak incidence of 52% in the year 2000. This study analyses CS rate variability by hospital type, foetal risk factors (low birth-weight, prematurity, plurality, anomalous presentations), maternal characteristics (age and parity) and delivery time. Data are drawn from birth certificates of 31,182 babies, that is 64.2% of all delivered in 65 out of 98 Campania birth-places. 16,251 (52%) babies are born by CS; 559 (1.8%) by operative vaginal delivery. The Attributable Risk for foetal risk factors is 6.9%. In absence of these the CS rate would be 48.5% instead of 52%. CS rate of primigravid women was 53.2%. 63% of CS take place during morning hours and 93% on working days. CS rate is higher in private than in public hospitals (58 vs 46%), though foetal risk factors are lower. Rate of older women was higher in public hospitals, rate of primigravid women was higher in private ones. Campania data confirm the marginal role of foetal risk factors in the increase of CS rate. In order to reduce CS rates it seems reasonable to offer special support to primigravid low risk mothers and to provide behavioural obstetrical guidelines for the peculiar Italian reality.

Adult↗
PubMed2003

Antenatal corticosteroids for fetal maturation in women at risk for preterm delivery.

The available data unambiguously support the beneficial, short-term fetal effects of antenatal corticosteroids in women at risk for preterm delivery. There are still several incompletely addressed questions, including the use of corticosteroids in women with preterm premature rupture of membranes, the optimal corticosteroid preparation to be used, and the impact of repeated dosing. These issues are discussed in this review from the perspective of recent scientific evidence on the mechanisms responsible for positive short-term effects on survival and possible harmful long-term effects.

Adrenal Cortex Hormones↗