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- Jennifer R Niebyl (22)
- Martha J. Craft-Rosenberg (4)
- Bradley J Van Voorhis (3)
- Maria A Lofgren (3)
- Rebecca Siewert (3)
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- Amy E.T. Sparks (2)
- Kimberly K. Leslie (2)
- Kirsten M. Hanrahan (2)
- Pamela J. Mulder (2)
- Sandra Daack-Hirsch (2)
- Ann Marie McCarthy (1)
- Baoli Yang (1)
- Cormac T. O'Sullivan (1)
- David P Bender (1)
- Deborah P. Schoenfelder (1)
- Donna A. Santillan (1)
- Eyup Hakan Duran (1)
- Ginny L. Ryan (1)
- Gregory S Skopec (1)
- Lisa S. Segre (1)
- Ruth E. Grossmann (1)
Articles 1 - 30 of 56
Full-Text Articles in Medicine and Health Sciences
Neonatal Respiratory Distress In The Community Hospital: When To Transport, When To Keep., H. Hein, J. Ely, Maria Lofgren
Neonatal Respiratory Distress In The Community Hospital: When To Transport, When To Keep., H. Hein, J. Ely, Maria Lofgren
Maria A Lofgren
Neonatal respiratory distress is a common problem confronting family physicians. Although respiratory distress may represent a benign, self-limited process, it may also be the first sign of sepsis or serious cardiopulmonary disease. Because it is crucial to differentiate the two, we offer a practical approach to the treatment of neonatal respiratory distress at community hospitals. Our method, the Rule of 2 Hours, is based on readily accessible clinical findings. We believe it will help physicians detect babies at risk for serious problems, but will not result in unnecessary referral of neonates that are simply adapting to extrauterine life.
The Changing Pattern Of Neonatal Mortality In A Regionalized System Of Perinatal Care: A Current Update., H. Hein, Maria Lofgren
The Changing Pattern Of Neonatal Mortality In A Regionalized System Of Perinatal Care: A Current Update., H. Hein, Maria Lofgren
Maria A Lofgren
OBJECTIVE: Our earlier studies about the changing pattern of neonatal mortality were based on data from 1978-1979 and 1982-1983. In this report, we provide a modern update of the causes of neonatal deaths to help focus prevention measures. STUDY DESIGN: We reviewed neonatal deaths for the years 1995 and 1996 and assigned a clinical cause of death. Deaths were reviewed and analyzed by place of birth and death, according to level of care. We provided an estimate of the change in causes of death between 1982-1983 and 1995-1996 and calculated an idealized neonatal mortality rate for each level of care …
Development Of A Resource Manual For Returning Neonates To Community Hospitals., Maria Lofgren
Development Of A Resource Manual For Returning Neonates To Community Hospitals., Maria Lofgren
Maria A Lofgren
To facilitate the transfer of an infant from a tertiary NICU to a community Level II hospital for convalescing follow-up care, the tertiary staff must know the referral center's capabilities. This will help to establish a trusting relationship between hospitals, will enable the tertiary staff to send infants back to the referral center in a timely manner, will enable them to reassure the patient's parents concerning the transfer, and will facilitate communication between the hospitals and the patient's family. This article describes the development of a referring hospital resource manual designed to facilitate the transfer process.
Disruption Of The Beta Subunit Of The Epithelial Na+ Channel In Mice: Hyperkalemia And Neonatal Death Associated With A Pseudohypoaldosteronism Phenotype., F. Mcdonald, Baoli Yang, R. Hrstka, H. Drummond, D. Tarr, P. Mccray, J. Stokes, M. Welsh, R. Williamson
Disruption Of The Beta Subunit Of The Epithelial Na+ Channel In Mice: Hyperkalemia And Neonatal Death Associated With A Pseudohypoaldosteronism Phenotype., F. Mcdonald, Baoli Yang, R. Hrstka, H. Drummond, D. Tarr, P. Mccray, J. Stokes, M. Welsh, R. Williamson
Baoli Yang
The epithelial Na+ channel (ENaC) is composed of three homologous subunits: alpha, beta and gamma. We used gene targeting to disrupt the beta subunit gene of ENaC in mice. The betaENaC-deficient mice showed normal prenatal development but died within 2 days after birth, most likely of hyperkalemia. In the -/- mice, we found an increased urine Na+ concentration despite hyponatremia and a decreased urine K+ concentration despite hyperkalemia. Moreover, serum aldosterone levels were increased. In contrast to alphaENaC-deficient mice, which die because of defective lung liquid clearance, neonatal betaENaC deficient mice did not die of respiratory failure and showed only …
Protective Immunization In Mice Against Group B Streptococci Using Encapsulated C5a Peptidase, Donna Santillan, M. E. Andracki, S. K. Hunter
Protective Immunization In Mice Against Group B Streptococci Using Encapsulated C5a Peptidase, Donna Santillan, M. E. Andracki, S. K. Hunter
Donna A. Santillan
OBJECTIVE: The purpose of the study was to test whether C5a peptidase encapsulated within a biodegradable polymer can act as a vaccine and elicit an immune response to prevent group B streptococci (GBS) infection in mice and provide protection to pups. STUDY DESIGN: C5a peptidase was encapsulated in semipermeable microspheres of poly(lactide-co-glycolide). Female ICR mice were immunized with encapsulated C5a peptidase, free C5a peptidase, or empty microparticles. Booster doses were given at days 21 and 42. Antibody responses were measured by enzyme-linked immunosorbent assay. Challenge with GBS type III was performed 4 days after the final booster in the vaginal …
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Amy E.T. Sparks
OBJECTIVE: To determine the risk of major birth defects in cohorts of children conceived through IVF or through IUI as compared with naturally conceived children. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): Children conceived by IVF or IUI at the University of Iowa from 1989 through 2002, compared with a matched cohort of naturally conceived children. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Outcome data were obtained from Iowa state birth and fetal death certificates and from the Iowa Birth Defects Registry. RESULT(S): Ninety of 1,462 IVF-conceived children (6.2%) and 17 of 343 IUI-conceived children (5.0%) had a major birth …
The Cost Of Infertility Evaluation And Therapy: Findings Of A Self-Insured University Healthcare Plan., D. Stovall, B. Allen, Amy Sparks, Craig Syrop, R. Saunders, Bradley Van Voorhis
The Cost Of Infertility Evaluation And Therapy: Findings Of A Self-Insured University Healthcare Plan., D. Stovall, B. Allen, Amy Sparks, Craig Syrop, R. Saunders, Bradley Van Voorhis
Amy E.T. Sparks
OBJECTIVE: To assess the total costs of infertility coverage, determine the proportion of healthcare costs related to infertility, compare infertility costs to those of other diseases, and calculate a per member per month cost of an infertility benefit. DESIGN: Historical prospective analysis. SETTING: A university-based, self-insured, fee-for-service healthcare plan. PATIENT(S): Healthcare policy members from January 1993 through December 1995. INTERVENTION(S): General and infertility-specific healthcare that included diagnostic tests for infertility, induction of ovulation, artificial insemination, donor gametes, in vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, microsurgical epididymal sperm aspiration, embryo cryopreservation, and frozen embryo transfer. MAIN OUTCOME MEASURE(S): Healthcare …
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility., J. Rampone, R. Sanders, Jennifer Niebyl
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility., J. Rampone, R. Sanders, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Treatment Of Premature Labor With Indomethacin., D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Treatment Of Premature Labor With Indomethacin., D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Jennifer R Niebyl
No abstract provided.
Kernicterus By Glucose-6-Phosphate Dehydrogenase Deficiency: A Case Report And Review Of The Literature, G. Gurrola, J. Araúz, Eyup Durán, M. Auilar-Medina, R. Ramos-Payán, N. García-Magallanes, G. Pacheco, E. Meraz
Kernicterus By Glucose-6-Phosphate Dehydrogenase Deficiency: A Case Report And Review Of The Literature, G. Gurrola, J. Araúz, Eyup Durán, M. Auilar-Medina, R. Ramos-Payán, N. García-Magallanes, G. Pacheco, E. Meraz
Eyup Hakan Duran
No abstract provided.
The Cost Of Infertility Evaluation And Therapy: Findings Of A Self-Insured University Healthcare Plan., D. Stovall, B. Allen, Amy Sparks, Craig Syrop, R. Saunders, Bradley Van Voorhis
The Cost Of Infertility Evaluation And Therapy: Findings Of A Self-Insured University Healthcare Plan., D. Stovall, B. Allen, Amy Sparks, Craig Syrop, R. Saunders, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To assess the total costs of infertility coverage, determine the proportion of healthcare costs related to infertility, compare infertility costs to those of other diseases, and calculate a per member per month cost of an infertility benefit. DESIGN: Historical prospective analysis. SETTING: A university-based, self-insured, fee-for-service healthcare plan. PATIENT(S): Healthcare policy members from January 1993 through December 1995. INTERVENTION(S): General and infertility-specific healthcare that included diagnostic tests for infertility, induction of ovulation, artificial insemination, donor gametes, in vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, microsurgical epididymal sperm aspiration, embryo cryopreservation, and frozen embryo transfer. MAIN OUTCOME MEASURE(S): Healthcare …
Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis
Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis
Bradley J Van Voorhis
The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affect the pregnancy rate, with the most important being a woman's age. Certain clinical diagnoses are associated with a poorer outcome from ART, including the presence of hydrosalpinges, uterine leiomyomata that distort the endometrial cavity, and decreased ovarian reserve. Multiple gestations are the major complication after ART. New laboratory techniques, …
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To determine the risk of major birth defects in cohorts of children conceived through IVF or through IUI as compared with naturally conceived children. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): Children conceived by IVF or IUI at the University of Iowa from 1989 through 2002, compared with a matched cohort of naturally conceived children. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Outcome data were obtained from Iowa state birth and fetal death certificates and from the Iowa Birth Defects Registry. RESULT(S): Ninety of 1,462 IVF-conceived children (6.2%) and 17 of 343 IUI-conceived children (5.0%) had a major birth …
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Ginny L. Ryan
OBJECTIVE: To determine the risk of major birth defects in cohorts of children conceived through IVF or through IUI as compared with naturally conceived children. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): Children conceived by IVF or IUI at the University of Iowa from 1989 through 2002, compared with a matched cohort of naturally conceived children. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Outcome data were obtained from Iowa state birth and fetal death certificates and from the Iowa Birth Defects Registry. RESULT(S): Ninety of 1,462 IVF-conceived children (6.2%) and 17 of 343 IUI-conceived children (5.0%) had a major birth …
The Effect Of Magnesium Sulfate On Fetal Heart Rate Baseline Variability, A. Babaknia, Jennifer Niebyl
The Effect Of Magnesium Sulfate On Fetal Heart Rate Baseline Variability, A. Babaknia, Jennifer Niebyl
Jennifer R Niebyl
Variability of the baseline fetal heart rate is correlated with good fetal outcome, and loss of baseline variability has been observed as a sign of fetal distress. Central nervous system depressing drugs may also decrease fetal heart rate variability, and thus recognition of the effect of medication on the baseline fetal heart rate is important for accurate interpretation of fetal monitor tracings. In the cases reported, marked decrease in fetal heart rate variability was observed within 4 minutes of intravenous administration of magnesium sulfate, and fetal outcome was good in all cases.
Folic Acid And Prevention Of Birth Defects, D. Van Dyke, P. Stumbo, J. Mary, Jennifer Niebyl
Folic Acid And Prevention Of Birth Defects, D. Van Dyke, P. Stumbo, J. Mary, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Prevention Of Perinatal Transmission Of Hepatitis B Virus: The Sensitivity, Specificity, And Predictive Value Of The Recommended Screening Questions To Detect High-Risk Women In An Obstetric Population, G. Mcquillan, T. Townsend, C. Johannes, T. Dillard, R. Molteni, P. Ness, Jennifer Niebyl
Prevention Of Perinatal Transmission Of Hepatitis B Virus: The Sensitivity, Specificity, And Predictive Value Of The Recommended Screening Questions To Detect High-Risk Women In An Obstetric Population, G. Mcquillan, T. Townsend, C. Johannes, T. Dillard, R. Molteni, P. Ness, Jennifer Niebyl
Jennifer R Niebyl
The Advisory Committee on Immunization Practices recommends that all pregnant women be questioned concerning risk factors for hepatitis B virus infection and that those giving positive responses be serotested. The sensitivity, specificity, and predictive value of those recommended questions among 692 parturient women were determined. A total of 59 currently or previously infected women (hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc) seropositive) were compared with the 633 seronegative women. Among nonwhite women, the sensitivity of a positive response to any one of the recommended questions was 60%. …
Neonatal Outcome After Indomethacin Treatment For Preterm Labor, Jennifer Niebyl, F. Witter
Neonatal Outcome After Indomethacin Treatment For Preterm Labor, Jennifer Niebyl, F. Witter
Jennifer R Niebyl
Forty-six infants exposed to indomethacin in utero for treatment for preterm labor were compared with infants from two control groups. In one control group the next consecutive patient treated with a tocolytic agent was used, and the other control group was formed by picking the next consecutive patient matched by gestational age who did not receive any tocolytic agent. There was no significant difference in Apgar scores, birth weight, or gestational age in the three groups. The incidence of neonatal complications including hypocalcemia, hypoglycemia, respiratory distress syndrome, patient ductus arteriosus, sepsis, and neonatal mortality were not significantly different in the …
A Placebo-Controlled Randomized Trial Of The Terbutaline Pump For Prevention Of Preterm Delivery, K. Wenstrom, C. Weiner, D. Merrill, Jennifer Niebyl
A Placebo-Controlled Randomized Trial Of The Terbutaline Pump For Prevention Of Preterm Delivery, K. Wenstrom, C. Weiner, D. Merrill, Jennifer Niebyl
Jennifer R Niebyl
To determine the efficacy of the terbutaline pump for the prevention of preterm delivery, patients in preterm labor defined by progressive cervical change underwent intravenous magnesium sulfate tocolysis (with or without oral indomethacin, as necessary), and once labor was arrested, were randomized to one of three treatment arms: terbutaline by pump, saline by pump (blinded), or oral terbutaline. If recurrent preterm labor occurred despite maximization of therapy, the treatment arm was determined and therapy was changed; saline pump and oral terbutaline were switched to terbutaline pump, terbutaline pump was switched to oral terbutaline. Patients who continued to labor were readmitted …
Penile Nerve Block For Newborn Circumcision, L. Maxwell, M. Yaster, R. Wetzel, Jennifer Niebyl
Penile Nerve Block For Newborn Circumcision, L. Maxwell, M. Yaster, R. Wetzel, Jennifer Niebyl
Jennifer R Niebyl
Circumcision in neonates is performed, almost universally, without anesthesia or analgesia. It is associated with pain, crying, agitation, and physiologic stress. Twenty infants receiving penile nerve block for circumcision were compared with ten infants having circumcision without anesthesia. Heart rate and blood pressure rose 34 and 15%, respectively, in unblocked infants, and were unchanged in infants receiving local anesthesia. Oxygen saturation declined 16% in unanesthetized infants compared with 6% in blocked infants (P less than .03). Anesthetized infants were less agitated and cried less. Peak plasma concentrations of the local anesthetic lidocaine averaged 0.51 +/- 0.17 microgram/mL (range 0.1-1.6), well …
Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson
Inhibition Of Preterm Labor, Jennifer Niebyl, J. Johnson
Jennifer R Niebyl
No abstract provided.
Consultations & Comments. Ssris And Pregnancy: What Risk To The Fetus?, Jennifer Niebyl
Consultations & Comments. Ssris And Pregnancy: What Risk To The Fetus?, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
The Inhibition Of Premature Labor With Indomethacin, Jennifer Niebyl, D. Blake, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
The Inhibition Of Premature Labor With Indomethacin, Jennifer Niebyl, D. Blake, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner
Jennifer R Niebyl
We administered indomethacin orally for the treatment of premature labor in a prospective, randomized, double-blind fashion, and all infants were followed up. Indomethacin was significantly more effective than placebo in inhibition of premature labor during a 24-hour course of therapy, with treatment failure during therapy occurring in only one of 15 indomethacin-treated patients compared to nine of 15 placebo-treated patients (p less than 0.01). Mean plasma concentrations of indomethacin were approximately 0.8 micrograms/ml at both 4 and 12 hours after administration. Mean plasma levels of 15-oxo-13,14-dihydroprostaglandin F2 alpha (PGFM) were similar in the two groups before treatment, decreased markedly in …
Acute Bacterial Endocarditis With Postpartum Aortic Valve Replacement, R. Cavalieri, L. Watkins, R. Abraham, H. Berkay, Jennifer Niebyl
Acute Bacterial Endocarditis With Postpartum Aortic Valve Replacement, R. Cavalieri, L. Watkins, R. Abraham, H. Berkay, Jennifer Niebyl
Jennifer R Niebyl
A case of acute bacterial endocarditis with aortic valve abscess, aortic insufficiency, and congestive heart failure at 32 weeks' gestation is described. Prompt valve replacement is indicated due to the risks of embolism to the coronary arteries and brain, and to the high mortality of such patients with medical management only. The infant was delivered prematurely to avoid the intraoperative risks to the fetus of cardiac surgery. General rather than regional anesthesia was chosen because venous pooling from a regional block would necessitate preoperative fluid loading and vasopressor therapy, which would be stressful for an already failing heart. In the …
Therapeutic Drugs In Pregnancy. Caution Is The Watchword, Jennifer Niebyl
Therapeutic Drugs In Pregnancy. Caution Is The Watchword, Jennifer Niebyl
Jennifer R Niebyl
Many medical conditions during pregnancy are best treated initially with nonpharmacologic remedies. Before a drug is used during pregnancy, the indications should be clear and the risk-benefit ratio should justify its use. Then, the minimum effective dose should be employed. If possible, therapy should be postponed until after the first trimester.
Clinical High-Risk Designation Does Not Predict Excess Fetal-Maternal Hemorrhage, P. Ness, M. Baldwin, Jennifer Niebyl
Clinical High-Risk Designation Does Not Predict Excess Fetal-Maternal Hemorrhage, P. Ness, M. Baldwin, Jennifer Niebyl
Jennifer R Niebyl
During a 5-year period, an enzyme-linked antiglobulin test was used to screen and quantitate fetal-maternal hemorrhage in 789 consecutive D-negative mothers who were delivered of D-positive babies. Six hundred seventy-two patients (85.2%) had no detectable fetal-maternal hemorrhage, and 117 patients (14.8%) had a detectable fetal-maternal hemorrhage. Eight of the 789 (1%) had a fetal-maternal hemorrhage greater than 30 ml and required more than one vial of Rh immune globulin. Two patients with fetal-maternal hemorrhage of 29 and 30 ml also received additional Rh immune globulin. Each case was reviewed for the presence of high-risk features that are thought to predict …
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility, J. Rampone, R. Sanders, Jennifer Niebyl
Ultrasonic Aspiration Transducer For Management Of Rh Incompatibility, J. Rampone, R. Sanders, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Management Of Sickle Cell Disease In Pregnant Patients, S. Charache, J. Scott, Jennifer Niebyl, D. Bonds
Management Of Sickle Cell Disease In Pregnant Patients, S. Charache, J. Scott, Jennifer Niebyl, D. Bonds
Jennifer R Niebyl
Data from a total of 74 pregnancies in 42 patients with sickling disorders seen at Johns Hopkins Hospital are compared with similar data from other centers. Although risks are still higher than those for women without sickle cell disease, they have diminished significantly from those reported earlier. Prophylactic transfusion therapy may decrease these risks further, but benefits of transfusion are unproved at present. Patients with sickling disorders should receive meticulous individualized treatment until further data are made available.
Premature Rupture Of The Membranes And Prolonged Latency, J. Johnson, N. Daikoku, Jennifer Niebyl, T. Johnson, V. Khouzami, F. Witter
Premature Rupture Of The Membranes And Prolonged Latency, J. Johnson, N. Daikoku, Jennifer Niebyl, T. Johnson, V. Khouzami, F. Witter
Jennifer R Niebyl
The aim of this retrospective study in 8320 patients with premature rupture of the membranes (PROM) was to determine the consequences of prolongation of the latent period. Among patients with pregnancies of more than 37 weeks' duration, those with PROM and latent periods of more than 1 day demonstrated an increased incidence of intrapartum fever (IPF), whereas those with latent periods of more than 3 days demonstrated a marked increase in fetal (but not neonatal) deaths. Although IPF and perinatal mortality were more common in preterm pregnancies, neither was found to increase or decrease with prolonged latency, provided differences in …
Pregnancy In Sickle Cell Disease, S. Charache, Jennifer Niebyl
Pregnancy In Sickle Cell Disease, S. Charache, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.