Medicine and Health Sciences Commons^™

Multicenter Study Of Pectus Excavatum, Final Report: Complications, Static/Exercise Pulmonary Function, And Anatomic Outcomes., Robert E. Kelly, Robert B. Mellins, Robert C. Shamberger, Karen K. Mitchell, M Louise Lawson, Keith T. Oldham, Richard G. Azizkhan, Andre V. Hebra, Donald Nuss, Michael J. Goretsky, Ronald J. Sharp, George W. Holcomb, Walton K T Shim, Stephen M. Megison, R Lawrence Moss, Annie H. Fecteau, Paul M. Colombani, Dan Cooper, Traci Bagley, Amy Quinn, Alan B. Moskowitz, James F. Paulson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: A multicenter study of pectus excavatum was described previously. This report presents our final results.

STUDY DESIGN: Patients treated surgically at 11 centers were followed prospectively. Each underwent a preoperative evaluation with CT scan, pulmonary function tests, and body image survey. Data were collected about associated conditions, complications, and perioperative pain. One year after treatment, patients underwent repeat chest CT scan, pulmonary function tests, and body image survey. A subset of 50 underwent exercise pulmonary function testing.

RESULTS: Of 327 patients, 284 underwent Nuss procedure and 43 underwent open procedure without mortality. Of 182 patients with complete follow-up (56%), …

Predictors Of Disease Progression In Pediatric Dilated Cardiomyopathy., Kimberly M. Molina, Peter Shrader, Steven D. Colan, Seema Mital, Renee Margossian, Lynn A. Sleeper, Girish S. Shirali, Piers Barker, Charles E. Canter, Karen Altmann, Elizabeth Radojewski, Elif Seda Selamet Tierney, Jack Rychik, Lloyd Y. Tani, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Despite medical advances, children with dilated cardiomyopathy (DCM) remain at high risk of death or need for cardiac transplantation. We sought to identify predictors of disease progression in pediatric DCM.

Methods and results: The Pediatric Heart Network evaluated chronic DCM patients with prospective echocardiographic and clinical data collection during an 18-month follow-up. Inclusion criteria were age <22 years and DCM disease duration >2 months. Patients requiring intravenous inotropic/mechanical support or listed status 1A/1B for transplant were excluded. Disease progression was defined as an increase in transplant listing status, hospitalization for heart failure, intravenous inotropes, mechanical support, or death. Predictors of disease progression were identified using …

The Effect Of Malnutrition On Patients Undergoing Elective Joint Arthroplasty., Ronald Huang, Md, Max Greenky, Bs, Glenn J. Kerr, Md, Mathew S. Austin, Md, Javad Parvizi, Md, Frcs

Rothman Institute Faculty Papers

Malnutrition has been linked to serious complications in patients undergoing elective total joint arthroplasty (TJA). This study prospectively evaluated 2,161 patients undergoing elective TJA for malnutrition as defined by either an abnormal serum albumin or transferrin. The overall incidence of malnutrition was 8.5% (184 of 2,161) and the rate of overall complications in the malnourished group was 12% as compared to 2.9% in patients with normal parameters (P55years-old undergoing TJA and is associated with a significant increase in post-operative complications.

Occupational Exposure To Hepatitis C Virus: Early T-Cell Responses In The Absence Of Seroconversion In A Longitudinal Cohort Study., Theo Heller, Jens Martin Werner, Fareed Rahman, Eishiro Mizukoshi, Yuji Sobao, Ann Marie Gordon, Arlene Sheets, Averell H. Sherker, Ellen Kessler, Kathleen S. Bean, Steven K. Herrine, M'Lou Stevens, James Schmitt, Barbara Rehermann

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: T-cell responses have been described in seronegative patients who test negative for hepatitis C virus (HCV) RNA despite frequent HCV exposure. However, the cross-sectional design of those studies did not clarify whether T cells were indeed induced by low-level HCV exposure without seroconversion or whether they resulted from regular acute infection with subsequent antibody loss.

METHODS: Over a 10-year period, our longitudinal study recruited 72 healthcare workers with documented HCV exposure. We studied viremia and antibody and T-cell responses longitudinally for 6 months.

RESULTS: All healthcare workers remained negative for HCV RNA and antibodies. However, 48% developed proliferative T-cell …

Spinal Anesthesia: Should Everyone Receive A Urinary Catheter?: A Randomized, Prospective Study Of Patients Undergoing Total Hip Arthroplasty., Adam G Miller, James Mckenzie, Max Greenky, Erica Shaw, Kishor Gandhi, William J Hozack, Javad Parvizi

Rothman Institute Faculty Papers

BACKGROUND: The objective of this randomized prospective study was to determine whether a urinary catheter is necessary for all patients undergoing total hip arthroplasty under spinal anesthesia.

METHODS: Consecutive patients undergoing total hip arthroplasty under spinal anesthesia were randomized to treatment with or without insertion of an indwelling urinary catheter. All patients received spinal anesthesia with 15 to 30 mg of 0.5% bupivacaine. The catheter group was subjected to a standard postoperative protocol, with removal of the indwelling catheter within forty-eight hours postoperatively. The experimental group was monitored for urinary retention and, if necessary, had straight catheterization up to two …

Spinal Anesthesia: Should Everyone Receive A Urinary Catheter?: A Randomized, Prospective Study Of Patients Undergoing Total Hip Arthroplasty., Adam G Miller, Md, James Mckenzie, Bs, Max Greenky, Ba, Erica Shaw, Rnp, Kishor Gandhi, Md, William J Hozack, Md, Javad Parvizi, Md, Frcs

Rothman Institute Faculty Papers

BACKGROUND: The objective of this randomized prospective study was to determine whether a urinary catheter is necessary for all patients undergoing total hip arthroplasty under spinal anesthesia.

METHODS: Consecutive patients undergoing total hip arthroplasty under spinal anesthesia were randomized to treatment with or without insertion of an indwelling urinary catheter. All patients received spinal anesthesia with 15 to 30 mg of 0.5% bupivacaine. The catheter group was subjected to a standard postoperative protocol, with removal of the indwelling catheter within forty-eight hours postoperatively. The experimental group was monitored for urinary retention and, if necessary, had straight catheterization up to two …

Decreased Expression Of The Heat Shock Protein Hsp70-2 Is Associated With The Pathogenesis Of Male Infertility, H. Feng, J. Sandlow, Amy Sparks

Amy E.T. Sparks

OBJECTIVE: To examine the expression of the heat shock protein hsp70-2, and the possible relationship with the pathogenesis of male infertility. DESIGN: Prospective study. SETTING: Reproductive testing laboratory in a university hospital. PATIENT(S): Men undergoing testicular biopsy during an investigation of subfertility. INTERVENTION(S): Testicular tissues were obtained from biopsies of men undergoing infertility evaluation and subdivided into three groups: normal testes, maturational arrest and Sertoli cell-only syndrome. Immunostaining and Western blotting techniques determined expression of the heat shock protein hsp70-2 MAIN OUTCOME MEASURE(S): Expression of the heat shock protein hsp70-2 in the testes. RESULT(S): The experimental data demonstrated that the …

Decreased Expression Of The C-Kit Receptor Is Associated With Increased Apoptosis In Subfertile Human Testes, H. Feng, J. Sandlow, Amy Sparks, A. Sandra, L. Zheng

Amy E.T. Sparks

OBJECTIVE: To examine the expression of the c-kit receptor and its ligand, stem cell factor, and their possible relation with apoptosis in infertile men. DESIGN: Prospective laboratory study. SETTING: Urology laboratory in a university hospital. PATIENT(S): Men undergoing testicular biopsy during an investigation of subfertility. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Expression of the c-kit receptor protein, stem cell factor, and apoptosis in the testes. RESULT(S): The c-kit receptor was strongly present in Leydig cells and type A spermatogonia of normal testes, with decreased staining in Leydig cells and type A spermatogonia of testes with maturational arrest, and staining in only …

In Vitro Fertilization Patients Support A Single Blastocyst Transfer Policy, S. Martini, Bradley Van Voorhis, B. Stegmann, Amy Sparks, T. Shochet, M. Zimmerman, Ginny Ryan

Amy E.T. Sparks

OBJECTIVE: To determine whether patients support a mandatory single blastocyst transfer (mSBT) policy in IVF. DESIGN: Prospective survey study. SETTING: Academic hospital-based infertility center. PATIENT(S): Two hundred sixty-two female patients presenting for fresh or cryopreserved/thawed ET after IVF. INTERVENTION(S): Internet-based in-clinic survey after ET. Follow-up at-home survey after pregnancy test results. MAIN OUTCOME MEASURE(S): Patient support for an mSBT policy and attitudes regarding patient input into IVF treatment. Logistic regression analyses tested associations among main outcome measures, patient characteristics, and treatment results. RESULT(S): Ninety-four percent of patients endorsed support for our mSBT policy; 95% and 87% felt they had the …

Sperm Dna Quality Predicts Intrauterine Insemination Outcome: A Prospective Cohort Study, Eyup Duran, M. Morshedi, S. Taylor, S. Oehninger

Eyup Hakan Duran

BACKGROUND: We aimed to investigate whether sperm DNA quality may predict intrauterine insemination (IUI) outcome. METHODS: The study was designed in a prospective cohort fashion, at a tertiary centre for reproductive medicine. A total of 119 patients underwent 154 cycles of IUI. Parameters related to demography, cycle management and semen sample used for IUI were evaluated. Conventional semen parameters, morphology (strict criteria), sperm DNA fragmentation and stability [evaluated by terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL) and acridine orange staining under both acid and acid + heat denaturing conditions respectively] were measured. The main outcome measure was clinical pregnancy, defined …

Efficacy And Pregnancy Outcome Of Two Methods Of Semen Preparation For Intrauterine Insemination: A Prospective Randomized Study., Mahmood Morshedi, E. Duran, Steven Taylor, Sergio Oehninger

Eyup Hakan Duran

OBJECTIVE: To examine pregnancy outcome with two methods of semen preparation for intrauterine insemination (IUI).

DESIGN: Prospective and randomized study.

SETTINGS: Academic tertiary center.

PATIENT(S): Three hundred eleven couples undergoing 676 consecutive cycles of assisted conception using IUI.

INTERVENTION(S): Semen samples collected for IUI were randomized to wash only or density gradient centrifugation (DGC) processing.

MAIN OUTCOME MEASURE(S): Various prepreparation and postpreparation semen parameters were used for IUI. The influence of the method of semen processing, and impact of various semen parameters and female factors on pregnancy were examined by receiver operating characteristics (ROC) curves, logistic regression, and life table …

The Impact Of A Gonadotropin-Releasing Hormone Antagonist On Gonadotropin Ovulation Induction Cycles In Women With Polycystic Ovary Syndrome: A Prospective Randomized Study, L. Stadtmauer, A. Sarhan, Eyup Duran, H. Beydoun, S. Bocca, B. Pultz, S. Oehninger

Eyup Hakan Duran

OBJECTIVE: To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS). DESIGN: Prospective, randomized, controlled study. SETTING: Academic infertility center. PATIENT(S): Ninety-eight anovulatory women with PCOS undergoing 154 gonadotropin OI cycles. INTERVENTION(S): Patients were treated with recombinant FSH alone (group 1) or in conjunction with Ganirelix when the leading follicle was >/=13 mm (group 2) versus from the beginning of stimulation (group 3), followed by IUI. MAIN OUTCOME MEASURE(S): Per cycle clinical pregnancy rate (CPR), live-birth rate (LBR), total gonadotropin dose, days of stimulation, serum LH and peak …

A Study Of The Cost, Accuracy, And Benefits Of 3-Dimensional Sonography Compared With Hysterosalpingography In Women With Uterine Abnormalities, S. Bocca, S. Oehninger, L. Stadtmauer, J. Agard, Eyup Duran, A. Sarhan, S. Horton, A. Abuhamad

Eyup Hakan Duran

OBJECTIVES: We conducted a prospective blinded study to evaluate the costs, accuracy, risks, and benefits of 3-dimensional (3D) transvaginal sonography compared to hysterosalpingography. METHODS: A total of 101 women aged 26 to 44 years with evidence of uterine anomalies were enrolled. All participants had routine hysterosalpingography as part of their infertility evaluation as well as 3D transvaginal sonography as part of the study. Surgical findings were used as the standard for final diagnosis. RESULTS: A total of 6 normal uteri and 119 uterine anomalies were classified: 30 congenital uterine anomalies (3 arcuate, 1 unicornuate, 4 bicornuate, 2 didelphys, and 20 …

A Logistic Regression Model Including Dna Status And Morphology Of Spermatozoa For Prediction Of Fertilization In Vitro, Eyup Duran, T. Gurgan, S. Gunalp, M. Enginsu, H. Yarali, A. Ayhan

Eyup Hakan Duran

To determine predictive values of routine semen analysis, sperm morphology evaluation using strict criteria and DNA status for in-vitro fertilization (IVF), 66 consecutive couples undergoing IVF in a university hospital IVF programme were prospectively investigated. Semen samples from 66 men were evaluated by routine semen analysis, morphology evaluation using strict criteria and acridine orange staining for determination of DNA status. A new technique is described for acridine orange scoring which consisted of evaluation of two smears per case, with and without heat treatment. Resistance to heat-provoked denaturation was determined by the difference between two evaluations. A logistic regression model was …

Does Insulin Secretion In Patients With One Abnormal Glucose Tolerance Test Value Mimic Gestational Diabetes Mellitus?, Tolga Ergin, Arda Lembet, E. Duran, Esra Kuscu, Tayfun Bagis, Esra Saygili, Sertac Batioglu

Eyup Hakan Duran

OBJECTIVE: The purpose of this study was to investigate the insulin response to a 3-hour oral glucose tolerance test and to compare the insulin levels in the gestational diabetes mellitus and single abnormal test value groups with a nondiabetic control group. STUDY DESIGN: One hundred ten Turkish women with uncomplicated pregnancy participated in this prospective controlled study between 24 to 28 weeks of gestation. A 100-g 3-hour oral glucose tolerance test was given, and glucose and insulin plasma levels were assayed. The subjects were classified according to established criteria. Early-phase insulin secretion was assessed by the insulinogenic index. Total insulin …

The Association Of Reproductive Senescence With Mitochondrial Quantity, Function, And Dna Integrity In Human Oocytes At Different Stages Of Maturation., Eyup Duran, Fatma Simsek-Duran, Sergio Oehninger, Howard Jones, Frank Castora

Eyup Hakan Duran

OBJECTIVE: To determine the impact of reproductive aging on oocyte mitochondrial quantity, function, and DNA (mtDNA) integrity. DESIGN: Prospective observational study. SETTING: IVF clinic in a tertiary academic care center. PATIENT(S): One hundred two oocytes from 32 women undergoing IVF. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Adenosine triphosphate (ATP) levels, mtDNA number, and mtDNA deletion occurrence in individual oocytes. RESULT(S): Oocyte ATP content increases with maturation (786 ± 87 fmol, 1,037 ± 57 fmol, and 1,201 ± 59 fmol for prophase 1 [P1], metaphase 1 [M1], and metaphase 2 [M2] oocytes, respectively), whereas mtDNA copy numbers do not change (64,500 ± …

Incidence Of Anti-Heparin/Platelet Factor 4 Antibodies And Heparin-Induced Thrombocytopenia In Medical Patients [Turkish], M. Demir, E. Tekgündüz, M. Edis, Eyup Duran, T. Kürüm

Eyup Hakan Duran

OBJECTIVE: Heparin-induced thrombocytopenia (HIT) is a life threatening complication of heparin therapy, causing thrombosis. The aim of our study was to find out the frequencies of HIT antibody seroconversion and clinical HIT in Turkish medical patients on different forms of heparins. METHODS: Our study included 61 patients who were on unfractionated heparin (UFH) (n: 37) and low molecular weight heparin (LMWH) (n: 24) therapies. The frequency of HIT antibody formation was determined by means of antigenic (ELISA), and functional assays (serotonin release assay-SRA). RESULTS: The seroconversion rates in UFH and LMWH groups were found to be 18.9% and 4.1% (ELISA), …

In Vitro Fertilization Patients Support A Single Blastocyst Transfer Policy, S. Martini, Bradley Van Voorhis, B. Stegmann, Amy Sparks, T. Shochet, M. Zimmerman, Ginny Ryan

Bradley J Van Voorhis

OBJECTIVE: To determine whether patients support a mandatory single blastocyst transfer (mSBT) policy in IVF. DESIGN: Prospective survey study. SETTING: Academic hospital-based infertility center. PATIENT(S): Two hundred sixty-two female patients presenting for fresh or cryopreserved/thawed ET after IVF. INTERVENTION(S): Internet-based in-clinic survey after ET. Follow-up at-home survey after pregnancy test results. MAIN OUTCOME MEASURE(S): Patient support for an mSBT policy and attitudes regarding patient input into IVF treatment. Logistic regression analyses tested associations among main outcome measures, patient characteristics, and treatment results. RESULT(S): Ninety-four percent of patients endorsed support for our mSBT policy; 95% and 87% felt they had the …

The Desire Of Infertile Patients For Multiple Births, Ginny Ryan, S. Zhang, A. Dokras, Craig Syrop, Bradley Van Voorhis

Bradley J Van Voorhis

OBJECTIVE: To determine the proportion of infertile women who prefer a multiple birth over a singleton, patient characteristics associated with this desire, and patient knowledge about the risks of multiple births. DESIGN: Prospective analysis. SETTING: Academic university hospital-based infertility center and private general gynecology clinic. PATIENT(S): Four hundred sixty-four female patients with infertility who presented for their initial visit. MAIN OUTCOME MEASURE(S): Demographic characteristics, infertility history, desire regarding multiple births, knowledge of the risks of multiple births, and goals of infertility evaluation and treatment were determined by using a 41-question survey. Univariate analysis was performed to assess patient characteristics associated …

Constipation In Pregnancy: Prevalence, Symptoms, And Risk Factors, Catherine Bradley, Colleen Kennedy, A. Turcea, S. Rao, I. Nygaard

Colleen Kennedy Stockdale

OBJECTIVE: To prospectively estimate constipation prevalence and risk factors in pregnancy. METHODS: We enrolled healthy pregnant women in this longitudinal study during the first trimester. At each trimester and 3 months postpartum, participants completed a self-administered bowel symptom questionnaire, physical activity and dietary fiber intake measures, and a prospective 7-day stool diary. Constipation was defined using the Rome II criteria (presence of at least two of the following symptoms for at least one quarter of defecations: straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, manual maneuvers to facilitate defecation, and fewer than three defecations per …

Urinary Incontinence, Depression And Posttraumatic Stress Disorder In Women Veterans, Catherine Bradley, I. Nygaard, M. Mengeling, J. Torner, Colleen Stockdale, B. Booth, A. Sadler

Colleen Kennedy Stockdale

OBJECTIVE: To study associations between urinary incontinence (UI) symptoms, depression, and posttraumatic stress disorder in women veterans. STUDY DESIGN: This cross-sectional study enrolled women 20 to 52 years of age registered at 2 midwestern US Veterans Affairs Medical Centers or outlying clinics within 5 years preceding study interview. Participants completed a computer-assisted telephone interview assessing urogynecologic, medical, and mental health. Multivariable analyses studied independent associations between stress and urgency UI and depression and posttraumatic stress disorder. RESULTS: Nine hundred sixty-eight women mean aged 38.7 +/- 8.7 years were included. Of these, 191 (19.7%) reported urgency/mixed UI and 183 (18.9%) stress …

Prevalence Of Vulvar And Vaginal Symptoms During Pregnancy And The Puerperium, Colleen Kennedy, A. Turcea, Catherine Bradley

Colleen Kennedy Stockdale

OBJECTIVE: To identify the prevalence of vulvar and vaginal symptoms during pregnancy and at 3 months post partum. METHODS: A prospective, longitudinal, descriptive study of 103 pregnant women was undertaken in which a self-administered questionnaire was completed at each trimester and 3 months post partum. Retrospective data was collected from 122 women, queried using similar tools, who comprised a nonpregnant control group. Descriptive and comparative statistics were employed. RESULTS: The prevalence of vulvar burning, itching, pain, and vaginal discharge generally increased during pregnancy, and improved postpartum. Dyspareunia increased during pregnancy, but remained elevated post partum. Compared with the historical nonpregnant …

The Desire Of Infertile Patients For Multiple Births, Ginny Ryan, S. Zhang, A. Dokras, Craig Syrop, Bradley Van Voorhis

Ginny L. Ryan

OBJECTIVE: To determine the proportion of infertile women who prefer a multiple birth over a singleton, patient characteristics associated with this desire, and patient knowledge about the risks of multiple births. DESIGN: Prospective analysis. SETTING: Academic university hospital-based infertility center and private general gynecology clinic. PATIENT(S): Four hundred sixty-four female patients with infertility who presented for their initial visit. MAIN OUTCOME MEASURE(S): Demographic characteristics, infertility history, desire regarding multiple births, knowledge of the risks of multiple births, and goals of infertility evaluation and treatment were determined by using a 41-question survey. Univariate analysis was performed to assess patient characteristics associated …

In Vitro Fertilization Patients Support A Single Blastocyst Transfer Policy, S. Martini, Bradley Van Voorhis, B. Stegmann, Amy Sparks, T. Shochet, M. Zimmerman, Ginny Ryan

Ginny L. Ryan

OBJECTIVE: To determine whether patients support a mandatory single blastocyst transfer (mSBT) policy in IVF. DESIGN: Prospective survey study. SETTING: Academic hospital-based infertility center. PATIENT(S): Two hundred sixty-two female patients presenting for fresh or cryopreserved/thawed ET after IVF. INTERVENTION(S): Internet-based in-clinic survey after ET. Follow-up at-home survey after pregnancy test results. MAIN OUTCOME MEASURE(S): Patient support for an mSBT policy and attitudes regarding patient input into IVF treatment. Logistic regression analyses tested associations among main outcome measures, patient characteristics, and treatment results. RESULT(S): Ninety-four percent of patients endorsed support for our mSBT policy; 95% and 87% felt they had the …

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

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 …

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 …

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 …

Maternal Parenting Stress And Mothers' Reports Of Their Infants' Mastery Motivation, T. Sparks, Stephen Hunter, T. Backman, G. Morgan, R. Ross

Stephen K. Hunter

No abstract provided.

Group B Streptococci Causing Neonatal Bloodstream Infection: Antimicrobial Susceptibility And Serotyping Results From Sentry Centers In The Western Hemisphere, J. Andrews, D. Diekema, Stephen Hunter, P. Rhomberg, M. Pfaller, R. Jones, G. Doern

Stephen K. Hunter

OBJECTIVE: Group B streptococcal infection is a common cause of neonatal sepsis. Surveillance of antimicrobial susceptibility and serotype frequencies of invasive group B streptococci is important to ensure the effectiveness of therapeutic regimens and to guide vaccine development. STUDY DESIGN: Prospective surveillance of neonatal bloodstream infection was performed at all Western Hemisphere sites participating in the SENTRY Program. From January 1997 through December 1999, a total of 122 isolates of bloodstream infections with group B streptococci were collected and sent to the University of Iowa for antimicrobial susceptibility testing and serotyping. RESULTS: No isolates were resistant to penicillin. More than …