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Full-Text Articles in Medicine and Health Sciences
Human Plasma Prekallikrein And High Molecular Weight Kininogen Decrease During Parturition, B. Alving, Jennifer Niebyl, D. Proud, B. Mason, J. Pisano
Human Plasma Prekallikrein And High Molecular Weight Kininogen Decrease During Parturition, B. Alving, Jennifer Niebyl, D. Proud, B. Mason, J. Pisano
Jennifer R Niebyl
Prekallikrein and high molecular weight kininogen were measured in plasma taken from nine women during parturition. Prekallikrein decreased significantly (p less than 0.01) from 1.49 +/- 0.15 S-2302 U/ml (mean +/- SEM) in early labor to 1.26 +/- 0.13 S-2302 U/ml in the immediate postpartum period. Immunoreactive high molecular weight kininogen also significantly decreased from 76 +/- 5 micrograms/ml to 68 +/- 5 micrograms/ml one day postpartum (p less than 0.01). Both proteins rose to normal levels within two days. The data suggest that the kallikrein-kinin system is utilized during parturition.
Drugs In Pregnancy, Jennifer Niebyl
The Effect Of Maternal Age On Primary Cesarean Section Rate, F. Witter, J. Repke, Jennifer Niebyl
The Effect Of Maternal Age On Primary Cesarean Section Rate, F. Witter, J. Repke, Jennifer Niebyl
Jennifer R Niebyl
A retrospective analysis of computerized data from 11,815 patients with no history of previous cesarean section revealed an increasing primary cesarean section rate with increasing maternal age. This increase occurred over the entire reproductive age span. Fetal distress as an indication for primary cesarean section may account for this increase.
Changes In The Diagnostic Process During 40 Years Of Clinicopathologic Conferences, A. Feinstein, Jennifer Niebyl
Changes In The Diagnostic Process During 40 Years Of Clinicopathologic Conferences, A. Feinstein, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
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 …
Reproducibility Of The Diagnosis Of Cervicitis In Pregnancy, J. Repke, L. Berlin, M. Spence, J. Horn, Jennifer Niebyl, S. Kanchanaraksa, E. Mackenzie, R. Nugent, B. Polk
Reproducibility Of The Diagnosis Of Cervicitis In Pregnancy, J. Repke, L. Berlin, M. Spence, J. Horn, Jennifer Niebyl, S. Kanchanaraksa, E. Mackenzie, R. Nugent, B. Polk
Jennifer R Niebyl
Cervicitis has been associated with several infections of the female genital tract. Criteria have been established for making the diagnosis of cervicitis in gynecologic populations but there are no well-established criteria for diagnosing cervicitis in obstetrical populations. Because of the association of the cervicitis and sexually transmitted diseases, and because of the association of sexually transmitted diseases and adverse pregnancy outcome, the present study was undertaken in an attempt to establish criteria for the diagnosis of cervicitis in pregnancy. We also attempted to determine the reproducibility of that diagnosis with respect to intra- and interobserver variability. We concluded that intraobserver …
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.
Lack Of Maternal Metabolic, Endocrine, And Environmental Influences In The Etiology Of Cleft Lip With Or Without Cleft Palate, Jennifer Niebyl, D. Blake, L. Rocco, R. Baumgardner, E. Mellits
Lack Of Maternal Metabolic, Endocrine, And Environmental Influences In The Etiology Of Cleft Lip With Or Without Cleft Palate, Jennifer Niebyl, D. Blake, L. Rocco, R. Baumgardner, E. Mellits
Jennifer R Niebyl
We studied metabolic, endocrine, and environmental factors in 59 women who had delivered a child with cleft lip with or without cleft palate (CL +/- CP) and compared these values with those of 56 mothers of unaffected children. There was no significant difference between the two groups with respect to race, age, weight, height, education, parity, menstrual history, medical illnesses, or the use of contraceptives, tobacco, alcohol, or caffeine. All patients had a normal XX karyotype confirmed by the fluorescent banding technique. The two groups demonstrated no significant difference in test results of serum chemistries, glucose tolerance, serum or erythrocyte …
Situational And Financial Barriers To Prenatal Care In A Sample Of Low-Income, Inner-City Women, P. St Clair, V. Smeriglio, C. Alexander, F. Connell, Jennifer Niebyl
Situational And Financial Barriers To Prenatal Care In A Sample Of Low-Income, Inner-City Women, P. St Clair, V. Smeriglio, C. Alexander, F. Connell, Jennifer Niebyl
Jennifer R Niebyl
The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more …
Overview Of Nausea And Vomiting Of Pregnancy With An Emphasis On Vitamins And Ginger, Jennifer Niebyl, T. Goodwin
Overview Of Nausea And Vomiting Of Pregnancy With An Emphasis On Vitamins And Ginger, Jennifer Niebyl, T. Goodwin
Jennifer R Niebyl
Patients suffering from nausea and vomiting of pregnancy (NVP) frequently do not receive therapy, in part because of fears of adverse effects of medications on the fetus. Several vitamin-based and herbal therapies have been shown to be effective and safe. Two randomized trials of vitamin B(6) have shown a benefit in reducing NVP. Women taking periconceptional multivitamins are less likely to have severe NVP. The combination of vitamin B(6) and doxylamine (previously marketed in the United States as Bendectin) has been shown to be safe for the fetus and effective in reducing NVP. Ginger was shown, in 2 studies, to …
Abnormal Glucose Screening In Pregnancy In Patients With Normal Oral Glucose Tolerance Tests As A Screening Test For Fetal Macrosomia, F. Witter, Jennifer Niebyl
Abnormal Glucose Screening In Pregnancy In Patients With Normal Oral Glucose Tolerance Tests As A Screening Test For Fetal Macrosomia, F. Witter, Jennifer Niebyl
Jennifer R Niebyl
Minor abnormalities of carbohydrate metabolism in pregnancy are a risk factor for delivery of a macrosomic infant. However, the 50-g 1-h oral glucose screen at 28 weeks is not a useful screening test for macrosomia in pregnant patients with normal glucose tolerance tests, because a positive screen does not raise the probability of delivering a macrosomic infant sufficiently to warrant intervention.
Pregnancy Following Total Hysterectomy, Jennifer Niebyl
Pregnancy Following Total Hysterectomy, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Drugs For Acute Infection During Pregnancy Need Careful Selection, Jennifer Niebyl
Drugs For Acute Infection During Pregnancy Need Careful Selection, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Biological Properties Of A Recombinant Human Immunoglobulin Epsilon-Chain Fragment, T. Ishizaka, B. Helm, J. Hakimi, Jennifer Niebyl, K. Ishizaka, H. Gould
Biological Properties Of A Recombinant Human Immunoglobulin Epsilon-Chain Fragment, T. Ishizaka, B. Helm, J. Hakimi, Jennifer Niebyl, K. Ishizaka, H. Gould
Jennifer R Niebyl
A recombinant human immunoglobulin epsilon-chain gene expression product (rFc epsilon) was compared with a human E myeloma protein in the affinity for epsilon-chain Fc fragment receptors (Fc epsilon R) on cultured human basophils. The association-dissociation kinetics of the rFc epsilon-Fc epsilon R interaction are indistinguishable from that of E myeloma protein, indicating that rFc epsilon and IgE have identical affinity for the receptors. The recombinant gene product sensitizes cultured basophils for anti-IgE-induced histamine release. A dose-response curve of histamine release indicates that the gene product is equally efficient in transducing the signal for degranulation as the natural IgE. Both the …
Morphologic And Immunologic Characterization Of Human Basophils Developed In Cultures Of Cord Blood Mononuclear Cells, T. Ishizaka, A. Dvorak, D. Conrad, Jennifer Niebyl, J. Marquette, K. Ishizaka
Morphologic And Immunologic Characterization Of Human Basophils Developed In Cultures Of Cord Blood Mononuclear Cells, T. Ishizaka, A. Dvorak, D. Conrad, Jennifer Niebyl, J. Marquette, K. Ishizaka
Jennifer R Niebyl
Selective growth of human basophilic granulocytes was obtained in suspension cultures of mononuclear cells from umbilical cord blood. Approximately 50 to 80% of nonadherent cells recovered from 2- to 3-wk-old cultures contained metachromatic granules, and these cells were identified as human basophilic granulocytes by electron microscopy. Histamine content of cultured human basophils was comparable to that in peripheral blood basophils. Cultured basophils bear 2.7 to 3.7 X 10(5) IgE receptors per cell that bind both human IgE and rodent IgE with comparable affinity. Average equilibrium constants of the receptors for human IgE and mouse IgE were 2.56 +/- 0.88 X …
Cocaine Abuse In A High Risk Obstetrical Population, S. Keller, Jennifer Niebyl
Cocaine Abuse In A High Risk Obstetrical Population, S. Keller, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
Effect Of Proteolipid Protein On Central Nervous System Myelin Membrane Fluidity, F. Brown, J. Beck, Jennifer Niebyl, I. Singh
Effect Of Proteolipid Protein On Central Nervous System Myelin Membrane Fluidity, F. Brown, J. Beck, Jennifer Niebyl, I. Singh
Jennifer R Niebyl
The effect which intrinsic (proteolipid) protein has on fluidity of central nervous system myelin membrane was measured through differences in temperature-dependent anisotropy of the lipid-soluble fluorescence probe, 1,6-diphenyl-1,3,5-hexatriene (DPH), in multilamellar vesicles (MLV) prepared from total myelin lipids in the presence and absence of proteolipid protein. Very little difference was observed in the anisotropies of DPH incorporated into intact myelin membrane vesicles compared with MLV reconstituted from total myelin lipid plus proteolipid protein but excluding myelin basic protein. In contrast, a significant decrease (P less than 0.01) in anisotropy was observed when MLV prepared from total myelin lipids depleted of …
The Pharmaceutical Industry: Friend Or Foe?, Jennifer Niebyl
The Pharmaceutical Industry: Friend Or Foe?, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
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 …
Unilateral Ovarian Abscess Associated With The Intrauterine Device, Jennifer Niebyl, T. Parmley, M. Spence, J. Woodruff
Unilateral Ovarian Abscess Associated With The Intrauterine Device, Jennifer Niebyl, T. Parmley, M. Spence, J. Woodruff
Jennifer R Niebyl
Four cases of primary ovarian abscess associated with intrauterine contraceptive devices are presented. It is proposed that both their unilaterality and the fact that they were primary in the ovary rather than tuboovarian are due to the fact that bacteria from the intrauterine device are shed continuously through the fallopian tubes, resulting in the inoculation of the corpus luteum, a unilateral structure. Removal of the ovarian abscess without additional surgical therapy is sufficient for a patient with this type of pelvic infection.
Sporadic (Nonepidemic) Puerperal Mastitis, Jennifer Niebyl, M. Spence, T. Parmley
Sporadic (Nonepidemic) Puerperal Mastitis, Jennifer Niebyl, M. Spence, T. Parmley
Jennifer R Niebyl
Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. With early antibiotic therapy, the infection can be cleared and abscess formation prevented. Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. Twenty women with acute puerperal mastitis had breast milk cultures, and Staphylococcus aureus was recovered in seven cases. All patients were treated with antibiotics and continued nursing. No abscesses developed, and no ill effects …
Prolactin And Plasma Prostaglandin Metabolite Levels In Patients Undergoing Nipple Stimulation Contraction Stress Tests, Asha Rijhsinghani, N. Dubin, H. Zacur, T. Johnson, Jennifer Niebyl
Prolactin And Plasma Prostaglandin Metabolite Levels In Patients Undergoing Nipple Stimulation Contraction Stress Tests, Asha Rijhsinghani, N. Dubin, H. Zacur, T. Johnson, Jennifer Niebyl
Jennifer R Niebyl
Twenty-five patients undergoing nipple stimulation contraction stress tests were enrolled in this study. Plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha and plasma prolactin concentrations were analyzed before and during the contraction stress tests. Prolactin concentrations were significantly higher (p less than 0.01) in patients who responded with a successful stress test versus those who did not. No significant changes were observed in the mean concentration of plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha levels between the two groups.
Clinical Practice. Nausea And Vomiting In Pregnancy, Jennifer Niebyl
Clinical Practice. Nausea And Vomiting In Pregnancy, Jennifer Niebyl
Jennifer R Niebyl
No abstract provided.
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.
Drugs For Inhibition Of Premature Labor, Jennifer Niebyl
Drugs For Inhibition Of Premature Labor, Jennifer Niebyl
Jennifer R Niebyl
Effective inhibition of premature labor depends on prompt initiation of treatment. The author discusses factors initiating parturition, and the benefits and risks for mother and child of administration of alcohol, beta adrenergic agents, magnesium sulfate, and other agents that may counteract them.
The Association Of Anti-P And Early Abortion, R. Shirey, P. Ness, T. Kickler, J. Rock, N. Callan, W. Schlaff, Jennifer Niebyl
The Association Of Anti-P And Early Abortion, R. Shirey, P. Ness, T. Kickler, J. Rock, N. Callan, W. Schlaff, Jennifer Niebyl
Jennifer R Niebyl
The current report details the serologic findings in a case reported previously of a P1k woman, para 0 gravida 13, who was treated during her fourteenth pregnancy with plasmapheresis to reduce the anti-P titer. These studies suggest that anti-P can induce early abortion in Pk women and that the abortions are immunologically mediated. Further, this case supports the disputed proposal that the anti-P component of anti-PP1Pk is responsible for pregnancy loss in p women.
The Safety And Efficacy Of Tocolytic Agents For The Treatment Of Preterm Labor, R. Besinger, Jennifer Niebyl
The Safety And Efficacy Of Tocolytic Agents For The Treatment Of Preterm Labor, R. Besinger, Jennifer Niebyl
Jennifer R Niebyl
Pharmacologic inhibition of uterine contractions remains the mainstay of treatment for preterm labor despite the ongoing controversy regarding its effectiveness. A diverse variety of tocolytic medications have been proposed for clinical use, with betamimetics and magnesium sulfate being the common therapeutic agents of choice in the United States today. The clinician using these agents should be aware of the significant maternal and fetal side-effects associated with these particular medications. New classes of pharmacologic agents, including prostaglandin synthetase inhibitors, calcium channel blockers and phosphodiesterase inhibitors, have been proposed as tocolytic agents and are currently undergoing critical clinical evaluation. The purpose of …
Cornual Contraction Ring With Retained Placenta In Midtrimester Abortion, Jennifer Niebyl, A. Montague, A. Tapper, T. Horrigan
Cornual Contraction Ring With Retained Placenta In Midtrimester Abortion, Jennifer Niebyl, A. Montague, A. Tapper, T. Horrigan
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.
The Pharmacologic Inhibition Of Premature Labor, Jennifer Niebyl, D. Blake, J. Johnson, T. King
The Pharmacologic Inhibition Of Premature Labor, Jennifer Niebyl, D. Blake, J. Johnson, T. King
Jennifer R Niebyl
Oxytocin, elevated estrogen-progesterone ratio, fetal corticosteroids, prostaglandins, catecholamines, and changes in uterine blood flow have all been implicated as triggers of labor. In approximately one-third of cases of threatened premature labor contractions stop spontaneously. Thus placebo-controlled randomized trials of any new drug for inhibition of premature labor are necessary, as the spontaneous cessation of contractions always favors the claimed therapeutic efficacy. Alcohol inhibits the release of endogenous oxytocin and has an additional direct effect on the myometrium. In one study alcohol was more effective than placebo in the postponement of delivery. Isoxsuprine, ritodrine, and terbutaline have also been shown to …