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Biomedical subjects

C L Cetrulo

Publications and source records attributed to C L Cetrulo.

At least 55 records · Page 3Linked to original sources

A microtechnique for studying chemiluminescence response of phagocytes using whole blood and its application to the evaluation of phagocytes in pregnancy.

Previous investigators have demonstrated that polymorphonuclear neutrophils exhibit intense chemiluminescence (CL) during phagocytosis and the CL response can be used to study the cellular and humoral aspects of the phagocytic process. A microtechnique that used 10 microliters of whole blood as a source of phagocytes was developed and used to measure the phagocytic CL response during pregnancy. Increased sensitivity was achieved by the use of a high concentration of luminol (0.5 mM), prepared by sonication, as a CL amplifier. The high intensity of CL produced with luminol permitted the use of a scintillation counter in the IN coincidence mode, avoiding the necessity of dark-adapting the counting vials and reagents and working under subdued red light. The CL response was dose dependent on the number of phagocytes and/or particles (polystyrene spherules, opsonized zymosan, and E coli). The CL response was decreased by inhibitors that prevent particle uptake (iodoacetate and fluoride), inhibitors that prevent free-radical production (sodium benzoate and superoxide dismutase), and by inhibitors that inactivate myeloperoxidase (cyanide and azide). Results suggested that the phagocytic CL response in our assay system was dependent on O2 activation followed by the activated O2 species reacting with myeloperoxidase and chloride. The new technique was used to demonstrate a progressive increase with gestation in the phagocytic CL response in pregnancy and a rapid decrease to normal values at 1 week postpartum.

Female↗

Premature rupture of the membranes at term. A comparison of induced and spontaneous labors.

Analysis of 150 patients at term (greater than 36 weeks) with premature rupture of the membranes (PROM) was made. In the group followed conservatively, 87.5% (98 of 112) began labor within 48 hours, and only 3.6% (4 of 112) had a latent period of greater than seven days. The incidence of cesarean section in patients with induced and spontaneous labors was compared in corrected groups. The induced group had a 39% (15 of 38) cesarean section rate as compared to 12% (11 of 91) in the spontaneous labor group (p = less than 0.01). None of the patients in the study showed signs of sepsis by central cultures, and only 12.7% (19 of 150) showed febrile morbidity. A conservative approach to term patients with PROM and an unfavorable cervix for induction seems to decrease the incidence of cesarean section.

Cesarean Section↗

Survival of infants born at 24 to 28 weeks' gestation.

Factors affecting the survival of 136 consecutive live-born infants delivered at 24 to 28 weeks' gestation during a 4-year period were analyzed. After careful assessment of gestational age, perinatal care for the fetus of at least 26 weeks' gestation was aggressive. Survival at 26 weeks was 45% and at 28 weeks, 92%. Multivariate analysis showed that the set of variables that best predicts neonatal outcome is gestational age, antepartum glucocorticoid administration, and resuscitation at birth.

Birth Weight↗

The effect of cervical/vaginal secretions on measurements of lecithin/sphingomyelin ratio and optical density at 650 nm.

Free-flowing amniotic fluid collected vaginally can be used in a reliable way for determination of fetal pulmonary maturity. Lavaging the vaginal/cervical area with sterile saline and examining the lavage fluid for lecithin/sphingomyelin (L/S) spots showed no detectable spots in the supernatants (one exception) and barely detectable L/S spots in the sediment. Vaginal-cervical saline-wash fluids did not affect fluid L/S ratios. Lavaging the vaginal-cervical area with abdominal amniotic fluid did not affect the L/S ratio of the original amniotic fluid.

Amniotic Fluid↗

Quantitative transcervical uterine cultures with a new device.

This study was initiated to examine the ability of a new device to take transcervical cultures of the endometrial cavity in the normal and postpartum uterus. Quantitative bacteriologic assessments were made. The results show there is a millionfold increase in the mean concentration of bacteria cultured from the infected puerperal uterus when contrasted with cultures from nonpregnant women and those who have just undergone repeat cesarean section. The authors conclude that the new device obtains cultures transcervically with marked reduction in contamination; however, some method for quantification of bacterial populations must complement the culture so that results differentiate between colonization and infection.

Bacteriological Techniques↗

Management of multiple gestation.

The following perinatal intensive care management protocol is suggested to minimize morbidity and mortality in multiple pregnancy. 1. Early diagnosis is essential, with ultrasound examination regarding as invaluable for all pregnant patients. If ultrasound examination has not been done, multiple pregnancy should be suspected in all patients who have a family history of dizygotic births, are large for dates or anemic, or have a low-grade preeclampsia. 2. Maternal care should be provided at a tertiary care (level III) perinatatl center, which is more fully equipped to manage multiple gestation. 3. Bed rest, if instituted early enough (26-29 weeks) appears to be of value, especially in promoting increased birth weight. 4. A liberal approach to performing cesarean birth is suggested when any abnormal presentation exists. 5. Aggressive management, using tocolytic agents to delay premature labor and steroids to accelerate pulmonary maturity, should be strongly considered. 6. The personnel of a neonatal intensive care unit should employ a team approach to the preparation for and management of multiple preterm births.

Bed Rest↗

Amniotic fluid optical density and neonatal respiratory outcome.

A simple, rapid, economical, and accurate test to assess fetal pulmonary maturity on a 24-hour basis, 7 days a week, is urgently needed. A 15-minute test has been developed that correlates well with fetal pulmonary maturity. Optical density (OD) readings at 650 nm of greater than or equal to 0.15 in pigment-free, centrifuged (2000 Xg, 10 minutes) amniotic fluids obtained from gestations of 33 to 42 weeks correlate with fetal pulmonary maturity (131 of 131, 100%). When OD readings are less than 0.15 in fluids from gestations of 24 to 40 weeks, and antepartum steroids are utilized, the incidence of respiratory distress syndrome (RDS) is 8.3% (14 of 169). The true false-negative rate in this group is therefore unknown.

Amniotic Fluid↗

Prognostic components of the nonreactive nonstress test.

From January 1976 to November 1978, 2592 nonstress tests were performed at the authors' institution on 862 fetuses, of which 2239 (86.3%) had reactive and 353 (13.6%) had nonreactive results. Of these 862 fetuses, 842 were delivered at the authors' hospital. Of these 842 fetuses, 109 were delivered within 1 week of a nonreactive tracing and 733 were delivered within 1 week of a reactive tracing. A retrospective analysis was performed on 102 of the nonreative tracings done within 1 week of delivery to assess the significance of various components of the nonstress test on the subsequent stress test and perinatal outcome. No significant difference could be observed in the number of fetal movements and total number of accelerations as compared with the subsequent stress test. However, the nonreactive tracings of the contraction stress test (CST)-positive group differed from those of the CST-negative groups in number of accelerations over 15 beats per minute (38% versus 48%) (P < .05) and in the number of accelerations lasting longer than 20 seconds (20% versus 50%) (P < .01). The number of nonreactive fetal movements per test (2.6 versus 0.96) (P < .05) and the percentage of nonreactive fetal movements (33% versus 15%) (P < .01) were different in both groups. The growth-retarded fetus in the nonreactive group did not differ in the number of fetal movements or total accelertions when compared to fetuses born appropriate for gestational age, but the number of accelerations was more than 15 beats per minute (26% versus 50%) (P < .01) and the number of accelerations lasting 20 seconds (11% versus 28%) (P < .01) did differ significantly.

Delivery, Obstetric↗

Premature rupture of the membranes: a conservative approach.

A conservative approach was followed in 188 patients with premature rupture of the membranes (PROM) over a 2 year period. There were no neonatal deaths from sepsis, and only one infant showed a positive central bacteriologic culture. Fifty-seven percent of all patients less than 37 weeks' gestation had a latent period of 24 hours and 19% went beyond 7 days before labor began. Patients less than 34 weeks' gestation who received antepartum steroids for lung maturation showed no increased infectious morbidity or mortality. A conservative approach to patients with PROM seems reasonable when either prematurity and/or a cervix unfavorable for induction further complicates the pregnancy.

Delivery, Obstetric↗

24-hour urine creatinine excretion in pregnancy.

A total of 489 consecutive 24-hour urine collection from 162 patients were analyzed for creatinine excretion. The 24-hour creatinine excretion increased with the urine volume. Creatinine excretions in 24-hour urine collections were not statistically different between in- and out-patients. The results indicate that the mean urine creatinine per 24 hours is 1.08 g for 24-hour urine volumes between 500 and 1500 ml. For urine volumes greater than 1500 ml it is 1.22 g. For 24-hour urine volumes less than 500 ml, the mean creatinine is 0.63 g.

Creatinine↗

Positive correlation of optical density at 650 nm. with lecithin/sphingomyelin ratios in amniotic fluid.

In this study, we have attempted to correlate optical density measurements of amniotic fluids with L/S ratios. We may conclude, with over a 98 per cent accuracy, that fluids having optical density readings of 0.15 and above, at 650 nm. will have an L/S ratio over 2.0. Fluids having optical density readings up to 0.05 will have L/S ratios of about 1.3. Finally, amniotic fluids having optical densities greater than 0.05 and less than 0.15 will have L/S ratios of approximately 1.5.

Amniotic Fluid↗