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Biomedical subjects

D Acker

Publications and source records attributed to D Acker.

30 records · Page 2Linked to original sources
PubMed1982

The effects of vaginal contamination on two pulmonary phospholipid assays.

During the examination to confirm premature rupture of membranes, amniotic fluid unavoidably contaminated with cervical mucus and other vaginal debris can often be obtained from the posterior fornix. This study was undertaken to determine the validity of phospholipid measurements on contaminated amniotic fluid. Fifteen paired amniocentesis and vaginally contaminated samples of amniotic fluid were used to measure the lecithin/sphingomyelin ratio and saturated phosphatidylcholine (SPC). The amniocentesis specimens had a mean L/S ratio of 3.94 +/- 0.22 (mean +/- SEM), and contaminated samples had a mean L/S ratio of 3.82 +/- 0.29 (mean +/- SEM). Paired t-test was unable to demonstrate a significant difference (p greater than 0.10), and the correlation coefficient between paired L/S samples was r = 0.79. SPC measurements on the amniocentesis fluid had a mean value of 1,243 microgram/DL +/- 217 (mean +/- SEM) as compared to the contaminated-specimen mean of 1.375 micrograms/dl 223 (mean +/- SEM). Paired t-test likewise was unable to demonstrate a significant difference (p greater than 0.10), and the correlation coefficient between paired SPC samples was r = 0.93. Within the design of this study, we were unable to demonstrate a statistically significant effect of brief vaginal contamination on the measurement of the L/S ratio or SPC.

Amniocentesis↗
PubMed1981

Diabetic nephropathy and perinatal outcome.

We studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, and infant development and determined the influence of pregnancy on maternal hypertension and renal function. Maternal proteinuria usually increased during pregnancy (greater than 3 gm/24 hours in 69%), and hypertension was present by the third trimester in 73%. The degree of proteinuria correlated with diastolic pressure and creatinine clearance. After pregnancy, proteinuria declined in 65% of the mothers, hypertension was absent in 43.5%, and the expected rate of fall in creatinine clearance was not accelerated. Among 35 patients, abortion occurred spontaneously or was performed electively in 25.7%, and 71% of the remainder underwent delivery before 37 weeks. Birth weight was related to maternal blood pressure and creatinine clearance. Neonatal morbidity was common, but the perinatal survival rate was 89%. Infants seen at follow-up without congenital anomalies had normal development at 8 to 36 months of age. We concluded that perinatal outcome has significantly improved for diabetic women with nephropathy.

Adult↗
PubMed1980

Ultrasound-facilitated intrauterine transfusions.

Ultrasound-facilitated intrauterine transfusion was performed on 35 fetuses. Eleven fetuses were hydropic and less than 26 weeks' gestation at the time of the first intrauterine transfusion (IUT). Only two (18%) neonates survived. Twelve fetuses were not hydropic and less than 26 weeks' gestation at time of IUT. Six (50%) neonates survived. Corrected neonatal survival rates for three hydropic and nine nonhydropic fetuses transfused after 26 weeks were 100% and 78%, respectively. The presence of ascites documented by ultrasound is an adequate indication for an IUT and permitted earlier detection of sicker fetuses; however, as a therapeutic aid, ultrasound neither diminished the fetal morbidity and mortality associated with the procedure nor completely eliminated the need for radiography to confirm proper intra-abdominal localization of the transfusion tubing.

Ascites↗
PubMed1980

Pregnancy complicated by the Kasabach-Merritt syndrome.

The Kasabach-Merritt syndrome is the association of cavernous hemangiomas and consumption coagulopathy marked by anemia, thrombocytopenia, and hypofibronigenemia. Exacerbation of the consumption coagulopathy has been described in the 2 previous reports of this syndrome when associated with pregnancy. The authors report a third patient whose delivery and postopartum course were marked by increased coagulation abnormalities and subsequent hemorrhage. This patient's 32-day hospital course and need for multiple blood transfusions, clotting factors, platelets, heparin, and finally epsilon-aminocaproic acid underscore the need for patients with this syndrome to deliver in a referral center hospital where replacement therapy and hematologic consultation are readily available.

Adult↗
PubMed1976

Regionalization of a birth defects prevention clinic.

Screening programs to detect the carrier state of Tay-Sachs disease have been established in many large urban areas. A regionalized program has been established in the middle-Tennessee area to permit smaller communities to benefit from such programs. The numerical and psychosocial results of this program are discussed. The general concept of regionalization of health care delivery as related to birth defects screening programs is presented. Through such regionalized programs, obstetricians may be provided with new information concerning diagnostic and screening tests for genetic diseases.

Amniocentesis↗
PubMedDate not supplied

[Value of stabilization of the tarsus in certain pseudo-vascular predominantly anterolateral leg pains].

The authors have studied 18 cases of patients presenting podiatric disorders as well as a moderate varicose or lymphatic involvement. The functional symptomatology, dominated by antero-lateral leg pain, was important enough to disturb professional or leisure activities. By preferring the study of walking abnormalities (varus effect, dominant varus or equal varus-valgus instability) and the search for an elective involvement of the lateral peroneus brevis, an accurate podiatric diagnosis was made along with its ensuing therapy: adequate fitting of shoes and prescription of well adjusted ortheses which correct a dynamic hollow foot. With this treatment, the functional disorders were regularly improved or they disappeared. This result could not have been obtained by treating only the vascular impairment, which was treated conjointly in function of its own indications which do not appear to be modified by the podiatric evaluation.

Adolescent↗