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Biomedical subjects

F Guidozzi

Publications and source records attributed to F Guidozzi.

At least 37 records · Page 2Linked to original sources
PubMed1994

46,XY pure gonadal dysgenesis (Swyer-James syndrome)--Y or Y not?: a review.

The designation "pure gonadal dysgenesis" is applied to a particular variety of defective organo-genesis, in which phenotypically female patients with a 46,XY karyotype have complete lack of functioning gonadal tissue. The latter are represented anatomically by the presence of bilateral, elongated, nonfunctioning, rudimentary "streak" gonads composed of fibrous tissue, although normal female internal genitalia are present. The purpose of this review is to present the existing literature accumulated from 1955 to 1992 pertaining to 46,XY pure gonadal dysgenesis (Swyer-James syndrome), add the findings of a personally observed patient, and highlight the complexities in attempting to determine the etiology of this rare condition.

Adult↗
PubMed1994

Human B19 parvovirus infection in an obstetric population. A prospective study determining fetal outcome.

In a prospective study of 1,967 pregnant women who were routinely screened for recent human B19 parvovirus infection, 64 (3.3%) were identified as being IgM positive. No adverse effects were documented by ultrasound in any of the fetuses. The outcome of pregnancy was favorable in 95.1% of these women, with no evidence of hydrops fetalis or any congenital abnormalities. Two neonates (3.4%) were small for gestational age, and there was one abortion. Samples of blood obtained from 20 neonates born to women with evidence of recent infection were B19 parvovirus IgM negative. Recent infection with human B19 parvovirus in pregnancy constitutes a low risk for the development of adverse fetal effects; hence, routine antenatal screening is not warranted.

Antibodies, Viral↗
PubMed1993

Ovarian cancer with metastatic deposits in the cervix, vagina, or vulva preceding primary cytoreductive surgery.

Ovarian cancer rarely metastasizes to the uterine cervix, vagina, or vulva. Equally important is the rarity of the disease in these sites at initial presentation. In a review of 148 patients with FIGO Stage III or IV ovarian cancer, 7 patients had cervical metastatic deposits. Four were due to direct extension of the primary; the 3 patients who had truly metastatic deposits all presented with cervical cytology showing the presence of adenocarcinoma cells. All the patients with cervical metastases had associated malignant ascites, retroperitoneal lymph node involvement, and significant peritoneal carcinomatosis. Their median survival was 4.4 months. There was no significant difference in survival between the patients who had truly metastatic deposits compared with those in whom the cervical disease was due to direct extension of the ovarian cancer. One patient presented with a vaginal secondary deposit 11 months prior to definitive diagnosis, and 1 had a vulval metastasis at initial examination. The patient with the vaginal deposit is still alive with no clinically detectable disease 27 months after initial presentation, while the patient with the vulval deposit had significant distant metastases at the time of presentation and died preoperatively.

Aged↗
PubMed1993

Living with ovarian cancer.

A structured questionnaire consisting of two parts was used to evaluate the impact of ovarian cancer and its management on quality of life in 28 patients with advanced disease. The first part rated their perceptions of behavioral disruption and emotional distress in five life areas, i.e., activity, daily living, health, support, and outlook as set out by the interviewer-rated Spitzer questionnaire "Quality of Life Index of Cancer Patients." The second part rated their response in the domain of sexual activity. Data were collected prospectively at three monthly intervals during the 2-year descriptive study. In 12 patients ovarian cancer persisted despite surgery and chemotherapy resulting in the demise of 8 women within 2 years. During the first year of study these patients described a similar deterioration in quality of life as those who had a complete response to treatment. However, after 1 year, patients with persistent disease rated their quality of life much lower. Diagnosis of persistent disease after conventional treatment proved more stressful than the diagnosis of the primary disease. Treatment of ovarian cancer will produce behavioral disruption and emotional distress, with lasting affects seen even in patients with complete response 2 years after commencing therapy.

Adult↗
PubMed1993

Is antenatal screening for rubella and cytomegalovirus justified?

Altogether 2,250 asymptomatic pregnant women attending an antenatal clinic were investigated for serological evidence of past exposure to rubella and cytomegalovirus (CMV) as well as for active primary infection or reinfection/reactivation. Only 7 (0.3%) active rubella infections were diagnosed, none of them primary. Similarly, out of 132 patients with active CMV, only 5 primary infections (3.8%) were diagnosed; the vast majority--127 (96%)--had reactivation infections. No congenital rubella infections were detected, while the transplacental transmission rate for CMV was 6.4%. None of the infants followed up was clinically affected at birth or at 6 months. No racial differences in seroprevalences for CMV or rubella immunoglobulin were observed, but immunoglobulin antibody prevalence to CMV was significantly lower in the white group. From this study there appeared to be no indication for routine antenatal screening for CMV in asymptomatic mothers.

Carrier State↗
PubMed1993

Should pregnant urban south African women be screened for hepatitis B?

The prevalence of hepatitis B virus (HBV) infection in the South African urban obstetric population, which consists of white, black, coloured and Asian patients from different socio-economic, cultural and geographical backgrounds, is unknown. Routine screening performed in 3,469 urban pregnant women revealed that 42 patients were HBV surface antigen-positive (a prevalence of 1.21%). Only 2 patients (4.6%) were hepatitis B e antigen (HBeAg)-positive (0.06% of the entire cohort), whereas the remaining 40 were identified as hepatitis B e antibody-positive. Despite a significant increase in the numbers of black patients, there has not been an accompanying increase in the number of HBV carriers. Replicative infection was equally distributed among white and black pregnant women. Because the low prevalence of HBeAg results in lack of perinatal transmission and the prevention of a single case of neonatal hepatitis B infection is costly, we conclude that in South African urban hospitals, routine screening for hepatitis B is not cost-effective.

Carrier State↗
PubMed1992

The obstetrician's dilemma during delivery of the very-low-birth-weight infant.

Delivery of the premature infant weighing less than 1,500 g poses a significant dilemma for the obstetrician. First-discharge survival of 218 very-low-birth-weight infants was retrospectively analysed and the survival rate of infants with a birth weight of less than 800 g was found to be only 15%. If the birth-weight of the infant was between 800 g and 999 g or 1,000 g and 1,500 g, the survival rates were 49% and 84%, respectively. Although first-discharge survival is not the optimal end-point of fetal outcome, estimating the gestational weight before delivery will give the obstetrician an indication of potential survival when dealing with very-low-birth-weight infants. This knowledge is especially pertinent to the obstetrician when the decision whether or not to achieve a survivor at all costs has to be made.

Delivery, Obstetric↗
PubMed1992

The effect of continuous low-dose epidural analgesia on uterine work during the active phase of the first stage of labour.

Fifty-six patients admitted to hospital in normal spontaneous labour were given a continuous epidural infusion of 10 ml (12.5 mg) of 0.125% bupivacaine during the 1st stage of labour. Uterine contractions were monitored with an intra-uterine pressure transducer and uterine work expressed both in Alexandria units and the area under the curve of the intra-uterine pressure recording summated over 15 minutes. Variables that have been shown to affect uterine contractions were strictly excluded. Our study showed that continuous low-dose epidural analgesia had no significant effect on uterine work during the active phase of the 1st stage of labour when cervical dilatation was 5 cm or more. If cervical dilatation was between 3 and 4 cm there was a 2.9% reduction. This reduction in uterine work was also not significant and in all patients spontaneously returned to its previous level within 91 minutes.

Adolescent↗
PubMed1992

Salivary calcium, magnesium, phosphate, chloride, sodium and potassium in pregnancy and labour.

Pregnancy and labour produce significant changes in salivary calcium, magnesium, phosphate and chloride when pregnant patients in labour are compared with non-pregnant patients. There is a decrease in concentration of these constituents in the 3rd trimester of pregnancy followed by a marked increase when labour occurs. Magnesium and chloride are the constituents most significantly affected and show the largest increase during labour. Changes in saliva flow rate were accounted for and are not responsible for these changes noted. Sodium and potassium follow a similar pattern. When their levels are corrected for saliva flow rate changes, both show a significant increase with the onset of labour.

Adult↗
PubMed1992

Major complications associated with extra-amniotic prostaglandin F2 alpha termination of the mid-trimester pregnancy.

Extra-amniotic prostaglandin F2 alpha (PGF2 alpha) termination of mid-trimester pregnancy can be associated with serious complications, defined for the purposes of this study as unintended major surgery or death as a result of the termination. A retrospective study of 319 such mid-trimester terminations at Johannesburg hospital revealed that 3 patients required hysterectomy, 1 developed a large tear of the posterior cervix and 1 died suddenly during the procedure. We are therefore considering changing our methods for second-trimester terminations.

Abortion, Induced↗
PubMed1991

Evaluation of preoperative investigations in patients admitted for ovarian primary cytoreductive surgery.

Consistent with universally established practice, it has been customary in our unit to subject patients with clinically suspected or biopsy proven ovarian cancer to a large number of preoperative investigations. This is in order to determine metastases, surgical strategy, and exclusion of pelvic kidney. This study presents a comparison of the preoperative ultrasonography, computerized tomography, intravenous pyelography, chest X-ray, liver and bone scintigraphy, and barium enema results performed in 100 cases with the operative findings. These investigations were found to have marginal value in determining extent of disease, upper gastrointestinal metastatic deposits, and the need for or extent of bowel resection. It is concluded that such a standard workup, which is time-consuming and distressing for an already anxious patient, is not cost effective for a surgical procedure which is ultimately determined at laparotomy.

Enema↗
PubMed1991

Three cycles of chemotherapy followed by primary cytoreductive surgery for unresectable ovarian cancer.

Definitive primary cytoreductive surgery was achieved at second laparotomy after three cycles of combination chemotherapy (cisplatin and cyclophosphamide) in three patients who presented with unresectable disease at our Ovarian Tumor Unit. The ovarian cancer was inoperable at the first laparotomy and no surgical procedure was performed other than biopsy of malignant tumor to confirm the diagnosis. Following interventional surgical cytoreduction the patients were given a further six courses of combination chemotherapy and then maintained for a further six cycles on oral chlorambucil. Two patients are disease free at 17 and 21 months, respectively, while the other patient has cytological evidence of malignancy but no other clinically detectable tumor deposits at 27 months.

Adult↗
PubMed1991

The tap test--a rapid bedside indicator of fetal lung maturity.

The reliability of two rapid bedside tests of fetal lung maturity was investigated in 80 amniotic fluid samples. The results of the 'tap' test and those of the shake test were compared with the results of laboratory measurements of phospholipid profiles for fetal lung maturity. The tap test was found to be more reliable with a positive predictive value of 91% and a negative predictive value of 63%, whereas the shake test had a positive predictive value of 79% and a negative predictive value of 31%. The tap test was also more reliable in identifying fetuses with borderline lecithin/sphingomyelin ratios in the range 3.2-3.7:1.

Amniotic Fluid↗
PubMed1991

Takayasu's arteritis in a pregnant woman. A case report.

Takayasu's arteritis in a pregnant white patient is described. This case highlights the fact that, irrespective of race, any patient who presents for the first time in pregnancy with pulseless hypertensive disease or other features suggestive of Takayasu's arteritis, should have their management in labour determined by the number of complications that are present. These are retinopathy, arterial aneurysms, hypertension and aortic regurgitation. These prognostic criteria will result in a classification of patients that will lead to appropriate management.

Adult↗
PubMed1990

Neonatal allo-immune thrombocytopenia. A case report and review of obstetric management.

The prime object in the obstetric management of mothers who have previously delivered an infant with neonatal alloimmune thrombocytopenia is to prevent the occurrence of intracranial haemorrhage, which may occur in subsequent pregnancies in 15-20% of infants with this disease. Elective caesarean section at 38 weeks' gestation may obviate the problem, since it prevents trauma during vaginal delivery but it will not eliminate neurological sequelae in those infants who have already suffered antenatal intracranial bleeding, an entity now well described in these fetuses. A review is presented in which all possible antenatal and post-natal modalities of treatment in the management of these cases are highlighted.

Adult↗
PubMed1990

Fanconi's anaemia in pregnancy. A case report.

Fanconi's anaemia associated with congenital anomalies is a rare aplastic anaemia occurring in childhood. No case of pregnancy occurring in the presence of this condition has previously been reported. The outcome of pregnancy in a patient with Fanconi's anaemia is described and guidelines for management of the disease in pregnancy suggested.

Adult↗