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Biomedical subjects

H N Nguyen

Publications and source records attributed to H N Nguyen.

At least 91 records · Page 5Linked to original sources
PubMed1991

The impact of National Health Service Corps physicians in the lowering perinatal mortality rate in Dade County, Florida.

In some parts of Dade County, Florida, perinatal mortality rates have revealed serious problems in the delivery of health care to poor pregnant women. From 1982-1985, the reported perinatal mortality rates varied from 32-36 per 1000 live births, more than double the national average. Under the leadership of the Primary Health Care Consortium of Dade County (a federation of community health centers and other primary care providers), National Health Service Corps obstetricians and pediatricians served inner-city, medically needy patients as part of a coordinated perinatal plan from 1987-1989. Data on fetal and neonatal deaths, collected from census tracts adjacent to the community health centers, were used to study the impact of Corps obstetrician and pediatrician placement. The respective perinatal mortality rates were compared with those of 1986 as historic controls. Within a year, the overall perinatal mortality rate was reduced by 45%. As a result, an estimated 320 lives were saved between 1987-1989. This public health achievement represents a measurable impact due to assignment of National Health Service Corps physicians and can be used as a working model to reduce perinatal mortality in medically underserved communities in the United States.

Evaluation Studies as Topic↗
PubMed1988

Biologic effects of equilin sulfate in postmenopausal women.

In order to determine the relative potency of equilin sulfate (EqS), a major constituent of conjugated equine estrogens, 15 women received oral doses of EqS (0.15, 0.31, and 0.625 mg) for 25 days. Doses of 0.31 and 0.625 mg significantly stimulated hepatic globulins. This stimulatory effect ranged from being 1.5 to 8 times greater than the effects of comparable doses of estrone sulfate and conjugated equine estrogens. A significant stimulation in high-density lipoprotein-cholesterol occurred with as little as 0.15 mg of EqS. Elevations in the high-density lipoprotein/low-density lipoprotein-cholesterol ratio occurred with EqS, which resulted in an approximately 4-fold greater response than that achieved with comparable doses of conjugated equine estrogens. The fasting urinary calcium/creatinine ratio was only significantly lowered with 0.625 mg of EqS and was less potent than conjugated equine estrogens in this regard. It is concluded that EqS is a potent estrogen that contributes significantly to the hepatic stimulatory effects of conjugated equine estrogens. These data also provide support for the suggestion that there may be a dissociation in potency between estrogenic effects on liver and bone.

17-Ketosteroids↗
PubMed1988

Continuing experience with the fetal acoustic stimulation test.

Antepartum fetal heart rate testing remains a useful method with which to assess fetal well-being in high-risk pregnancies. Recently the adjunctive use of transabdominal acoustic stimulation was proven effective in reducing the number of nonreactive nonstress tests (NSTs) without changing the predictive reliability of the test. Our continuing experience with this method involved 1,503 women undergoing 3,935 tests. A reactive test occurred in 93%, and the fetal death rate was 1.3/1,000. In an attempt to evaluate the incidence of mortality in a large population, data from the current investigation were pooled with those from other reports from our institution. In our aggregate experience of 7,763 tests, fetal death occurred within seven days of a reactive test with an incidence of 1.9/1,000 in patients receiving acoustic stimulation. This finding contrasts favorably with a death rate of 1.6/1,000 in fetuses with spontaneous reactivity. Fetal acoustic stimulation testing seems to offer advantages over the more traditional NST, and the predictive values of normal tests seem to be equivalent.

Acoustic Stimulation↗
PubMed1987

Fetal death following antepartum fetal heart rate testing: a review of 65 cases.

The nonstress test (NST) remains in widespread use for antepartum fetal surveillance. Our institutional experience with 14,028 patients and 38,645 tests over eight years reveals a fetal death rate of 2.6 per 1000 within seven days of a reactive NST. The autopsy findings of 53 fetal deaths are presented. The most common findings, in descending order of frequency, were meconium aspiration, perinatal infection, and abnormal umbilical cord position. These findings support changes we have made in our antepartum assessment protocols.

Female↗
PubMed1986

Intrapartum assessment of fetal well-being: a comparison of fetal acoustic stimulation with acid-base determinations.

Many authorities advocate the use of fetal blood sampling as the final arbiter of abnormal intrapartum fetal heart rate patterns. Alternatively, the presence of an acceleratory fetal heart rate response to scalp stimulation during fetal scalp blood sampling led to the observation that, if present, the likelihood of acidosis was remote. Consequently a prospective intrapartum analysis of evoked accelerations and fetal acid-base status was undertaken. Patients who, on the basis of abnormal fetal heart rate patterns, were judged candidates for acid-base assessment underwent transabdominal acoustic stimulation. The presence or absence of an acceleration was then determined. Sixty-four patients with abnormal intrapartum fetal heart rate patterns underwent intrapartum acoustic stimulation. Thirty fetuses were reactive and all had a pH of greater than or equal to 7.25. Of the 34 fetuses who were nonreactive, 18 were acidotic. This preliminary observation suggests that acoustic stimulation may be a reasonable clinical alternative to fetal blood sampling when a reactive pattern is observed. In the nonreactive fetuses additional evaluation would appear warranted.

Acid-Base Equilibrium↗
PubMed1986

Peripartum colloid osmotic pressures: correlation with serum proteins.

Colloid osmotic pressure is a principal regulator of capillary fluid exchange. Alterations in colloid osmotic pressure in preeclamptic patients, as well as significant peripartum changes in colloid osmotic pressure in normotensive patients, are reported. In a study of 72 normotensive and preeclamptic patients, peripartum colloid osmotic pressure, serum albumin, and total serum protein were compared. Both groups exhibited significantly lower colloid osmotic pressure in the postpartum period than that measured antepartum. The mean antepartum colloid osmotic pressure in preeclamptic patients was significantly lower than in normotensive subjects. Regression equations were calculated [colloid osmotic pressure = 5.21 (total serum protein) -11.4 (r2 = 0.851)] and [colloid osmotic pressure = 8.1 (serum albumin) -8.2 (r2 = 0.891)]. Within the physiologic ranges most commonly reported for normotensive and preeclamptic patients, the use of these equations allowed calculation of colloid osmotic pressure to within 10% of measured values in 75 and 80% of the cases, respectively. Where direct measurement of colloid osmotic pressure is not readily available, calculated values may be helpful in patient management.

Adolescent↗
PubMed1985

In vitro covalent binding of cismethrin, bioresmethrin, and their common alcohol to hepatic proteins.

When [14C]Alcohol-labeled cismethrin, bioresmethrin, and 5-benzyl-3-furylmethyl alcohol (BFA) were incubated with rat liver S 9 homogenates or microsomes, a proportion of the radioactive compounds was covalently bound to proteins. The covalent binding was greater with phenobarbital-pretreated rats, and dependent on a NADPH-generating system. When a S 9 homogenate was used, the bound compounds were twofold higher for cismethrin than for bioresmethrin and BFA. Inversely, when microsomes were used more covalent binding occurred with bioresmethrin and BFA than with cismethrin. The inhibition of esterases by tetraethyl pyrophosphate (TEPP) in a S 9 homogenate did not alter the amount of covalent binding to the three compounds whereas malathion inhibited this binding. Treatment of a S 9 homogenate with piperonyl butoxide, however, greatly reduced covalent binding. Covalent binding was inhibited when the microsomes were incubated with carbon monoxide or modified by thermal denaturation. It is suggested that oxidative metabolism was responsible for the covalent binding.

Animals↗
PubMed1980

Radioimmunoassay for colchicine: synthesis and properties of three haptens.

For the development of radioimmunoassay procedures for colchicine, three haptens, N-ethylamino-colchiceinamide, 4-formylchochicine - (O-carboxymethyl) oxime and 4-hydroxymethylcolchicine O-hemisuccinic acid were synthetized and characterized by mass and proton magnetic resonance spectrometries. The conjugates obtained by coupling the haptens to bovine serum albumin were employed to immunize rabbits and goats.

Animals↗
PubMedDate not supplied

Biology of cervical carcinoma.

Cervical cancer is generally a locoregional disease. The endopelvic fascia envelops the cervix in anterior-posterior fashion and serves as a natural barrier. Thus, cervical cancer preferentially grows to the parametria and involves the ureters before it infiltrates the bladder or rectum. Disease stage, grade, cell type, tumor volume, depth of stromal invasion, vascular space invasion, and lymph node status are common prognostic indicators. Irregular vaginal bleeding and discharge are the two most frequent complaints. Although cervical cancer is still staged clinically, data continue to accumulate favoring a conversion to surgical staging to improve accuracy and treatment outcome.

Female↗
PubMedDate not supplied

The Bethesda system and evaluation of abnormal pap smears.

The Bethesda Pap Smear system and its 1991 revisions aim to simplify Papanicolaou (Pap) smear reporting and make it more reproducible. It redefines the Pap smear request as a medical consultation. The pathologist consultant is required not only to provide the smear reading but also its clinical recommendation. The Bethesda system insists on a detailed Pap smear report assessing specimen adequacy and types of epithelial changes. Squamous cell abnormalities are grouped according to their biologic potential. Both cervical intraepithelial neoplasia, grade I (CIN I) (mild dysplasia) and human papillomavirus (HPV) lesions are grouped together as low-grade squamous intraepithelial lesions (LGSIL), while moderate and severe dysplasia (CIN II and III) belong to the high-grade squamous intraepithelial lesion (HGSIL) category. Atypical squamous cells of undetermined significance (ASCUS) and atypical glandular cells of undetermined significance (AGCUS) need further qualification as to whether they favor either a reactive or neoplastic process. Guidelines for management of abnormal Pap smears are discussed in detail.

Female↗