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Biomedical subjects

Joseph Apuzzio

Publications and source records attributed to Joseph Apuzzio.

8 recordsLinked to original sources

Is testing for cytomegalovirus and cystic fibrosis indicated in members of a nonwhite pregnant population in whom the fetus has an echogenic bowel?

The purpose of this study was to determine whether testing for cystic fibrosis (CF) and cytomegalovirus (CMV) infection is necessary in African-American and Hispanic gravidas in whom the fetus had an echogenic bowel. This retrospective study consisted of only African American and Hispanic patients in whom the fetus had an echogenic bowel, referred to the Maternal and Fetal Medicine unit at New Jersey Medical School for a specialized ultrasound, between June 30, 2004, and March 31, 2005. Sixty-five patients met the inclusion criteria for our study. Maternal serum testing for CF was done in 32 patients and all newborns were screened for the disease. There were no positive results for CF. CMV serology was tested in 38 patients and there were no cases of acute congenital CMV infection. In our population of 65 patients, there was one intrauterine growth restricted (IUGR) fetus and five intrauterine fetal demise (IUFD). Although all patients who were tested for CMV infection tested negative, the true incidence in our selected population may be underestimated because some of our patients were not tested. There were no cases of congenital CMV infection and all newborn screening tests for CF were negative. Prenatal diagnosis of fetal echogenic bowel was associated with a 7.6% incidence of IUFD and 1.6% incidence of IUGR.

Adult↗

Intravenous methotrexate for treatment of interstitial pregnancy: a case report.

BACKGROUND: Ectopic pregnancy is the leading cause of first-trimester maternal death, accounting for 9% of pregnancy-related deaths. Interstitial (cornual) pregnancies represent 6% of all ectopics but account for a disproportionately higher mortality rate. Surgical management has been the treatment of choice for interstitial pregnancies. A very limited number of articles pre have explored the use of intravenous methotrexate to treat cornual pregnancy as a possible conservative first-line therapy in selected, hemodynamically stable patients. CASE: A patient with a confirmed interstitial pregnancy was treated with intravenous methotrexate. The patient's beta-hCG levels decreased to zero within 9 weeks. CONCLUSION: Intravenous methotrexate was used successfully in the treatment of an interstitial pregnancy without complications.

Abortifacient Agents, Nonsteroidal↗

Parvovirus B-19 infection during pregnancy.

The development of an acute parvovirus B-19 infection during pregnancy can cause pregnancy complications ranging from early pregnancy loss to nonimmune hydrops. There is no treatment, but preventive measures can be used to decrease perinatal mortality. The diagnosis is made on the basis of clinical suspicion and serology. If the fetus exhibits hydrops in the latter part of pregnancy, the main treatment options include either correcting the associated anemia with intrauterine blood transfusion or birth with extrauterine management. Although the serious problems associated with this virus during pregnancy are uncommon, they can be fatal. In view of this, a pregnant woman who is antibody negative should try to avoid contact with large groups of young children in order to decrease contact with potential vectors.

Adolescent↗

Risk factors for hepatitis C infection among sexually transmitted disease-infected, inner city obstetric patients.

OBJECTIVE: To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups. METHODS: All patients in our prenatal clinic (July 1997-April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed. RESULTS: A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7-13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p = 0.006). Multiple logistic regression analysis confirmed only older age (p = 0.0 16) and positive HIV status (p = 0.023) to be significant predictors of hepatitis C infection. CONCLUSIONS: Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection.

Adolescent↗

Varicella vaccination during early pregnancy: a cause of in utero miliary fetal tissue calcifications and hydrops?

BACKGROUND: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation. CASE: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fetus developed miliary fetal tissue calcifications and fetal hydrops detected by a targeted sonogram at 15 weeks gestation. CONCLUSION: Varicella vaccination during early pregnancy may be a cause of miliary fetal tissue calcifications and fetal hydrops.

Abortion, Therapeutic↗

Birth defects surveillance.

Birth defects are identified at the time of delivery in approximately one out of thirty-three babies. Birth defect surveillance has become a very important public health tool for tracking rates and trends in the prevalence of these abnormalities and is useful in establishing risk factors and potential etiologies.

Congenital Abnormalities↗