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Michael Kupferminc

Publications and source records attributed to Michael Kupferminc.

6 recordsLinked to original sources

Preeclampsia is associated with increased susceptibility of serum lipids to copper-induced peroxidation in vitro.

BACKGROUND: Several reports suggest preeclampsia to be associated with oxidative stress. In view of potential experimental artifacts in these studies, we tested the effect of preeclampsia on the oxidizibility of maternal serum lipids, using an optimized ex vivo method. METHODS: This prospective study included 28 pregnant women with preeclampsia and 28 women matched for maternal and gestational age with normal pregnancies. Venous blood was drawn from the consenting women. Serum levels of lipid peroxidation products and the kinetics of copper-induced oxidation ex vivo were monitored spectroscopically by continuous recording of absorbance at 245 nm. RESULTS: The initial optical density (OD) at 245 nm, attributed to preformed products of lipid peroxidation, was higher in the women with preeclampsia than in the controls (1.26 +/- 0.02 vs. 1.17 +/- 0.02 OD units; p = 0.01). The lag phase preceding oxidation, reflecting resistance of serum lipids to oxidation, was significantly shorter in the preeclampsia group than in the controls (47.4 +/- 2.3 vs. 57.6 +/- 4.0 min; p = 0.027). CONCLUSIONS: High levels of serum hydroperoxides and increased susceptibility of serum lipids to copper-induced peroxidation ex vivo indicate preeclampsia to be associated with high oxidative stress. The role of this high oxidizibility in the pathogenesis of preeclampsia has yet to be evaluated.

Adult↗

Labor does not affect the neonatal absolute nucleated red blood cell count.

We investigated whether the presence or absence of physiologic labor may affect the neonatal nucleated red blood cell (RBC) count. We compared absolute nucleated RBC counts taken at approximately 6 hours of life in term infants born by elective cesarean delivery without trial of labor ( n = 32) and in vaginally delivered infants ( n = 28). Venous blood samples were analyzed and differential cell counts were performed manually; absolute nucleated RBC were counted and expressed as an absolute number. There were no significant differences between groups in birth weight, gestational age, maternal age, gravidity, parity, maternal analgesia during labor, 1- and 5-minute Apgar scores, and infant sex. There was a significantly higher hematocrit and RBC count in the vaginally delivered group as compared with the cesarean group. The absolute nucleated RBC, corrected leukocyte and lymphocyte, and platelet counts were strikingly similar in both groups. We conclude that labor does not affect the neonatal nucleated RBC count. This finding supports the speculation that physiologic labor does not induce a fetal hypoxemia severe or prolonged enough to produce hematological evidence of increased erythropoiesis.

Adult↗

The management of symptomatic hydronephrosis in pregnancy.

OBJECTIVE: To present and to evaluate the conservative and surgical management of hydronephrosis in pregnancy. DESIGN: Retrospective analysis of an interventional cohort. SETTING: A tertiary maternity ward. SAMPLE: Of the 30,552 women delivering in our institution between January 1998 and June 2001, 56 women (0.2%) were admitted to the prenatal care unit due to symptomatic hydronephrosis. METHODS: For each patient, renal sonography, urinalysis, serum creatinine levels, white blood cell counts and urine culture were obtained. All patients were treated conservatively by analgesics, intravenous fluids and antibiotics. Failure of these measures: non-resolving infection, deteriorating renal function, absence of Doppler sonographic evidence of ureteral flow or intractable pain led to instrumental drainage of the affected kidney. A double pigtail polyurethane ureteric stent was passed under cystoscopic vision and sonographic guidance. MAIN OUTCOME MEASURES: Resolution of clinical symptoms. RESULTS: Conservative treatment led to resolution in 52 women (92.9%), whereas four women (7.1%) failed to respond and were treated successfully and without complications by pigtail insertion. Early induction of labour was unnecessary and good perinatal outcome was the rule. CONCLUSIONS: Although the vast majority of cases of symptomatic hydronephrosis in pregnancy may be treated conservatively, pigtail insertion is an efficient and safe modality for the rare patient with refractory symptoms.

Adult↗

Impact of pregnancy on respiratory capacity in women with muscular dystrophy and kyphoscoliosis. A case report.

BACKGROUND: Restriction of the chest wall in pregnancy prevents adaptive physiologic hyperventilation. This in turn might gradually promote respiratory insufficiency. CASE: Two consecutive pregnancies occurred in a woman with severe kyphoscoliosis due to juvenile muscular dystrophy. The patient died postpartum. CONCLUSION: Pregnancies with restrictive lung diseases, including severe scoliosis and kyphoscoliosis, should be considered high risk and thus should be monitored and managed carefully.

Adult↗

Pre-eclampsia.

Pre-eclampsia is a major cause of maternal mortality (15-20% in developed countries) and morbidities (acute and long-term), perinatal deaths, preterm birth, and intrauterine growth restriction. Key findings support a causal or pathogenetic model of superficial placentation driven by immune maladaptation, with subsequently reduced concentrations of angiogenic growth factors and increased placental debris in the maternal circulation resulting in a (mainly hypertensive) maternal inflammatory response. The final phenotype, maternal pre-eclamptic syndrome, is further modulated by pre-existing maternal cardiovascular or metabolic fitness. Currently, women at risk are identified on the basis of epidemiological and clinical risk factors, but the diagnostic criteria of pre-eclampsia remain unclear, with no known biomarkers. Treatment is still prenatal care, timely diagnosis, proper management, and timely delivery. Many interventions to lengthen pregnancy (eg, treatment for mild hypertension, plasma-volume expansion, and corticosteroid use) have a poor evidence base. We review findings on the diagnosis, risk factors, and pathogenesis of pre-eclampsia and the present status of its prediction, prevention, and management.

Female↗