Biomedical subjects

Michael Lindsay

Publications and source records attributed to Michael Lindsay.

6 recordsLinked to original sources

PubMed2006

Uterine torsion and fetal bradycardia associated with external cephalic version.

BACKGROUND: Torsion of the gravid uterus is a rare obstetric complication in humans, but has been reported in association with malpresentation and with uterine leiomyomata. CASE: We report a case of uterine torsion diagnosed at emergency cesarean delivery after external cephalic version with prolonged fetal bradycardia. CONCLUSION: Physicians should be aware of the possibility of uterine torsion as a complication of external cephalic version. To minimize diagnostic delay, placental localization on ultrasonography should be noted before and after external cephalic version as an indicator of uterine orientation.

Adult↗

PubMed2006

Early warning of Ross River virus epidemics: combining surveillance data on climate and mosquitoes.

BACKGROUND: Ross River virus disease is spread by mosquitoes, and an average of 5000 people are infected each year in Australia. It is one of the few infectious diseases for which climate-based early warning systems could be developed. The aim of this study was to test whether supplementing routinely collected climate data with mosquito surveillance data could increase the accuracy of disease prediction models. METHODS: We focused on a temperate region of Western Australia between July 1991 and June 1999. We developed "early" and "later" warning logistic regression models to test the sensitivity of data on climate (tide height, rainfall, sea surface temperature) and mosquito counts for predicting epidemics of disease. RESULTS: Climate data on their own were moderately sensitive (64%) for predicting epidemics during the early warning period. Addition of mosquito surveillance data increased the sensitivity of the early warning model to 90%. The later warning model had a sensitivity of 85%. CONCLUSIONS: We found that climate data are inexpensive and easy to collect and allow the prediction of Ross River virus disease epidemics within the time necessary to improve the effectiveness of public health responses. Mosquito surveillance data provide a more expensive early warning but add substantial predictive value.

Alphavirus Infections↗

PubMed2005

Temporal trends in HIV Type 1 incidence among inner-city childbearing women in Atlanta: use of the IgG-capture BED-enzyme immunoassay.

Recently, we developed an immunoglobulin G (IgG)-capture BED-enzyme immunoassay (BED-CEIA) to identify recent HIV-1 infections. We estimated HIV-1 incidence among inner-city pregnant women in Atlanta, Georgia (1991-1998) using this assay. The annual cumulative incidence was estimated at 2.4/1000 (95% CI = 2.0-2.9). Incidence declined from 3.1/1000 in 1991-1994 to 1.4/1000 in 1995-1998 (risk ratio = 2.3, 95% CI = 1.5-3.4). Women with recent HIV-1 infection more often reported a previous negative antibody test (p = 0.018) and sexual relations with men other than the father during the past year (p = 0.046). Fewer seroconverters in 1995-1998 used crack cocaine than in the earlier time period. A high but declining HIV-1 incidence was found among inner-city pregnant women in Atlanta.

Adolescent↗

PubMed2003

The challenges of informed consent for rapid HIV testing in labor.

BACKGROUND: Although increasing attention has been focused on the adequacy of the informed consent process for participation in research studies, there has been little systematic evaluation of the process, particularly when consent is obtained in the labor and delivery setting. The Mother Infant Rapid Intervention at Delivery (MIRIAD) study is an ongoing multisite study initiated by the Centers for Disease Control and Prevention (CDC) designed to evaluate the feasibility of offering 24-hour counseling and voluntary rapid HIV testing and antriretroviral therapy when indicated to women with unknown HIV status who are in labor. METHODS: To address concerns about obtaining informed consent from women in labor, we have completed focus groups, conducted a pilot of the informed consent process among women in labor, developed flip-charts to enhance comprehension, and plan an ongoing evaluation of the informed consent process throughout the course of the MIRIAD study. RESULTS: In the pilot study, approximately 70% of women were able to state in their own words the purpose and benefits of the research study. Substantially fewer women (25%) were able to state one or more risks of the study. CONCLUSIONS: We hope that the MIRIAD study will make a valuable contribution by defining best approaches for informed consent and will provide guidance when it is necessary to obtain consent from laboring women for crucial interventions.

AIDS Serodiagnosis↗

PubMed2003

Torsion of the gallbladder in pregnancy. A case report.

BACKGROUND: Gallbladder torsion is rarely diagnosed in pregnancy, but prompt surgical intervention is necessary to avoid possible sepsis and death. CASE: A 28-year-old, African American woman at 30(6/7) weeks' gestation was admitted with the presumed diagnosis of acute cholecystitis. The patient was treated conservatively. However, on re-examination, the patient's physical examination and laboratory values worsened. She underwent an exploratory laparotomy, which revealed a twisted gallbladder. A cholecystectomy was performed after untwisting of the gallbladder. Postoperatively the patient did well and subsequently delivered a healthy infant at 38(2/7) weeks' gestation. CONCLUSION: Surgical evaluation of an acute abdomen in pregnancy should not be delayed. For a presumed diagnosis of acute cholecystitis that does not improve after conservative measures are taken, gallbladder torsion should be added to the differential diagnosis.

Adult↗

PubMed2002

Diagnosing postpartum depression: can we do better?

OBJECTIVE: The purpose of this study was to evaluate the efficacy of the Edinburgh Postnatal Depression Scale versus routine clinical evaluation to detect postpartum depression among a low-income inner-city population and to evaluate risk factors associated with a positive score on the Edinburgh Postnatal Depression Scale. STUDY DESIGN: On the basis of the day of the month, all English-speaking patients who were seen for their postpartum visit were assigned either to routine clinical evaluation for postpartum depression or routine clinical evaluation plus the use of the 10-question Edinburgh Postnatal Depression Scale. RESULTS: During the 7-week study period, 72 women participated in the study: 35 women in the routine evaluation group and 37 women in the Edinburgh Postnatal Depression Scale group. Women who completed the Edinburgh Postnatal Depression Scale were significantly more likely than those in the routine evaluation group to be identified as being at risk for depression: 11 of 37 women (30%) versus 0 of 35 women (P <.001). A failed attempt at breast-feeding was associated with an increased risk of a score of > or =10 on the Edinburgh Postnatal Depression Scale (relative risk, 3.78; 95% CI, 1.03-13.89). CONCLUSION: The Edinburgh Postnatal Depression Scale appears to be a valuable and efficient tool for the identification of patients who are at risk for postpartum depression.

Adult↗