PubMed Health⌕ Search

Biomedical subjects

P A Hawrylyshyn

Publications and source records attributed to P A Hawrylyshyn.

10 recordsLinked to original sources
PubMed1983

Short-term antibiotic prophylaxis in high-risk patients following cesarean section.

A prospective, blinded, placebo-controlled study was performed to determine the minimum effective duration of short-term antibiotic prophylaxis following cesarean section. Cefoxitin was selected as the study drug, and 189 women at high risk for postoperative infectious morbidity were randomly assigned to three cohorts, each receiving intravenous infusions at cord clamping and at 4 and 8 hours postoperatively. The incidence of endometritis in the placebo group was 29.3% versus 9.4% in patients receiving one dose of cefoxitin (2 gm) at cord clamping and 5.0% in patients receiving three doses of cefoxitin (p less than 0.0001). Cefoxitin prophylaxis significantly reduced the incidence of endometritis in patients with postoperative anemia. There were no serious complications or drug reactions in the treated groups.

Adult↗
PubMed1982

Twin pregnancies--a continuing perinatal challenge.

A 5-year retrospective analysis of the management of 177 twin pregnancies was undertaken. Despite increased use of bed rest and ultrasonography as currently recommended, the perinatal mortality among twins (13.2%) remained almost 10 times that for singleton births. Although elective hospitalization for bed rest prolonged the pregnancy, it did not decrease the perinatal mortality. The authors believe this was attributable to bed rest being instituted too late, as 70% of perinatal mortality occurred before the 30th week of gestation, which was also the period of greatest neonatal morbidity. Suggested recommendations for improving management of twin pregnancies are discussed.

Bed Rest↗
PubMed1981

Risk factors associated with infection following cesarean section.

A retrospective study by means of multivariant discriminant analysis was performed on 496 deliveries (250 vaginal and 246 cesarean sections) is identify risk factors which predispose to postoperative febrile morbidity, in particular, endometritis. The infection rates for endometritis by type of delivery were: vaginal, 3.6%; elective repeat cesarean section, 6.0%; nonurgent primary cesarean section, 22.2%; and emergency cesarean section, 38.4%. No patient-related risk factors were identified for elective repeat cesarean section, and bacterial isolates were most frequently Staphylococcus aureus. However, four statistically significant risk factors were associated with the occurrence of endometritis after primary cesarean section. In increasing order of significance, they were duration of labor, number of preoperative vaginal examinations, time membranes were ruptured prior to delivery, and postoperative anemia. Internal fetal monitoring was not a risk factor. The clinical relevance of these findings to the use of prophylactic antibiotics and other attempts aimed at decreasing postoperative morbidity is discussed.

Anti-Bacterial Agents↗
PubMed1980

A new computer technique for continuous measurement of the pre-ejection period in the human fetus: physiologic significance of pre-ejection period patterns.

A new interactive computer graphics system was developed for continuous online or offline measurement of the pre-ejection period (PEP) in the human fetus during both the antepartum and the intrapartum period. A significant feature is the system's ability to accurately measure PEP from the onset of QRS complex to the beginning of aortic opening with a resolution of less than 2 milliseconds. Normal patterns of PEP prolongation were observed with fetal movement and occlusion of the umbilical cord, whereas progressive shortening of PEP was noticed with late decelerations associated with acute hypoxia. A pathologic pattern of PEP prolongation associated with late decelarations and poor heart rate variability was observed with chronic hypoxia and acidosis. These patterns suggest that continuous monitoring of PEP may be a useful adjunct to current monitoring methods when attempting to assess fetal cardiac performance and well-being.

Computers↗
PubMed1980

The pre-ejection period as an antepartum indicator of fetal well-being.

A preliminary study was made of the potential usefulness of the pre-ejection period (PEP) as an antepartum indicator of fetal well-being. PEP was evaluated in 108 subjects over a 2-year period. It is essential to correct for the effects of heart rate and gestational age on PEP before attempting to relate it ot fetal status. From the control group of 95 fetuses within our study, an equation to correct PEP to a standard heart rate of 140 beats per minute and gestational age of 40 weeks was derived: PEP140,40 = PEP + 0.36(FHR-140) + 1.4(40-GA). PEP140,40 for our control group was 72.9 +/- 2.8 msec. Of the 13 fetuses classified as abnormal in the study, four had a normal PEP140,40 eight showed significant shortening, and one had significant prolongation. These changes in PEP were related to underlying fetal status, and, when used together with other parameters of antenatal assessment, appear to be useful in predicting the ability of the fetus to withstand stress compatible with survival. Continuing evaluation on larger populations will be required to confirm the results of this study. The use of PEP140,40 is suggested as a valid method for comparing reports from different investigators.

Acidosis↗
PubMed1978

Quantitative indices of short- and long-term heart rate variability.

Two quantitative indices of heart rate variability are proposed. Instantaneous variability is defined as the average of the absolute value of instantaneous rate differences over a 30 second interval. It is sensitive to short-term variability changes. Bandwidth variability is defined as twice the standard deviation of instantaneous heart rates over a 30 second interval, and it is a measure of long-term variability. The rationale for the choice of these indices is discussed, and they are compared with other published indices of variability. Samples of computer printout of instantaneous and bandwidth variability obtained from fetal heart rate records are given.

Electrocardiography↗
PubMed1978

Vestibulothalamic projections in man--a sixth primary sensory pathway.

1. Responses suggesting activation of the vestibular system, elicited by electrical stimulation of the human thalamus during 22 routine stereotaxic neurosurgical procedures, were examined in a retrospective study to determine the possible existence of vestibulothalamo-cortical projections in man. 2. Such responses were most frequently described as sensations of movement through space and were associated with two distinct vestibulothalamic projections: a) an anterior relay was situated ventral to the medial lemniscus, passing lateral to the red nucleus and dorsal to the subthalamic nucleus prior to terminating in the nucleus ventrointermedius (Vim) (comparable to VPLo in primates); b) a posterior relay associated with the auditory pathway (lateral lemniscus and brachium of the inferior colliculus) projected to the medial geniculate body. 3. The production of sensations of motion in conscious patients by stimulating areas that are similar to those reported constituting vestibulothalamic pathways in cats and primates implies a distinct primary sensory cortical projection for processing information from the vestibular receptors pertaining to the recognition of spatial movements.

Brain Mapping↗
PubMedDate not supplied

Third ventricular width and the thalamocapsular border.

65 patients were selected to assess variations in third ventricular width. The patients suffered from various extrapyramidal movement disorders, and all had undergone stereotactic VL thalamotomies. Third ventricular width was correlated with age, sex, diagnosis and intercommissural distance. Based upon the analysis of somatosensory response mappings, a medial displacement of the thalamocapsular border was demonstrated for patients with narrow third ventricles.

Age Factors↗