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Biomedical subjects

P Curiel

Publications and source records attributed to P Curiel.

At least 19 recordsLinked to original sources
PubMed2000

Routine use of external cephalic version in three hospitals.

BACKGROUND: External cephalic version has been advocated as a safe alternative to vaginal breech delivery or cesarean birth. The purpose of this study was to determine the efficacy of routine use of external cephalic version at 36 weeks or more of gestation in three different levels of hospitals. METHODS: External cephalic version was performed on 923 women with a single breech fetus at three hospitals in Italy. The procedure was attempted with a tocolytic agent for uterine relaxation and with no maternal analgesia. The version technique adopted was the "forward roll." RESULTS: Version was successfully performed on 579 fetuses (62.7%); each hospital had a similar success rate, and 56.9 percent of the women delivered vaginally. The procedure was more successful in multiparas and in women with an incomplete type of breech, polyhydramnios, and posterior localization of the placenta. Vaginal bleeding was experienced by 14 women; eight cesarean sections were performed for suspected abruptio placentae, confirmed in four cases. Two cephalic-turned fetuses experienced an episode of persistent bradycardia and were turned again to breech; in five cases a nonstress test recorded after the version showed repeated variable decelerations and in one case a cesarean section was performed. Neonatal outcomes were good in 922 infants. A fracture of the femur attributable to the version was observed in one newborn. CONCLUSIONS: External cephalic version is effective in reducing the number of cesarean deliveries in term breech infants in different obstetric settings, with no major neonatal adverse outcomes.

Adult↗
PubMed1996

[Vaginal colonization of Streptococcus B in pregnancy].

In the last few years the importance of GBS as the cause of serious neonatal sepsis has become more evident. The number of cases of this infection clearly exceeds the number of other congenital infections, for which antenatal screening is performed. Asymptomatic colonization of the genital tract of the pregnant woman has the most important role in transmission of GBS and several risk factors are connected to neonatal infection. In order to assess the epidemiological situation in Tuscany, 5079 pregnant women have been recruited by the Obstetrical Department of 16 Hospitals and evaluated for the vaginal colonization by GBS. 3654 couples mother-neonate have also been studied to ascertain the transmission of this germ to the neonate. A vaginal swab was collected at the admission to the Hospital at delivery-time and swabs from several sites of the neonate were obtained just after birth. A blood-agar culture and a latex agglutination test were employed to detect the GBS. GBS was present in 6.6% of the vaginal cultures, with a wide variation in colonization rates. 2.2% of the neonates were positive. The transmission of GBS from the positive mother to the neonate occurred in 20% of the cases. Furthermore one positive neonate out of three was born from a negative mother. No correlation between GBS positivity and preterm delivery was found. The rates of prevalence of GBS in our population, both mother and neonates, suggest a situation that can no longer be neglected. Our data are probably underestimated because of the low sensibility of the culture method. A preventive strategy has to be employed to avoid serious neonatal sepsis. An antenatal screening that provides a vaginal culture at the 36th week of gestation and a chemoprophylaxis intra-partum in the positive cases appears to be the most effective approach.

Female↗
PubMed1994

[Screening for Salmonella in pregnancy].

National and Regional Health Authorities advise a stool culture in pregnant women before term in order to detect Salmonella carriers, prevent the spread of this microorganism to the newborn and avoid outbreaks of this infection in the nurseries. The Tuscany section of the Italian Association of Obstetricians and Gynecologists decided to test the usefulness of this Salmonella screening. In 7431 pregnant women at the 36th week a stool sample was examined for the presence of Salmonella. The occurrence of diarrhoea in these women was also investigated. The prevalence of Salmonella excretors in our obstetric population was 0.27%. Thirty per cent of the positive women complained of diarrhoea; that means that the risk of being positive in the presence of this symptom is 11.8 times larger. The positive cases were detected essentially in late summer and fall. No nursery outbreak occurred during the period studied. The Salmonella-carrying mother can not take advantage of an effective antimicrobic therapy and a single stool sample allows the detection of only part of the carriers. Therefore screening can not prevent the possibility of transmission during birth. The unfavorable ratio between costs and benefits suggests that stool culture for Salmonella may be useful only in late summer and fall and in symptomatic women. In order to obtain better results in the prevention of infections among newborns the observance of careful hygienic rules in the delivery rooms and in the nurseries is mandatory.

Feces↗
PubMed1991

Endometrial carcinoma in tamoxifen-treated breast cancer patients.

Tamoxifen is an important agent for the treatment of breast cancer. Occasionally the drug, which is an antiestrogen, has agonistic estrogenic activity. The authors describe three new cases of endometrial carcinoma developing in breast cancer patients taking tamoxifen and stress the necessity of carefully monitoring the uterine cavity under tamoxifen treatment.

Breast Neoplasms↗
PubMed1990

Postpartum coronary artery dissection followed by heart transplantation.

A rare case of coronary artery dissection was observed in a 33-year-old woman on the fourth postpartum day. The ischemic syndrome was followed by aneurysmal dilatation of the left ventricle and progressive heart failure that necessitated cardiac transplantation. The patient is alive and well 3 years after the transplantation.

Adult↗
PubMed1986

[Squalene-cholesterol ratio in the amniotic fluid and gestational age: changes in the threshold in relation to the preparation of the sample].

The squalene/cholesterol ratio in pellets prepared from amniotic fluid is closely correlated to the gestation age and shows a marked increase in the 39th week of pregnancy. However, the absolute value of the squalene/cholesterol ratio may very considerably in relation to the process used to prepare the sample. The washing of the sedimentary cells seems to be critical point in this procedure; therefore, if it is not correctly standardized, erroneous result may be obtained.

Amniotic Fluid↗
PubMed1984

[Levels of free and conjugated catecholamines in amniotic fluid and in umbilical and maternal blood in patients undergoing cesarean section].

A new radioenzymatic assay was used to evaluate free and conjugate catecholamines in six pregnant women who underwent cesarean section at term, in their newborns and in the amniotic fluid. Free adrenaline in maternal plasma was higher while noradrenaline and dopamine were lower at the moment of surgery than 24 hours before the operation. In umbilical plasma adrenaline and noradrenaline are higher than in maternal plasma while only traces of free dopamine and salsolinol are present. In the amniotic fluid high levels of free and conjugated salsolinol are found. The high level of free and conjugated catecholamines found in the umbilical plasma demonstrates that fetal sympathetic nervous system is strongly activated at delivery. Furthermore the presence of sulfoconjugating activity similar to that of the adult is confirmed.

Amniotic Fluid↗
PubMed1980

Lipid content of amniotic fluid cells.

The lipid content of fetal cells was determined in 45 samples of human amniotic fluid. Free and total cholesterol were estimated using a gas chromatographic method, and glycerides were evaluated through the enzymatic assay of their glycerol content. The number of orange cells was estimated after staining with Nile Blue sulphate. The chemically measured lipid content appeared closely related to the number of orange cells. Total cholesterol and glycerides showed a sharp increase after the 37th week of pregnancy. These tests seem to assess fetal maturity successfully, providing a further useful aid in the management of high-risk pregnancies. The chemical determination of cell-associated lipids showed good accuracy and reliability and, when compared with the histochemical method, allowed a better evaluation of progressive lipid accumulation within the amniotic fluid cells.

Amniotic Fluid↗
PubMed1979

[Hypouricemia and xanthinuria. Observation of 3 cases].

The Authors refer about three cases of asymptomatic xanthinuria pointed out after the discovery of very low serum uric acid levels (below 1 mg/100 ml). The above-mentioned cases come out from 137.194 evaluation of serum uric acid carried out in a period of about four years. The values of serum and urinary uric acid and those of total oxypurines in urine of same kinsmen of the three patients have been evaluated; all these values were in the normal range.

Adult↗