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Biomedical subjects

P Jakobi

Publications and source records attributed to P Jakobi.

At least 19 recordsLinked to original sources
PubMed1992

Pulmonary complications of antepartum pyelonephritis: more alertness is needed.

Three cases of pulmonary complications associated with antepartum pyelonephritis are presented, in two of them tracheal intubation and mechanical ventilation were required. All three cases were related to recurrent urinary infections with failure of first line antimicrobial therapy and a concomitant usage of tocolytic therapy. The possible etiology, risk factors and clinical approach, aimed to prevent pulmonary complications in antepartum pyelonephritis are discussed.

Adult↗
PubMed1992

Survival and long-term morbidity in preterm infants with and without a clinical diagnosis of periventricular, intraventricular hemorrhage.

The prognosis of clinically diagnosed periventricular, intraventricular hemorrhage on the survival and long-term outcome of 169 infants delivered at 24 to 30 weeks gestation who survived more than 48 hours was evaluated. Periventricular, intraventricular hemorrhage was confirmed by ultrasound in 37.9% of the survivors. In this group the survival rate was 64% and the major handicap rate was 14.6%. In contrast, the survival of infants who did not have a clinical diagnosis of periventricular, intraventricular hemorrhage was greater than 90% with a major handicap rate of only 3.2% (P < 0.0001 and P < 0.03, respectively). Infants with clinical diagnosis of periventricular, intraventricular hemorrhage who were found to have grades 1-2 by ultrasound had the same survival rate as those without a clinical diagnosis of periventricular, intraventricular hemorrhage (90.5%), while infants with grades 3-4 had a survival rate of only 51.2% (P < 0.01). We conclude, that preterm infants who survive longer than 48 hours and do not have a clinical suspicion of periventricular, intraventricular hemorrhage, have an excellent prognosis. In these circumstances brain sonography can be deferred without jeopardizing the infants' health.

Cerebral Hemorrhage↗
PubMed1992

Cardiotocographic and sonographic findings in two cases of antenatally diagnosed intrauterine fetal brain death.

Intrauterine fetal brain death is a rare cause of a fixed fetal heart rate pattern. Seven cases have been previously reported in the literature, but only two of them were diagnosed prenatally and all the newborns died soon after delivery. Two additional cases of antepartum diagnosis of intrauterine fetal brain death, managed expectantly, are reported. We had the unique opportunity to document progressive sonographic cerebral changes during the follow-up period, following the neurological event, while the fetus continued life and growth in utero. The cardiographic and sonographic findings suggesting intrauterine fetal brain death were a prolonged fixed fetal heart rate, even following a vibroacoustic and contraction stress test; an atonic fetus without breathing and body movement; and the appearance of hydramnios and the development of ventriculomegaly.

Adult↗
PubMed1992

Endogenous digoxin-like immunoreactivity measured in seminal fluid from a normal male population.

Endogenous digoxin-like immunoreactivity (EDLI) has been detected in different biological fluids and in several pathophysiological conditions. In this study, using radioimmunoassay we reported for the first time the existence of bound and unbound EDLI in normal seminal fluid. The unusual finding was the detection of unbound EDLI in the seminal fluid, while this reactivity was undetected in plasma. Two main hypotheses are presented: (1) local secretion of unbound EDLI and/or (2) passive diffusion from plasma to the seminal fluid of unbound EDLI and subsequent local concentration.

Adult↗
PubMed1992

Peripartum changes in free and protein-bound digoxinlike immunoreactive factor.

The appearance of free digoxinlike immunoreactive factor in pregnancy and its rapid disappearance after delivery is well documented. The protein-bound fraction, a common component of plasma, does not change during pregnancy. We investigated the peripartum changes in both free and protein-bound fractions of digoxinlike immunoreactive factor and observed different peripartum patterns of those fractions. While the disappearance of the free fraction after delivery was reconfirmed, the protein-bound fraction exhibited a biphasic pattern: a rapid decrease after delivery with a slow increase to predelivery levels seven weeks later. The disappearance of free digoxinlike immunoreactive factor after delivery may reflect the elimination of the fetal source. The changes in the protein-bound fraction imply that the fraction may also vary in certain clinical situations and may be produced in response to certain homeostatic changes and suggest a possible interaction between fetal and maternal systems that produce digoxinlike immunoreactive factor during pregnancy.

Blood Proteins↗
PubMed1992

Continuous ambulatory peritoneal dialysis as the primary approach in the management of severe renal insufficiency in pregnancy.

Pregnancy is an unusual event in patients with chronic renal failure undergoing dialysis. The outcome in these cases is usually poor. We report a pregnancy complicated by severe renal insufficiency that was managed successfully by continuous ambulatory peritoneal dialysis. Dialysis was initiated at 24 weeks' gestation. At 34 weeks, premature labor associated with peritonitis resulted in the spontaneous delivery of a healthy male infant weighing 2400 g. The use of continuous ambulatory peritoneal dialysis during pregnancy offers theoretical advantages compared with hemodialysis. Our case, added to the available limited experience with this new modality, suggests that it may be an appropriate approach in women developing renal disease for the first time during pregnancy.

Adult↗
PubMed1991

Management of triplet pregnancies in the 1980s--are we doing better?

The incidence of triplet pregnancies has increased with the introduction of ovulation induction agents and is expected to further increase with the implementation of multiple embryo transfer in the in vitro fertilization programs. We review our experience with 29 triplet pregnancies in the last 10 years. Despite early sonographic diagnosis, close follow-up, increased use of tocolytics, and prophylactic cervical suture, we could not document prolongation of pregnancy, increased infants' weight, or a significantly decreased perinatal mortality, which still remains about 14%. Furthermore, the use of cesarean section as the delivery method of choice did not change the well-documented unfavorable relationship between birth order and fetal outcome. There is an urgent need for prospective assessment of the value of different treatment modalities, which nowadays becomes possible with the increasing incidence of triplet pregnancies. The prevention of triplet pregnancies or treatment by selective fetal reduction deserves a second thought.

Adult↗
PubMed1991

Endogenous digoxin-like immunoreactivity in follicular fluid and in vitro fertilization.

Plasma digoxin-like immunoreactive factor (DLIF) has been detected in various pathophysiological conditions associated with volume expansion. In this study, using radioimmunoassay, we confirmed the existence of high levels of DLIF in the stimulated follicular fluid, a rapidly volume-expanding biological model. The concentration of the various fractions of DLIF in follicular fluid was 2-9 times higher than in plasma, suggesting local concentration or production. No difference in concentration was observed between follicles containing fertilized oocytes and follicles with unfertilized oocytes. The role of DLIF in follicular homeostasis remains to be further investigated.

Blood Proteins↗
PubMed1990

Total digoxin-like immunoreactive factor(s) in healthy population, uncomplicated term pregnancies and neonates.

Free digoxin-like immunoreactive factor(s) (DLIF) which may have a homeostatic role, as documented in different physiological conditions, but is generally undetectable in plasma from normal population. Total digoxin-like immunoreactive factor(s) (protein bound and free) can be estimated after plasma is heated. In this study, total digoxin-like immunoreactive factor(s) as measured in plasma in a well defined control population and compared to healthy term pregnant women and neonates, categories known to be associated with increased free digoxin-like immunoreactive factor(s) concentrations. The mean level of this factor(s) in the control group was 706 +/- 129 pg digoxin equivalent/ml (pg/ml) and was unaffected by age and sex. Significantly increased levels of total digoxin-like immunoreactive factor(s) were found in pregnant women and neonates (928 +/- 127 and 1242 +/- 367 pg/ml, respectively). We conclude that levels of total digoxin-like immunoreactive factor(s) are increased in term pregnancies and neonates, similarly to its free form. However total digoxin-like immunoreactive factor(s) is detected in the normal population as a plasma component, contrary to its free form, which is generally undetectable.

Adult↗
PubMed1990

The effect of cervical cerclage on the course of labor.

Although it is generally believed that patients with previous cervical cerclage have abnormal labor patterns, there is little evidence to support this belief. We analyzed the pattern of cervical dilatation during labor in 114 women with cervical cerclage by the McDonald procedure who delivered vaginally at term and compared them with 150 normal laboring women. Similar patterns of cervical dilatation were found in both groups and there was no case of cervical dystocia, a commonly cited complication of cervical cerclage.

Adult↗