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Biomedical subjects

T L Gross

Publications and source records attributed to T L Gross.

At least 19 recordsLinked to original sources
PubMed1991

The clinical utility of maternal body mass index in pregnancy.

To describe maternal body mass index and to compare the use of maternal weight and body mass index for risk assessment at the initial prenatal visit, 6270 gravid women who were consecutively delivered of infants were studied. Body mass index increased with advancing maternal age, parity, and advancing gestational age and was significantly greater in black women than in nonblack women. Risks for the development of adverse outcome associated with maternal obesity, including development of gestational diabetes, preeclampsia, fetal macrosomia, and shoulder dystocia, were comparably predicted by either maternal weight or body mass index greater than 90th percentile. Maternal weight was as predictive of preeclampsia, macrosomia, and shoulder dystocia as was body mass index when these factors were analyzed as continuous variables, whereas increasing body mass index was more predictive of gestational diabetes. The prediction of factors associated with low maternal weights, small-for-gestational-age birth, prematurity, low birth weight, and perinatal death was equivalent for maternal weight and body mass index that was less than 10th percentile. This study indicates that in the initial risk assessment of outcomes related to maternal weight, the calculation of maternal body mass index offers no advantage over simply weighing the patient. This finding contrasts with results in nonpregnant women.

Adult↗
PubMed1990

Glucagon-producing pancreatic endocrine tumors in two dogs with superficial necrolytic dermatitis.

A newly recognized disease in dogs, ulcerative dermatosis associated with diabetes mellitus (diabetic dermatopathy), was diagnosed in 2 dogs with pancreatic endocrine tumors that had immunohistologic evidence of glucagon production. Dogs developed diabetes mellitus in the later stages of the illness, months after the skin disease was first observed. Liver disease was identified and characterized by high serum alkaline phosphatase and alanine transaminase activities. Clinically, erythema and crusting involved the footpads, the face, perioral and genital skin, and ventrum. Histologically, skin lesions were intercellular and intracellular edema and necrosis of the upper half of the epidermis and diffuse parakeratosis. Clinically and histologically, skin lesions closely resembled necrolytic migratory erythema of people, a skin disease that usually is associated with a glucagon-secreting pancreatic endocrine tumor and diabetes mellitus (glucagonoma syndrome): The morphologically descriptive term, superficial necrolytic dermatitis, was preferred over the previously proposed names hepatocutaneous syndrome and diabetic dermatopathy, which each connote only a single feature of the disease.

Animals↗
PubMed1990

Correlation of commonly used measures of intrauterine growth with estimated neonatal body fat.

Several morphometric measures have been used to identify infants at greatest risk from aberrant intrauterine growth. 119 near-term infants were studied to answer the more basic question of how well measures, such as birthweight percentile, ponderal index, the body mass index and the weight/length ratio reflect body fat in the neonate. Skinfold thicknesses were measured as an estimate of fat stores. Multiple regression analysis revealed that the weight/length ratio showed the strongest correlation with relative adiposity, explaining 52% of the variance. Further, sequential exponentiation of the crown-heel length in body mass index and ponderal index decreased the correlation with estimates of body fat. The simple weight/length ratio, exhibiting both a close correlation with body fat and independence of gestational age, race and sex, in near-term infants may be the best morphometric measure of the nutritional component of intrauterine growth in the neonate.

Adipose Tissue↗
PubMed1988

Determinants of morbidity in obese women delivered by cesarean.

Studies examining the increased surgical morbidity among obese gravidas have focused mainly on differences in outcome between obese and nonobese mothers. Little is known, however, about the cause for worsened operative outcome in obese mothers or the potential impact of perioperative interventions. To define more precisely the clinical determinants of postoperative morbidity, multivariate analysis was used to relate antepartum and intrapartum variables to three measures of morbidity in 107 consecutively delivered obese women undergoing cesarean. Although obesity is clearly an operative risk factor, this study suggested that among obese gravidas, varying degrees of maternal obesity and accompanying medical complications, such as diabetes and hypertension, were not associated with greater operative morbidity. Furthermore, neither choice of skin incision nor type of anesthesia appeared to be related to operative morbidity. However, two factors potentially under the control of the clinician, increased length of surgery and operative blood loss, were associated significantly with measures of operative morbidity. A finding of worsened outcome with prophylactic antibiotics and heparin requires further study.

Adolescent↗
PubMed1987

Heartworm disease manifested by encephalomyelitis and myositis in a dog.

A 2-year-old Boston Terrier was referred because of depression and hindlimb and tail paresis. Clinical examination and serum biochemical analysis resulted in a diagnosis of encephalomyelitis and myositis. Results of testing for Dirofilaria immitis were positive. Gross and histologic examination revealed an aberrant adult heartworm infection resulting in thrombosis of the femoral artery and multiple muscular branches, with subsequent muscle necrosis and inflammation in one hindlimb. Additionally, an unusual larval-tissue interaction to microfilariae yielded a multifocal encephalomyelitis in the brain and spinal cord.

Animals↗
PubMed1987

Shoulder dystocia: a fetal-physician risk.

Trauma that occurs as a result of shoulder dystocia is an important cause of neonatal morbidity. If the occurrence of severe shoulder dystocia, resulting in fetal asphyxia and trauma, could be accurately predicted from maternal risk factors, then a cesarean section would be indicated to prevent the poor outcome. The information available in the obstetric literature, however, is contradictory regarding whether shoulder dystocia can be predicted. In the present study, the patients at greatest risk of shoulder dystocia (all 394 mothers delivering neonates with birth weights greater than or equal to 4000 gm over a 2-year period) were examined. A three-way discriminant analysis was used to determine if a model could be developed that could effectively predict those patients who would be included in each of the groups of no shoulder dystocia, shoulder dystocia without trauma (29 patients), and shoulder dystocia with trauma (20 patients). Three factors, including birth weight, prolonged deceleration phase, and length of second stage labor, were found individually to contribute significantly to the classification. However, when examined in detail, it was noted that while 94% of cases with no shoulder dystocia would be detected, only 16% of the cases of shoulder dystocia with trauma would be predicted by this model. We conclude that in the group of pregnancies delivering neonates greater than or equal to 4000 gm, the occurrence of shoulder dystocia cannot be predicted from clinical characteristics or labor abnormalities, and that the occurrence of shoulder dystocia is not evidence of medical malpractice.

Birth Injuries↗
PubMed1987

Molluscum contagiosum in a horse with granulomatous enteritis.

Widespread cutaneous papules in a yearling Standardbred filly were attributed by light and electron microscopic examination to molluscum contagiosum. Concomitant granulomatous enteritis, suspected clinically due to protein-losing enteropathy, was verified histopathologically. An associated altered altered immune response is suggested as the reason for the widespread poxvirus infection.

Animals↗
PubMed1987

Recurrent small for gestational age birth: perinatal risks and outcomes.

The risk of recurrent small for gestational age birth, as well as maternal and fetal-neonatal characteristics associated with recurrence, was examined in 174 mothers of consecutively delivered small for gestational age infants followed through an additional 240 livebirths. There was a twofold and fourfold increase in the risk for small for gestational age birth after one and two small for gestational age births, respectively. Although an intervening average for gestational age birth decreased the risk of recurrence, these women remained at increased risk over the general population. Given the history of a previous small for gestational age birth, perinatal risks and outcomes considered individually would not improve the prediction of recurrence. However, the significantly higher frequency of these variables, considered as a group, among mothers with recurrent small for gestational age birth suggests an association with underlying maternal disease, for example, chronic hypertension, substance use and abuse, more severe fetal-neonatal compromise, and recurrent small for gestational age birth. Recurrent small for gestational age birth should initiate a search for persistent, underlying maternal disease.

Female↗
PubMed1987

The cutaneous histology of dermatomyositis in collie dogs.

Cutaneous lesions of 36 collie dogs affected with dermatomyositis were reviewed. The most common histologic features were follicular atrophy and perifollicular inflammation in 30 dogs, which correlated with alopecia clinically. Other less common findings included formation of colloid bodies, basal cell vacuolation, and subepidermal vesiculation. Results indicated that the most diagnostic cutaneous histologic features of dermatomyositis may be follicular atrophy and inflammation.

Animals↗
PubMed1987

Neonatal complications following in utero exposure to intravenous ritodrine.

Intravenous administration of ritodrine for tocolysis has been associated with maternal cardiovascular and metabolic changes. Studies with other tocolytic agents, such as isoxsuprine, have shown an increased neonatal morbidity among infants born soon after failure of such therapy. We examined the potential side effects of maternal intravenous ritodrine therapy in 58 neonates born within 12 h following discontinuation of maternal medication. 'Low dextrostix' was significantly greater in the ritodrine exposed neonates (p less than 0.05) than in the controls. It occurred within a mean 1.0 +/- 0.5 h following birth. The mean 1 min and 5 min Apgar scores, neonatal pH, bicarbonate levels, hypotension and neonatal mortality were comparable in the ritodrine-exposed and control groups of neonates. The occurrence of any of the neonatal morbidity variables, including 'low dextrostix' was not related either to the total dose of ritodrine used or to the interval between drug discontinuation and delivery. Administration of ritodrine by the standard protocol to stop preterm labor is not associated with any significant increase in neonatal morbidity.

Female↗
PubMed1986

Correlation of histologic and immunologic findings in cats with miliary dermatitis.

Eighteen cats with miliary dermatitis were evaluated, using skin testing and histology. Sixteen cats had allergic skin disease (14 cats had positive skin-test reactions to flea antigen [two of which were also atopic], one was atopic only, and one was allergic to beef). In the two remaining cats, the cause of miliary dermatitis was not identified. Histologically, 17 of the cats had superficial eosinophilic dermatitis and epidermal spongiosis, crusting, and ulceration, which were compatible with an allergic cause. Four of these cats had concurrent eosinophilic plaques, which histologically resembled miliary lesions. This overlap of plaques with miliary lesions indicated that when plaques and miliary dermatitis are found concurrently, both lesions may be caused by the same allergens.

Animals↗
PubMed1986

Ritodrine pharmacokinetics.

The purpose of this study was to add to the limited information available regarding the pharmacology of ritodrine in the peripartum period when treatment fails and labor is not inhibited. Plasma or urine samples from eight parturients and 13 infants were studied; in addition plasma samples at delivery were obtained from a total of 26 mothers and infants. All the mothers received ritodrine in the 24 hours before delivery. Plasma and urine ritodrine (free and conjugated) were determined with HPLC by electrochemical detection. In maternal plasma, an apparent rapid distribution phase with a t1/2 of 32 +/- 21 minutes was followed by a prolonged equilibrium phase with a t1/2 of 17 +/- 10 hours. Seventy-six percent of the ritodrine excreted by the mother was in the form of a conjugate. Ninety percent of the ritodrine excreted by the neonate was also excreted in the form of a conjugate.

Blood Proteins↗
PubMed1986

Multifocal intraepidermal carcinoma in a dog histologically resembling Bowen's disease.

A middle-aged, spayed female dog developed multiple cutaneous neoplasms that had clinical and histologic features of Bowen's disease in humans. Although lesions began in sun-exposed, glabrous skin, they progressed to hairy skin and to mucous membranes. Metastasis did not occur, although one lesion eventuated in local invasion of bone. The dog subsequently developed metastatic cutaneous myxosarcoma and euthanasia was requested by the owners.

Animals↗
PubMed1986

Maternal upright posture and mobility in labor--a review.

There has been a relatively recent interest in alternative birthing techniques, including increased maternal mobility during labor. This literature review was pursued to evaluate the effect of upright maternal posture and ambulation on the first stage of labor. Although previous reviews frequently assume that maternal ambulation speeds labor progress, the data presented in this review are not conclusive as to whether the upright maternal posture or ambulation during the first stage of labor shortens labor length or improves fetal outcome. However, it is clear that ambulation in labor is not harmful either to the mother or fetus. In addition, many investigators have reported that mobility in labor results in greater maternal comfort and ability to tolerate labor and decreased use of anesthesia and analgesia. Thus, acceptance of mobility in labor by patients and staff is generally reported. This information can serve as a guide to clinical management. However, there is a need for further analysis of the effect of maternal ambulation during labor, and specific suggestions for research are presented.

Clinical Trials as Topic↗