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Biomedical subjects

V Yu

Publications and source records attributed to V Yu.

16 recordsLinked to original sources

Intrauterine lignocaine as an anaesthetic during endometrial sampling: a randomised double-blind controlled trial.

OBJECTIVE: To evaluate the effectiveness of intrauterine lignocaine as an anaesthetic during endometrial sampling. DESIGN: Prospective, randomised, double-blind, placebo-controlled trial. SETTING: Outpatient gynaecological minor operation unit in a public hospital. POPULATION: Two hundred premenopausal women scheduled for endometrial sampling because of abnormal uterine bleeding. METHODS: Transcervical intrauterine instillation of 5 mL of 2% lignocaine or 5 mL of normal saline before performing endometrial sampling with vacuum aspirator. MAIN OUTCOME MEASURES: Evaluation of pain associated with the procedure using a visual analogue scale. RESULTS: The use of intrauterine lignocaine reduced pain during suction curettage in endometrial sampling. CONCLUSIONS: Transcervical instillation of lignocaine reduced pain during endometrial sampling.

Adult↗

Chorioamnionitis and outcome in extremely preterm infants.

INTRODUCTION: Chorioamnionitis is a risk factor for preterm delivery. Intrauterine infection leads to the fetal inflammatory response which is characterised by elevated cytokine levels. Chorioamnionitis is reported to cause accelerated but abnormal lung maturation, resulting in decreased incidence of respiratory distress syndrome (RDS) but increased chronic lung disease (CLD), and predisposes the infant to cerebral injury. OBJECTIVE: To investigate the relation between chorioamnionitis and RDS, CLD, cerebral lesions, neurodevelopmental outcome and mortality in a cohort of extremely premature infants. MATERIALS AND METHODS: Infants born between 1997 and 2001 with a gestational age of less than 28 weeks or a birth weight of less than 1000 g were divided into two groups: Group 1 with evidence of chorioamnionitis and Group 2 without. Outcomes of these two groups of infants were compared. RESULTS: A total of 388 infants were included (105 in Group 1 and 283 in Group 2). Chorioamnionitis was significantly associated with an increased risk of extreme preterm delivery. Group 1 showed a trend towards an increased incidence of CLD and mortality, while the incidence of periventricular leukomalacia, retinopathy of prematurity (ROP) and necrotising enterocolitis (NEC) were similar between the two groups. Subgroup analysis of 2-year neurodevelopmental outcome showed an increased trend towards cerebral palsy and visual impairment, while the incidence of developmental delay and hearing impairment are similar between the two groups. CONCLUSION: Extremely preterm infants with chorioamnionitis showed a trend towards an increased incidence of CLD, mortality, cerebral palsy and visual impairement, but a decreased risk of RDS.

Chorioamnionitis↗

Variation in mortality and intraventricular haemorrhage in occupants of Pacific Rim nurseries.

OBJECTIVE: A network of neonatal intensive care units in Pacific Rim countries was formed to compare infant risk factors, clinical practices, and outcomes for very low birthweight infants. METHODOLOGY: A multicentre, prospective study compared outcomes for infants born smaller than 1501 g or at less than 31 weeks gestation. RESULTS: Gestational age-specific survival and incidence of intracranial haemorrhage varied for infants born in these nurseries. We found differences in infant risk factors among the nurseries. There were also significant differences in the use of antenatal steroids, but similar rates for Caesarean section and surfactant treatment. The factor most predictive of neonatal death and severe intracranial abnormality was an elevated Clinical Risk Index for Babies (CRIB) score. Antenatal steroid treatment (>24 h prior to delivery) was associated with improved survival and decreased incidence of severe intracranial abnormalities. Antenatal steroid treatment for less than 24 h prior to delivery was not associated with improved survival. Caesarean delivery was associated with improved survival, but showed no benefit regarding the incidence of severe intracranial abnormality. CONCLUSIONS: Our Pacific Rim nursery network found differences in neonatal outcomes that correlated best with measures of neonatal risk at birth, antenatal steroid treatment, and Caesarean delivery. These data emphasize the importance of obstetric care to improve postnatal outcomes in premature infants, and highlight the usefulness of CRIB scores in these patients.

Analysis of Variance↗

Caretaker Brca1: keeping the genome in the straight and narrow.

Inheritance of germline BRCA1 mutations is associated with a high risk of breast and ovarian cancers. A multitude of cellular functions has been ascribed to BRCA1, including transcription activation and various aspects of DNA repair. So far, indirect evidence has indicated a role for BRCA1 in the repair of double-strand breaks. Recently, an elegant gene targeting design was used to provide definitive evidence that BRCA1 promotes homologous recombination and limits nonhomologous mutagenic repair processes. This reaffirms the role of BRCA1 as caretaker in preserving genomic integrity.

BRCA1 Protein↗

Hepatitis B carrier and perinatal outcome in singleton pregnancy.

The objective of this article is to evaluate the effect of hepatitis B antigenemia on perinatal outcome. Perinatal outcome of 824 women with hepatitis B surface antigen (HbsAg) was compared with 6281 women without hepatitis B surface antigen (control) from June 1996 to September 1998. The maternal characteristics were comparable between the two groups. Perinatal outcome was comparable between groups. The incidences of preterm birth, premature prelabor rupture of membranes, prelabor rupture of membranes, small for gestational age, neonatal jaundice, fetal distress, perinatal asphyxia, congenital abnormality, gastrointestinal tract abnormality, and perinatal mortality were similar among the two groups. We conclude that the presence of hepatitis B surface antigen in pregnant women does not pose additional risk for the pregnancy.

Adult↗

Outcome in infants of birth weight 500 to 999 g: a continuing regional study of 5-year-old survivors.

During 1979 and 1980, 351 infants of birth weight 500 to 999 g were born in the State of Victoria: 89 (25.4%) survived to the age of 2 years corrected for prematurity, and 83 were fully assessed by a multidisciplinary team; partial data were obtained on the remainder. At the age of 5 years, corrected for prematurity, 85/89 (96%) were evaluated by a multidisciplinary team, although not all children could be fully evaluated by the psychologists. Reports were available for another three children; one child was untraced. Of the survivors able to be classified at 5 years, 59/82 (72%) had no functional handicap. Functional handicaps was severe in 16 (19%), moderate in four (5%), and mild in three (4%). Functional handicaps were present in 50% (8/16) of outborn survivors compared with the 23% (15/66) for the inborn survivors (P = 0.02). Cerebral palsy was diagnosed in eight children at 5 years and in 12 children at 2 years. The diagnosis was stable for the children not ambulant at 2 years; five of seven 2-year-old children with mild cerebral palsy had "outgrown" the diagnosis by 5 years, but ataxic cerebral palsy was not identified in one child until 5 years. Six children were blind; four had severe sensorineural or mixed deafness, one more than at 2 years. Of 82 children assessed according to identical criteria for functional handicap at both 2 and 5 years, 52 (63%) remained in the same category at 5 years, three (4%) were judged to be more severely handicapped, and 27 (33%) were less severely handicapped. The 2-year evaluation of extremely low birth weight children often proved to be unduly pessimistic, for many showed improvement or recovery from functional handicaps and impairments by 5 years of age.

Australia↗

Characterization of a labile naloxone binding site (lambda site) in rat brain.

A high-affinity binding site selective for naloxone and other 4,5-epoxymorphinans (lambda site) has been previously described in rat brain. Following homogenization of freshly dissected brain, the lambda sites convert from a high-affinity to a low-affinity state. When measured with [3H]naloxone, the decay is very rapid at 20 degrees C (t 1/2 less than 2 min), whereas it is progressively slowed at lower temperatures. Proteinase inhibitors, antoxidants, and sulfhydryl group-protecting agents failed to prevent this conversion. Kinetic measurements of mu and lambda binding at varying temperatures demonstrated that the decrease in lambda binding does not coincide with the concurrent increase in mu binding and that the loss of high-affinity lambda binding at 20 degrees C can be partially restored when the temperature is lowered to 0 degrees C. The low-affinity state of the lambda site is rather stable in the Tris buffer homogenates and is susceptible to digestion by a protease. The (-)-isomer of WIN 44,441, a benzomorphan drug, binds to lambda sites with moderate affinity (dissociation constant, KD = 63 nM), whereas the (+)-isomer does not (KD greater than 10,000 nM), thus establishing stereoselectivity of the binding process. Neither the high-affinity nor the low-affinity state of lambda binding is significantly affected by the presence of 100 mM sodium chloride or 50 microM Gpp(NH)p, (a GTP analog), which is in contrast to the dramatic effect of these agents on the established opioid receptor system. Naltrexone, naloxone, nalorphine, and morphine (in this order of decreasing potency) bind to the lambda site in vivo in intact rat brain over dosage ranges that are commonly employed in pharmacological studies.

Animals↗

Outcome in infants with birth weight 500 to 999 gm: a regional study of 1979 and 1980 births.

During 1979 and 1980, 351 infants weighing 500 to 999 gm were born in the State of Victoria, Australia; 89 (25.4%) survived to 2 years of age. Survival was better for tertiary center births (29%) than for those born elsewhere (17%). Multidisciplinary teams reviewed 83 of the survivors at 2 years of age postterm; some data were available for the other six children. Overall, 22.5% of infants had severe functional handicap, 29.2% had either moderate or mild handicap, and 48.3% had no handicap. Severe functional handicap was present in 50% of outborn infants; this was significantly more common than in those born in tertiary centers (15.5%), and the Bayley Mental Developmental Index was also significantly lower in outborn infants. The prevalence of cerebral palsy (13.5%), bilateral blindness (3.4%), and severe sensorineural deafness (3.4%) did not differ significantly in the inborn and outborn infants. Singleton inborn infants of appropriate weight for gestational age had significantly less severe functional handicap (9.1%), compared with 37.5% for the group of infants who were either small for gestational age or one of multiple births. Six of the 18 outborn infants could have been transferred in utero, and improvements in immediate neonatal care were possible in seven other infants.

Age Factors↗

Outcome of extremely low birth-weight infants in relation to the hospital of birth.

There were 351 liveborn infants of birth-weight 500-999 g born in the State of Victoria in the years 1979 and 1980; 89/351 (25.4%) survived to the age of 2 years: 42 (47.2%) survivors were of gestational ages of 24 to 26 weeks and 47 (52.8%) were born at 27 to 32 weeks' gestation. Survival of these extremely low birth-weight infants was significantly better (71/245, 29%) for births in tertiary centres compared with those born elsewhere (18/106, 17%). Of the 351 livebirths, 69.8% occurred in 1 of the 3 tertiary centres. All 89 survivors were traced; 84 (94.4%) were assessed at the age of at least 2 years by a multidisciplinary team. Three children had been fully assessed at 1 year of age and paediatric reports were available for 2 children. The quality of survival of children born in tertiary centres was significantly better than those transferred to a tertiary centre after birth; the prevalence of serious functional handicap was 72.2% (13/18) for outborn children compared with 22.5% (16/71) for those born in tertiary centres. The prevalence of serious functional handicap in the inborn survivors was lowest (9/55, 16.4%) in singleton births who had been of appropriate birth-weight for gestation. A review of the 18 surviving outborn infants' records indicated that 6 (33.3%) could have been transferred to a tertiary centre in utero and for the 12 infants where birth in a tertiary centre was not feasible, improvements in the early neonatal care were possible in another 7 infants.

Australia↗

Intravenous solutions in parenteral nutrition.

A review of the theoretical basis on which amino acid intravenous solutions are formulated leads to the conclusion that the first class protein model is not ideal for the very small premature infant. Comparison of the serum and urine amino acid levels in a controlled trial between intravenous feeding with "Vamin" and intragastric milk feeding, and further comparison of these values with the cord blood values of premature infants supports the conclusion that the first class protein model is not ideal. The balance studies also support the view that the urinary output of amino acids, as well as the serum levels, should be taken into account in determining the ideal amino acid input.

Amino Acids↗

Obstetric care of the very premature fetus.

A group of 27 premature fetuses, between 27 and 35 weeks of gestation, were studied in the fetal intensive care unit. Both late deceleration of fetal heart rate and loss of beta to beat variation were associated with significantly lower Apgar scores. Four of 5 of the very premature fetuses who died of asphyxia soon after birth, showed evidence of asphyxia in the fetal heart rate trace before birth. Because of the improved short- and long-term outlook for the liveborn very premature fetus, active obstetric intervention when intrauterine asphyxia is diagnosed may furthther improve survival rate.

Apgar Score↗

Haemoglobin Bart's hydrops fetalis syndrome in an infant of Greek origin and prenatal diagnosis of alpha-thalassaemia.

An unusual case of Bart's hydrops fetalis is reported where the patient was born to parents of Greek origin. An exchange transfusion was given. Adult haemoglobin (HbA) was present in addition to HbBart's and HbPortland. A low level of synthesis of alpha-chains was evident. The mother presented again in a subsequent pregnancy for prenatal diagnosis of thalassaemia. The fetus was diagnosed as an alpha-thalassaemia carrier, a diagnosis which was confirmed at birth. The nature of alpha-thalassaemia in the family is discussed.

Australia↗