ABSTRACT
Liposome Extruder Purification (LEP) allows for the rapid purification of diverse liposome formulations using the same extrusion apparatus employed during liposome formation. The LEP process provides a means for purifying functionalized liposomes from non-conjugated drug or protein contaminants with >93% liposome recovery and >93% contaminant removal in a single step.
Subject(s)
Chemical Fractionation/methods , Liposomes/isolation & purification , Animals , Cattle , Chemistry, Pharmaceutical , Liposomes/chemistry , Time FactorsABSTRACT
BACKGROUND: Three cases of anaphylactoid syndrome of pregnancy developed in association with the use of intracervical dinoprostone for cervical ripening. CASES: All cases occurred at our institution between October 1996 and February 2001. The patients developed respiratory symptoms shortly after placement of 0.25 mg of intracervical dinoprostone gel. Hemodynamic changes, manifested by tetanic uterine contractions and fetal heart rate decelerations, followed. Subsequently all 3 patients developed disseminated intravascular coagulation, characterized by severe hypofibrinogenemia. CONCLUSION: There appears to be an association between intracervical dinoprostone for cervical ripening and anaphylactoid syndrome of pregnancy. Clinicians utilizing this route of dinoprostone administration should be familiar with this rare but potentially life-threatening complication.
Subject(s)
Anaphylaxis/chemically induced , Cervical Ripening/drug effects , Dinoprostone/adverse effects , Dinoprostone/therapeutic use , Disseminated Intravascular Coagulation/etiology , Oxytocics/adverse effects , Oxytocics/therapeutic use , Administration, Topical , Adult , Dinoprostone/administration & dosage , Female , Heart Rate, Fetal , Humans , Middle Aged , Oxytocics/administration & dosage , Pregnancy , SyndromeABSTRACT
OBJECTIVE: To develop normative data for nasal bone length between 11 and 20 weeks' gestation and to assess the utility of nasal bone hypoplasia in the detection of fetal aneuploidy in the second trimester. METHODS: Well-dated, nonanomalous fetuses were examined between 11 and 20.9 weeks' gestation. The nasal bone was assessed and measured, and normative data from 11 to 20 weeks' gestation were determined. The nasal bone lengths in fetuses with confirmed aneuploidy were compared with the normative data. RESULTS: The fetal nasal bone length increased linearly with advancing gestational age. Nomograms including the 10th, 50th, and 90th percentiles were created. Nasal bone hypoplasia was seen in 6 of 6 cases of fetal trisomy in the second trimester. CONCLUSIONS: Nasal bone hypoplasia in the early second trimester identifies a cohort of fetuses at high risk for aneuploidy.
Subject(s)
Fetus/anatomy & histology , Nasal Bone/diagnostic imaging , Nasal Bone/embryology , Ultrasonography, Prenatal , Adult , Aneuploidy , Cross-Sectional Studies , Female , Gestational Age , Humans , Pregnancy , Pregnancy Trimester, First , Pregnancy Trimester, Second , Prospective Studies , Reference ValuesABSTRACT
OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of combined first-trimester screening for fetal Down syndrome with second-trimester maternal serum triple screening. STUDY DESIGN: A first-trimester screening approach that used nuchal translucency measurement and maternal serum screening was evaluated against second-trimester maternal serum triple screening in a hypothetic population. Screening sensitivities and screen-positive rates were 91% and 5% for the first-trimester approach and 70% and 7.5% for the second-trimester approach, respectively. The costs of fetal Down syndrome, live-born Down syndrome cost, and total costs (screening plus live-born costs) were calculated for each screening program. RESULTS: First-trimester screening was associated with lower screening and live-born Down syndrome costs versus second-trimester serum screening. Total Down syndrome screening costs were 29.1% lower with first-trimester screening. CONCLUSION: In this hypothetic model, combined first-trimester screening for fetal Down syndrome was more cost-effective than universal second-trimester triple serum screening.
Subject(s)
Down Syndrome/diagnosis , Health Care Costs , Mass Screening/economics , Adult , Cost-Benefit Analysis , Down Syndrome/economics , Female , Humans , Mass Screening/methods , Neck/embryology , Pregnancy/blood , Pregnancy Trimester, First , Pregnancy Trimester, Second , Ultrasonography, PrenatalABSTRACT
PURPOSE: To describe the initial experience of state mandated prenatal HIV screening at a large community hospital. METHODS: HIV screening was provided to all pregnant women as of October 1, 1999. All HIV-positive women identified received aggressive antiretroviral therapy to reduce the likelihood for vertical transmission. Neonates were screened for HIV at zero, six, and 12 months of age. RESULTS: Seven pregnant women (0.3%) and two additional family members tested positive for HIV. All seven infants born to the identified HIV-positive women have tested negative for infection. We estimated that six of nine cases of HIV infection identified would have been missed under a policy of voluntary HIV screening. CONCLUSIONS: Universal screening for HIV in pregnancy is achievable and desirable and provides the best opportunity to minimize the number of new neonatal HIV infections.
