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Ricardo Gomez - One of the best experts on this subject based on the ideXlab platform.

  • serum c reactive protein White Blood Cell count and amniotic fluid White Blood Cell count in women with preterm premature rupture of membranes
    Obstetrics & Gynecology, 1996
    Co-Authors: Bo Hyun Yoon, Ricardo Gomez, Jong Kwan Jun, Kyo Hoon Park, Hee Chul Syn
    Abstract:

    Objective To compare the diagnostic performance of maternal Blood C-reactive protein, White Blood Cell count (WBC), and amniotic fluid (AF) WBC in the identification of positive AF culture, histologic and clinical chorioamnionitis, and neonatal morbidity in women with preterm premature rupture of membranes (PROM). Methods Maternal Blood was collected for the determination of C-reactive protein and WBC at the time of amniocentesis from 90 women with preterm PROM. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasmas. Amniotic fluid WBC was determined for research purposes. Receiver operating characteristic curve and logistic regression were used for statistical analysis. Results The prevalence of positive AF culture was 28% (25 of 90). Women with positive AF culture and clinical chorioamnionitis had significantly higher median C-reactive protein, WBC, and AF WBC than did women without these conditions ( P P 3 had a greater sensitivity than C-reactive protein (cutoff, 0.7 mg/dL) and WBC (cutoff, 13,000 Cells per mm 3 ) in the detection of positive AF culture and histologic chorioamnionitis. Logistic regression analysis indicated that among AF WBC, C-reactive protein, and WBC, AF WBC was the best predictor of positive AF culture (odds ratio [OR] 24.2, 95% confidence interval [CI] 6.0, 97.5, P P P = .057), and neonatal morbidity (OR 4.3, 95% CI 1.1, 16.6, P Conclusion Amniotic fluid WBC performs better than C-reactive protein and maternal Blood WBC in the diagnosis of positive AF culture, histologic and clinical chorioamnionitis, and neonatal morbidity in women with preterm PROM.

  • the value of amniotic fluid interleukin 6 White Blood Cell count and gram stain in the diagnosis of microbial invasion of the amniotic cavity in patients at term
    American Journal of Reproductive Immunology, 1994
    Co-Authors: Ricardo Gomez, Roberto Romero, Maurizio Galasso, Ernesto Behnke, A Insunza, David B Cotton
    Abstract:

    Problem Subclinical microbial invasion of the amniotic cavity occurs in 18.8% of women with term labor and intact membranes and in 34% of patients with term PROM and is a risk factor for the development of puerperal infection related morbidity. Although amniotic fluid White Blood Cell count, interleukin-6 determination, and Gram stain examination have been used for the diagnosis of intrauterine infection in patients with preterm labor and preterm premature rupture of membranes, no information is available about the accuracy and specific cut-off values for these tests in patients at term. The purpose of this study was to compare the performance of the amniotic fluid Gram stain examination, White Blood Cell count, and interleukin-6 determination in the identification of microbial invasion of the amniotic cavity in patients at term with and without PROM. Method Amniotic fluid was retrieved from 148 patients with term gestations (90 patients with spontaneous labor and intact membranes and 58 patients with PROM). Samples were cultured for bacteria and Mycoplasma species. Amniotic fluid Gram stain, White Blood Cell count, and interleukin-6 determinations (ELISA, sensitivity: 43 pg/ml) were performed in all samples. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture for microorganisms. Analysis was conducted using Mann-Whitney U test, Fisher's exact test, receiver operating characteristic curves and logistic regression. Results Patients with spontaneous labor and intact membranes: The prevalence of microbial invasion of amniotic cavity in this group was 15.6% (14/90). The most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determination (sensitivity for: interleukin-6 > or = 5.7 ng/ml = 86%, White Blood Cell count > or = 20 Cells/mm3 = 64%, Gram stain = 28%). The most specific test was the Gram stain of the amniotic fluid (specificity for: Gram stain = 84%, interleukin-6 = 79% and White Blood Cell count = 63%). Multiple logistic regression demonstrated that amniotic fluid interleukin-6 concentration was the only covariate that retained statistical significance when intrauterine infection was used as outcome variable. Patients with PROM: The prevalence of a positive amniotic fluid culture in this group was 39.7% (23/58). Logistic regression demonstrated that only interleukin-6 retained a significant relationship with the results of amniotic culture when all variables were entered simultaneously into a model to predict amniotic fluid culture results. The most sensitive tests for the detection of intrauterine infection were interleukin-6 determination and White Blood Cell count (sensitivity for interleukin-6 > or = 3.4 ng/ml and White Blood Cell count > or = 20 Cells/mm3 = 69.6% for both). The most specific test was Gram stain (97.1%). Conclusions Amniotic fluid interleukin-6 determination is the best rapid test for the detection of microbial invasion of the amniotic cavity in patients at term with and without PROM. When this test is not available, amniotic fluid Gram stain and White Blood Cell count represent valid diagnostic tools to assess the microbial state of amniotic cavity.

  • the diagnostic and prognostic value of amniotic fluid White Blood Cell count glucose interleukin 6 and gram stain in patients with preterm labor and intact membranes
    American Journal of Obstetrics and Gynecology, 1993
    Co-Authors: Bo Hyun Yoon, Moshe Mazor, Ricardo Gomez, Michael P Diamond, John S Kenney, Marcelo Ramirez, Paul L Fidel, Yoram Sorokin, David B Cotton
    Abstract:

    Objective: Our goal was to compare the value of amniotic fluid tests in the detection of microbial invasion of the amniotic cavity and in the relationship with the amniocentesis-to-delivery interval and neonatal complications in patients with preterm labor and intact membranes. Study Design: Amniotic fluid was retrieved by transabdominal amniocentesis from 120 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Amniotic fluid analysis included a Gram stain, White Blood Cell count, glucose and interleukin-6 determinations. Logistic regression and Cox's proportional hazards model were used for analysis. Results: (1) The prevalence of positive amniotic fluid cultures was 9.2% (11/120); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complications rate than patients with a negative culture; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 11.3 ng/ml) (sensitivity; for interleukin-6 100%, for glucose 81.8%, for White Blood Cell count 63.6%, and for Gram stain 63.6%; p p Conclusion: Interleukin-6 concentrations in amniotic fluid are better indicators of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval, and neonatal complications than the amniotic fluid Gram stain, glucose concentration, or White Blood Cell count.

Bo Hyun Yoon - One of the best experts on this subject based on the ideXlab platform.

  • serum c reactive protein White Blood Cell count and amniotic fluid White Blood Cell count in women with preterm premature rupture of membranes
    Obstetrics & Gynecology, 1996
    Co-Authors: Bo Hyun Yoon, Ricardo Gomez, Jong Kwan Jun, Kyo Hoon Park, Hee Chul Syn
    Abstract:

    Objective To compare the diagnostic performance of maternal Blood C-reactive protein, White Blood Cell count (WBC), and amniotic fluid (AF) WBC in the identification of positive AF culture, histologic and clinical chorioamnionitis, and neonatal morbidity in women with preterm premature rupture of membranes (PROM). Methods Maternal Blood was collected for the determination of C-reactive protein and WBC at the time of amniocentesis from 90 women with preterm PROM. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasmas. Amniotic fluid WBC was determined for research purposes. Receiver operating characteristic curve and logistic regression were used for statistical analysis. Results The prevalence of positive AF culture was 28% (25 of 90). Women with positive AF culture and clinical chorioamnionitis had significantly higher median C-reactive protein, WBC, and AF WBC than did women without these conditions ( P P 3 had a greater sensitivity than C-reactive protein (cutoff, 0.7 mg/dL) and WBC (cutoff, 13,000 Cells per mm 3 ) in the detection of positive AF culture and histologic chorioamnionitis. Logistic regression analysis indicated that among AF WBC, C-reactive protein, and WBC, AF WBC was the best predictor of positive AF culture (odds ratio [OR] 24.2, 95% confidence interval [CI] 6.0, 97.5, P P P = .057), and neonatal morbidity (OR 4.3, 95% CI 1.1, 16.6, P Conclusion Amniotic fluid WBC performs better than C-reactive protein and maternal Blood WBC in the diagnosis of positive AF culture, histologic and clinical chorioamnionitis, and neonatal morbidity in women with preterm PROM.

  • maternal Blood c reactive protein White Blood Cell count and temperature in preterm labor a comparison with amniotic fluid White Blood Cell count
    Obstetrics & Gynecology, 1996
    Co-Authors: Bo Hyun Yoon, Soon Ha Yang, Jong Kwan Jun, Kyo Hoon Park, Chong Jai Kim, Roberto Romero
    Abstract:

    Objective To compare the diagnostic and prognostic performance of maternal Blood C-reactive protein, White Blood Cell count (WBC), and temperature with that of amniotic fluid (AF) WBC in preterm labor. Methods One hundred two women with preterm labor and intact membranes were studied. Maternal Blood was collected to measure C-reactive protein concentration and WBC, and maternal temperature was also measured. Amniotic fluid obtained by amniocentesis was cultured and WBC determined. Receiver operating characteristic curve, logistic regression, and survival techniques were used for analysis. Results Patients with acute histologic chorioamnionitis had significantly higher median C-reactive protein concentration, WBC, temperature, and AF WBC than patients without this lesion ( P P P Conclusion An elevated C-reactive protein, WBC, or AF WBC identified patients with intrauterine infection and adverse perinatal outcomes. Amniotic fluid WBC was a better independent predictor of these outcomes than C-reacrive protein, WBC, or temperature.

  • the diagnostic and prognostic value of amniotic fluid White Blood Cell count glucose interleukin 6 and gram stain in patients with preterm labor and intact membranes
    American Journal of Obstetrics and Gynecology, 1993
    Co-Authors: Bo Hyun Yoon, Moshe Mazor, Ricardo Gomez, Michael P Diamond, John S Kenney, Marcelo Ramirez, Paul L Fidel, Yoram Sorokin, David B Cotton
    Abstract:

    Objective: Our goal was to compare the value of amniotic fluid tests in the detection of microbial invasion of the amniotic cavity and in the relationship with the amniocentesis-to-delivery interval and neonatal complications in patients with preterm labor and intact membranes. Study Design: Amniotic fluid was retrieved by transabdominal amniocentesis from 120 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Amniotic fluid analysis included a Gram stain, White Blood Cell count, glucose and interleukin-6 determinations. Logistic regression and Cox's proportional hazards model were used for analysis. Results: (1) The prevalence of positive amniotic fluid cultures was 9.2% (11/120); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complications rate than patients with a negative culture; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 11.3 ng/ml) (sensitivity; for interleukin-6 100%, for glucose 81.8%, for White Blood Cell count 63.6%, and for Gram stain 63.6%; p p Conclusion: Interleukin-6 concentrations in amniotic fluid are better indicators of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval, and neonatal complications than the amniotic fluid Gram stain, glucose concentration, or White Blood Cell count.

David B Cotton - One of the best experts on this subject based on the ideXlab platform.

  • the value of amniotic fluid interleukin 6 White Blood Cell count and gram stain in the diagnosis of microbial invasion of the amniotic cavity in patients at term
    American Journal of Reproductive Immunology, 1994
    Co-Authors: Ricardo Gomez, Roberto Romero, Maurizio Galasso, Ernesto Behnke, A Insunza, David B Cotton
    Abstract:

    Problem Subclinical microbial invasion of the amniotic cavity occurs in 18.8% of women with term labor and intact membranes and in 34% of patients with term PROM and is a risk factor for the development of puerperal infection related morbidity. Although amniotic fluid White Blood Cell count, interleukin-6 determination, and Gram stain examination have been used for the diagnosis of intrauterine infection in patients with preterm labor and preterm premature rupture of membranes, no information is available about the accuracy and specific cut-off values for these tests in patients at term. The purpose of this study was to compare the performance of the amniotic fluid Gram stain examination, White Blood Cell count, and interleukin-6 determination in the identification of microbial invasion of the amniotic cavity in patients at term with and without PROM. Method Amniotic fluid was retrieved from 148 patients with term gestations (90 patients with spontaneous labor and intact membranes and 58 patients with PROM). Samples were cultured for bacteria and Mycoplasma species. Amniotic fluid Gram stain, White Blood Cell count, and interleukin-6 determinations (ELISA, sensitivity: 43 pg/ml) were performed in all samples. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture for microorganisms. Analysis was conducted using Mann-Whitney U test, Fisher's exact test, receiver operating characteristic curves and logistic regression. Results Patients with spontaneous labor and intact membranes: The prevalence of microbial invasion of amniotic cavity in this group was 15.6% (14/90). The most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determination (sensitivity for: interleukin-6 > or = 5.7 ng/ml = 86%, White Blood Cell count > or = 20 Cells/mm3 = 64%, Gram stain = 28%). The most specific test was the Gram stain of the amniotic fluid (specificity for: Gram stain = 84%, interleukin-6 = 79% and White Blood Cell count = 63%). Multiple logistic regression demonstrated that amniotic fluid interleukin-6 concentration was the only covariate that retained statistical significance when intrauterine infection was used as outcome variable. Patients with PROM: The prevalence of a positive amniotic fluid culture in this group was 39.7% (23/58). Logistic regression demonstrated that only interleukin-6 retained a significant relationship with the results of amniotic culture when all variables were entered simultaneously into a model to predict amniotic fluid culture results. The most sensitive tests for the detection of intrauterine infection were interleukin-6 determination and White Blood Cell count (sensitivity for interleukin-6 > or = 3.4 ng/ml and White Blood Cell count > or = 20 Cells/mm3 = 69.6% for both). The most specific test was Gram stain (97.1%). Conclusions Amniotic fluid interleukin-6 determination is the best rapid test for the detection of microbial invasion of the amniotic cavity in patients at term with and without PROM. When this test is not available, amniotic fluid Gram stain and White Blood Cell count represent valid diagnostic tools to assess the microbial state of amniotic cavity.

  • the diagnostic and prognostic value of amniotic fluid White Blood Cell count glucose interleukin 6 and gram stain in patients with preterm labor and intact membranes
    American Journal of Obstetrics and Gynecology, 1993
    Co-Authors: Bo Hyun Yoon, Moshe Mazor, Ricardo Gomez, Michael P Diamond, John S Kenney, Marcelo Ramirez, Paul L Fidel, Yoram Sorokin, David B Cotton
    Abstract:

    Objective: Our goal was to compare the value of amniotic fluid tests in the detection of microbial invasion of the amniotic cavity and in the relationship with the amniocentesis-to-delivery interval and neonatal complications in patients with preterm labor and intact membranes. Study Design: Amniotic fluid was retrieved by transabdominal amniocentesis from 120 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Amniotic fluid analysis included a Gram stain, White Blood Cell count, glucose and interleukin-6 determinations. Logistic regression and Cox's proportional hazards model were used for analysis. Results: (1) The prevalence of positive amniotic fluid cultures was 9.2% (11/120); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complications rate than patients with a negative culture; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 11.3 ng/ml) (sensitivity; for interleukin-6 100%, for glucose 81.8%, for White Blood Cell count 63.6%, and for Gram stain 63.6%; p p Conclusion: Interleukin-6 concentrations in amniotic fluid are better indicators of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval, and neonatal complications than the amniotic fluid Gram stain, glucose concentration, or White Blood Cell count.

Roberto Romero - One of the best experts on this subject based on the ideXlab platform.

  • maternal Blood c reactive protein White Blood Cell count and temperature in preterm labor a comparison with amniotic fluid White Blood Cell count
    Obstetrics & Gynecology, 1996
    Co-Authors: Bo Hyun Yoon, Soon Ha Yang, Jong Kwan Jun, Kyo Hoon Park, Chong Jai Kim, Roberto Romero
    Abstract:

    Objective To compare the diagnostic and prognostic performance of maternal Blood C-reactive protein, White Blood Cell count (WBC), and temperature with that of amniotic fluid (AF) WBC in preterm labor. Methods One hundred two women with preterm labor and intact membranes were studied. Maternal Blood was collected to measure C-reactive protein concentration and WBC, and maternal temperature was also measured. Amniotic fluid obtained by amniocentesis was cultured and WBC determined. Receiver operating characteristic curve, logistic regression, and survival techniques were used for analysis. Results Patients with acute histologic chorioamnionitis had significantly higher median C-reactive protein concentration, WBC, temperature, and AF WBC than patients without this lesion ( P P P Conclusion An elevated C-reactive protein, WBC, or AF WBC identified patients with intrauterine infection and adverse perinatal outcomes. Amniotic fluid WBC was a better independent predictor of these outcomes than C-reacrive protein, WBC, or temperature.

  • the value of amniotic fluid interleukin 6 White Blood Cell count and gram stain in the diagnosis of microbial invasion of the amniotic cavity in patients at term
    American Journal of Reproductive Immunology, 1994
    Co-Authors: Ricardo Gomez, Roberto Romero, Maurizio Galasso, Ernesto Behnke, A Insunza, David B Cotton
    Abstract:

    Problem Subclinical microbial invasion of the amniotic cavity occurs in 18.8% of women with term labor and intact membranes and in 34% of patients with term PROM and is a risk factor for the development of puerperal infection related morbidity. Although amniotic fluid White Blood Cell count, interleukin-6 determination, and Gram stain examination have been used for the diagnosis of intrauterine infection in patients with preterm labor and preterm premature rupture of membranes, no information is available about the accuracy and specific cut-off values for these tests in patients at term. The purpose of this study was to compare the performance of the amniotic fluid Gram stain examination, White Blood Cell count, and interleukin-6 determination in the identification of microbial invasion of the amniotic cavity in patients at term with and without PROM. Method Amniotic fluid was retrieved from 148 patients with term gestations (90 patients with spontaneous labor and intact membranes and 58 patients with PROM). Samples were cultured for bacteria and Mycoplasma species. Amniotic fluid Gram stain, White Blood Cell count, and interleukin-6 determinations (ELISA, sensitivity: 43 pg/ml) were performed in all samples. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture for microorganisms. Analysis was conducted using Mann-Whitney U test, Fisher's exact test, receiver operating characteristic curves and logistic regression. Results Patients with spontaneous labor and intact membranes: The prevalence of microbial invasion of amniotic cavity in this group was 15.6% (14/90). The most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determination (sensitivity for: interleukin-6 > or = 5.7 ng/ml = 86%, White Blood Cell count > or = 20 Cells/mm3 = 64%, Gram stain = 28%). The most specific test was the Gram stain of the amniotic fluid (specificity for: Gram stain = 84%, interleukin-6 = 79% and White Blood Cell count = 63%). Multiple logistic regression demonstrated that amniotic fluid interleukin-6 concentration was the only covariate that retained statistical significance when intrauterine infection was used as outcome variable. Patients with PROM: The prevalence of a positive amniotic fluid culture in this group was 39.7% (23/58). Logistic regression demonstrated that only interleukin-6 retained a significant relationship with the results of amniotic culture when all variables were entered simultaneously into a model to predict amniotic fluid culture results. The most sensitive tests for the detection of intrauterine infection were interleukin-6 determination and White Blood Cell count (sensitivity for interleukin-6 > or = 3.4 ng/ml and White Blood Cell count > or = 20 Cells/mm3 = 69.6% for both). The most specific test was Gram stain (97.1%). Conclusions Amniotic fluid interleukin-6 determination is the best rapid test for the detection of microbial invasion of the amniotic cavity in patients at term with and without PROM. When this test is not available, amniotic fluid Gram stain and White Blood Cell count represent valid diagnostic tools to assess the microbial state of amniotic cavity.

Donna S Nussman - One of the best experts on this subject based on the ideXlab platform.

  • the value of White Blood Cell counts before revision total knee arthroplasty
    Journal of Arthroplasty, 2003
    Co-Authors: Bohannon J Mason, Thomas K Fehring, Susan M Odum, William L Griffin, Donna S Nussman
    Abstract:

    A White Blood Cell count (WBC) of >50,000 Cell/mm3 from a knee aspirate with ≥80% polymorphonuclear Cells (PMNCs) is suggestive of infection. This study sought to determine if these same criteria were applicable when interpreting aspirates from a total knee. Of 440 revision total knee arthroplasties, 86 patients had preoperative aspirations of the knee before revision. Fifty-five aspirates were from aseptic failures; 31 aspirates were from patients determined to have septic failure. The mean White Blood Cell (WBC) count in aspirates from the aseptic group was 645 Cells/mm3 (SD = 878). The mean WBC count in the septic group was 25,951 Cells/mm3 (SD = 34,994; P=<.001). The mean percentage of PMNCs was statistically higher in the septic group compared with the aseptic group (72.8% vs 27.3%; P=<.001). The synovial fluid WBC count differential analysis is a statistically relevant indicator of the presence or absence of infection in revision knee arthroplasty. Aspirates with a WBC count of 2,500 per milliliter and 60% PMNCs are highly suggestive of infection.

  • the value of White Blood Cell counts before revision total knee arthroplasty
    Journal of Arthroplasty, 2003
    Co-Authors: Bohannon J Mason, Thomas K Fehring, Susan M Odum, William L Griffin, Donna S Nussman
    Abstract:

    Abstract A White Blood Cell count (WBC) of >50,000 Cell/mm3 from a knee aspirate with ≥80% polymorphonuclear Cells (PMNCs) is suggestive of infection. This study sought to determine if these same criteria were applicable when interpreting aspirates from a total knee. Of 440 revision total knee arthroplasties, 86 patients had preoperative aspirations of the knee before revision. Fifty-five aspirates were from aseptic failures; 31 aspirates were from patients determined to have septic failure. The mean White Blood Cell (WBC) count in aspirates from the aseptic group was 645 Cells/mm3 (SD = 878). The mean WBC count in the septic group was 25,951 Cells/mm3 (SD = 34,994; P=