摘要:

Eight hundred cases of interval sterilization using suprapubic minilaparotomy were performed between August 1976 and November 1980. The high-risk population was defined as patients who had any preexisting medical condition, including obesity. No significant differences were found when the control patients were compared with the high-risk group in terms of operative and postoperative problems. All procedures were done under intravenous sedation and local anesthesia on an outpatient basis. The follow-up rate at 1 week was 100%. As of August 1980, 480 of the 482 patients due for 1-year follow-up were seen; the remaining 2 were contacted by telephone. Neither serious complications nor readmission to the hospital was found. There were no patients rejected on medical grounds and no failures to achieve tubal occlusion. In 3 patients, because of findings during minilaparotomy, laparotomy was carried out under general anesthesia as a continuation of the original procedure.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Both the precepts and the impact of regional planning for maternity care are often misunderstood. Here, a summary of 8 separate studies in 5 geographic regions describes the reactions of obstetrician-gynecologists to systems of regional planning, as well as their use of the system and the impact of regional planning on their practices. Overall, few physicians acquired new obstetric privileges, and closure of maternity services had limited impact on their practices. Approximately 50% of the physicians referred some patients to level 2 or 3 units, but only 25% actually transferred patients in a given year. The perceptions of a majority of physicians were of improvement in patient services and physician education as a result of regional planning activities. Recommendations are offered for additional needed studies of regional planning efforts.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Cultural, serologic, and epidemiologic aspects of Chlamydia trachomatis in acute salpingitis were assessed. Of 111 patients, 52 (47%) harbored C trachomatis in the cervix or urethra, or both. Neisseria gonorrhoene was isolated in 41 patients of 209 (20%). A majority (79%) of women with gonorrhea were also infected with C trachomatis. A fourfold titer rise of chlamydial IgG antibodies or significant IgM titer, or both, was demonstrated in 37 patients of 72 (51%) from whom paired sera were obtained. The serologic response distinguished 3 different phases of chlamydial infection: acute, subacute, and chronic or reinfection. The patients' male sex partners were examined on a voluntary basis, and C trachomatis was detected in 68%, indicating a need for effective partner examination and treatment.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Two groups in Denmark and Sweden, totalling 943 healthy women in the first trimester of pregnancy who were undergoing elective abortion, were examined in a prospective study. Group 1 consisted of 432 women from Denmark, all examined prior to and 2 weeks after the operation. At the first examination, samples were taken from the cervix for the isolation of chlamydiae and gonococci. Chlamydia trachomatis was isolated from 23 (5.3%) of the women. Postoperatively, 15 patients developed acute pelvic inflammatory disease (PID). Five of these patients harbored C trachomatis before the operation, and all 5 developed a significant change in the titer of immunoglobulin G microimmunofluorescence antibodies to the organism. In group 2, 25 (4.9%) of the 511 women from Sweden harbored C trachomatis before the intervention. Patients with chlamydiae were treated, before or in conjunction with the operation, with antibiotics active against chlamydiae. None of the women with cultures positive for chlamydiae showed signs of PID postoperatively. The difference in the postoperative frequency of PID in chlamydia-positive patients between groups 1 and 2 was significant (2P=.0393, Fisher exact test). Gonorrhea was diagnosed in 1% of the women in both groups. Only 1 of these patients developed PID postoperatively, but no pili antibodies to Neisseria gonorrhoeae were found during the course of the disease. It is concluded that women applying for abortion should be examined and treated not only for gonorrhea but also for infection with C trachomatis either before or, at the latest, in conjunction with the abortion.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Factitious or self-induced illness has rarely been mentioned in gynecologic literature. Described herein are 4 nonpregnant women, 3 of whom had vaginal bleeding of unknown origin and 1 who had recurrent fevers and an acute abdomen. In gynecologic practice, factitious illness should be suspected whenever a patient presents with a protracted illness that has eluded diagnosis. Furthermore, the index of suspicion for factitious illness should be high whenever a patient has an abnormal psychiatric history or has worked in a paramedical field.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Animal studies are described that investigate which cofactors influence the progression of herpesvirus hominis type II (HVH-II)-induced atypia of the cervical epithelium to malignancy. Results indicate that neither chemical nor physical factors markedly affect atypical development. However, sperm factors are implicated in influencing this atypical development. These data are considered in relation to the etiologic role of HVH-II in carcinoma of the cervix.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Twenty-six women with advanced or recurrent endometrial cancer were treated with cisplatin at a dose of 50, 70, or 100 mg/m2every 4 weeks. An objective response was obtained in 11 of 26 patients (42%), with 10 partial responses and 1 complete response. The median duration of remission was 5 months, with a range of 2 to 11 months. The complete response lasted 8 months. Five patients had stable disease lasting an average of 5 months. One of 6 patients (16.6%) responded to cisplatin at a dose of 50 mg/m2, 4 of 7 (57%) responded to the dose of 70 mg/m2, and 6 of 13 (46%) responded to the dose of 100 mg/m2, but the differences were not statistically significant (P=.2). In 8 of 26 cases (31%) cisplatin was discontinued because of toxicity. Three patients developed a peripheral neuropathy, 1 patient refused further therapy because of vomiting, 2 patients had nephrotoxicity, and 2 others had both nephrotoxicity and neurotoxicity. The average total cumulative dose of cisplatin administered when renal deterioration and neuropathy occurred was approximately 500 mg/m2. Cisplatin is definitely active against endometrial cancer, but toxicity precludes its prolonged administration in high doses on an outpatient basis. By maintaining a forced diuresis, toxicity can probably be decreased, thereby permitting continued administration of cisplatin. The drug may also be more useful when used at a lower dose in combination with other active agents against endometrial cancer.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Specimens from 53% (16 of 30) of patients with untreated ovarian epithelial cancers between October 1976 and February 1979 had estrogen binding levels greater than 30 fmoles/mg of cytosol protein (receptor rich). The likelihood of a specimen being receptor rich appeared to be independent of patient age, histologic grade of tumor, clinical stage, and amount of residual tumor left after surgery. For 20 patients with previously untreated advanced disease a life-table analysis showed no significant difference when receptorrich and -poor groups were compared in terms of either survival or time to first progression of disease. Analysis of more recent specimens (predominantly obtained after February 1979) indicates high-affinity binding of the estrogen consistent with receptor; occasional substantial heterogeneity in estrogen binding results between different sites of tumor involvement; and progestin-specific binding in some specimens. In an analogy to breast cancer, patients whose tumors are cytosol estrogen receptor rich might theoretically be responsive to the administration of antiestrogens.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Questionnaires on the material and the size of sutures used in obstetric-gynecologic surgery were sent to the directors of 110 residency programs in the specialty in medical schools in the United States. Replies were received from 80 (73%) programs. The findings indicate that the use of chromic catgut still predominates, but that the newer synthetic absorbable materials such as polyglactin acid and polyglactin 910 are becoming popular for some procedures, including certain steps in abdominal closure and in reconstructive tubal surgery. The increasing use of these materials for hysterectomy and cesarean section, heretofore exclusively the domain of chromic catgut, suggests that there is possibly under way a reorientation of attitudes about the materials used for sutures in obstetric-gynecologic surgery. The characteristics of catgut and of synthetic absorbable materials are herein described and compared in relation to their current use.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID