摘要:

One hundred seventy-four women with invasive cervical carcinoma were interviewed about their cervical smear histories to assess the accuracy of self-reporting and to relate the smear history with patient and tumor characteristics. Patients reported significantly more frequent, more recent, and more normal smears than were documented in medical records. The interval between onset of cancer symptoms and previous smear correlated directly with advanced stage. Sixteen women with normal smears within 36 months had significantly more advanced cancers than did 25 women with recent abnormal smears. Women with recent normal and abnormal smears had similar sociodemographic and behavioral characteristics. Because of inaccuracies in patients' self-reported smear histories and cancers developing in women with recent normal smears, we conclude that a specific screening interval should not be relied upon.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In a 5-year study, 425 women had conization performed for cervical intraepithelial neoplasia (CIN) I, II, or III. Conization was performed only in cases of positive endocervical curettage or when colposcopy was inconclusive. In all other cases, local destruction was the operation of choice. In the early years of the study, conization was done by the cold-knife method (N=201), whereas CO2 laser was used in the latter part of the study (N=224). Success and complication rates were the same for the two methods. Abnormal cytology after conization was found in a total of 53 cases (12.5%), but a histologic confirmation of residual or recurrent CIN was made in only 27 women (6.4%). This corresponds to a success rate of 92% after cold-knife and 95% after laser conization. The CIN grading of the residual or recurrent CIN was similar to or less than the CIN diagnosis of the cone. Because our success rate was comparable to that of other series with much less strict referral criteria, our policy seems adequate.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A prospective observational study of postoperative infection after gynecologic surgery assessed the need for antibiotic prophylaxis with special reference to the urinary tract. Catheterization requirements in the postoperative period were compared with the development of urinary tract infection after excluding both preoperative and postoperative bacteriuria. Forty-six of 115 patients (40%) developed a urinary tract infection in the postoperative period. Furthermore, this was not clearly related to the need for postoperative catheterization. Significant wound and vaginal vault infections were uncommon, indicating that antibiotic prophylaxis should be directed specifically at the urinary tract.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A retrospective review was conducted of 53 women with invasive carcinoma of the vagina and without documented exposure to diethylstilbestrol who were seen at the University of California Irvine Medical Center, Long Beach Memorial Medical Center, and Saddleback Memorial Medical Center from 1976-1988. Forty-seven (89%) had squamous cell carcinoma and six (11%) adenocarcinoma. Thirty-seven (70%) were treated with whole-pelvis irradiation and brachytherapy, nine with surgery alone, and the other seven with a combination of treatments. The crude and corrected 2-year survival rates for the entire group were 47 and 69%, respectively. Those with previous pelvic surgery were more likely to develop serious treatment-related complications. There was a statistically significant correlation between previous hysterectomy and the diagnosis of primary invasive carcinoma of the vagina after the onset of symptoms. Women diagnosed during routine examination, before symptom onset, tended to have a survival advantage. All women, including those who have had hysterectomy, should be counselled to continue gynecologic cancer surveillance regardless of age.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The effects of repeated cervical infections followed by a single direct tubal inoculation with Chlamydia trachomatis, serovars D and F, were examined in 11 pig-tailed macaques to test the hypothesis that tubal inoculation after cervical priming causes a more severe disease than primary tubal inoculation alone. Animals were cervically inoculated between two and five times. Fallopian tubes were inoculated with serovar D or F 1 week after the last cervical challenge. Three control monkeys received only one direct tubal inoculation without previous cervical inoculation. Infection was confirmed by isolating the microorganism from the endocervix in 13 of 14 monkeys and from the endosalpinx in four only after the tubal inoculation. Antibody was detected in post-infection sera of all 14. Tubal edema occurred in seven of 11 animals after the first cervical inoculation, and uterine erythema occurred in 11 of 11 after the second cervical inoculation. Peritubal adhesions were induced before the tubal inoculation in zero of seven given three or fewer cervical inoculations and four of four given five cervical inoculations (P<.01). After direct tubal inoculation, peritubal adhesions became more prominent, and the 11 hysterectomy specimens showed plasma cell endometritis in nine and salpingitis in nine. Two control monkeys developed minor adhesions, the other none. One tube in two of three controls showed mild plasma cell infiltrates, whereas no evidence of endometritis was observed in controls. Histopathology in these monkeys was characteristic of chlamydial endometritis and salpingitis. However, the pathogenesis of these changes is uncertain because C trachomatis was not isolated from the endosalpinx after cervical inoculations alone.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Torulopsis glabrata is second only to Candida albicans in frequency of isolation from the vagina in both asymptomatic women and patients with yeast vaginitis. We retrospectively studied 33 patients from whom vaginal isolates of T glabrata were obtained. Torulopsis glabrata caused symptomatic vaginitis in 42% of the patients but was unassociated with symptoms in 30%; in 27% of patients, its importance was uncertain because of concomitant pathology. Antifungal susceptibility testing was performed on 39 T glabrata strains isolated from 39 patients. The minimal inhibitory concentrations (MICs) of the majority of T glabrata isolates fell within the sensitive range of the antimycotic drugs tested; however, no correlation was found between in vitro antifungal MICs and the response to azole drug therapy. Clinical success was achieved in 67% of the patients although mycologic cure occurred in only 33%. A small number of patients developed recurrent and often chronic Torulopsis vaginitis unresponsive to conventional therapy. Limited experience suggests that vaginal boric acid therapy may be of value in these recalcitrant cases.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The purpose of this study was to determine the efficacy and safety of 0.5% podofilox solution (Condylox) for the treatment of genital warts in women. Thirty-seven women with anogenital warts applied the solution to the surface of these warts twice daily for 3 days, followed by 4 drug-free days. A minimum of two and a maximum of four treatment cycles were given. The subjects were evaluated weekly for the first 4 weeks and again at 6 and 10 weeks. At the end of 10 weeks, the mean number of warts per patient was reduced from 6.27 to 1.1, and half of the patients were completely cleared of warts. Only eight of 37 subjects (21.6%) developed new warts during the study period. Approximately 15% of patients reported “severe” local reactions to the treatment after the first treatment cycle, but this was reduced to only 5% by the last treatment cycle. During the same period, the patients reporting no side effects increased from 44 to 86%. The only woman who discontinued the study did so because of dizziness and epigastric discomfort, probably unrelated to drug use. Thus, 0.5% podofilox solution appears to be an effective treatment for condylomata acuminata, with acceptable side effects that are local and temporary.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Three hundred ninety women treated for cervical dysplasia by local tissue ablation were studied retrospectively to test the hypothesis that the treatment failure rate is lower if the male sexual partner is also treated. In 190 cases, the male sexual partner was examined and treated successfully for genital condylomata. Controls were 200 women treated during the same time period and closely matched to the study group regarding age, race, socioeconomic status, histologic grade of dysplasia, distribution of the lesions, and methods of therapy, but the male partner was neither examined nor treated. The treatment failure rate for women whose partners were also treated was not significantly different from that for women whose partners were not treated (6.8 versus 7.5%; P>.05), suggesting that treating genital condylomata in men does not affect the failure rate of cervical dysplasia in female sexual partners.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A retrospective case-control investigation was conducted for risk factors in 47 parturients whose episiotomies dehisced in the immediate postpartum period. Data were extracted from the inpatient, outpatient, and pathology records of each of these 47 patients, as well as from the same records for each of the next two patients who delivered with the same type and degree of episiotomy. No difference between subjects and controls was found for age, parity, or medical history. Except for human papillomavirus (HPV), past or present history of sexually transmitted diseases was not a risk factor. However, active lesions, history thereof, or subsequent development of infection with HPV was found in 14 of 47 patients (29.8%) who had episiotomy breakdown, compared with 13 of 94 women (13.8%) who did not experience this complication, a statistically significant difference (P<.023). Eleven subjects (23.4%) and nine controls (9.6%) gave a history of smoking during pregnancy, also a statistically significant difference (P<.026).

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Unfavorable fetal position during diagnostic obstetric ultrasound can interfere with visualization of certain structures, leading to prolonged or repeated examination. Fetal acoustic stimulation induces a fetal startle reflex and an increase in fetal movements. This report describes our experience with fetal acoustic stimulation to prompt fetal movement in an effort to improve fetal visualization. At gestational ages of 28 weeks or more a 94.1% success rate was noted, in 30 seconds or less in 70.6% of the cases. We conclude that fetal acoustic stimulation may be a valuable adjunct to diagnostic obstetric ultrasound.

ISSN:0029-7844    

出版商:OVID    

年代:1990

数据来源: OVID