摘要:

Two hundred fifty-one patients with premature rupture of membranes between 28 and 34 weeks' gestation were followed prospectively to evaluate the maternal and neonatal effects of chorioamnionitis. Forty-seven (19%) developed intrauterine infection prior to delivery. Fetal tachycardia, maternal leukocytosis, and uterine contractions were not predictive of intrauterine infections in afebrile patients. In afebrile patients, however, amniocenteses positive for bacteria on Gram stains and/or with subsequent positive culture correlated with subsequent development of antenatal maternal fever. Other than an increased rate of postpartum endometritis no serious maternal complications were seen in patients with chorioamnionitis. Neonatal outcome, however, was significantly adversely affected with respect to increase in perinatal mortality, overall neonatal infection rate, and respiratory distress syndrome (RDS) in patients with maternal infection. Neither trial of labor nor duration of labor in patients with chorioamnionitis correlated with adverse neonatal outcome. However, the appearance of maternal fever prior to the onset of labor correlated more significantly with neonatal death and RDS in the newborn than did the development of maternal fever in the intrapartum period

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Eighty-six pregnant patients with confirmed asymptomatic bacteriuria were treated with a single-dose, single-antimicrobial regimen. Overall the immediate rate of failure for the antimicrobial treatment regimen was 31.0%, with a subsequent recurrence rate of 3.5%. These data are applicable to populations with poor compliance to prescribed medications, as single-dose therapy will be effective in eradicating microorganisms for two thirds of the patients treated

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Chlamydia trachomatis is one of the main etiologic agents in pelvic inflammatory disease (PID) in Oslo. Up to two thirds of the 65 PID cases studied were associated with a Chlamydial infection. The incidence of cervical gonorrhea was low (7.7%). Anaerobic bacteria were not isolated from the fallopian tubes or peritoneal fluid of any of the patients. Chlamydia-associated PID is characterized by a protracted course and vague symptoms. The laparoscopic findings indicate more severe inflammatory changes of the tubes than in patients in whom these agents were not found. The highest incidence of chlamydia-associated PID occurred in younger subjects, among whom the intrauterine contraceptive device was more frequently used. Perihepatitis was diagnosed in PID patients with and without Chlamydial infection of the genital tract.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Ovulatory-phase cervical mucus columns demonstrate that microorganisms migrate in the cervical mucus with moving spermatozoa. Cultures obtained from the distal end of the mucus column after spermatozoal migration was complete yielded the same aerobic and anaerobic microbial isolates that were originally recovered from the seminal fluid. Exogenous aerobic bacteria added to the seminal fluid also appeared at the top of the mucus column. After removal of the spermatozoa, no bacteria were observed migrating through the mucus. It is concluded that spermatozoa may provide a vehicle for bacteria present in the seminal fluid prior to ejaculation and for those already present in the cervix or vagina. The significance of this finding is discussed, and one mechanism for the development of salpingo- oophoritis in the female is proposed.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The technique of managing allergies by optimum-dose (provocative neutralization) testing and treatment using aqueous progesterone has been studied in 132 women having progesterone-related symptoms due to the menstrual cycle, pregnancy, or exogenous hormone administration. When extremely small doses of progesterone (0.0016 mg or below, up to a maximum of 2.5 mg) were administered following determination of specific dose requirement by skin testing, startlingly rapid and effective clearing of symptoms was observed. With these individualized doses, symptoms cleared completely or almost completely within 30 minutes in the majority of patients. A single-blind technique was employed to rule out placebo effect. Some common problems found to respond well to the procedure were nausea and vomiting during pregnancy (100%), premenstrual syndrome (96%), and dysmenorrhea (84%).

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

An investigation has been made of the relationship between the histologic features of detected cancers of the uterine cervix and the history of previous cervical screening in 732 cases. Six hundred forty-nine of 732 (88.7%) cases with cancers of the uterine cervix were from the group of unscreened women, whereas only 83 cases (11.3%) were from the group of screened women. Frank invasive carcinoma was found in 21.0% (136 cases) of the former group and in only 3.6% (3 cases) of the latter. Adenocarcinoma of the uterine cervix was found in 0.3% (21 cases) of the unscreened women and in 7.2% (6 cases) of the screened women. Among the women who had undergone cervical screening within 3 years prior to a histologically confirmed diagnosis, invasive carcinoma (excluding adenocarcinoma) was found in 23.3% (14 of 60 women), whereas carcinoma in situ was found in 76.7%. This ratio (1:4) of invasive carcinoma to carcinoma in situ was found to be unchanged among the women of this group regardless of whether the interval from the previous screening was 1, 2, or 3 years. In contrast, when the interval between screenings was 4 or more years, the ratio of invasive carcinoma increased to 52.9% (9 of 17 cases)

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Eight hundred sixty-five patients with confirmed adenocarcinoma of the endometrium were studied. Eight hundred eleven were followed up for at least 5 years or until death, and 537 were followed up for 10 years. The survival rate was 77.1% at 5 years and 61.0% at 10 years. Age at diagnosis was the single most important clinical determinant of survival. Tumor grade was an important predictor of the course of disease, and nuclear grade was a significantly more accurate indicator than was histologic grade. Stage and depth of invasion were also important predictors of survival. The 5- year survival rate for black women was only 41.9%. Stage for stage and grade for grade, women undergoing hysterectomy alone and with radiation had similar survival rates. Adenoacanthoma had a better prognosis than did adenocarcinoma without squamous metaplasia; there were no deaths at 5 or 10 years in women diagnosed before age 50. The subtype of carcinoma was found to be a highly significant predictor of prognosis.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Ovarian epithelial carcinomas still have a poor prognosis. Great efforts are being made to improve treatment modalities; chemotherapy in particular is in a period of dynamic development. A basic requirement for the necessary research is a thorough knowledge of the natural history of ovarian cancer and its prognostic influence. In this report the importance of tumor stage, histologic type, and degree of differentiation is analyzed in an unselected and well-controlled Swedish ovarian cancer series comprising 501 cases. The great prognostic significance of tumor grade for survival is demonstrated and it is proposed that this histopathologic factor, as well as tumor stage and histologic type, should be included in the international classification of primary epithelial tumors of the ovary.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Thirteen patients with rapidly advancing recurrent epithelial ovarian cancers, in whom chemotherapy and, in some cases, radiation therapy failed, were treated with the estrogen antagonist tamoxifen. The presence of cytosol estrogen receptors, which have recently been identified in ovarian cancer specimens, was determined in the tumor from each patient prior to tamoxifen treatment. No complete responses were observed. One patient had a partial response and 4 patients had prolonged stabilization of disease. All patients with stabilized disease had estrogen receptor levels that were borderline or high. Eight patients demonstrated no response to oral tamoxifen therapy, but 5 of these had partial small bowel obstruction secondary to advanced recurrent cancer. As tamoxifen in this preliminary study may have stabilized rapidly advancing recurrent ovarian cancer, its role in the primary treatment of ovarian cancer in combination with cytotoxic chemotherapy should be considered.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The present study is concerned with surveillance/management programs for hereditary ovarian cancer syndromes. These syndromes lack distinguishing premonitory physical signs or biomarkers; therefore, in these genotypic settings, ovarian cancer risk must be assessed by analysis of the patient's pedigree. The authors describe 10 families showing a hereditary proclivity to ovarian carcinoma and/or associated cancer(s) in accord with their respective cancerprone genotypes. Cancer education, genetic counseling, and surveillance should be instituted early. In addition to bimanual pelvic examination, ultrasound should be tested for its possible efficacy as a screening technique. The option of prophylactic bilateral oophorectomy and hysterectomy is thoroughly discussed with highly selected candidates. The authors believe that the aggressive management approach proposed for ovarian carcinoma is warranted for high-risk members of cancer-prone families, wherein the risk for ovarian cancer may approach 50%.

ISSN:0029-7844    

出版商:OVID    

年代:1982

数据来源: OVID