摘要:

A review of 493 cases was undertaken to identify which patients undergoing hysterectomy for benign disease had 1) received a preoperative intravenous pyelogram (IVP), 2) an abnormality identified by IVP, and 3) intraoperative ureteral injuries. Intravenous pyelograms were performed on 299 patients (60.6%). Factors significantly associated with obtaining a preoperative IVP included an abdominal approach, uterine size of 12 weeks or greater, and uterine prolapse. Seventy-seven patients (27%) had an abnormal IVP; factors likely to be associated with abnormality included uterine size of 12 weeks or larger or an adnexal mass of 4 cm or larger. Endometriosis, pelvic inflammatory disease, pelvic relaxation, and previous intra-abdominal surgery were not associated with an increased prevalence of abnormal IVP findings. Two ureteral injuries were documented, one in the IVP group (0.3%) and one in the non-IVP group (0.5%). Clinical findings may be used to select for a preoperative IVP those patients who are likely Lo have abnormalities of importance to the pelvic surgeon.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Fifty-one patients with clinical and urodynamic diagnoses of stress urinary incontinence were randomly allocated to either suprapubic (N= 24) or transurethral (N= 27) bladder drainage after vaginal surgery for stress incontinence (revised Pereyra procedure). Postoperative use of suprapubic bladder drainage significantly reduced febrile morbidity (calculated as fever index;P< .01) and length of hospitalization (P< .05). Postoperative normal bladder functions resumed more quickly when suprapubic drainage was used (P< .05), so that most patients did not need bladder catheterization upon discharge, as opposed to more than half of those with Foley catheters, who left the hospital with a catheter in place (P< .05). We conclude that it is both beneficial and cost-effective to use suprapubic bladder drainage after a Pereyra operation for stress urinary incontinence.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Two commercially available rapid bacteriuria screening procedures were evaluated for routine screening for 104or more colony forming units per milliliter of pathogenic bacteria in two female patient populations. In 694 obstetric patients with 56 cases of significant bacteriuria, the sensitivity, specificity, positive predictive, and negative predictive values, respectively, were as follows: for Chemstrip LN, 69.6, 83.4, 26.9, and 96.9%; and for Bac-T-Screen, 96.4, 56.0, 16.1, and 99.4%. In 143 nonpregnant females with 32 cases of significant bacteriuria, these values were: for Chemstrip LN, 71.9, 75.7, 46.0, and 90.3%; and for Bac-T-Screen, 84.4, 65.8, 41.5, and 93.6%. These results indicate that the LN strip did not have acceptable sensitivity in either patient group. The Bac-T-Screen had better sensitivity, particularly for obstetric patients; however, a high false-positive rate and high cost per test may restrict its use in those clinical settings where culture is available and cost-effective.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Human papillomavirus infection of the genital tract was identified by the filter in situ hybridization test. Exfoliated cervical cells were tested separately for the prevalence of human papillomavirus 6/11 and 16/18. Human papillomavirus deoxyribonucleic acid (DNA) was identified in 70 and 92% of specimens of U.S. and West German women, respectively, who showed concurrent cytologic and colposcopic abnormalities, and in 50 and 54% of women, respectively, who showed neither cytologic nor colposcopic abnormalities at the time of examination. In the cytologic categories of condyloma, mild to moderate dysplasia (cervical intraepithelial neoplasia I/II), and severe dysplasiacarcinoma in situ (cervical intraepithelial neoplasia III), the overall DNA detection rate of human papillomavirus 6/11 and 16/18 varied between 75 and 83%; but human papillomavirus 16/18 was recovered relatively more frequently from the more severe lesions. Forty-eight West German women were monitored cytologically over a period of three to 24 months; progression to carcinoma in situ (cervical intraepithelial neoplasia III) was correlated with initial isolation of human papillomavirus 16/18. The vagina and vestibule were found to be frequent sites of human papillomavirus infection with the same virus type as in the cervix. In an investigation of male partners of 40 human papillomavirus–positive women, human papillomavirus was identified in exfoliated cells from 26; in 19 instances, the males harbored the same human papillomavirus types as their female partners.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Toxic-shock syndrome toxin-1 (TSST-1)-producingStayliylococcirsatireus MN8 was grown in dialyzed beef heart infusion broth, or dialyzed beef heart infusion broth supplemented with 5% human blood or with 5% human semen, in the presence and absence of Today contraceptive sponges. Early growth of the organism was inhibited by the presence of the sponges in aerobic, static aerobic, and anaerobic cultures. In aerobic cultures that contained the sponge, minimal TSST-1 was detected by immunodiffusion assay, whereas in control cultures that did not contain the sponge, extensive toxin production was seen. In static and anaerobic cultures, the presence of the contraceptive sponge resulted in toxin levels less than or equal to the low levels seen in control cultures. These results suggest that Today cantraceptive sponges may inhibit TSST-1 production byS aureus.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Of 2276 patients who underwent screening for gestational diabetes mellitus, 1854 (81.5%) had normal glucose screening tests after a 50-g carbohydrate load (serum glucose below 135 mg/dL). Three hundred fifty-seven patients (15.7%) had abnormal glucose screening tests and went on to complete three-hour glucose tolerance tests, of whom 176 (48.7%) were shown to be nondiabetic when further tested using a carbohydrate-loaded, 100-g glucose, three-hour glucose tolerance test. The 176 women with abnormal glucose screens but normal glucose tolerance tests were compared with the 1854 who had normal screening values. The frequency of infants weighing more than 4000 g (greater than 95th percentile at our institution) was 11.9% in the study group and 6.4% in the control group (P= .0086). When the data were corrected for other macrosomia risk factors (advanced age, high parity, obesity, white race, and prolonged gestation), there was still a significantly higher frequency of macrosomia in the study group; this fact suggests that patients with minor abnormalities of carbohydrate metabolism during pregnancy are at risk for delivering a macrosomic infant.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The widespread belief that fetal heart tones are first detected with an unamplified fetoscope at about 20 weeks' gestation has been studied prospectively only twice. Using data collection prospectively from 352 visits of 77 patients between 15 and 23 weeks' pregnancy, we studied various clinical aspects of fetal heart tone detection. We determined the gestational age at the time of initial auscultation of fetal heart tones with an ordinary fetoscope, and its relationship to quickening, parity, and placenta location. Fetal heart tones were first identified by auscultation at a mean gestational age of 19.4 weeks (range 17–22 weeks). Detection was possible in 81% of patients examined at 20 weeks and in virtually all patients examined at 21 weeks or later. Once heard, fetal heart tones were identified in every subsequent visit for all patients. Parity and placenta location were significant factors influencing initial fetal heart tone detection. Auscultation preceded quickening in only 12% of patients. Recommendations for using initial fetal heart tone detection in clinical practice are given.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

One hundred eighty-nine twin pregnancies were delivered at Wilford Hall United States Air Force Medical Center from July 1977 through December 1985. Among these, 57 were referred from distant bases and were excluded from further analysis. The remaining 132 pregnancies from our local population make up the study group. Sixty-seven women (51%) followed our advice to be hospitalized at or before 28 weeks' gestation for prophylactic ward rest. The remaining 65 women (49%) were not hospitalized until after 28 weeks' gestational age or until a pregnancy complication or labor occurred. Only three of 134 infants (2%) whose mothers were admitted died, versus 11 of 130 infants (8.5%) whose mothers were not admitted (P< .03). The results suggest that prophylactic ward rest, implemented at or before 28 weeks' gestational age, may reduce perinatal mortality in this condition.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Cord blood concentrations of insulin, growth hormone (GH), triiodothyronine (T3), thyroxine (T4), and thyroidstimulating hormone (TSH) from 20 patients treated with oral salbutamol were compared with those of 18 matched patients who had not received any betamimetic agents. No significant difference was found in circulating insulin, T3, T4, and TSH between both groups. However, GH levels were significantly higher in the treated group (36.5 ± 17.4 ng/mL) than in the control group (17.4 ± 6.6 ng/mL;P< .001). The unexpected increase in GH levels in the treated group could reflect either fluctuating fetal blood glucose in response to episodic betamimetic administration or direct fetal pituitary production through adrenergic stimulation.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncom- plicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels peaked at ten weeks' gestation and decreased progressively to term. Relaxin was detectable in all pregnant subjects assessed at the time of the first missed menses. The mean relaxin levels in patients having in vitro fertilization and embryo transfer who sub- sequently delivered a single infant were significantly higher than those in normal antenatal patients at an equivalent gestational age. Patients with twin pregnancies after in vitro fertilization and embryo transfer generally had higher levels than patients with single pregnancies. Some pregnant pa- tients who aborted after in vitro fertilization and embryo transfer had declining levels of relaxin before 40 days postlaparoscopy.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID