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Biomedical subjects

C Egarter

Publications and source records attributed to C Egarter.

At least 73 records · Page 4Linked to original sources

[Therapy of infections in gynecology].

Infections of the female genitals are among the most common conditions seen by primary care physicians. Approximately 75% of all women experience at least one episode of vaginitis during their reproductive life. Bacterial flora of the female genital tract is complex and dynamic. Those organisms which may cause gynecological infections in the appropriate setting are often present at a different stage in the woman's life as normal flora. The treatment of gynecological infections is dependent on the symptoms of the patient, the pathogen, and the medical history with regard to recurrences of the same disease. Since identification of the pathogen is often difficult, empirical therapy is administered frequently, which requires detailed knowledge of the most common bacterial pathogens and the resistance pattern of these organisms. An accurate initial diagnosis is the best basis for appropriate therapy, especially in view of the fact that once empirical antibiotic therapy has been administered, signs and symptoms are modified and the site of infection is rendered much more obscure.

Anti-Bacterial Agents↗

[Acetylsalicylic acid in pregnancy].

Preeclampsia is characterized by a functional imbalance between vascular prostacyclin and thromboxane A2 production. Studies have demonstrated that the increase in thromboxane A2 can be corrected by administration of low-dose aspirin without causing a further decrease in prostacyclin production. Low-dose aspirin during pregnancy appears to be safe for both mother and child. Furthermore, clinical trials have demonstrated that it is effective in reducing the incidence of preeclampsia and/or intrauterine growth retardation in selected high-risk women. The use of aspirin in the treatment of existing preeclampsia and in the prevention of premature labor is not recommended. With regard to recurrent spontaneous abortion, further studies are warranted to evaluate its efficacy.

Aspirin↗

[Ovarian hyperstimulation syndrome].

The ovarian hyperstimulation syndrome (OHSS) is caused iatrogenically by the application of agents for ovulation induction. The syndrome may be characterized by different symptoms sometimes including an increase in blood viscosity, changes in coagulation parameters as well as renal perfusion. Although the incidence of the severe forms of the syndrome is very low, there is a general increase due to the wide spread use of ovulation induction. The only treatment of the syndrome is prevention by close monitoring of serum oestradiol levels and follicular development.

Ascites↗

[Tuboscopy. Initial experiences with microendoscopic tubal diagnosis].

To date, investigators have relied on hysterosalpingography, hysterosalpingoscintigraphy, and laparoscopic chromopertubation for the diagnosis of tubal disease causing infertility. With the development of the "linear everting catheter" system it may now be possible to evaluate the tubal lumen and to diagnose changes in the tubal wall or the tubal mucosa by direct visualization. This paper describes our initial clinical experience with 14 women who underwent evaluation for infertility. The new catheter system allowed both inspection of the tubal ostium without cervical dilation or concomitant hysteroscopy and virtually atraumatic access to the tube by means of an endoscope measuring half a millimeter in diameter and a magnification of 40. Given adequate experience with this technique it may also be performed in an outpatient setting. Ultimately, tuboscopy may come to play a major part in the diagnosis of sterility. Other potential applications of this new technology are the tubal transfer of embryos, intratubal insemination and the conservative treatment of tubal pregnancy.

Adult↗

Reproductive performance after local and systemic prostaglandin for ectopic pregnancy.

The injection of different substances into early, unruptured tubal pregnancies is increasingly advocated. In this study, fertility was evaluated after treatment of tubal pregnancy by means of prostaglandins. The overall tubal patency rate was 86.4% and 14 of 20 patients (70%) could subsequently achieve pregnancy.

Abortifacient Agents, Nonsteroidal↗

[Retrospective comparative study of the treatment of tubal pregnancy by pelviscopic surgery or prostaglandin injection].

The incidence of tubal pregnancy has been increasing in recent years. The improvement in diagnostic procedures leads to an early detection of tubal pregnancies. As a result, conservative treatment modalities are more feasible today. In this study, we compared the treatment of tubal pregnancy by means of locally applied prostaglandin with pelviscopic surgery. 75 patients with an early tubal pregnancy were included in each group. The comparison between the two groups showed, that prostaglandin treatment has a higher failure rate, than treatment by pelviscopic surgery. However, postoperative fertility indicated better results in the prostaglandin treated patients.

Adult↗

Prostaglandin versus expectant management in early tubal pregnancy.

Since ectopic pregnancy may terminate in spontaneous recovery we compared treatment by means of prostaglandin (PG) application with expectant management in laparoscopically verified tubal gestations. Twelve patients received local and systemic PG, 4 patients were treated with sodium chloride and in 7 patients laparoscopy was discontinued without medical therapy. The comparison between the PG group and the placebo groups revealed a highly significant difference with regard to a subsequent necessary surgical intervention and hospitalisation. Expectant management may only be recommended in very selected cases, whereas PG treatment seems to produce favourable results in cases of early tubal pregnancy.

Chorionic Gonadotropin↗

Trichosanthin injection in tubal pregnancy.

.6 mg trichosanthin, a drug which is frequently used for midtrimester abortion in China, was applied laparoscopically in a case of tubal pregnancy. No side effects occurred and beta-human chorionic gonadotropin decreased within several days.

Adult↗

[Incidence and therapy of hyperstimulation following local prostaglandin administration for labor induction].

A major cause of concern with respect to local prostaglandin (PG) E2 application is uterine hyperstimulation. The purpose of the present study was to evaluate the incidence of hyperstimulation and the possibility of treating this complication. A total of 181 cases were registered in two obstetric centres over a 51-month period. The rates of hyperstimulation were 7.3% in the group receiving intravaginal PG E 2 tablets (3 mg), 2.9% with intravaginal gel (2.5 mg), and 0.5% with intracervical gel (0.5 mg). In 178 cases (98.3%) the infusion of a beta-2 adrenergic drug (hexoprenaline or terbutaline) led, without adverse effects, to the rapid resolution of the alarming findings. Caesarean section was necessary in 3 patients. Depressed Apgar scores and an umbilical artery pH less than 7.20 were uncommon and, indeed, no more frequent than in PG E 2-treated cases without hyperstimulation. We conclude that uterine hyperstimulation is uncommon after low-dose PG E 2 therapy and is usually rapidly reversible, without apparent untoward intrapartum or neonatal effects.

Adolescent↗

[Treatment concepts in tubal pregnancy].

The incidence of tubal pregnancy has increased markedly over the past years. Reasons for this are increased infections of and operations on the tubes and also improved diagnosis of the condition. The development of sensitive pregnancy tests, a constant improvement in ultrasound, introduction of laparoscopy and last, but not least, an increase in the degree of awareness amongst the general public have led to a much earlier diagnosis of tubal pregnancies. Therefore, it is possible to treat tubal pregnancies in a more conservative fashion operatively but also medically.

Dinoprost↗

[Effect of inguinal lymph node irradiation on the treatment result of vulvar cancer with different risk factors].

The clinical data from 101 patients with invasive squamous cell cancers of the vulva with less than 10 mm stromal invasion in depth, treated between 1972 and 1983, were studied. 43 of these patients underwent merely a radical vulvectomy, the remaining 58 patients underwent a combination therapy of vulvectomy and irradiation of inguinal lymph nodes. Although the majority of risk factors, like clinically suspicious nodes, stromal invasion of more than 5 mm, tumour expansion of more than 2 cm and clitoral location, occurred more frequently (p<0,001) in the combination therapy group. There was no statistical significance in the five-year survival rate between our two therapy groups (88,4% versus 79,3%). In stage I and II cases inguinal relapses occurred in the group with vulvectomy alone in 9.3%, in the group with adjuvant external irradiation of the inguinal fields in 2.6%. We believe, the data presented show the important role of radiotherapy of inguinal nodes in the curative management of vulvar cancer.

Adult↗

[Tumor markers and creatine kinase in the differential diagnosis of tubal pregnancy].

In the present study we tried to evaluate the cancer marker CA 19-9, CA 12-5, CA 15-3 as well as the enzyme creatine-kinase (CK) whether they are of any diagnostic value in cases of tubal pregnancies. 15 patients with laporoscopically verified tubal pregnancy were compared with 15 patients with normal intrauterine pregnancies of the same age. Except one case of elevated CK in a patient with tubal pregnancy all other values were within the normal range. We concluded, that tumor markers and CK are inefficient for preoperative differential diagnosis in cases of tubal pregnancies.

Antigens, Tumor-Associated, Carbohydrate↗

[A new method of treating tubal pregnancy using prostaglandin F2a and E2].

The present paper reports on the treatment of 30 tubal pregnancies verified by laparoscopy by means of intratubal prostaglandin (PG) F2a and systemic PG E2. Tubal pregnancy was successfully treated in 25 patients; three patients exhibited side effects. The comparison with surgical management showed better results concerning the tubal patency in the PG-treated group. Further studies should clarify whether this technically simple procedure is superior to the existing methods.

Chorionic Gonadotropin↗