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Biomedical subjects

C J Dewhurst

Publications and source records attributed to C J Dewhurst.

13 recordsLinked to original sources
PubMed1977

Sperm/cervical-mucus crossed hostility testing and antisperm antibodies in the husband.

The behaviour of sperms has been investigated in preovulatory cervical mucus in 44 infertile couples. In 22 couples, immobilising and agglutinating autoantibodies were detected in the husband's sera in high titres. In 10 couples, antisperm antibodies were detected in the husbands by indirect immunofluorescent testing. In 12 couples, no evidence of antisperm antibodies was found in either husbands or wives. The results obtained with husband and wife were compared with the behaviour of the husband's sperms in cervical mucus from fertile donors, and with the behaviour of sperms from fertile donors in the wives' mucus. This crossed hostility test indicated that high tires of immobilising and agglutinating antisperm antibodies in the husband effectively prevented the sperms from penetrating the cervical mucus, even though the sperms appeared normal on seminal analysis. Antibodies detected by indirect immunofluorescence did not have this effect. Poor penetration was also observed with low sperm motility or poor cervical mucus. It is concluded that this test, taken with the postcoital test, could provide a useful screen for immunological causes of infertility and an accurate test for the clinical relevance of antisperm antibody tests.

Agglutination Tests↗
PubMed1977

The treatment of hirsutism with cyproterone acetate (an anti-androgen).

The rationale of anti-androgen treatment for hirsutism is explained. The results are presented of treatment with cyproterone acetate of idiopathic hirsutism or hirsutism associated with polycystic ovarian disease. Ten out of 14 patients showed a good response after six months treatment. The response was dramatic in two patients.

Adolescent↗
PubMed1977

Inhibition of puerperal lactation. A double blind study of bromocriptine and placebo.

Bromocriptine and placebo were randomly allocated for three weeks to 52 postpartum patients requiring lactation suppression. Bromocriptine significantly lowered plasma prolactin levels and suppressed breast milk, breast pain and engorgement quicker than placebo. No side-effects were noted and rebound lactation did not occur. Menstruation appeared to re-start sooner when Bromocriptine was given.

Bromocriptine↗
PubMed1976

Recognizing the fetus at risk.

Impairment of either fetal growth potential or placental growth support may cause fetal growth retardation. Impaired growth potential is associated with a number of congenital abnormalities. Awareness of the increased possibility of fetal anomaly comes from the obstetric patient's reproductive history or family history more than from anything else. In general, if the likelihood of fetal anomaly seems increased, investigation in the form of amniocentesis, ultrasonic monitoring of fetal growth, radiologic study, or all three may be required. More common than poor growth potential is poor placental growth support. Here, historical evidence of maternal hypertension or toxemic disorders, among other abnormal clinical findings, is an indication for fetal monitoring.

Abnormalities, Multiple↗
PubMed1976

Using ultrasound to assess the fetus at risk.

In early pregnancy, ultrasonic scanning is valuable if the patient's menstrual history is unreliable or if uterine size is less than expected. The crown-rump length of the embryo can be measured from the sixth week of gestation, and pulsation of the heart detected from the seventh. The crown-rump length of the early embryo gives precise information about maturity. Somewhat later in pregnancy, fetal maturity and growth rate can be assessed accurately by measurement of the biparietal diameter. The head circumference and the fetal upper abdominal circumference together give the head-abdomen ratio, which can be helpful in assessing fetal nutrition. The abdominal circumference also may be used to predict fetal weight.

Amniocentesis↗
PubMed1975

The resistant ovary syndrome.

A patient is described with primary amenorrhoea, raised FSH and LH levels and ovaries containing many primary follicles. These features were characteristic of the "resistant ovary syndrome". After ovarian wedge resection the patient began to menstruate.

Adult↗
PubMed1975

Replacement hormone therapy in gonadal dysgenesis.

Curettage carried out during the third week of treatment of ethinyl oestradiol in 14 patients with gonadal dysgenesis showed cystic glandular hyperplasia in seven patients developed a large endometrial polyp and in one atypical changes were found in the hyperplastic endometrium. In seven patients treated by an oestrogen-progestogen combination normal secretory endometrium was seen in five, proliferative change only in one (thought to be due to incorrect timing of the curettage) and a small proliferative polyp in association with secretory endometrium elsewhere in the uterus in the seventh. In view of these changes and report of adenocarcinoma of the endometrium in patients with gonadal dysgenesis treated with oestrogens alone it is suggested that a regime of low dose oestrogen therapy for 21 days accompanied by a progestogen on days 15 to 21 is preferable to oestrogens alone.

Adolescent↗
PubMed1975

Vaginoplasty at the Chelsea hospital for women: a comparison of two techniques.

The results have been compared of 37 McIndoe-Read operations and 39 Williams' operations carried out at the Chelsea Hospital for Women. The McIndoe-Read procedures comprised 28 primary operations for congentital absence of the vagina, five repeat procedures and four operations for other conditions; the Williams' procedures comprised 27 primary operations, four operations following the previous vaginoplasty and eight operations following other procedures. The results favoured the Williams' vulvovaginoplasty. Special mention must be made of the dangers of repeating the McIndoe-Read procedure and of the fact that the vagina constructed by the Williams' technique showed no tendency to contract if intercourse did not occur.

Adolescent↗