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Biomedical subjects

E Amsterdam

Publications and source records attributed to E Amsterdam.

26 records · Page 2Linked to original sources
PubMed1979

Is conception in infertile couples treatment-related? A survey of 309 pregnancies.

309 couples with infertility of 1 to 11 years duration in whom pregnancies occurred during examination or treatment were evaluated. The couples were classified into diagnostic groups according to the main cause of their infertility; anovulatory, mechanical, male, cervical, unexplained, combined. Pregnancies were divided into treatment-related and nontreatment-related. Analysis of results revealed that whereas in infertile patients with a defined cause of infertility, the treatment-related pregnancy rate was 73.1%, in the unexplained infertility group the incidence of treatment-related pregnancies was only 6.6%. We concluded that a meticulous fertility survey should be carried out in each infertile couple in order to detect a specific cause impeding fertility, but if such a cause cannot be found, reassuring of patients and decreasing their anxiety is more effective in inducing pregnancy than nonspecific therapy.

Adult↗
PubMedDate not supplied

Tube graft replacement of abdominal aortic aneurysm: is concomitant iliac disease a contraindication?

One hundred and fifty nine patients underwent surgery for abdominal aortic aneurysm (AAA) from 1975 to 1985. Of these, a tube graft was inserted in 86 patients (55.1%). Immediate and late results of these 86 patients were evaluated retrospectively as to the effect of concomitant common iliac artery (CIA) disease on early and late results. There were 77 males and nine females aged 35-91 (average 70.7) years. Surgery was elective in 44 patients (51.2%), and as an emergency due to expanding, ruptured or thrombosed AAA in 42 patients (48.8%). The CIAs showed unilateral or bilateral aneurysmal dilatation or atherosclerotic changes in 47 patients (54.7%). At the time of surgery additional bypass grafting from the tube graft to one femoral artery was performed in four patients, and patch angioplasty to the CIA in one. Operative mortality was 4.6% (two patients) in the elective group, and 45.2% (19 patients) in the emergency operations. Follow-up was 94% complete for a mean of 4.1 (range 0.5-10) years). Late mortality for the whole series was 20.0% (12 patients). Only one patient died of a cause related to the AAA operation. All but one of the 48 late survivors are free of any peripheral vascular problems. We conclude that tube graft replacement of AAA is a good choice even in the presence of some degree of CIA atherosclerosis or aneurysmal dilatation.

Aged↗
PubMedDate not supplied

Antithrombosis routines and hemorrhagic complications: a seven year survey comparing vascular and general surgical operations.

Prospective monitoring of the occurrence of venous thromboembolism (VTE) and bleeding complications was carried out during a seven year period in a department of general and vascular surgery. Low dose heparin was given by pre-determined criteria to over 1200 patients undergoing general surgical operations, and to almost 700 patients having vascular surgical operations. Over 450 vascular patients received full dose anticoagulation and 3400 patients from both groups received no antithrombotic treatment. Clinically significant major VTE occurred in one percent of all patients. Nine patients died of pulmonary emboli (0.15%). There were 130 patients with bleeding complications (2.2%) half of them severe. Both VTE and bleeding were more common in the vascular patients (1.4 and 3.1% respectively) as compared with general surgery (0.7 and 1.6%). Patients receiving low dose heparin had a 3.4 percent incidence of bleeding but in one half of these cases a technical factor or a breach of the treatment protocol could have contributed to the bleeding. Possible modifications of antithrombosis routines are suggested.

Adult↗
PubMedDate not supplied

Mononitrates: defining the ideal long-acting nitrate.

As a result of recent advances in our understanding of the role of nitric oxide and endothelial-derived relaxing factor (EDRF) in vascular control, physicians now have the potential to overcome the loss of EDRF effect by administering nitrates. Nitrates are converted to nitric oxide, resulting in vasodilator effects that improve the myocardial oxygen supply-demand imbalance responsible for myocardial ischemia. This discovery has resulted in a renewed interest in the nitrates for the treatment of ischemic syndromes, particularly chronic stable angina pectoris. Over the past 2 years, an important new formulation of nitrate has become available--isosorbide-5-mononitrate. Three different mononitrate formulations are available in the United States: Ismo tablets in December 1992; followed over a year later by Monoket tablets, available since June 1993; and Imdur extended-release tablets, available since August 1993. Although the mononitrates share the same generic name, they are not similar in regard to their formulations, which suggests the need for future studies designed to explore any clinical differences.

Adrenergic beta-Antagonists↗