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Biomedical subjects

H Hammill

Publications and source records attributed to H Hammill.

27 records · Page 2Linked to original sources
PubMed1992

Prevalence of active Chlamydia trachomatis infection at the time of exploratory laparotomy for ectopic pregnancy.

Cultures of the fallopian tube, cul-de-sac, and cervix were obtained from 50 patients undergoing exploratory laparotomy for ectopic pregnancy. Chlamydia trachomatis was cultured from the cervix in four patients (8%). All the cultures from the fallopian tube or cul-de-sac were negative. Immunofluorescent stain of deparaffinized cross-sections of fallopian tube at the site of tubal involvement with the ectopic pregnancy failed to reveal any C trachomatis inclusions.

Adolescent↗
PubMed1991

Bacteriologic findings with ectopic pregnancy.

The fallopian tubes and peritoneum of 27 patients were cultured at the time of salpingotomy/salpingectomy to determine if active tubal infection was the cause of post-operative temperature elevations. Infection was documented in six patients (22%). Previous exposure to Chlamydia trachomatis was documented with 2 endocervical cultures and 17 serum specimens positive for IgG antibody. The culture results, however, did not correlate with the postoperative febrile morbidity.

Adolescent↗
PubMed1990

Treatment of postpartum endometritis.

In this study, cefoxitin alone (2 gm, every 8 hours) was generally sufficient to cure postpartum endometritis, even when the patient had received prophylaxis with a beta-lactam antibiotic. When single-agent therapy fails, addition of ampicillin usually results in a prompt clinical response.

Cefoxitin↗
PubMed1990

Comparison of cefotaxime, cefoxitin and clindamycin plus gentamicin in the treatment of uncomplicated and complicated pelvic inflammatory disease.

Patients with uncomplicated pelvic inflammatory disease (PID) (acute salpingitis and no pelvic masses) were randomly assigned for treatment with either cefotaxime or cefoxitin. A clinical cure was achieved in 17 of 20 cases (82%) and 19 of 22 cases (84%), respectively. Within the complicated PID group, patients were assigned to two subgroups: those with a tubo-ovarian complex (26 patients), and those with a tubo-ovarian abscess (32 patients), as confirmed by ultrasonography or surgery. Patients within each of these two subgroups were then randomly assigned for treatment with either cefotaxime or clindamycin plus gentamicin. Within the tubo-ovarian complex subgroup, a clinical cure was achieved in 11 of 13 cases (85%) treated with cefotaxime and 10 of 13 cases (77%) treated with clindamycin plus gentamicin. Within the tubo-ovarian abscess subgroup, a clinical cure was achieved in 12 of 16 cases (75%) treated with cefotaxime and 11 of 16 cases (69%) treated with clindamycin plus gentamicin. No differences in any category were statistically significant. Specimens for culture were obtained from the endocervix, endometrium, and when possible, the cul-de-sac, fallopian tubes, and abscess. Neisseria gonorrhoeae (33%) was isolated more frequently than Chlamydia trachomatis (12%) in patients with PID, and neither of these organisms was isolated with any increased frequency in patients with complicated PID. The majority of the patients were considered to have polymicrobial infection. Cefotaxime was as efficacious as cefoxitin and clindamycin plus gentamicin for the treatment of acute salpingitis, tubo-ovarian complex and tubo-ovarian abscess.

Adolescent↗
PubMed1989

Comparison of two endometrial sampling devices. Cotton-tipped swab and double-lumen catheter with a brush.

The potential for bacterial contamination during transvaginal recovery of endometrial samples in patients with postpartum endomyometritis spawned an investigation into various protective measures and techniques. The confirmation and determination of the extent of contamination was attempted in 120 postpartum women with the diagnosis of postpartum endometritis. Each woman underwent endometrial sampling for bacterial culturing utilizing two devices--an unprotected, cotton-tipped swab and a protective, double-lumen catheter with a brush. Although a statistically greater number of bacterial species were recovered with the swab than with the brush (2.4 vs. 1.6, respectively [P less than .001]), they were not representative of species commonly thought of as causing cervicovaginal contamination. Individual species found with greater frequency with the swab were Streptococcus faecalis (P = .023), Escherichia coli (P = .007), Proteus mirabilis (P = .025), Bacteroides bivius (P less than .001 and Bacteroides melaninogenicus (P = .02). Thus, with proper cervical preparation and an extended-reach, transvaginal, cotton-tipped swab, true fundal specimens were obtained that provided a representative and cost-efficient sample of the infected endometrial cavity.

Bacterial Infections↗
PubMed1989

Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis.

One hundred fifty-two women who received cefazolin prophylaxis and subsequently developed postpartum endometritis were randomized to treatment with either ticarcillin/clavulanic acid (75) or clindamycin-gentamicin (77). Bacteria isolated from the endometrium were predominantly facultative anaerobic bacteria. The ratio of facultative anaerobes to obligate anaerobes was 3:1. Nineteen percent of the women were bacteremic, with mycoplasma the organism most frequently isolated from venous blood specimens. Cure rates were similar for both groups: ticarcillin/clavulanic acid 85% and clindamycin-gentamicin 81%. The advantages of ticarcillin/clavulanic acid are an increased spectrum of activity against beta-lactamase-producing bacteria, less toxicity, and lower cost.

Adult↗
PubMed1986

Adverse effects of pregnancy on multifocal eosinophilic granuloma.

An unusual case of a patient diagnosed as having the histiocytic proliferative disorder characterized by the lesion eosinophilic granuloma (histiocytosis X) is presented. Fifteen-year follow-up revealed a progression from a solitary eosinophilic granuloma of the bone to multifocal involvement of many body structures including the vulva, vagina, and cervix. This progression occurred after nine asymptomatic years and was temporally related to the patient's first pregnancy. After successful treatment and remission, rapid appearance and growth of observable genital lesions were noted during a second pregnancy. Pregnancy termination in the first trimester was advised due to signs of dissemination and local symptoms.

Abortion, Therapeutic↗
PubMed1984

Comparison of ultrasonic and direct biparietal diameter measurements and placental localization.

The accuracy of fetal biparietal diameter (BPD) measurements and placental localizations performed by physicians in a university hospital obstetrical service using real-time ultrasound equipment was determined. The sonographic estimations were compared to caliper measurements on the neonate and to the implantation site of the placenta found at surgery in 40 patients undergoing repeat cesarean section. The correlation coefficient 0.93 and p less than 0.00001 indicate high agreement between the BPD measurements. The regression of caliper on sonar measurements gave 95% prediction intervals of +/- 3.50 mm compared to +/- 2.4 mm calculated from data reported by ultrasonic laboratories. Placental localization was in error in 5.9% of the cases. Thus, physicians should be aware that their errors are likely to be larger than those which have been published by experts in ultrasound diagnosis.

Cephalometry↗