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Biomedical subjects

H R Barber

Publications and source records attributed to H R Barber.

At least 109 records · Page 6Linked to original sources
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Ovarian cancer.

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Female↗
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Ovarian cancer, Part II.

Early diagnosis is the most effective means of reducing the currently high mortality rate associated with ovarian cancer. The palpation of what appears to be a normal size ovary in a premenopausal woman suggests an ovarian tumor in a postmenopausal woman. Also, rule out ovarian cancer in any 40-year or older woman who presents with persistent, unexplained gastrointestinal symptoms. Ninety percent of all ovarian tumors are of epithelial origin. Treatment consists of total hysterectomy, bilateral salpingo-oophorectomy, omentectomy and appendectomy. P32 instillation is optional. In Stages IIb, III and IV chemotherapy is advised, while in Stages I and IIa the use of prophylactic chemotherapy must be judged on an individual basis. Ovarian cancer in children that is beyond the localized stage is one of the most frustrating of all gynecologic diseases. Total surgical extirpation of localized disease is the only hope for cure and, as yet, early diagnosis is more chance than scientific method.

Adolescent↗
PubMedDate not supplied

Ovarian cancer.

Early diagnosis is the most effective means of reducing the currently high mortality rate associated with ovarian cancer. The palpation of what appears to be a normal size ovary in a premenopausal woman suggests an ovarian tumor in a postmenopausal woman. Ovarian cancer should be ruled out in any woman 40 years of age or older who has persistent, unexplained GI symptoms. Ninety percent of all ovarian tumors are of epithelial origin. Treatment consists of total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and appendectomy. Instillation of P32 is optional. In stages IIb, III, and IV tumors, chemotherapy is advised; in stages I and IIa, the use of prophylactic chemotherapy must be judged on an individual basis. In children, ovarian cancer that is beyond the localized stage is one of the most frustrating of all gynecologic diseases. Total surgical extirpation of disease is the only hope for cure; for now, early diagnosis is more chance than scientific method. Thanks to better public and professional education, ovarian cancer is now being diagnosed at an earlier stage. The earlier the diagnosis, the greater the chance for cure. It is becoming obvious that ovarian cancer is a disease of the GI tract, and physicians treating ovarian cancer should be prepared to deal with bowel-associated problems. The practice of tapping women with ascites for diagnosis as well as doing an exploration merely to obtain a biopsy should be discouraged. Unless the physician is prepared to carry out the optimal surgical approach for the patient, it is crucial that the patient be referred to either a center or to a physician who is actively engaged in the day-to-day care of cancer patients. With the combined use of all the available treatment methods, patients with ovarian cancer are now living longer and more comfortably. There is also indication that their long-term survival will be increased. The one message that is important for both patients and physicians is that the gloom and doom of the 1960s and 1970s can now be replaced by a spirit of optimism.

Adolescent↗
PubMedDate not supplied

New frontiers in ovarian cancer diagnosis and management.

Ovarian carcinoma is now the leading cause of death among women. Surgery has reached its limits, and further aggressive surgery will result in an inordinate morbidity and mortality. Ovarian carcinoma is ideally treated by complete surgical removal of the cancer, followed by anti-cancer chemotherapy. Since it is often impossible to remove all of the cancer, adjunctive chemotherapy is playing an increasingly important role in the management of the cancer. New anti-cancer drugs must be found or synthesized, and new combinations of current anti-cancer drugs with mechanisms to protect the bone marrow must be explored. The field of genetics and the identification of the patient at high risk because of a familial history of ovarian cancer must be expanded. The role of tumor markers and oncogenes requires more in-depth study so that these signs can play a greater role in monitoring and identifying the patient with early ovarian cancer. The emerging fields of genetic engineering and biologic response modifiers are opening up new avenues for additional modalities of therapy. The expanding areas of research in cancer are starting to dispel the doom and gloom of the last three decades with a spirit of optimism for the diagnosis and treatment of ovarian cancer, as the new century approaches.

Alkaloids↗
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The malpractice crisis in obstetrics and gynecology: is there a solution?

The malpractice ripoff began when the no-fault automobile accident law was passed. Many lawyers were in a panic at this time and turned to medical malpractice litigation to make a living. It became the conduit to quick wealth. The patient was the loser, the lawyer the winner, and the physician often devastated by the patient's ingratitude. For a patient-plaintiff to maintain a successful lawsuit for medical negligence against a physician, four elements must be alleged and proved in a court of law: duty, breach of duty, causation, and damages. Each must be proved by a patient to prevail against a physician. Since this is very difficult to do, the lawyers have subtly brought in a new approach called maloccurrence. This is defined as a bad outcome unrelated to the quality of care provided. The lawyers need not prove the four elements to win a malpractice case; many are won on deceit and in violation of the law by introducing the concept of maloccurrence. Not only are tort reforms needed but out of court alternatives must be mandated by law or our health care delivery system will be destroyed. Government interference and the malpractice ripoff has had a devastating effect on the talent attracted to medical school, and the number of applicants is falling rapidly. The medical malpractice crisis could soon be translated into a health delivery service crisis. Concerned citizens must join together with the medical profession and leaders of the legal profession to halt this monstrous injustice. The litigation milieu has not only paralyzed the health care industry but it has had a devastating effect across the board on the way Americans live and do business. It must be solved now for justice delayed is justice denied.

Cerebral Palsy↗
PubMedDate not supplied

An update on DES in the field of reproduction.

The general consensus is that a DES daughter is about 35% less likely than a non-DES-exposed woman of equivalent age and health to have a noneventful pregnancy. It is important to state that fertility rates refer to couples. The male partner is responsible for 40% to 50% of infertility problems. Age is also an important factor, and female fertility is known to decrease with age from the early 20s. These two factors receive little consideration in most articles. However, it can be said that if there are no marked congenital anomalies present in the cervix and the uterus, then the probability that a DES-exposed daughter will have a normal child is quite good.

Abnormalities, Drug-Induced↗