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Biomedical subjects

J D Bass

Publications and source records attributed to J D Bass.

23 records · Page 2Linked to original sources
PubMed1995

Infectious morbidity, operative blood loss, and length of the operative procedure after cesarean delivery by method of placental removal and site of uterine repair.

OBJECTIVE: This study was done to determine the impact of the method of placental removal and the site of uterine repair on postcesarean infectious morbidity rates in women receiving prophylactic antibiotics at cesarean delivery. STUDY DESIGN: This prospective study included 284 women who underwent cesarean delivery and who were randomly assigned to four groups based on the method of placental removal and the site of uterine repair: group 1, spontaneous placental removal and in situ uterine repair; group 2, spontaneous placental removal and exteriorized uterine repair; group 3, manual placental removal and in situ uterine repair; and group 4, manual placental removal with exteriorized uterine repair. Exclusion criteria were repeat cesarean deliveries without labor, active infection at the time of cesarean delivery, and patient refusal to participate. RESULTS: There was no significant difference among the groups in maternal age, race, parity, weight, the length of time from rupture of membranes (ROM) or the number of vaginal examinations from ROM to cesarean delivery, or preoperative hematocrit. Intraoperatively, the type of uterine incision, anesthesia administered, incidence of meconium-stained amniotic fluid, Apgar scores, and cord gases were similar between groups. The incidence of postcesarean endometritis was greater in group 4 (32 [45 percent] of 71, p = 0.003) compared with group 1 (17 [24 percent] of 71), group 2 (12 [30 percent] of 71); and group 3 (13 [18 percent] of 71). CONCLUSIONS: Manual placental removal and exteriorization of the uterus for repair of the surgical incision increases the infectious morbidity rate in women receiving prophylactic antibiotics at the time of cesarean delivery and increases the length of hospitalization.

Adult↗
PubMed1994

Effect of blood transfusion in patients with gynecologic malignancy.

OBJECTIVES: To determine the effect of blood transfusion on long-term outcome (disease-free interval, recurrence of disease after treatment, and survival) in women with invasive gynecologic malignancy. METHODS: In this retrospective study, 125 patients with gynecologic malignancy were assessed over a 36-month period. The variable of whether patients received blood transfusion during therapy was used to divide the sample into two groups. RESULTS: There were no differences in the age, ethnicity, and site-stage of tumor of the two groups. Treatments (surgery, radiotherapy, chemotherapy, or multimodal) were similar between the two groups, as were initial hematocrits. The disease-free interval was significantly better in women who did not receive homologous blood (P < 0.001). Life table analysis illustrated that more patients were alive and free of disease if they did not receive blood (P < 0.001). Likewise, persistence-recurrence of cancer was more common in the transfusion group (P < 0.001). Finally, overall survival time was adversely affected by transfusion (P = 0.045). CONCLUSIONS: The use of blood products in patients with invasive gynecologic cancer is associated with enhanced recurrence or persistence of malignancy, a decrease in the disease-free interval, and reduction in the probability of survival without evidence of disease.

Adult↗
PubMed1994

Comparison of Vineland Adaptive Behavior Scales-Survey Form age equivalent and standard score with the Bayley Mental Development Index.

The Vineland Adaptive Behavior Scales-Survey Form standard score, Vineland Adaptive Behavior Scales-Survey Form age equivalent and Bayley scales' Mental Development Index were given to 44 high-risk infants age 12 mo. and suspected of developmental delay. The VABS-Survey Form, a revision of the Vineland Social Maturity Scale is frequently used in assessment of developmental delay; however, questions have arisen as to whether the standard score or age equivalent is the better measure. A developmental quotient based on VABS-SF age equivalent and VABS-SF standard score was compared with the Bayley Mental Development Index. The mean VABS-SF standard score was significantly higher than the age equivalent quotient and the Bayley Mental Development Index. Implications for the use of VABS-SF age equivalent in evaluating such infants are discussed.

Age Factors↗
PubMedDate not supplied

Accelerated recovery from severe preeclampsia: uterine curettage versus nifedipine.

OBJECTIVE: We investigated the ability of uterine curettage and nifedipine to accelerate postpartum recovery from severe preeclampsia. METHODS: Forty-five parturients with severe preeclampsia were randomly assigned to one of three groups following delivery. Patients in group 1 were managed with intravenous magnesium sulfate (2 g/hour) and observed in the obstetric recovery room until blood pressure had stabilized (systolic blood pressure less than 150 mmHg and diastolic blood pressure less than 100 mmHg) and adequate diuresis was noted. Group 2 was treated in a similar manner but with the addition of oral nifedipine, 10 mg every 4 hours postpartum for 48 hours. Group 3 underwent an ultrasound-directed curettage immediately following delivery in the delivery/operating room and was then treated as in group 1. All three groups were assessed postpartum for mean arterial pressure (MAP) and urine output (UO) every 2 hours, hematocrit and platelet count every 6 hours, and lactic dehydrogenase/aspartate aminotransferase every 12 hours for 48 hours postpartum. RESULTS: Fifteen women were assigned to each of the three treatment groups. The MAP decreased significantly (P < .0001) in all three groups during the first 48 hours postpartum. Treatment interaction indicated specific differences among the groups. Standard therapy (group 1) was significantly inferior to nifedipine (group 2) and curettage (group 3) in regard to MAP decrease (P = .0017) and UO increase (P = .0137). No statistical differences existed between nifedipine and curettage. The rise in the platelet count following delivery was significantly different among the three groups (P = .033), with a much more rapid recovery in the curettage group (12-18 hours) than in the other groups (P = .0106). CONCLUSIONS: Nifedipine and uterine curettage both appear to accelerate recovery from severe preeclampsia, as measured by MAP and UO. Uterine curettage appears the most effective in rapidly resolving the thrombocytopenia associated with severe preeclampsia.

Adult↗