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Biomedical subjects

J R Evrard

Publications and source records attributed to J R Evrard.

At least 19 recordsLinked to original sources
PubMed1989

Fetal skull fracture from an automobile accident.

This is a case report of a fetal skull fracture that resulted in fetal death caused by a high-velocity automobile accident. As a 25-year old gravida 3, para 2, was pulling out of a driveway onto a highway, her car was struck in the left front end by a car traveling perpendicular to her vehicle. She died almost instantly from shock caused by massive injuries and internal hemorrhage. She had a fractured rib and multiple fractures of the pelvis as well as bilateral hemothorax and ruptured splenic and renal vessels. The fetus had depressed multiple skull fractures. The probable mechanism of fetal injury, as well as the influence of seat restraints on injury to the mother and fetus, are discussed.

Accidents, Traffic↗
PubMed1989

Puerperal uterine inversion.

A 10-year retrospective study of acute puerperal inversion of the uterus was undertaken at Women and Infants Hospital of Rhode Island. There were 11 inversions in 70,481 deliveries for an incidence of one in 6407. The age ranged from 19-31 years. Seventy-three percent occurred in nulliparous women. All cases were recognized immediately, and vaginal replacement was successful in nine patients. One patient had a placenta accreta necessitating a supracervical hysterectomy, and one patient required a laparotomy and Huntington procedure for replacement. Six patients had blood loss greater than 1000 mL and three required transfusion. There were no maternal deaths.

Adult↗
PubMed1987

Lithopedion. A case report.

In a case of lithopedion the fetus survived to 15 weeks' gestation. The mother had an infertility problem, and following tuboplasty she became pregnant and had an incomplete abortion, although no fetal parts or chorionic villi were found at dilatation and curettage. Five and one-half years later a second laparotomy was performed, and the lithopedion was discovered.

Abortion, Incomplete↗
PubMed1985

Infection with Chlamydia trachomatis in female college students.

Chlamydia trachomatis was isolated from genital specimens from 21 (4.9%) of 431 female college students. Antibody to C. trachomatis was found in the genital secretions of 52 (11.9%) of 437 women. Multiple logistic regression analysis showed race, number of sexual partners, and use of barrier methods of contraception to be predictive of infection with C. trachomatis. Logistic regression analysis found race, number of sexual partners, use of barrier methods of contraception, and presence of cervical erythema to be predictive of local chlamydial antibody. White participants were infected less often (12 of 388 (3.1%)) than black participants (9 of 43 (20.9%)) (p less than 0.001) and were less likely to have local chlamydial antibody. None of the sexually inexperienced women were infected or had local antibody. Among the sexually experienced women, chlamydial infection and local chlamydial antibody increased with increasing number of sexual partners only for women who were not using barrier methods of contraception. Sexually experienced women who used barrier methods of contraception (condom, diaphragm) were less likely to be infected (one of 105 (1.0%)) than were sexually experienced women who used other contraceptive measures or who did not use contraception (20 of 276 (7.2%)) (p = 0.031). Women who used barrier methods of contraception also were less likely to have local chlamydial antibody. Women with cervical erythema were more likely to have local chlamydial antibody (4 of 11 (36.4%)) than women without cervical erythema (48 of 426 (11.3%)). Vaginal colonization with other sexually transmitted microorganisms (Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis) was noted more often among women with chlamydial infection than among uninfected women.

Adult↗
PubMed1981

Sexually transmitted conditions among women college students.

We studied 500 unselected young women who consulted a gynecologist in a student health service. Most participants were symptom-free and had normal physical examinations. Few sexually transmitted infections were encountered. Neisseria gonorrhoeae was recovered from two and Trichomonas vaginalis was obtained from 14 of 500 women. Chlamydia trachomatis was recovered from 20 (4.6%) of 439 participants. Genital warts, genital herpes, and molluscum contagiosum, respectively, were noted in seven, four, and one of the 500 participants. There was no cases of syphilis, scabies, or pediculosis pubis. Mycoplasma hominis and Ureaplasma urealyticum, respectively, were recovered from 17.6 and 56.8% of the subjects. Prevalent vaginal bacteria included lactobacilli, streptococci, Staphylococcus epidermidis, and diphtheroids. Gardnerella vaginalis was isolated from the vaginal specimens of about one third of the participants.

Adolescent↗
PubMed1981

Cesarean section for delivery of the second twin.

Four cases of combined vaginal-abdominal delivery of twins are presented, and an additional 5 cases from the recent literature are discussed. Malposition, malpresentation, and contracted cervix were the main indications for cesarean section for the birth of twin B. In the 9 cases presented, there were 2 perinatal deaths.

Anesthesia, Obstetrical↗
PubMed1981

Rubella, the Trojan horse of obstetrics.

Documentation has been provided that health care personnel working in prenatal clinics have exposed their patients to the rubella virus. Various states have instituted rules and regulations toward the prevention of spread of rubella to pregnant women. These regulations have been ineffectual as rubella antibody testing and immunization programs do not include all health care providers. Cogent reasons for rubella antibody testing and immunization of all susceptible health care providers, whether they are physicians, nurses, or students, are presented.

Antibodies, Viral↗
PubMed1980

Cesarean section: a contemporary assessment.

A one-year retrospective study of cesarean section (CS) at Women and Infants Hospital of Rhode Island is reported. There were 5,467 women delivered, including 1,011 who delivered by CS, yielding a total CS rate of 18.5% and a primary rate of 13.4%. The four leading indications for primary CS were: dystocia (38.8%), breech presentation (14.9%), malposition (11.9%) and fetal distress (11.3%). Sepsis was responsible for 75% of the complications. The incidence of low-birth-weight infants was 14.2% for primary CS and 6.7% for repeat CS. The perinatal death rate was 21.2% per 1,000. The relationship of these findings to changing obstetric practice is discussed.

Adolescent↗
PubMed1979

Chlamydia trachomatis in women: antibody in cervical secretions as a possible indicator of genital infection.

One hundred eighty-five women college students were examined for genital infection with Chlamydia trachomatis. This organism was isolated from nine (5%) of the 185 women. Antibody was demonstrated in the genital secretions of 26 (14%) and in the serum of 70 (38%) of the women. None of the sexually inexperienced women was infected. Among those sexually experienced, the prevalence of isolation of C. trachomatis and of detection of local antibodies in cervical secretions and serum antibodies to C. trachomatis increased in relation to the number of life-time sexual partners. Local antibody appeared to be a more reliable indicator of infection with C. trachomatis than serum antibody in this college population.

Adolescent↗
PubMed1979

Epidemiology and management of sexual assault victims.

One hundred and twenty-six sexual assault victims were examined and treated at the Women and Infants Hospital of Rhode Island from July 1 1976, through June 30, 1977. Sixty-six were less than 18 years of age, and of this group, 54 were less than 16 years of age, and 26 of these were prepubertal. Evidentiary examination was performed on 100 victims. No pregnancies resulted, and no victim acquired syphilis from the assault. Five patients had positive cultures for gonorrhea at the time of initial examination and all were cured by therapy. Epidemiologic correlates of sexual assault are discussed.

Adolescent↗
PubMed1977

Vaginal colonization with group B streptococcus: a study in college women.

Vaginal specimens for culture of group B Streptococcus and anonymous questionnaires were obtained from 499 college women. Group B Streptococcus was isolated from 90 (18.0%) of the participants. A selective broth medium was more sensitive for detection of vaginal isolates (85 of 493; 17.2%) than was direct inoculation of blood agar plates (44 of 466; 9.4%). The most prevalent serotypes among the isolates were type III (37.9%) and type II (25.3%). Logit analysis identified four factors associated with a higher prevalence of vaginal colonization with group B Streptococcus. These organisms were isolated significantly more often from (1) women who had an intrauterine device (50% vs. 18.6%; P less than 0.001), (2) sexually experienced women (20% vs. 7.1%; P less than 0.02), (3) women studied during the first half of the menstrual cycle (26.5% vs. 14.5%; P less than 0.01), and (4) women 20 years of age or younger (21.4% vs. 14.8%; P less than 0.05). The prevalence of colonization with group B Streptococcus was not related to sexual practices, history of venereal disease, use of oral contraceptives, presence of gynecologic symptoms, use of antibiotics, race, educational level, marital status, or history of pregnancy.

Adult↗
PubMed1977

Vaginal colonization with Corynebacterium vaginale (Haemophilus vaginalis).

Vaginal cultures for Corynebacterium vaginale and confidential questionnaires were obtained from unselected young women who consulted a gynecologist in a student health service. In all, 466 women were studied, 150 (32.2%) of whom were colonized with C. vaginale. Logit analysis defined four factors that were significantly associated with colonization with C. vaginale: nonwhite race, use of oral contraceptives, no history of marriage, and a history of pregnancy. Sexual experience had little influence on colonization; C. vaginale was isolated from 16 (29%) of 56 sexually inexperienced women and from 40 (41%) of 98 women who had had intercourse with six or more men. After a few patients with trichomoniasis were excluded, there was no association between colonization with C. vaginale and an abnormal vaginal discharge, either as reported by the participant or as noted by the examining physician.

Black People↗