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J Segal

Publications and source records attributed to J Segal.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Transvaginal ultrasound and diagnostic hysteroscopy as a predictor of endometrial polyps: risk factors for premalignancy and malignancy.

The aim of this study is to assess accuracy of transvaginal ultrasound (TVUS) and diagnostic hysteroscopy in diagnosing endometrial polyps and to determine premalignancy and malignancy rates in asymptomatic women. The study was designed to retrospectively analyze 438 women who underwent operative hysteroscopy in a day-care unit when endometrial polyp was suspected after TVUS and diagnostic hysteroscopy. Multivariate logistic regression modeling showed effects of age, previous breast cancer with tamoxifen treatment, and menopause with or without bleeding on pathologic results. The results indicate that positive predictive value of TVUS with diagnostic hysteroscopy was 79.9%. Premalignancy or malignancy occurred in 3.2% and was significantly related to menopause with abnormal bleeding (P < 0.001), which carried a 20-fold higher risk of pathology than any other group. Age was also a risk factor. It was concluded that TVUS with diagnostic hysteroscopy reliably evaluates endometrial polyps. The low incidence of endometrial tumors in asymptomatic (especially premenopausal) women suggests that their operative evaluation may not be cost effective. Larger studies are needed to support this tentative conclusion.

Adult↗
PubMedDate not supplied

An improved valve-spreading catheter for producing reversible graded acute aortic regurgitation.

A valve-spreading catheter capable of producing graded reversible acute aortic regurgitation has been described. We modified this device to improve its safety and steerability. The modified valve-spreading catheter was composed of a removable core flexible guidewire and a caged catheter. The guidewire could easily and safely be steered into the left ventricle. The caged catheter could then be advanced over the guidewire to the aortic valve area with greater safety and ease. Opening of the caged catheter resulted in graded reversible acute aortic regurgitation. The modified valve-spreading catheter was used in 5 anesthetized mongrel dogs to create reversible graded acute aortic regurgitation, demonstrating its safety, and thus its utility. This device qualifies as an ideal instrument for creating variable and transient acute aortic regurgitation in intact animals.

Acute Disease↗
PubMedDate not supplied

Maternal and fetal serum and tissue levels of ceftriaxone following preoperative prophylaxis in emergency cesarean section.

The use of antibiotic prophylaxis in emergency cesarean section has become the standard of care. Concern over fetal exposure has been the reason that antibiotics are traditionally given post cord clamping, but this does not allow adequate antibiotic levels in maternal blood and tissue to be achieved at the stage of incision and during surgery. We evaluated by bioassay maternal and fetal serum and placental ceftriaxone concentrations following the intravenous administration of 1.0 g of ceftriaxone upon the decision to perform cesarean section. The preoperative prophylaxis with ceftriaxone resulted in adequate protective levels in the mother and very low fetal blood levels.

Amniotic Fluid↗
PubMedDate not supplied

[Measles].

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Child↗
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Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial.

Case reports and studies of other neuroleptics suggest the efficacy of risperidone in the treatment of mania. Forty-five inpatients with DSM-IV mania were studied in a 28-day randomized, controlled, double-blind trial of either 6 mg daily of risperidone, 10 mg daily of haloperidol, or 800 to 1200 mg daily of lithium. The patients in all three groups showed a similar improvement on the total score for all rating scales at day 28 (Brief Psychiatric rating scale; lithium 9.1, haloperidol 4.9, risperidone 6.5, F = 1.01, df = 2, p = 0.37; Mania rating scale; lithium 15.7, haloperidol 10.2, risperidone 12.4, F = 1.07, df = 2, p = 0.35 [analysis of variance]). The Global Assessment of Functioning and Clinical Global Impression data showed a similar pattern of improvement. This study suggests that risperidone is of equivalent efficacy to lithium and haloperidol in the management of acute mania. The extrapyramidal side effects of risperidone and haloperidol were not significantly different.

Adult↗