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Biomedical subjects

N P Veridiano

Publications and source records attributed to N P Veridiano.

At least 19 recordsLinked to original sources
PubMed1999

Cervical sarcoma botryoides. A case report.

BACKGROUND: Sarcoma botryoides is a rare gynecologic malignancy. Reported treatment protocols range from localized resection of the tumor to radical surgery and adjuvant chemotherapy. Recently, limited excisional surgery combined with chemotherapy has contributed to excellent survival rates and preserved bladder and rectal function. CASE: We report a case of cervical sarcoma botryoides with minimal invasion. The patient had primary surgical treatment with complete resection of the tumor without adjuvant chemotherapy. Four months after surgery she presented with extensive metastatic retroperitoneal disease and died two weeks later. CONCLUSION: The clinical course of this patient suggests that complete surgical resection in cases of localized disease is not adequate therapy for sarcoma botryoides. Adjuvant chemotherapy should always be used, even at a very early stage.

Diagnosis, Differential↗
PubMed1996

Genital fistulas caused by diverticular disease of the sigmoid colon.

OBJECTIVE: Our purpose was to bring to the attention of gynecologists a subject not mentioned in a single textbook of gynecology, namely, genital fistulas resulting from diverticular disease of the sigmoid colon. STUDY DESIGN: We report our experience with 13 genital fistulas caused by sigmoid diverticulitis. RESULTS: Ten fistulas involved the vagina, one the vagina and bladder, one the tube, and one the uterus. Average age of the patients was 68.6 years (range 54 to 89 years). Presenting symptom in 12 patients was a malodorous vaginal discharge. All with vaginal lesions had previously undergone total hysterectomy. A barium enema failed to demonstrate a fistula in 8 of 11 patients. Colonoscopy failed in 8 of 8 patients. All fistulas were demonstrated by retrograde dye studies. Ten patients operated on were cured. Three patients refused surgery; of these, 1 had intestinal obstruction, 1 may have had spontaneous closure of the fistula, and 1 is being observed. Surgery involved staged procedures in 2 patients, fistulectomy in 4, and bowel resection and anastomosis in 4. CONCLUSIONS: Sigmoidovaginal fistulas are the most prevalent variety of cologenital fistula caused by sigmoid diverticulitis. The diagnosis should be considered in a patient > 50 years old who complains of a foul vaginal discharge and has a history of total hysterectomy. Its presence is best demonstrated by vaginogram. Surgical therapy is advised, the extent of which will rest on the surgeon's judgment of the severity of the inflammatory process found at exploration.

Aged↗
PubMed1996

Genital fistulas secondary to diverticular disease of the colon: a review.

Genital fistulas that complicate diverticular disease of the sigmoid colon may no longer be considered esoteric, or even rare phenomena. The vast majority of such lesions present with a foul, often fecal, sometimes purulent and occasionally blood-tinged, vaginal discharge for which patients customarily first seek relief from their gynecologists. Despite this fact, the topic is not mentioned in a single American textbook of gynecology. It is the purpose of this report to review the pertinent literature and to include the authors' experience with 13 additional cases in order to bring this topic to the attention of our gynecologic colleagues.

Diverticulitis, Colonic↗
PubMed1992

Prenatal exposure to diethylstilbestrol (DES): childhood play behavior and adult gender-role behavior in women.

Data from lower mammals suggest a masculinizing or defeminizing influence of pre- or perinatal diethylstilbestrol (DES) exposure on various aspects of the sex-dimorphic behavior (including juvenile rough-and-tumble play) of genetic females. However, three previous studies on childhood play and adult gender-role behavior in human females have led to ambiguous results. In a follow-up study of 60 women with prenatal exposure to DES and 26 controls, we used psychometrically well-designed multi-item scales based on self-report inventories for the assessment of these aspects of behavior. No effects of DES could be demonstrated. We conclude that, at the doses studied, prenatal DES exposure in human females has not led to behavioral masculinization or defeminization of childhood play and adult gender-role behavior.

Adolescent↗
PubMed1992

Squamous cell carcinoma of the endometrium. A case report.

Invasive squamous cell carcinoma of the endometrium occurred secondary to squamous cell carcinoma in situ of the cervix. There have been 27 previous reports of secondary endometrial squamous cell carcinoma and 31 of primary.

Carcinoma, Squamous Cell↗
PubMed1991

Gender-related behavior development in females exposed to diethylstilbestrol (DES) in utero: an attempted replication.

This report concerns the role of prenatal hormones in normal and abnormal psychosexual differentiation. Several studies indicate that perinatal treatment of infrahuman female mammals with diethylstilbestrol (DES) masculinizes certain features of their brain and behavior. Accordingly, the authors have hypothesized that prenatal exposure to DES may also masculinize the gender-role behavior of girls and women. A previous study suggested that prenatally DES-exposed women show decreased interest in parenting. The authors failed to replicate these findings in a different sample despite the use of similar methodology. Post-hoc analysis shows that the assessment devices would have detected masculinization if it were present. The implications of these findings for an understanding of psychosexual development are discussed.

Adolescent↗
PubMed1989

The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES).

Animal research has shown that diethylstilbestrol (DES) present during the sensitive developmental periods of the hypothalamus and adjacent areas of the brain affects the development of sex-dimorphic brain structures and subsequent behavior. To test for corresponding behavioral effects in humans, 30 women with a history of prenatal DES exposure were contrasted with 30 unexposed women who had been referred to the same clinic for a colposcopic examination because of an abnormal Pap smear. Gender-role behavior of childhood, adolescence, and adulthood was assessed by means of a semistructured interview, the Gender Role Assessment Schedule-Adult, and the Bem Sex Role Inventory. The mothers of these women were interviewed about their daughters with the "mother form" of the same interview schedule. The results suggest that DES women show less orientation toward parenting than the controls. There were no consistent group differences in other domains of gender-role behavior.

Adolescent↗
PubMed1989

Vaginal delivery after cesarean section.

We retrospectively analyzed 194 pregnancies in women with a history of previous cesarean section (CS) who were offered a trial of labor. We offered every woman a trial of labor as long as she did not have a known previous classical scar. One hundred fifty-one women delivered vaginally (79%), 24 women had multiple uterine scars. Multiple gestations and breech presentation were not considered a sole indication to perform CS. Fetal and maternal morbidity are presented. We conclude that women with multiple previous CS scars can safely deliver vaginally as can women with unknown uterine scars, with careful intrapartum surveillance. Although our numbers of women with breech presentation and multiple gestations are small, in the absence of significant morbidity, we continue to allow these women to labor and deliver vaginally.

Cesarean Section↗
PubMed1985

Sexual orientation after prenatal exposure to exogenous estrogen.

Thirty women aged 17 to 30 years with documented prenatal exposure to the nonsteroidal synthetic estrogen diethylstilbestrol (DES) were compared to thirty women of similar demographic characteristics from the same medical clinic who had a history of abnormal Pap smear findings. A subsample of the DES women were also compared to their DES-unexposed sisters. Sexual orientation in its multiple components was assessed by systematic semistructured interviews. In comparison to both control groups, the DES women showed increased bisexuality and homosexuality. However, about 75% of the DES women were exclusively or nearly exclusively heterosexual. Nonhormonal and hormonal interpretations of these findings are discussed.

Adolescent↗
PubMed1984

Psychosexual milestones in women prenatally exposed to diethylstilbestrol.

Thirty women aged 17 to 30 years with a record-confirmed history of prenatal exposure to diethylstilbestrol (DES) were compared to 30 women of similar age and demographic background with a history of abnormal Pap smear findings. Heterosocial and heterosexual histories were assessed by systematic semistructured interviews. The groups differed neither in the age at menarche nor in the age at attainment of various psychosexual milestones.

Adolescent↗
PubMed1982

Abdominal pregnancy: review of current management and addition of 10 cases.

Ten cases of abdominal pregnancy managed at the Brookdale Hospital Medical Center over a 17-year period are presented. An incidence of 1 abdominal pregnancy in 7095 deliveries occurred in this series; another institution reported 1 in 7931. A perinatal mortality rate of 80% and no maternal mortality in the study are contrasted to rates of 75 to 95% and 2 to 18%, respectively, from the world literature. Recurrent abdominal pain in the gravid patient with a prior history of infertility, tubal pregnancy, and/or surgery may signal abdominal pregnancy. Similarly, the management of fetal death should include consideration of the presence of abdominal pregnancy. The role of ultrasonography in diagnosis and the importance of immediate surgical intervention with minimal disturbance of the placenta are stressed.

Adult↗
PubMed1981

A fifteen year experience with ectopic pregnancy.

The increasing importance of an ectopic pregnancy as a cause of maternal death presents a challenge that will be met when primary care physicians combine a high index of suspicion with the ability to recognize the patient most at risk. The major symptoms, abdominal pain, secondary amenorrhea and abnormal vaginal bleeding are well known, as are the major signs, abdominal tenderness, adnexal mass and tenderness on motion of the cervix. Less well known are factors in the clinical history which indicate the patient to be at high risk. These include primary or secondary infertility, previous abortion or ectopic pregnancy and previous tubal operation, either reconstructive or sterilizing. In addition, the use of an intrauterine contraceptive device or its recent removal because of abdominal pain or bleeding, or both, is highly significant. Of major importance is a history of recent uterine evacuation. Should the diagnosis of ectopic pregnancy be under consideration, procrastination by observation is no longer acceptable. An active effort must be made to confirm or deny the diagnosis, Culdocentesis should be performed in the emergency department or clinic. If positive, prompt laparotomy is indicated. Should the result of culdocentesis be unsatisfactory or negative, laparotomy should be undertaken with further delay.

Adult↗
PubMed1981

Reproductive performance of DES-exposed female progeny.

The reproductive performance of 106 patients exposed in utero to diethylstilbestrol by maternal ingestion is described. Fetal wastage is high, apparently because of spontaneous abortion during the first and second trimesters. Recommendations are made for preconception counseling of exposed progeny to increase fetal salvage.

Abortion, Spontaneous↗