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P O'Donovan

Publications and source records attributed to P O'Donovan.

At least 19 recordsLinked to original sources
PubMed2004

Selecting distending medium for out-patient hysteroscopy. Does it really matter?

BACKGROUND: The aim of this prospective randomized study was to evaluate the role of carbon dioxide (CO2) and normal saline for diagnostic accuracy in out-patient hysteroscopy. METHODS: Women admitted to our Department in order to undergo total abdominal hysterectomy also underwent diagnostic hysteroscopy, 12-24 h prior to surgery. The selection of distending medium was made after randomization. Two groups of patients were formed, group A (CO2; n=39) and group B (normal saline; n=35). More than half of the women in the study population were post-menopausal. Post-hysteroscopy, all women were asked to rank any symptom that they felt during the procedure on a 4-point scale (0=none; 1=mild; 2=severe; 3=inability to perform hysteroscopy). The hysteroscopic diagnosis was compared with the macroscopic findings and the histological examination of the surgical specimen after hysterectomy. RESULTS: The percentage who completed hysteroscopy was 89.74% within group A and 97.14% within group B. Most patients of both groups felt some pain of mild intensity. The diagnostic accuracy of hysteroscopy was similar for both media when major pathology [large polyps (group A 91.7%; group B 92.7%), myomas (group A 81.25%; group B 92.7%) and/or hyperplasia (group A 87.5%; group B 90.2%)] of the endometrial cavity was detected. In contrast, in cases of minor pathology (small polyps, mucosal elevations, crypts, hypervascularization), hysteroscopy with saline presented with significantly higher diagnostic accuracy (85.4%) compared with hysteroscopy with CO2 (64.6%). CONCLUSIONS: In out-patient hysteroscopy, CO2 and normal saline were comparable with regard to patient discomfort and for the detection of major pathology of the endometrial cavity. Normal saline seems to be the most appropriate medium for the detection of minor pathology of the endometrial cavity.

Adult↗
PubMed2000

Microwave endometrial ablation in the management of menorrhagia: current status.

Menorrhagia is a common clinical problem. Recently several different ablative techniques have been described to treat it in the expectation of reducing hysterectomy rates. This paper describes the current status of microwave endometrial ablation, its clinical efficacy, its safety profile and future development.

Endometrium↗
PubMed1998

Cervical pregnancy managed by suction evacuation and balloon tamponade.

A woman with a very poor obstetric history with a cervical pregnancy was managed without hysterectomy. Diagnosis was made by the transvaginal ultrasound. Haemorrhage was controlled by suction evacuation and balloon tamponade. Although cervical perforation occurred, the tamponade was able to control haemorrhage after repair of the perforation.

Adult↗
PubMed1998

Transudative malignant pleural effusions: prevalence and mechanisms.

BACKGROUND: Malignant pleural effusions are classically exudative, though occasionally they can be transudative. We attempted to determine the prevalence of transudative malignant pleural effusions and to describe their clinical and radiographic characteristics. METHODS: We studied the medical records of 215 patients with malignant pleural effusion, which contained complete data on pleural fluid analysis for 171 of them. RESULTS: Eight cases of transudative malignant effusion were found. Seven of these eight patients had a concomitant disorder known to cause transudative pleural effusion. One patient had fluid overload due to renal failure, and another had been admitted earlier with congestive heart failure. Two patients had definite evidence of deep venous thrombosis, allowing us to postulate pulmonary embolism as a factor contributing to transudation. Three patients had CT evidence of superior vena cava obstruction. Only one patient had no known associations with causes of transudative effusion. CONCLUSION: Malignant pleural effusions were transudative in 5% of our patients. In all except one patient, some evidence suggested the concomitant presence of a transudative state.

Aged↗
PubMed1994

Failed validation of a clinical decision rule for the use of radiography in acute ankle injury.

AIM: To validate the Ottawa clinical decision rule for the use of radiography in acute ankle injuries. METHOD: A prospective, multicentre trial of 350 adult patients presenting with acute ankle injuries consisting of correlation of the features of the Ottawa clinical decision rule with the results of x-rays. RESULTS: There were 75 fractures in 350 patients, five of which would have been missed by the clinical decision rule. The sensitivity of the rule was 93% with a specificity of 11%. The positive predictive value was 22%, the false negative rate 14%. Fractures that would have been missed by the clinical decision rule included one unstable fracture of the ankle, one fracture of the talus, one calcaneal fracture and one fracture each of the cuboid and navicular. CONCLUSION: The Ottawa clinical decision rule for the use of radiography in acute ankle injuries is unacceptable for application in emergency departments in New Zealand due to a high false negative rate.

Acute Disease↗
PubMed1993

Flow cytometric studies of ploidy and proliferative indices in the Yorkshire trial of adjuvant progestogen treatment of endometrial cancer.

OBJECTIVE: To estimate whether flow cytometric indices provide independent measures of prognosis or predict response to prophylactic progestogens in endometrial cancer. DESIGN: Endometrial tumour specimens were retrieved and analysed by flow cytometry from 257 women who had been randomly allocated in a previous trial to receive prophylactic progestogen in addition to conventional therapy for endometrial carcinoma. SETTING: Fourteen district and two teaching hospitals in West Yorkshire. SUBJECTS: Women developing primary endometrial cancer between 1975 and 1983. MAIN OUTCOME MEASURES: Tumour ploidy status and proliferative indices and the relation of these to tumour stage and grade, to prognosis and to response to progestogens. RESULTS: Ploidy status and proliferative indices were related to tumour stage, grade and patient survival but were not independent predictors of survival. They did not predict patients who would respond to progestogens although there was a nonsignificant trend towards patients with diploid tumours surviving longer after progestogen treatment. CONCLUSIONS: Flow cytometry adds little to established prognostic indicators for endometrial cancer.

Aged↗
PubMed1990

The results of tubal surgery in the treatment of infertility in two non-specialist hospitals.

The results of surgery for tubal damage, other than reversal of sterilization, were studied in two large hospitals. This is the first recent study from centres claiming no special expertise in this surgery. An unusually high follow-up rate was obtained. The term pregnancy rate for patients operated on for bilateral distal tubal occlusion was 4%. The success rate is lower than the lowest reported, overall success rates for each cycle of in vitro fertilization (IVF) and very much lower than cumulative term pregnancy rates for tubal surgery reported by most other authors. Patients with distal tubal occlusion but minimal adhesions had the best prognosis. Our results suggest that, provided in vitro fertilization is available, only those patients with good prognostic factors should undergo tubal surgery. These represent the minority of all patients with non-iatrogenic tubal blockage.

Adult↗
PubMed1989

Learning economics.

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMed1988

Is routine antenatal booking vaginal examination necessary for reasons other than cervical cytology if ultrasound examination is planned?

Sixteen ovarian cysts, including one borderline ovarian malignancy, and ten trichomonal vaginal discharges but no cases of cervical incompetence or ectopic pregnancy had been detected at booking vaginal examination in 11,622 consecutive antenatal case records abstracted retrospectively. In an attitude survey of pregnant women 77% believed that vaginal examination was reassuring, 55% found it unpleasant, and 18% thought it could cause miscarriage. This, and a review of the literature, suggests that routine vaginal examination if ultrasound is planned has few advantages beyond the taking of a cervical smear.

Attitude to Health↗