Postpartum hemorrhage and shock.
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Biomedical subjects
Publications and source records attributed to P Watson.
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Eighteen cases of acute and subacute puerperal inversion were studied to identify important predisposing factors and to assess management and postpartum morbidity. The study patients did not differ from case-matched controls in age, parity, duration of labor, type of delivery, or management of the third stage. The most common signs noted were hemorrhage (94%) and shock (39%). All inversions were recognized immediately and manually replaced within 60 minutes. Shock was treated prior to repositioning in all cases. Calculated blood loss averaged 1775 ml. There was no mortality nor febrile morbidity. The average hospital stay of the study patients and their case-matched controls was 3 days. Immediate recognition of uterine inversion and prompt initiation of therapy will ensure a normal postpartum course.
In vivo platelet function, serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and serum triglycerides (TG) were determined in 26 women starting oral contraceptives (OCA). Studies were run prior to, and after one and two months of therapy. Platelet aggregation time decreased by 50 percent or more in eight of the 26 women from a pre-experimental mean value of 387 +/- 136 seconds. TC did not vary but after the women were on medication for two months, HDL decreased from 56 +/- 14.4 mg/dl to 52 +/- 12.3 mg/dl (p less than 0.05). There was a progressive increase in TG under treatment, 74 +/- 23.3 mg/dl on the pre-experimental measurement to 93 +/- 31.0 mg/dl after two months of therapy (p less than 0.005). Women planning to use OCA might best be advised to have aggregation and serum lipid studies done before and early in usage.
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The history of a patient with rheumatoid arthritis and necrotizing vasculitis affecting only the central nervous system is reported. Clinical and pathological involvement by this process was present in both cerebral hemispheres, the pons and spinal cord. Review of the literature revealed that cerebral vasculitis in rheumatoid arthritis has been reported rarely and spinal cord vasculitis not at all.
The results are given of a survey of skin doses received in mammography by a phantom breast containing a simulated spherical tumour. The survey covered the 18 centres in New Zealand where mammography was carried out in 1976. The techniques used included xeroradiography, non-screen film and film with a back screen. If the best parameters for each technique were chosen, the "tumour" could be readily seen. Unfortunately this was not often the case and in practice only xeroradiography produced mammograms where the tumour was clearly seen in both the cranio-caudal and medio-lateral views. No centre produced a mammogram of the highest quality with an entrance dose of less than 1 rad. Within each technique there was a very wide range of entrance doses for the same quality of mammogram. At two centres with large workloads, the entrance doses to 11 patients were measured and, in general, the skin doses received by the patients were within 25% of those measured with the Rando phantom.
The capability of pregnant mare serum (PMS) and human chorionic gonadotropin (HCG) to induce estrus and ovulation was tested in mature, anestrous bitches. The PMS was given for 10 consecutive days in 1 of 3 regimens: 500 IU/day (experiment 1), 250 IU/day (experiment 2), or 20 IU/kg/day (experiment 3). The HCG was given as a single 500-IU dose on experimental day 10. Controls were given saline solution. Vaginal smears were collected on days 1, 3, 5, 7, 9, and 12 by jugular venipuncture, and the plasma was assayed for progesterone concentration by radioimmunoassay. On day 13, the bitches were euthanatized, ova were flushed from the uterine tubes (oviducts), and the ovaries were collected and prepared for microscopic examination. Fourteen of 25 bitches treated with PMS and HCG showed estrus and ovulated. Proestrus (vaginal bleeding) commenced between experimental days 7 and 10. Estrus commenced on day 9 or 10. Progesterone increased from approximately 1 ng/ml on day 1 to more than 6 ng/ml on day 12. Numbers of ovulation sites on both ovaries were 4.7 +/- 1.1 and 4.6 +/- 0.5 (mean +/- SEM) in those given the daily doses of 500 and 250 IU of PMS and 9.8 +/- 1.5 in experiment 3 bitches. Eleven hormone-treated dogs and 7 saline-treated dogs did not show any detectable response. Neither cystic nor unovulated, luteinized follicles appeared on the ovaries.
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