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Biomedical subjects

R C Reiter

Publications and source records attributed to R C Reiter.

42 records · Page 3Linked to original sources
PubMed1990

Demographic and historic variables in women with idiopathic chronic pelvic pain.

A comprehensive historic, demographic, and medical questionnaire was administered to 106 women referred to a multidisciplinary clinic for evaluation of idiopathic chronic pelvic pain and to 92 age-matched, pain-free control patients presenting for routine annual examination. Although racial distribution, mean gravidity and parity, and rates of elective abortion were similar in both groups of respondents, spontaneous abortion was reported significantly more frequently among women with pelvic pain. Patients in the study group were also more likely to be on active military duty, to have undergone previous nongynecologic surgery, and to have sought treatment for unrelated somatic complaints. Finally, although the mean ages at first intercourse were similar, women with idiopathic pelvic pain reported a higher total number of sexual partners and were significantly more likely to have experienced previous significant psychosexual trauma. These findings confirm that predisposing psychosocial variables are important in the pathogenesis of idiopathic pelvic pain and emphasize the significance of multidisciplinary evaluation and management.

Abortion, Spontaneous↗
PubMed1989

Validation of hysterectomy indications and the quality assurance process.

Hysterectomy is one of the most commonly performed major operations in the United States. Despite efforts to explain its high incidence, the perception remains that a significant number of hysterectomies are unjustified. More indications are listed for hysterectomy than for any other major operation. A quality assurance process is presented that requires the surgeon to select preoperatively one designated indication for each hysterectomy performed. The pathology report is expected to verify the surgical indication in 66% of the cases. The other 34% of hysterectomy specimens are not expected to show tissue pathology based on the listed indication. For these cases, predetermined validation criteria must be satisfied in the surgeon's preoperative note. Applying the process in this series of 584 consecutive hysterectomies, 93% (N = 396) of the "pathology expected" indications were verified by the pathology report and 98% (N = 188) of the "no pathology expected" indications were validated by the surgeon's preoperative note. The process of using a single designated indication and reviewing only two documents (the pathology report and the surgeon's preoperative note) has greatly simplified the quality assurance process. This system enables a quality assurance committee to monitor easily the appropriateness of hysterectomy indications for their institution. Information obtained from this process can influence changes regarding the acceptability of certain indications. As a result of this study, adenomyosis, because of its low (38%) verification rate, is no longer considered a reliable preoperative indication for hysterectomy at San Diego Naval Hospital.

California↗
PubMed1989

Consumer advocacy, elective surgery, and the "golden era of medicine".

The process of medical quality assurance evolved logically from the consumer advocacy movement of the past decades. This process has fundamentally altered the personal and legal relationship between patients and physicians. The need for development and adoption of a medically, ethically, and fiscally sound standard of elective surgical practice is clear and immediate. A system that may be used to evaluate the appropriateness of elective surgical procedures is proposed.

Consumer Advocacy↗
PubMed1986

Management of initial atypical cervical cytology: a randomized, prospective study.

Five hundred twelve patients who presented with initial atypical cervical cytology between February 1982 and February 1983 at Naval Hospital, San Diego were randomized with respect to antibiotic treatment and interval before repeat cytologic examination. Treatment before repeat cytology did not improve the rate of reversion to normal cytology. Reexamination before three months, however, resulted in an increased rate of persistent atypical cytologies. Patients who failed to revert to normal cytology on repeat examination were found to be at substantial risk for development of cervical intraepithelial neoplasia (CIN). To date, adequate follow up and histologic diagnosis has been achieved for 110 such patients, 49 of whom (44.5%) have been found to harbor CIN. Patients in whom initial cytology demonstrated marked atypia unassociated with inflammation are particularly at risk (76.2%) for development of CIN.

Adolescent↗
PubMed1985

Treatment of endometriosis with danazol: report of a 6-year prospective study.

Presented are the results of a 6-year prospective study designed to evaluate the effectiveness of danazol for the treatment of endometriosis. Ninety-six patients completed 6 months of therapy at a dosage of 800 mg daily, and 107 patients completed therapy with 400 mg daily. No difference was reported in the incidence of side effects, regardless of dosage. Gross resolution of disease (as determined by second-look laparotomy or laparoscopy) was evaluated in 110 patients and found to be similar, regardless of dosage. Ovarian endometriosis greater than 1 cm was observed to respond significantly less well to danazol than peritoneal or ovarian disease less than 1 cm. Pregnancy rates for 157 patients with no other discernible causes of infertility were slightly higher for the 800-mg danazol regimen than for the 400-mg regimen. In patients with mild disease, the use of danazol alone resulted in pregnancy rates lower than those achieved with conservative surgery alone. Its use preoperatively for all stages of disease resulted in slightly higher pregnancy rates than when conservative surgery alone was employed. Danazol was less effective when used postoperatively. No differences were observed between three classification schemes in their ability to predict subsequent prognosis for conception.

Adult↗