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Biomedical subjects

R T Burkman

Publications and source records attributed to R T Burkman.

85 records · Page 5Linked to original sources
PubMed1977

Culture and treatment results in endometritis following elective abortion.

Endometrial culture and treatment results from 228 patients who developed endometritis following elective abortion were analyzed. The most common organisms isolated were group B beta hemolytic streptococci, Bacteroides, Neisseria gonorrhoeae, E. coli, and Staphylococcus aureus. In general, patients responded to treatment with penicillin or ampicillin, with the addition of an aminoglycoside for these requiring hospitalization. Curettage was an important adjunctive treatment for hospitalized patients and for some outpatients.

Abortion, Induced↗
PubMed1977

Coagulopathy with midtrimester induced abortion: association with hyperosmolar urea administration.

Coagulation changes, usually subclinical, have been reported in association with the induction of midtrimester abortion by the administration of intra-amniotic hypertonic sodium chloride, hyperosmolar urea, hyperosmolar urea plus prostaglandin F2alpha, and hyperosmolar ura or hypertonic glucose plus prostaglandin E2. In addition, clinically significant coagulopathy has been described in association with the administration of hypertonic sodium chloride. This study details a three-year experience involving 3,034 cases of midtrimester elective abortion and describes six cases of coagulopathy in association with the administration of hypertonic sodium chloride and two cases in association with the administration of hyperosmolar urea. The significance of these findings and etiologic considerations are discussed.

Abortifacient Agents↗
PubMed1977

The management of midtrimester abortion failures by vaginal evacuation.

The management of 58 failed midtrimester primary abortion procedures by vaginal uterine evacuation is described. The indications, technic, and complications of this procedure are presented. This method was the only means of managing failed primary abortion over a 3-year period in which 2045 elective midtrimester abortions were performed. With the development of experience this technic offers significant advantages over other procedures, such as hysterotomy, in the management of such patients.

Abortifacient Agents↗
PubMed1976

Untreated endocervical gonorrhea and endometritis following elective abortion.

A matched-pair analysis of 228 cases of endometritis occurring over a two-year period in 4,823 elective abortion patients was carried out. Patients with postabortal endometritis were matched with control subjects for age, parity, race, pay status, time of abortion, and type of abortion procedure. The prevalence of endocervical gonorrhea was 2.7% in the entire group seeking abortion, with 14.7% of patients with gonorrhea subsequently developing endometritis. The matched-pair analysis detected a threefold increased risk for endometritis in patients with untreated gonoccocal endocervicitis when compared with control subjects (p less than 0.05). The significance of these findings to centers performing abortions is discussed.

Abortion, Induced↗
PubMed1976

Intra-amniotic urea and prostaglandin F2 alpha for midtrimester abortion: a modified regimen.

A study comparing intra-amniotic urea plus intravenous oxytocin and intra-amniotic urea with 10 mg. prostaglandin F2 alpha was completed. In addition, the results obtained with a further 150 patients receiving urea and prostaglandin are reported. Mean injection-abortion intervals ranged from 15.75 hours for urea-prostaglandin to 18.93 hours for urea-oxytocin. The advantages of urea-prostaglandin and suggested improvements are discussed. Over all, the method appears efficacious though incomplete abortions and cervical laceration are persistent problems.

Abortion, Induced↗
PubMed1975

Continuing education of obstetricians and gynecologists in fertility management.

One of the current fundamental problems in medicine is the massive quantity of new information that continues to develop and the requirement for the application of these data to good patient care. New techniques of merit need to be placed rapidly in the patient-care arena and the time lag between the steps from laboratory to clinic minimized. One approach to the achievement of the goal in fertility management is described in the following report; namely, a summary of the results of an education program in fertility management established in November, 1972, for the continued education of obstetricians and gynecologists from "developing countries". This report reviews the experience and data derived from the first 95 physicians completing a course in population dynamics. An estimate of the factual knowledge that these individual physicians possessed at the beginning of the course is compared with an estimate of the knowledge acquired within the 4 week training program. In a similar manner, an important part of this survey was a study of the attitudes of the clinical fellows in the areas of sex education, contraception, sterilization, and abortion. The results of this study suggest that newly developed techniques in clinical medicine may be taught to a specific and highly motivated group in an effective and efficient manner. The initial interest and response of physicians for admission to this program have demonstrated the need for the development of more similar educational programs.

Abortion, Legal↗
PubMed1975

Menstrual extraction.

This report documents the clinical outcome of 137 consecutive menstrual extractions. The pre- and postprocedural pregnancy testing is correlated with histologic examination of tissue obtained. This report reviews the management of the unsuccessful cases.

Abortion, Induced↗
PubMedDate not supplied

Compliance and other issues in contraception.

About 5% of women in the United States (approximately three million) are not using contraception despite being at risk of unintended pregnancy. Teenagers have the highest rate of unintended pregnancy. Women 40 years and older most frequently terminate unintended pregnancy. Multiple theories and models, including the health belief model, the health decision model, the Prochaska change model, and the conviction-confidence model, have been developed to address choices and change in health behavior. Despite this information, current data on contraceptive compliance show considerable need for improvement. Side effects and patients' beliefs and preferences appear to influence strongly whether a method will be used appropriately. Systems improvements that address issues such as access and enhancement of provider-patient interaction appear to be areas of potential opportunity. Despite continued need for improvement, there is a paucity of information testing new approaches to improve contraceptive compliance.

Adolescent↗
PubMedDate not supplied

Cardiovascular issues with oral contraceptives: evidenced-based medicine.

Recent studies of current oral contraceptives indicate that the risk of cardiovascular sequelae is low in young (age 20-24 years) reproductive-aged women. Venous thromboembolism remains the one event that occurs in users independent of the presence of risk factors. However, the attributable risk is small, in the range of 7 to 18 events per 100,000 women annually. This risk is proportional to estrogen dose until the level of 30-35 microg is reached; type of progestin may also influence risk, though recent studies are controversial. Modifiable risk factors for venous thromboembolism include the presence of hemostatic disorders, especially factor V Leiden, and perhaps obesity. Stroke is even more uncommon, with an attributable risk of about 1.5 events per 100,000 women annually. Cigarette smoking and hypertension are modifiable risk factors for both ischemic and hemorrhagic stroke; use of preparations with 50 microg of estrogen or higher and migraine headaches are risk factors for ischemic stroke. Eliminating risk factors among users substantially reduces the risk of ischemic stroke and virtually eliminates the risk of hemorrhagic stroke. Myocardial infarction is rare among young women, occurring at a rate of about 0.2 event per 100,000 women annually. Oral contraceptive users who are non-smoking and normotensive do not have an increased risk of myocardial infarction. However, the presence of these risk factors along with age acts synergistically to increase the risk among oral contraceptive users.

Adolescent↗