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Biomedical subjects

W Thompson

Publications and source records attributed to W Thompson.

206 records · Page 12Linked to original sources
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Premature luteinization and ovulation induction using human menopausal gonadotrophin or pure follicle stimulating hormone in patients with polycystic ovary syndrome.

High ovulation rates can be achieved in women with PCOS, using hMG or FSH to induce ovulation, but the pregnancy rate is lower than expected. To determine whether this might be due to premature luteinization, progesterone levels were measured in the follicular phase of 49 infertile women with PCOS treated with hMG or FSH. The ovulation rate was 88.6% overall and 20 patients conceived. Six pregnancies aborted within four weeks of ovulation. Premature luteinization occurred in 32% of treatment cycles, of which three resulted in conception, compared to 17 conceptions in the 68% of cycles not associated with premature luteinization (p = 0.06). Of the 17 conceptions not associated with premature luteinization, three aborted and 14 proceeded to term; all three conceptions associated with premature luteinization aborted (p = 0.01). These results indicate that premature luteinization in women with PCOS is common, and has a deleterious effect on the rate of conception, and may also be a causal factor in early pregnancy loss.

Female↗
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Nurses in demand.

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Australia↗
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Nurses in demand.

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Australia↗
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The surgical approach and source of bone graft for symptomatic nonunion of the scaphoid.

In 2 groups of patients treated by bone grafting for scaphoid nonunions, one group had a dorsal or dorsolateral surgical approach with a bone graft from the radius while the other group had a volar approach with an iliac graft. The best results were obtained with an iliac graft. Through the volar approach it is relatively easy to avoid damage to the scaphoid arterial supply. A small proximal vascular pole led to a failure rate of 36%.

Adolescent↗
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Evaluation of routine ultrasound in the prenatal diagnosis of structural anomalies of the fetus.

The objective of this study was to evaluate routine obstetric ultrasound in detecting fetal structural anomalies and the impact of changing clinical practice on success rates. A retrospective study of routine ultrasound in a population of 6,869 pregnancies was performed during 1985-86 (phase 1) to establish efficacy of ultrasound in the detection of fetal anomalies. Changes in ultrasound practice comprised timing, personnel and technique of fetal examination. After alterations in practice, a prospective study of 6,969 pregnancies during 1987-89 (phase 2) was performed. All abnormal fetuses (cases) were assessed in both studies. Random samples of normal infants (controls) were chosen from both populations to establish specificity. In 83 cases in phase 1,116 anomalies were diagnosed postnatally of which 11 were suspected by routine prenatal ultrasound at < 24 weeks (sensitivity 9%, 95% C.I. 4-15). In 72 cases in phase 2, 89 anomalies were identified postnatally of which 27 were suspected by routine prenatal ultrasound at < 24 weeks (sensitivity 30%, 95% C.I. 21-41). The change in sensitivity was statistically significant (p = 0.0003). Of the 382 control infants randomly selected in phase 1, false abnormal scans were not identified (specificity 100%, 95% C.I. 99-100). Of the 367 control infants in phase 2, 12 false abnormal scans were identified (specificity 96.7%, 95% C.I. 95-99). The decrease in specificity was statistically significant (p = 0.0013). The detection of urorenal and to a lesser degree central nervous system anomalies showed most improvement between the two phases. The alterations to routine ultrasound practice in timing, personnel and technique have significantly improved the detection of all fetal structural anomalies but at the cost of a small but significant loss of specificity.

Adult↗