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At least 955 records · Page 53Linked to original sources
PubMed1990

Twin pregnancy complicated by single intrauterine death. Problems and outcome with conservative management.

During an 11-year period we encountered 16 pregnancies in which one twin died in utero and the pregnancy continued. Eight of these twin pregnancies were monochorionic. None of the women developed severe disseminated intravascular coagulation. The fetal outcome indicates that the prognosis for a surviving dichorionic twin is relatively good, with immaturity the main hazard. By contrast the surviving monochorionic twin has a poor prognosis with a high frequency of neurological damage. This damage is not related to intrapartum or neonatal problems and at present cannot be diagnosed before birth. There is no evidence that birth of the surviving twin by caesarean section will improve the prognosis. Early diagnosis of monochorionic twins and subsequent ultrasound follow up should identify fetal growth discrepancy and possible twin to twin transfusion requiring early delivery.

Female↗
PubMed1991

Experience with tissue expansion vaginoplasty.

In vaginal agenesis, a vagina can be treated by tissue expansion vaginoplasty. We have performed 17 such procedures. One procedure was abandoned because of infection of the temporary implant. In four women the first stage had to be repeated: in one the implant was placed too superficially, in another it did not provide adequate expansion, in a further instance the implant became infected and the fourth woman received a surgical wound to her labia. The second stage was successful in all 16 women who now have a vagina lined with viable epithelium. The vaginal length was satisfactory in all but one. Two women complained of a vaginal discharge due to hair at the vaginal vault, two women developed postoperative haematomas and one experienced introital stenosis. The disadvantage of the procedure is that it requires two operative stages and involves a prolonged hospital stay but it is not technically complex and results in a full length vagina that does not require dilatation.

Adolescent↗
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↗
PubMed1993

Destruction of CIN 1 and 2 with the Semm cold coagulator: 13 years' experience with a see-and-treat policy.

OBJECTIVE: To assess the efficacy of the Semm Cold Coagulator (100 degrees C) for CIN 1 and 2 applying a 'see and treat' policy. DESIGN: Retrospective review of women with CIN 1 and 2 seen and treated at their first visit when specific criteria were satisfied. SETTING: Colposcopy Clinic, Ninewells Hospital, Dundee. SUBJECTS: 485 women with CIN 1 and 680 women with CIN 2 confirmed by colposcopically directed biopsy and treated between 1 January, 1978 and 31 December, 1990. RESULTS: Overall, a 96.7% primary success rate with a single treatment (97.1% for CIN 1, 96.5% for CIN 2) and 99% overall success rate after one or more treatments with the cold coagulator. None of the women developed micro-invasive or invasive cancer and only 1.1% developed CIN 3. In 98.3% treatment was undertaken at their first and only colposcopy clinic attendance. Heavy vaginal bleeding occurred in 1.5% after treatment and 0.6% complained of a heavy vaginal discharge. One woman developed cervical stenosis which required dilatation because of dysmenorrhoea. CONCLUSION: Cold coagulation at 100 degrees C of CIN 1 and 2 proven by colposcopically directed biopsy using a 'see and treat' policy subject to specific conditions is a safe, cost effective, practical approach. It is more likely to return the cervix to sustained normality than withholding treatment and simply maintaining cytological surveillance, and it should prevent some of the invasive cancers that have been described in reports of management by cytological surveillance.

Carcinoma in Situ↗
PubMed1994

Endometrial resection follow up: late onset of pain and the effect of depot medroxyprogesterone acetate.

OBJECTIVE: To observe longer term (9 to 18 months) follow up of women after a transcervical resection of the endometrium (TCRE) and the effect of post-operative medroxyprogesterone acetate on the results. DESIGN: An observational study. SETTING: A district public hospital and a nearby private hospital in Sydney, Australia. SUBJECTS: Sixty-one women who underwent TCRE from January to December 1991 were contacted 9 to 18 months after the procedure. They were questioned about symptoms and levels of satisfaction at six months, 12 months and at the time of interview, 9-18 months after the procedure. The 27 women treated from 1 January to 31 August 1991 were given medroxyprogesterone acetate 150 mg at the time of surgery. From 1 September to 31 December 1991 no medroxyprogesterone acetate was given (32 women). Two women underwent immediate hysterectomy, and are included as unsuccessful TCREs but are excluded from description of effects of medroxyprogesterone acetate on the results of TCRE. RESULTS: Late onset, defined as after 12 months, of pain with or without bleeding occurred in 7 out of 52 women (13.5%). Overall, 49 out of 61 women (80.3%) were satisfied with the operation at the time of interview, 9 to 18 months post-operatively. Success rates, measured by satisfaction, were 89% (24/27) in the medroxyprogesterone acetate group and 75% (24/32) in the no medroxyprogesterone acetate group. CONCLUSION: Follow up after endometrial resection revealed that a definite subgroup of women develop late onset of pain with or without bleeding. Results at four to six months do not necessarily correlate with longer term outcomes. This needs to be investigated with larger, long term follow up studies, as does the apparently beneficial effects of medroxyprogesterone acetate on the long term results of TCRE.

Adult↗
PubMed1995

The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension.

OBJECTIVE: To study the effects of addition of 3 g eicosapentaenoic acid daily to the diet, on recurrence rate of intrauterine growth retardation and pregnancy induced hypertension in a high risk population. DESIGN: Prospective, double blind, randomised multicentre study. Eicosapentaenoic acid or placebo were given from 12 to 14 weeks of gestation onwards. SETTING: University Hospital and regional hospitals in the north of the Netherlands. SUBJECTS: Sixty-three women with a history of intrauterine growth retardation (birthweight < 10th centile) with or without pregnancy induced hypertension in the previous pregnancy. MAIN OUTCOME MEASURES: Birthweight centiles and signs of pregnancy induced hypertension in current pregnancy. RESULTS: One-third of the women developed pregnancy induced hypertension and one-third of the infants had a birthweight below the 10th centile. There were no differences between eicosapentaenoic acid and placebo group. CONCLUSION: Addition of 3 g eicosapentaenoic acid daily does not prevent recurrence of intrauterine growth retardation or pregnancy induced hypertension in a high risk population.

Birth Weight↗
PubMed1995

Diagnosis, prevention and management of ovarian hyperstimulation syndrome.

The overall incidence of clinically important (moderate to severe) OHSS ranges from 1% to 10% of IVF cycles, but only a small proportion (0.5% to 2%) of the cases are severe. In extreme but rare cases, secondary complications such as deep vein thrombosis, respiratory distress and acute hepato-renal failure may occur. The main risk factors are the presence of polycystic ovaries, high ovarian response to superovulation therapy, the use of hCG to trigger the ovulatory process or for luteal phase support, and the endogenous production of hCG by an early pregnancy. The pathogenesis of OHSS is unknown, although the predominant biochemical mediator is thought to be the renin-angiotensin system. Ovarian stimulation should always be carefully monitored to identify those women at risk. In IVF cycles, the hCG injection should be withheld if the risk is judged to be too great. Some women will benefit from a policy of proceeding to collect oocytes, but electively cryopreserving any resulting embryos, thus allowing the ovarian stimulation cycle not to be wasted. The administration of albumin at the time of oocyte collection will reduce the chance of severe OHSS occurring. If a decision is made to proceed with oocyte recovery and embryo transfer, it may be advisable to give 5000 IU of hCG, rather than 10,000 IU, as the ovulatory trigger. Progesterone, and not hCG, should be given in the luteal phase. Women developing mild or moderate OHSS should be kept under outpatient surveillance to detect the minority that may progress to severe OHSS. Those with severe OHSS should be hospitalised for fluid and electrolyte management. Paracentesis under ultrasound guidance is recommended where there are tense ascites, but further surgical intervention should rarely be undertaken and only when there is good clinical evidence of ovarian torsion or haemorrhage.

Female↗
PubMed2005

Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies.

OBJECTIVES: To evaluate the outcome of pregnancies after uterine artery embolisation for uterine fibroids. DESIGN: Retrospective analysis of pregnancy subsequent to uterine artery embolisation by one interventional radiologist. SETTING: A UK District General Hospital. POPULATION: Twenty-nine pregnancies in 671 women who had undergone uterine artery embolisation. METHODS: Cases were identified by screening questionnaire and from the study database. Detailed information was collected by questionnaires, direct conversations with women and, when necessary, from hospital records. MAIN OUTCOME MEASURES: Pregnancy outcome, complications and neonatal outcomes. RESULTS: Of 26 completed pregnancies, detailed information was available for 24 and limited information for 2. Seven (27%) ended in miscarriage, there were two terminations and one ectopic pregnancy. Of 16 deliveries after 24 weeks, first and second trimester bleeding occurred in 40% and 33%, respectively, 4 (25%) had preterm deliveries and the caesarean section rate was 88%. Two (13%) women developed proteinuric hypertension and two others had preterm spontaneous rupture of the membranes. Fourteen of 16 cases were delivered by caesarean section. The rate of primary postpartum haemorrhage was 3/15 (20%). The mean birthweight of term babies was 3.39 kg (SD 0.64) and none required admission to neonatal intensive care. There was one (6.7%) case of fetal growth restriction. CONCLUSION: Although this study is relatively small, there is an increase in delivery by caesarean section. There does not appear to be any other major excess obstetric associated risk when the demographics of the population in question is considered.

Abortion, Spontaneous↗
PubMed1989

Effect on pregnancy on gallstone formation.

An ultrasound study was carried out to determine the incidence of gallstone formation during pregnancy. One hundred and thirty seven pregnant women attending antenatal clinics were studied; 70 women were primigravidas and 67 were 1 para or more. An ultrasound of the gallbladder was carried out at 20 weeks or less of gestation and a repeat of ultrasound examination was performed soon after delivery. Five women had gallstones diagnosed before pregnancy; 1 of these was a primigravida, the other 4 were para 1 or more. None of the women developed gallstones during pregnancy. This finding suggests that pregnancy is unlikely to be an important factor in gallstone formation.

Cholelithiasis↗
PubMed2001

Misoprostol versus dinoprostone for cervical priming prior to induction of labour in term pregnancy: a randomised controlled trial.

A prospective randomised controlled trial was performed to compare the efficacy and safety of intravaginal misoprostol to that of intravaginal dinoprostone when used for cervical priming prior to the induction of labour; 126 women were recruited to the study and randomised to receive either intravaginal dinoprostone (n = 63) or misoprostol (n = 63) for cervical priming prior to induction of labour. The mean time from insertion of the priming agent to vaginal delivery was significantly shorter in the misoprostol group (925.8 versus 1577.6 minutes), the mean duration of the active length of labour was significantly shorter in the misoprostol group (353.7 versus 496.8 minutes) and more women in the misoprostol group delivered in less than 12 hours (92% versus 76.5%). Women in the misoprostol group were less likely to require a repeated dose of prostaglandin for cervical priming and less likely to require oxytocin for augmentation of labour. There was no difference in the number of women who were delivered vaginally or by Ceasarean section between the two groups. More women developed hyperstimulation during labour in the misoprostol group; however there was no difference between the groups in neonatal outcome in respect to low cord pH or Apgar score at delivery or admission to the neonatal special care nursery.

Adult↗
PubMed2006

Fibrinogen plasma levels modify the association between the factor XIII Val34Leu variant and risk of coronary artery disease: the EPIC-Norfolk prospective population study.

BACKGROUND: The factor (F) XIII Val34Leu variant has been implicated in coronary artery disease (CAD). In vitro evidence suggests an interaction between this variant and fibrinogen concentrations in determining thrombus structure. OBJECTIVES: To test whether this interaction is relevant in influencing coronary risk in apparently healthy individuals. METHODS: In an 8-year prospective population study of 25 663 men and women, we compared 898 apparently healthy men and women developing incident CAD with 1580 matched controls. RESULTS: Overall, the FXIII Val34Leu variant was not associated with the risk of future CAD. However, a significant interaction existed between the Val34Leu variant and fibrinogen levels for the risk of future CAD (P = 0.004). Among people in the lowest tertile of fibrinogen concentrations, LeuLeu carriers had an odds ratio (OR) of 2.88 (95% confidence interval; CI 1.24-6.74) compared to wild-type individuals (P for linearity = 0.003). By contrast, among those in the highest fibrinogen tertile, LeuLeu carriers were had a lower risk than wild-type individuals (OR 0.47, 95% CI 0.18-1.17, P for linearity = 0.1). CONCLUSIONS: Our results suggest that a significant gene-covariate interaction exists between the FXIII Val34Leu variant and fibrinogen levels. Relationships between genotype and disease risk may be altered by biological covariates. Simplistic paradigms of gene or biomarker associations are unlikely to fully characterize disease risk in populations.

Adult↗
PubMedDate not supplied

Code pink: a system for neonatal resuscitation.

It has been documented that the care given to the high-risk neonate in the first moments after birth correlates with the incidence of mortality and morbidity in the first 24 hours of life. In an effort to reach optimal outcome for each individual infant, Columbia Hospital for Women developed an emergency system for neonatal resuscitation and provided a team of highly skilled professionals to deliver this emergency care. "Code Pink" provided an effective method of reducing mortality and morbidity and improving outcome.

Asphyxia Neonatorum↗
PubMedDate not supplied

Postcesarean infection.

In 1998, 20.2% of the approximately 4 million births in the United States occurred via cesarean delivery. Routine antibiotic prophylaxis has significantly reduced morbidity, yet each year between 41,000 and 206,000 women develop a subsequent infection of the uterus or surgical incision. A thorough understanding of the pathophysiology and complex interaction of risk factors for metritis and wound infection is vital for perinatal nurses. Nurses have a critical role in the identification and treatment of postcesarean infection.

Cesarean Section↗
PubMed1987

Airborne pigmented contact dermatitis due to musk ambrette in incense.

We reported 2 patients with pigmented contact dermatitis caused by occupational airborne contactants, whitening dyes in clothes and formaldehyde in packing adhesive tapes. A women developed airborne pigmented contact dermatitis due to musk ambrette in incense. Patch testing confirmed the diagnosis. Since olden times, people in Japan have burnt incense when they worshipped their ancestors. Recently, it has been in fashion to enjoy perfumes and people may burn incense all day long every day. Our patient burnt 2 kinds of incense every day for about 5 years. We assumed musk ambrette was volatilized when incense was burnt, and contact on her face being dissolved in sebum, thus inducing allergic pigmented contact dermatitis.

Adolescent↗
PubMed1988

Irritant contact dermatitis due to a Chinese herbal medicine lu-shen-wan.

A Chinese herbal medicine Lu-Shen-Wan, which contains 6 ingredients, is sometimes applied topically to treat boils, carbuncles and other skin infections. 2 elderly women developed a rash after applying Lu-Shen-Wan. Patch tests showed positive reactions to Lu-Shen-Wan and to one of its 6 ingredients, Venenum Bufonis. A study in 15 control patients showed that 13 had positive reactions to 50% Lu-Shen-Wan and 50% Venenum Bufonis but that only 2 showed mild reactions when the concentration of the latter was reduced to 5%. The results suggest that Venenum Bufonis in Lu-Shen-Wan can cause irritant contact dermatitis. The present paper demonstrates that a Western dermatological investigative method, the patch test, is applicable to traditional medicine in confirming the cause of contact dermatitis from a Chinese herbal preparation and in identifying the causative ingredient. Such knowledge is very useful for the improvement of the preparation by reducing the concentration of the irritant, by removing it or by substituting it with an alternative non-irritant substance.

Administration, Cutaneous↗
PubMed2006

Perinatal choline influences brain structure and function.

Choline is derived not only from the diet, but also from de novo synthesis. It is important for methyl-group metabolism, the formation of membranes, kidney function, and neurotransmission. When deprived of dietary choline, most adult men and postmenopausal women develop signs of organ dysfunction (fatty liver or muscle damage) and have a decreased capacity to convert homocysteine to methionine. Choline is critical during fetal development, when it influences stem cell proliferation and apoptosis, thereby altering brain structure and function (memory is permanently enhanced in rodents exposed to choline during the latter part of gestation).

Brain↗
PubMed1983

Amiodarone induced cornea verticillata.

Among 30 patients (17 men, 46-76 years and 13 women, 15-70 years), treated with the antiarrhythmic drug amiodarone, 21 patients (11 men and 10 women) developed bilateral cornea verticillata. Total doses up to 494 g had been given and the duration of therapy was up to 113 weeks. In 14 patients samples of 50 microliters tear fluid were analyzed for aminodarone. No amiodarone was present in the tears at low serum concentrations but a rapid increase in tear concentrations was seen at serum values above 1.2 micrograms/ml (P less than 0.001). The grade of cornea verticillata was significantly correlated to total dose as well as to duration of treatment (P less than or equal to 0.001). On the day of examination at the eye clinic there was no significant correlation between se-amiodarone, tear-amiodarone concentration and the grade of cornea verticillata. One patient complained of coloured haloes. None had decreased visual acuity, fundus changes, cataract, exophthalmus, increased intraocular pressure, abnormal colour vision, or abnormal central corneal thickness, which could be attributed to the treatment of amiodarone.

Adolescent↗
PubMed1995

Detection of genital human papillomavirus by single-tube nested PCR and type-specific oligonucleotide hybridization.

Cervical cancer is, on a global scale, the second most common form of cancer in women. Development of cervical carcinoma is strongly associated with infection by certain types of human papillomavirus (HPV). To facilitate the detection and molecular typing of HPV in clinical samples, nested-PCR amplification systems were developed for regions of the E1 and L1 genes. The nested amplifications were performed in a single reaction tube, and shifting between inner and outer primer pairs was achieved by a two-phase amplification with different annealing temperatures. This method eliminates cross-contamination between samples during transfer from the first to the second amplification step. A set of type-specific oligonucleotide probes were designed for the E1 system and used to distinguish 19 genital HPV types. The sensitivities of our amplification systems compare favorably with that for the L1 system on the basis of the MY09-MY11 primer pair (M.M. Manos, Y. Ting, D. K. Wright, A. J. Lewis, T. R. Broker, and S. M. Wolinsky, Cancer Cells 7:209-214, 1989) and our systems can be used on materials such as HPV-infected cell lines, cytobrush samples, cancer biopsies, and recent as well as archival Papanicolaou (Pap) smears. The high sensitivity coupled with the effective elimination of contamination in the transfer between the two amplification steps of the nested PCR makes these systems suitable for research as well as clinical analyses.

Base Sequence↗