RESUMEN
A group of 60 consecutive women admitted to the gynaecology department of Eastbourne District General Hospital for pelvic pain were entered into this study. Evidence of C. trachomatis infection of the genital tract was investigated by detection of chlamydial lipopolysaccharide antigen in the peritoneal fluid collected from the pouch of Douglas during laparoscopy and in the endocervical swab. The test used was an Enzyme-Linked Immunosorbent Assay (ELISA). Peritoneal fluid was positive in 11 subjects (18%, P < 0.05), endocervical swab was positive in 3 (5%, P < 0.05). The difference was statistically significant (P = 0.01, two tailed test at 1% level). Ten women with a positive ELISA on the peritoneal fluid had a negative cervical swab, 2 women with a positive cervical swab had negative peritoneal fluid and in only one woman were both cervical swab and peritoneal fluid positive.
Asunto(s)
Infecciones por Chlamydia/patología , Chlamydia trachomatis , Laparoscopía , Enfermedad Inflamatoria Pélvica/patología , Frotis Vaginal , Adulto , Antígenos Bacterianos/análisis , Líquido Ascítico/inmunología , Técnicas Bacteriológicas , Cuello del Útero/patología , Chlamydia trachomatis/inmunología , Chlamydia trachomatis/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática , Femenino , HumanosRESUMEN
We describe the management by CO 2 laser of a case of recurrent extramammary Paget's disease of vulva and perineum, previously managed on three occasions with conventional surgical excision. Ablation of the whole lesion took less than 30 minutes, and the patient was able to go home on the third postoperative day. There were no significant complications. At follow-up after 12 months, multiple biopsies from the lasered area have shown no recurrence, and the symptomatic improvement has been satisfactory.
Asunto(s)
Terapia por Láser , Recurrencia Local de Neoplasia/cirugía , Enfermedad de Paget Extramamaria/cirugía , Perineo/cirugía , Neoplasias de la Vulva/cirugía , Anciano , Femenino , Humanos , Terapia por Láser/métodosAsunto(s)
Aorta Abdominal/cirugía , Prótesis Vascular , Arteria Femoral/cirugía , Embarazo , Adulto , Femenino , Humanos , Útero/irrigación sanguíneaRESUMEN
A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pregnancy and its outcome is described. The need for practitioners to remember vomiting as a presenting sign of thyrotoxicosis is stressed.
Asunto(s)
Hiperemesis Gravídica/etiología , Hipertiroidismo/complicaciones , Complicaciones del Embarazo , Adulto , Femenino , Humanos , Hiperemesis Gravídica/terapia , Hipertiroidismo/tratamiento farmacológico , Nutrición Parenteral , Embarazo , Propranolol/uso terapéutico , Crisis Tiroidea/tratamiento farmacológicoRESUMEN
A clinical trial involving 60 patients was conducted to assess the relative efficacy of intravenous oxytocin and oral prostaglandin E2 in ripening the unfavourable cervix, when given as a priming dose on the day before induction of labour. There was significant improvement in the Bishop score, and the subsequent induction-delivery interval following priming with prostaglandin. This improvement appeared to be dose-related.
PIP: Sixty patients in need of labor induction were observed to compare the effectiveness of oxytocin and of prostaglandin E2 (PGE2) in ripening the cervix. Initial Bishop score was 4 or less in all patients. Patients were divided into 4 groups: A) controls, to whom no medication was given; B) who were given intravenous oxytocin on an incremental regime; C)oup C who were given 0.5 mg PGE2 orally every hour for 10 hours; and, D) who were given 1 mg of PGF2 hourly for 10 hours. All patients were brought to the delivery room at the same time the following morning and oxytocin was again injected till labor was established. Labor was significantly shorter in group D than in groups A, B, or even C. A 1 mg dose of oral PGF2 hourly for 10 hours the day before delivery seemed to be an effective method to deal with the problem. There were no maternal side effects and only 1 case of fetal distress, which was solved by cesarean delivery.
Asunto(s)
Trabajo de Parto Inducido/métodos , Oxitocina/uso terapéutico , Prostaglandinas E/uso terapéutico , Cuello del Útero/efectos de los fármacos , Ensayos Clínicos como Asunto , Femenino , Humanos , Oxitocina/administración & dosificación , Embarazo , Prostaglandinas E/administración & dosificación , Prostaglandinas E/efectos adversosRESUMEN
A pregnant patient with anaemia due to beta-thalassaemia trait is described. The patient was apparently of British stock.
Asunto(s)
Complicaciones Hematológicas del Embarazo , Talasemia , Adulto , Femenino , Humanos , Embarazo , Complicaciones Hematológicas del Embarazo/diagnóstico , Talasemia/diagnóstico , Población BlancaRESUMEN
A patient is described who had two pregnancies complicated by severe pre-eclampsia in the second trimester which resulted in intrauterine death. During the third pregnancy anticoagulant therapy with warfarin was instituted at 14 weeks gestation and a healthy female infant was delivered at 38 weeks gestation.
Asunto(s)
Preeclampsia/prevención & control , Warfarina/uso terapéutico , Adulto , Femenino , Humanos , Embarazo , Segundo Trimestre del EmbarazoRESUMEN
Peripheral pulses became impalpable following the administration of ergometrine during Caesarean section. The subsequent clinical course suggested sensitivity to ergometrine in a patient with Raynaud's disease.
Asunto(s)
Hipersensibilidad a las Drogas/etiología , Ergonovina/efectos adversos , Enfermedad de Raynaud/complicaciones , Anestesia Intravenosa , Anestesia Obstétrica , Cesárea , Femenino , Humanos , EmbarazoRESUMEN
The case history is presented of a 24-year-old woman who had a uterus duplex, grossly underdeveloped cervices, absent vagina and who menstruated regularly through a communication between one cervical canal and the urethra.