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51.
52.
Watts DH Krohn MA Hillier SL Eschenbach DA 《Infectious diseases in obstetrics and gynecology》1994,1(5):220-227
Objective: The objective of this study was to assess whether antibiotic therapy plus tocolysis given to women in preterm labor would prolong pregnancy compared with tocolysis alone.Methods: A randomized, double-blind trial of intravenous mezlocillin and oral erythromycin therapy vs. placebo was used in addition to tocolysis among women in preterm labor =34 weeks gestation with intact membranes. Amniocentesis was performed, and chorioamnionic membranes were examined histologically and cultured for microorganisms after delivery.Results: Clinical characteristics including gestational age at enrollment, frequency of contractions, cervical Bishop's score, and white blood cell count on admission were similar in the 2 groups. Antibiotic therapy was well tolerated. No significant differences in the interval to delivery, birth weight, and neonatal outcomes were observed between the 2 groups. Women in the antibiotic group had a significantly lower incidence of postpartum infections compared with women in the placebo group. Patients with evidence of upper genital tract infection in either group had a significantly shorter interval to delivery, lower gestational age at delivery, lower mean birth weight, and increased neonatal hospitalization time.Conclusions: Lack of an antibiotic effect on the gestational age at delivery may be due to the low prevalence of upper genital tract infection among unselected women in preterm labor, to advanced preterm labor unresponsive to antibiotic therapy, or to an inability of antibiotics given alone to inhibit the cytokine response. Further work is needed to identify markers of upper genital tract infection among women in preterm labor and to evaluate other potential therapeutic interventions. 相似文献
53.
PURPOSE: The initiation and progression of noncarious cervical notch lesions (NCCL) continues to perplex clinicians worldwide and poses a considerable restorative challenge. The purpose of this brief communication is to report what is believed to be the first in vitro production of notch-shaped lesions in the cervical third of premolar teeth. MATERIALS AND METHODS: The lesions, were produced by axial loading of selected permanent premolar teeth in a 10% aqueous solution of sulfuric acid over a period of 5 days, followed by immersion in water for 7 days. RESULTS: Results revealed macroscopic and microscopic features similar to those observed in noncarious cervical lesions in vivo. The lesions were incidental findings while the authors were studying stress corrosion of enamel at low pH. Although much remains to be investigated regarding the etiology and pathogenesis of NCCL, axial loading and a corrosive environment may be implicated in these processes. The artificial lesions arose in clinically sound teeth, suggesting that there is no simple clinical examination to identify teeth at risk from NCCL. CLINICAL SIGNIFICANCE: The relationship between the development of NCCL and applied stress indicates that occlusal factors may play the most significant role in the initiation and progression of NCCL. 相似文献
54.
The clinical course of ocular toxocariasis and the chronological development of peripheral retinal and macular granulomas are reported. Removing the epiretinal as well as subretinal component of the granuloma via pars plana vitrectomy and retinotomy techniques yielded an excellent clinical result. Clinicopathologic correlation of the specimen confirmed the diagnosis with histological evidence of degenerated larval structures in granulomatous inflammation. 相似文献
55.
Cervical antibodies to herpes simplex virus proteins in pregnancy and puerperium: a pilot study 总被引:1,自引:0,他引:1 下载免费PDF全文
Watts DH Guise JM Brown Z Corey L Ashley RL 《Infectious diseases in obstetrics and gynecology》1996,4(1):7-15
Objective: This study was undertaken to evaluate the changes in total and anti-herpes simplex virus (HSV)-specific cervical IgA and IgG antibody profiles during and after pregnancy.Methods: Serum and cervical secretions were obtained from pregnant patients before 20 weeks gestation, at 34-36 weeks gestation, and at 6 weeks postpartum and tested for total IgA and IgG antibody and for IgA and IgG to HSV proteins by Western blot.Results: Seven women were HSV seronegative, 14 HSV-1 seropositive, and 14 HSV-2 +/- HSV-1 seropositive. Minimal changes in the serum anti-HSV profiles were seen over the 3 visits. The total cervical IgA, IgG, and protein levels did not change between the 2 pregnancy visits but tended to increase at the postpartum visit. No consistent change in cervical HSV-specific IgA and IgG was seen during pregnancy, but the levels increased markedly at the postpartum visit.Conclusions: Lower cervical anti-HSV antibody levels may be related to the previously reported increased frequency of a reactivation of HSV during late pregnancy. Further evaluation is necessary to confirm and quantify the changes in genital immunity during pregnancy and to evaluate whether the increased levels at the postpartum visit are sustained. 相似文献
56.
In a 1994 telephone survey, only 13% of 522 adult Hispanic respondents in the Southwest used media as the main source of information for physicians, while 19% used media for information regarding health services. Family and friends were main sources. About 75% of the respondents had a family physician with the mother (68%) making health care decisions for the family. A large majority of respondents said that neither the physician's sex, nor race were factors in choosing physicians. 相似文献
57.
58.
J. Kappler R. W. E. Watts E. Conzelmann D. A. Gibbs P. Propping V. Gieselmann 《European journal of pediatrics》1991,150(4):287-290
We report on a family with a sibship of three children for whom the diagnosis of an unusual form of metachromatic leukodystrophy (MLD) had been suggested earlier. The patients had choreiform movements and dystomic posturing accompanied by dysarthria since childhood. The availability of the polymerase chain reaction enabled us to show that the three siblings have a pseudodeficiency genotype (ASAp/ASAp). There was no abnormal sulphatiduria, and we propose that the neurological disease and low arylsulphatase A activity are unrelated to one another in this family. A diagnosis of MLD carries very serious implications, and we recommend that gene amplification by polymerase chain reaction and hybridization with allele-specific oligonucleotide probes should be used to corroborate the diagnosis, especially when there is no abnormal sulphatiduria and when metachromatic material cannot be demonstrated in a sural nerve biopsy. 相似文献
59.
Distinct patterns of glomerular disease in Lima, Peru 总被引:2,自引:0,他引:2
Hurtado A Escudero E Stromquist CS Urcia J Hurtado ME Gretch D Watts D Russell K Asato C Johnson RJ 《Clinical nephrology》2000,53(5):325-332
AIM: We performed both a retrospective and prospective study to elucidate the types of glomerular diseases present in adults in Lima, Peru. MATERIAL AND METHODS: In the retrospective study, we analyzed 1,263 renal biopsies over a 10-year period (1985 -1995) that were processed at a central reference renal pathology laboratory in Lima. 101 cases were examined in the prospective study. RESULTS: The most common glomerular diseases observed were those due to systemic lupus erythematosus (30.2%), membranoproliferative glomerulonephritis (MPGN, 14.8%), and focal and segmental glomerulosclerosis (FSGS, 13.9%). Although mesangial-proliferative nephritis was observed in 9.5% of cases, IgA nephropathy was rare (0.9%). Examination of the year to year frequency showed that MPGN has tended to decrease in frequency with time whereas FSGS has been increasing. Although there is known to be a high frequency of infections in Peru, only 4.2% of the cases in the retrospective study were associated with infection. Furthermore, in the prospective study, only one case of hepatitis C and no cases of hepatitis B viral infection were detected, including in the 11 cases of MPGN observed. CONCLUSION: We conclude that the epidemiology of glomerular disease in Lima, Peru, is distinct from most areas of the world, but has similarities to certain regions in Africa, in that MPGN is common whereas IgA nephropathy appears to be rare. Further studies are necessary to elucidate the reasons why the patterns of glomerular disease are different from that observed in other parts of the world. 相似文献
60.