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Biomedical subjects

B V Lewis

Publications and source records attributed to B V Lewis.

At least 19 recordsLinked to original sources
PubMed1992

Validation of a method of treating menorrhagia by endometrial ablation.

Menstrual blood loss was measured by intravenous injection of radioactive iron (59Fe) and whole-body counting in 19 women complaining of menorrhagia due to dysfunctional bleeding. Fifteen patients were then treated by radiofrequency endometrial ablation, after which blood loss was re-measured. The majority of the patients were bleeding excessively before treatment (mean 281 (SD 156) ml per cycle averaged over two cycles, range 49-665 ml, n = 19). In the 15 treated patients, average blood loss was reduced to 52 (SD 39) ml per cycle and the mean reduction in blood loss was highly significant (P < 0.001). These quantitative data correlate well with the patients' subjective reports.

Adult↗
PubMed1990

Treatment of functional menorrhagia by radiofrequency-induced thermal endometrial ablation.

42 patients were enrolled in a trial of radiofrequency-induced thermal endometrial ablation for the treatment of functional menorrhagia. The radiofrequency electromagnetic energy was delivered via a probe placed within the endometrial cavity. 10 patients received 330 kJ of energy, 10 received 445 kJ, and the other 22 received 660 kJ. 19 (87%) of those receiving the highest dose became amenorrheic or had a considerable reduction in menstrual flow. The procedure is simple and the heat induced in the endometrium does not penetrate much beyond the inner layers of the myometrium. There is no need for distension of the uterine cavity with flushing media.

Adult↗
PubMed1990

Experimental and clinical studies with radiofrequency-induced thermal endometrial ablation for functional menorrhagia.

A method of ablating the endometrium has been introduced into clinical practice that uses radiofrequency electromagnetic energy to heat the endometrium, using a probe inserted through the cervix. Preliminary studies suggest that over 80% of patients treated will develop either amenorrhea or a significant reduction in flow. The advantages of radiofrequency endometrial ablation over laser ablation or resection are the avoidance of intravascular fluid absorption, simplicity (no special operative hysteroscopic skills are required), speed of operation, and reduced cost compared with the Nd:YAG laser. In this paper, we describe the experimental studies performed during development of this new technique.

Adult↗
PubMed1990

Large loop excision of the transformation zone (LLETZ) compared to carbon dioxide laser in the treatment of CIN: a superior mode of treatment.

A series of 199 patients with histologically confirmed cervical intraepithelial neoplasia (CIN) grade II or III were allocated by hospital number to receive out-patient treatment by carbon dioxide laser vaporization or large loop excision of the transformation zone (LLETZ). All patients received local anaesthesia. The women in the LLETZ group experienced less post operative haemorrhage, less discomfort, operative time was greatly reduced, and histological material was available for confirmation of the diagnosis. There was no significant difference in recurrence of CIN after treatment between the two groups. At 6 month follow-up, recurrence rates of 8.2% (CIN II) and 7.5% (CIN III) were observed in the laser-group and 5% (CIN II) and 5.3% (CIN III) in the LLETZ group. Further advantages of LLETZ are reduced capital expenditure and no hazard to the eyesight of the surgeon, but laser treatment is preferable in patients with widespread vaginal involvement.

Adolescent↗
PubMed1979

Vaginal breech delivery or cesarean section.

In 579 singleton breech deliveries the total perinatal mortality rate was 10.4% and the corrected perinatal mortality rate was 0.67%. There were 452 babies delivered vaginally (78.1%) and 127 delivered by cesarean section (21.9%). The perinatal mortality rate was very high in the premature breech delivery and in the low-birth-weight infant. Cesarean section should be used to avoid a traumatic vaginal delivery and it should be used more liberally in the mature breech, but it is unlikely that cesarean section rates in excess of 50% will significantly reduce the perinatal mortality mortality rate. More information is required as to whether extending the indications for cesarean section in the low-birth-weight infant will further reduce the perinatal mortality rate.

Adult↗
PubMed1978

Changing pattern in a general practitioner obstetric unit.

Over the past nine years in Watford the proportion of hospital confinements has increased and domiciliary confinements have almost ceased. The proportion of patients originally booked into the general practitioner obstetric unit and subsequently transferred to the consultant unit has increased. Most patients are transferred during pregnancy, and the numbers transferred in labour are decreasing. The proportion of GPs attending their patients for delivery is low: local practitioners appear to be prepared for the consultant unit to supervise delivery with the practitioner co-operating in antenatal and postnatal care and family planning. There seems little doubt that the success of GP units depends on the enthusiasm and interest of individual practitioners.

Family Practice↗
PubMed1977

Screening for endometrial carcinoma using a negative pressure intra-uterine "jet wash".

Endometrial jet washings, which permit lavage of the uterine cavity by sterile isotonic saline under negative pressure, were performed as a screening technique in one hundred and one selected patients attending a gynaecological clinic. The material collected was assessed by both cytological and histological methods. A formal curettage was subsequently performed on all patients and the results of the two methods compared. Fifteen per cent of patients were diagnosed as having an endometrial carcinoma by jet washing and these results were confirmed by the histological reports from curettage. There were no false positive nor false negative results. It is suggested that endometrial jet washing is a simple and convenient method of screening women for endometrial carcinoma and gives diagnostic results comparable to those obtained by a conventional curettage.

Curettage↗
PubMed1975

A clinical service for prenatal diagnosis.

A centralised clinical prenatal diagnostic service has been established and the results of amniocentesis in 174 patients are discussed. Termination of pregnancy was performed in 3 patients on the basis of cytogenetic abnormalities (47,XXY, 47,XXX, 47,XY 21+): in 2 patients with anencephalic fetuses on the basis of alpha-fetoprotein and ultrasound investigations, and 1 patient with fetal Hurler's syndrome. One mother, aged 45, refused amniocentesis and gave birth to a child with Down syndrome. Amniocentesis was followed by fetal death and abortion in 3 patients, all of whom had repeat amniocentesis. Cytogenetic results were not obtained from cell-culture in 9 out of 155 patients, but it was possible to explain all but 2 of the failures. An unexplained error in fetal sex determination occurred once.

Abortion, Spontaneous↗