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Biomedical subjects

C Christianson

Publications and source records attributed to C Christianson.

9 recordsLinked to original sources
PubMed1999

Limb deformations in oligohydramnios sequence: effects of gestational age and duration of oligohydramnios.

In order to study the pathogenesis of prenatal deformities, we reviewed maternal histories, delivery records, pathology reports, radiographs, and photographs of 90 fetuses with prenatally documented oligohydramnios at gestational ages from 14 weeks to term. The causes of oligohydramnios included premature rupture of membranes (44 cases), fetal renal insufficiency (25 cases), idiopathic (15 cases), and twin-twin transfusion (6 cases). The fetuses were grouped according to gestational age at delivery and duration of oligohydramnios. Sixty-three fetuses (70%) had documented contractures. As expected, contractures were more frequent with earlier onset and longer duration of oligohydramnios. During the 2nd trimester, the frequency of contractures in fetuses with oligohydramnios was 77% compared to 52% in the 3rd trimester (chi(2) = 5.33, 1 df, P =.02). Considering all gestational ages together, 57% of fetuses had contractures after less than 2 weeks of oligohydramnios compared to 81% of fetuses with a longer duration of oligohydramnios (chi2 = 6.23, 1 df, P <.02). The type of contracture varied with gestational age. Clubfoot was the most frequent at all ages, but hand contractures such as camptodactyly were common only in the 2nd trimester while the broad flat hand originally described in Potter sequence was found almost exclusively in the fetuses with oligohydramnios in the 3rd trimester. Of the 63 fetuses with oligohydramnios and contractures, 25 (40%) had either additional malformations or family history that could explain contractures independent of oligohydramnios.

Abruptio Placentae↗
PubMed1997

Development and testing of a process measure of nursing home quality of care.

OBJECTIVE: To develop and test quality of care process measures for three medical conditions of nursing home patients: fever, shortness of breath, and chest pain. DESIGN: Flowsheets designed to capture the critical elements of care for the above conditions were developed by an expert panel. Nursing home residents charts were reviewed retrospectively using the flow sheets. The reviews were translated into clinical scenarios, and the quality of care the scenarios represented was rated by an expert panel. SETTING: All nursing homes in Hennepin County, MN, that care for Medicaid patients. PATIENTS: A random sample of 1405 Medicaid nursing home residents from 1984 and 1988. MEASURES: Measures of quality of physician assessment and intervention, quality of nurse assessment and intervention, and global quality were developed and the intra- and interrater reliability were tested. The measures' validity was assessed by their ability to predict resident death. RESULTS: Intrarater reliability was measured as the correlation of the ratings of blinded duplicates. The correlation for the global scale and the four subscales ranged from .74 to .88 (P < .001 for all). Interrater reliability was tested by examining what percentage of the quality ratings were within one unit (1-5 scale) for all three raters. All three raters were within one unit for more than 72% scenarios for all scales. The subscale of quality of physician assessment was able to predict resident death when the worst episode of care (OR = .47, 95% CI(.31-.74)) or the mean episode of care (OR .54, 95% CI(.30-.99)) was used. None of the other subscales or the global measure predicted death. CONCLUSIONS: Through the use of an expert panel, measures of nursing home quality of care were developed for shortness of breath, fever, and chest pain. These measures have reasonable reliability and significant face validity. Their validity is supported further by the ability of one of the measures to predict resident death.

Aged↗
PubMed1993

A case of a hepatitis B infected practitioner.

The first case of a dental practitioner infected by a blood-borne pathogen to be identified to the College of Dental Surgeons of B.C. and reviewed by the Dental Profession Advisory Program's infected practitioner program committee is reported. After the committee was contacted, the infected practitioner's status was evaluated and guidelines were provided to him. This paper reviews the committee's decision-making process, particularly with respect to its management of the infected dental practitioner.

British Columbia↗
PubMed1985

Ultrasound guidance for human embryo transfer.

Embryo transfer is facilitated with ultrasound guidance. The 16 ultrasound-guided transfers were rated easier, and there was less catheter distortion, in comparison with 12 transfers guided by "clinical feel." The benefits we ascribe to ultrasound guidance are as follows: (1) transfers can be done with the patient supine in the lithotomy position; (2) the catheter tip is accurately positioned in the fundus of the uterine cavity; (3) the ejection of the transfer bubble into the uterus and its persistence during catheter removal and documented; and (4) the continuance of the bubble is comforting to the patient. Greater experience is needed before the impact of ultrasound-guided transfer can be correlated with the rate of pregnancy continuance.

Adult↗
PubMed1983

Pregnancy following use of the cervical cup for home artificial insemination utilizing homologous semen.

Sixty-one couples with infertility from 1 to 11 years were instructed in the use of the cervical cup for artificial insemination using homologous semen in the privacy of their own homes. There have been 36 reported pregnancies in 32 of these couples. Among women with primary infertility, the pregnancy rate was 43%; it was 67% for those with secondary infertility and 53% overall. Sperm counts and percent motility, as well as postcoital test results, however, failed to be indicative of eventual ability to conceive. Regardless, among couples with documented infertility, this method provided over half of the couples with at least one pregnancy. Additionally, the technique is simple, inexpensive, without significant risk or discomfort, and can be carried out by a couple at their convenience and in privacy.

Female↗
PubMed1981

Combined laparoscopic surgery and danazol therapy for pelvic endometriosis.

The role of combined laparoscopic surgery and postoperative danazol treatment for endometriosis in infertile patients has been reviewed in 66 cases. Thirty-five patients with mild endometriosis and twenty-five patients with moderate endometriosis received a standardized laparoscopic surgical procedure followed by danazol therapy with a minimum of 6 months' follow-up. Six patients with severe endometriosis received 4 months of danazol treatment followed by conservative surgery. Fifty-four per cent of these patients conceived, with 92% delivering a live child. By excluding patients with other significant infertility factors, a "corrected" fertility rate of 68% was obtained. The majority of patients conceiving after danazol treatment did so within the first 6 months after therapy. Reported complications to drug treatment were minimal. Second-look laparoscopy when performed in patients who had not conceived within 6 months revealed a significant decrease in residual endometriosis.

Danazol↗
PubMed1981

Safe intraperitoneal use of 32% dextran 70 after surgical treatment of infertility.

It has been suggested that 32% dextran 70 be used to reduce adhesions after pelvic surgery. Other authors have investigated the use of this drug in animal studies and suggested it as an adjuvant to infertility surgery in humans. No previous report has mentioned the extensive use of this solution in the pelvis after surgery in humans. This paper reports the use of intraperitoneal dextran in the volume of 100 ml after pelvic and laparoscopic surgery in 267 patients. No complications occurred in any of these patients that could be attributed to the use of the intraperitoneal dextran solution.

Dextrans↗
PubMedDate not supplied

Support groups for infertile patients.

Support groups offer infertile couples an opportunity to share feelings and concerns in a confidential, nonjudgmental setting--an alternative to coping with the crisis alone. Nurse involvement in organizing and maintaining a support group is described. The nurse can be a valuable asset to the support group in the role of patient liaison, small-group counselor, or community resource person.

Counseling↗