As anti-HBc screening has been proposed for blood donor testing, we investigated its effectiveness during pregnancy. Among 4,023 successive pregnant women screened for anti-HBc, 539 (13.4%) were positive and further tested for HBsAg and anti-HBs. HBsAg was found in 73 (1.81%) and anti-HBc only was positive in 66 (1.64%). Among the 73 women positive for HBsAg, HBV DNA was found in the serum of seven, the cord blood of two, the placenta of three. Of the 58 infants given HBV immunoglobulins and vaccine, only four had transient HBsAg. None of the 66 women positive for anti-HBc only had anti-HBc IgM, HBeAg, or HBV DNA in serum, cord blood or placenta but five women became HBsAg positive before, at, or after delivery. Among the infants born of these 66 mothers, three had high ALT, two had HBsAg and one HBV DNA without HBsAg. Screening for anti-HBc may be cost effective, at least in low HBV prevalence areas, since there is evidence for infectivity of pregnant women positive for anti-HBc only.

Carrier State↗

PubMedDate not supplied

[Insertion of a sub-urethral sling through the obturating membrane for treatment of female urinary incontinence].

OBJECTIVE: The use of a TVT device has been for a few years the operation most often performed to treat female urinary incontinence. One of the most frequent complications of this surgery is bladder perforation. MATERIAL AND METHODS: To prevent this complication we use the way initially suggested by Delorme, in which the two ends of the sling were passed through the obturating membrane and the muscles which cover it, by circumventing the ischiopubic bone with Emmet needle introduced from outside to inside. RESULTS: No bladder perforation was noted among the first 71 operated patients. For the first 68 patients re-examined 6 to 12 weeks after the surgery, two patients had improved and 64 were totally cured. CONCLUSION: The effectiveness of this method is the same as that of the traditional method.

Adult↗

PubMedDate not supplied

[Caring for stage IB cancer of the cervix. Proposal for a protocol based on a review of the literature. Gynecol Obstet Fertil 2003; 31: 2-13].

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Antineoplastic Protocols↗

PubMedDate not supplied

Effect of radiotherapy on pelvic lymph node metastasis in cervical cancer stages IB2-IVA: a retrospective analysis of two comparative series.

Efficiency of radiotherapy in controlling lymph node metastasis is a controversial issue. A continuous series of 87 patients affected by cervical cancer stages IB2-IVA and treated using pelvic radiotherapy is presented. A retrospective comparison is made between two populations. In the two populations, a staging lymphadenectomy was carried out before the onset of the therapeutic program. In the first population (53 patients), the pelvic nodes only were dissected and in the second one (34 patients), the pelvic lymph nodes were left in place and the paraaortic nodes only were dissected. In both series, a completion surgery was performed after finalization of the radiotherapy. It was carried out at open abdomen in both series. It included a systematic pelvic dissection for the patients whose pelvic nodes had been intentionally left in place at the time of the initial staging lymphadenectomy. Both series were identical as far as classic risk factors were concerned (FIGO stage, maximal tumor diameter, lymphovascular space involvement). The radiotherapy administered to the pelvis was the same in both populations. The number of patients with pelvic lymph node metastasis was 21 (39.6%) in the first population versus 6 (17.6%) in the second one (P = 0.03). The percentage of positive lymph nodes among the retrieved lymph nodes was 18.94 in the first population versus 2.8 in the second one (P = 0.0001). Pelvic radiotherapy is likely to control most of the pelvic lymph node metastasis, but not all of them. Practical deductions and further developments are discussed.

Adult↗