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Biomedical subjects

D R Popkin

Publications and source records attributed to D R Popkin.

13 recordsLinked to original sources
PubMed1985

The changing concepts of condyloma. A retrospective study of colposcopically directed cervical biopsies.

Human papillomavirus has been implicated in the etiology of cervical intraepithelial neoplasia. A retrospective audit was conducted on all colposcopically directed biopsies performed from June through November, inclusive, in the years 1980 and 1982, a total of 317 cases. In 1980, the misdiagnosis rate for condyloma was 88.9% (69 of 78) and, in 1982, the misdiagnosis rate was reduced to 28.5% (40 of 140). On review, the association of cervical intraepithelial neoplasia with condyloma was 73% (107 of 146), p less than 0.005. The differences in mean ages of patients with condyloma alone, cervical intraepithelial neoplasia with condyloma, and cervical intraepithelial neoplasia alone were significant, p less than 0.02. When condyloma is not recognized, the pathologist tends to overdiagnose grade 3 cervical intraepithelial neoplasia as shown in 28 original cases; 16 of 28 (57.1%) were condyloma alone on review. Fifteen (53.6%) of these 28 patients underwent a cone biopsy or hysterectomy when a less radical procedure would have been acceptable. The morphologic changes indicating cervical condyloma were not fully appreciated by the pathologist, and this resulted in overdiagnosis and later overtreatment by the gynecologist.

Adult↗
PubMed1983

Treatment of cervical intraepithelial neoplasia with the carbon dioxide laser.

The carbon dioxide laser was used to treat 138 patients with cervical intraepithelial neoplasia between February, 1979, and February, 1981. All patients in this study were assessed in the colposcopy clinic prior to treatment. The diagnosis of cervical intraepithelial neoplasia was based on colposcopic examination, cytologic findings, colposcopically directed biopsy, and endocervical biopsy in all cases. Included in the 138 patients were 26 with grade 1, 82 with grade 2, and 30 with grade 3 cervical intraepithelial neoplasia. The persistence rate of abnormal cytologic findings at 7 months after treatment was 11% for grade 1, 8.5% for grade 2, and 10% for grade 3 cervical intraepithelial neoplasia. No major complications accompany this treatment modality, which was performed in the outpatient clinic without the use of anesthesia or analgesia.

Adult↗
PubMed1983

Metronidazole in the prophylaxis of anaerobic infections in gynecologic surgery.

A double-blind study was initiated in January 1978 to determine the effectiveness of the prophylactic use of metronidazole, either orally or intravenously, in patients undergoing elective gynecologic surgery. A total of 121 women were evaluated; 42 women received oral metronidazole, 40 women intravenous metronidazole, and 39 women placebo therapy. Evidence of postoperative infection was present in 20% of patients treated with placebo, whereas in the active drug groups the incidence of infection was 12%. Blood levels of metronidazole during the operations had a mean value of 22.2 and 17.9 micrograms/ml for patients receiving intravenous and oral metronidazole, respectively. Preoperative cultures for anaerobic organisms revealed an incidence range of 23% to 45% for the three study groups. The incidence of positive anaerobic cultures declined dramatically by the second postoperative day for patients receiving intravenous and oral metronidazole, In the placebo group, the incidence was not significantly different from that in the preoperative period. This preliminary study revealed that the incidence of postoperative infections subsequent to gynecologic surgery can be reduced significantly through the use of prophylactic metronidazole.

Cesarean Section↗
PubMed1982

Diffuse peritoneal seeding in immunoblastic lymphosarcoma.

The authors report a case of immunoblastic lymphosarcoma of B cells with an unusual presentation. Laparotomy on a 67-year-old women with an abdominal mass revealed extensive peritoneal seeding resembling carcinomatosis. At autopsy, immunoblastic lymphosarcoma, probably originating in the bowel wall, was found. It was studied by light, immunofluorescent and electron microscopy. Histologic examination showed monomorphic proliferation of malignant immunoblasts with plasmacytoid features. Immunofluorescent microscopy was positive for intracytoplasmic IgG, IgA, kappa and lambda light chains. The presence of diffuse peritoneal seeding in patients with malignant lymphomas is not well documented. The clinical and pathologic features of this entity and its relation to Mediterranean lymphoma are discussed.

Aged↗
PubMed1979

Early diagnosis of ovarian cancer.

Ovarian cancer is the most common fatal gynecologic malignant disease. Unfortunately 60% to 70% of patients present initially with advanced disease. Progress in the treatment of this condition will be made only if it can be diagnosed early. Pelvic examination is still the best screening test despite attempts to make an early diagnosis with the use of cytology, ultrasonography, and serum determinations for fibrin degradation product; haptoglobin, protein-bound fucose and tumour-associated antigens. The best prospect for a screening test for ovarian cancer probably lies in the field of tumour immunology.

Antigens, Neoplasm↗
PubMed1979

Prolonged amenorrhea and oral contraceptives.

Of 106 consecutive women referred for secondary amenorrhea of more than 1 year's duration, 65 were diagnosed as having functional amenorrhea. Of these 65, 29 had amenorrhea directly following discontinuation of oral contraceptives (OC group) and 36 had never used oral contraceptives (NOC group). There was no difference in the incidence of prior menstrual irregularity in either group. Similarly, there was no difference in the resting serum estrone, estradiol, luteinizing hormone, follicle-stimulating hormone, and prolactin levels between the OC and NOC groups. Nor was there a difference between the OC and NOC groups in response to medroxyprogesterone acetate, clomiphene citrate, or luteinizing hormone-releasing factor. Of 106 patients, 17 were proven to have prolactinomas. Eight patients had a prior history of OC use, whereas nine did not. With the exception of elevated serum prolactin levels, there were no significant differences in biochemical tests or history of oral contraceptive use between the prolactinoma group and patients with prolonged "functional" amenorrhea (OC plus NOC groups). The lack of historical or biochemical difference between the OC and NOC subjects indicates homogeneity between groups, and does not support the existence of a "postpill" syndrome.

Adult↗
PubMed1978

Cryosurgery for the treatment of cervical intraepithelial neoplasia.

Cryosurgery was used to treat 208 patients with cervical intraepithelial neoplasia. These patients were referred to our Colposcopy Clinic for investigation of an abnormal Papanicolaou smear. Prior to treatment a colposcopically directed biopsy was taken in all cases. The regrigerant used for cryosurgery was nitrous oxide. Included in the 208 patients were 57 with mild dysplasia, 76 with moderate dysplasia, 44 with severe dysplasia and 31 with carcinoma in situ. The cure rates were 100 per cent for patients with mild dysplasia, 95 per cent for those with moderate dysplasia, 96 per cent for those with severe dysplasia and 91 per cent for those with carcinoma in situ. Cryosurgery is an effective method of treating cervical intraepithelial neoplasia, with cures obtained in 199 of 208 patients in this study.

Adolescent↗