PubMed Health⌕ Search

Biomedical subjects

DC Martin

Publications and source records attributed to DC Martin.

6 recordsLinked to original sources
PubMed1996

Association of Positive Chlamydia trachomatis and Chlamydia pneumoniae Immunoglobulin G Titers with Increasing Age

Due to previously reported associations of ovarian cancer with pelvic inflammatory disease, tubal infertility, and positive Chlamydia trachomatis titers, women undergoing follow-up for ovarian cancer were screened with a C. trachomatis IgG titer. Positive titers were seen in 15 (79%) of 19 women with ovarian cancer, 9 (90%) of 10 age-matched controls, and 14 (67%) of 21 patients with infertility and pain. When analyzed by age, 4 (40%) of 10 women under 30 years of age and 34 (85%) of 40, 30 years of age or older had positive titers (p = 0.007). Of 21 women with positive Chlamydia pneumoniae titers, 17 (81%) had positive C. trachomatis titers, whereas 17 (85%) of 20 with positive C. trachomatis titers had positive C. pneumoniae titers. The high rate of positive C. trachomatis titers in older women may be due to cross-reaction with C. pneumoniae titers. Although C. trachomatis IgG titers may be useful as an immunologic screening marker in infertile women, the results of these tests should be interpreted with caution. A positive test may not be evidence of C. trachomatis infection and is not an indication for specific therapy.

Journal Article↗
PubMed1994

Correlation of Chlamydia IgG Antibodies with Hysterosalpingogram and Laparoscopy

One hundred and eight hysterosalpingograms (HSG) available in the Department of Radiology of women identified as also having laparoscopy, were reviewed by a gynecologist and a radiologist blinded to clinical history, laboratory findings, and laparoscopic findings. Positive IgGs were associated with hydrosalpinges and salpingitis isthmica nodosa. With a positive IgG, a positive hysterosalpingogram for corkscrew was not statistically significant. Corkscrews were not specific for adhesions or for endometriosis. Positive IgG and positive hysterosalpingogram suggest chlamydia IgG, and HSG can be used to identify patients at increased risk of pelvic pathology. However, even patients with negative IgG and negative HSG had a 48% incidence of pelvic adhesive pathology.

Journal Article↗
PubMed1994

Association of Chlamydia IgG Titers with Laproscopic Findings of Dystrophic Calcification and Hydrosalpinges but not with Endosalpingiosis

Psammoma bodies are discrete forms of dystrophic calcification which represent cross-sections of calcified papillary formations. At laparoscopy, these have been confused with both endometriosis and cancer. A recent abstract (Khare et al: AAGL, 1993) reported the association of peritoneal psammoma bodies (grain-like inclusions) with positive IgG chlamydia titers (p=0.012). The purpose of this study is to investigate a possible correlation of chlamydia IgG titers with endosalpinges. Histologic slides and charts of 60 consecutive women were reviewed in a blinded fashion for calcification, hydrosalpinx, endosalpingiosis, and other significant changes. Although dystrophic calcification and hydrosalpinges were associated with positive chlamydia IgG titers (p<0.05), endosalpingiosis was found in only one patient. This study confirms previous studies in showing a relationship of chlamydia IgG titers with dystrophic calcification and hydrosalpinges but did not demonstrate a relationship with endosalpingiosis.

Journal Article↗
PubMed1994

Use of Algorithmic Pathways to Develop Quality Care Oriented, Cost Effective Clinical Care

This study analyzed the cost of diagnosis of hydrosalpinges and pelvic adhesions using four pathways. This is an example of the use of algorithmic pathways in developing medical service delivery which provides quality care to women while maintaining cost-effectiveness. The four pathways are: Chlamydia IgG antibody titer -> hysterosalpingogram -> diagnostic laparoscopy; chlamydia IgG titer -> diagnostic laparoscopy, hysterosalpingogram -> diagnostic laparoscopy; and diagnostic laparoscopy with no preliminary studies. These pathways are limited in that they require several assumptions that are not based on biologic data and do not include history, physical, other laboratory finding or other disease processes. However, with these limitations, the least costly approach to the diagnosis of 19 of 26 of the hydrosalpinges was pathway one with a total cost of $103,120. On the other hand, pathway three, with a total cost of $139,440 and a yield of 26 of 27 hydrosalpinges, was less expensive per patient with a cost of $5,363 as compared with the per patient cost of $5,427 using pathway one. In analyzing pelvic adhesions, pathway one was the least expensive at $186,280 but yielded only 13 (42%) of 31 patients with adhesions. Pathway four was the most expensive overall at $332,640 but was the least expensive per patient diagnosis at $10,730. Developing these type pathways will require computer assistance. However, even computer assistance will be inadequate without biologically significant data and without well defined goals and expectations.

Journal Article↗
PubMed1994

Clear and Opaque Vesicles: Endometriosis, Psammoma Bodies, Endosalpingiosis or Cancer?

Three case reports are used to demonstrate the similarities between the appearances of endometriosis, psammoma bodies, endosalpingiosis and cancer. Although clear "amenorrheic" lesions of endometriosis have been noted since 1950 by Fallon, these have been confused in clinical practice with a similar appearance of psammoma bodies, endosalpingiosis and ovarian cancer. The difference between these must be made on the basis of histology and appearance. Furthermore, the presence of psammoma bodies in an infertility population is more compatible with post-inflammatory changes from chlamydia than with cancer. The diagnosis of cancer is based on epithelium and not the appearance of calcification.

Journal Article↗