PubMed Health⌕ Search

Biomedical subjects

E W Savage

Publications and source records attributed to E W Savage.

At least 19 recordsLinked to original sources
PubMed1994

Significance of a first-time atypical Papanicolaou smear in a young, high-risk African-American and Latino-American population.

The first atypical Papanicolaou smear in young, sexually active Latino and African-American women of low socioeconomic status may be predictive of underlying cervical neoplasia and human papillomavirus infection of significant quantity. The optimal management of first-time atypia on routine Pap smear has not been established. In many clinics, colposcopically directed sampling of the cervix is recommended only if atypia persists following specific or nonspecific treatment of cervicitis or after an arbitrarily determined time interval. Others recommend immediate colposcopic evaluation. To determine the best approach to the first-time atypical Pap smear in young minority women at high risk for the development of cervical cancer, 250 such patients were evaluated with colposcopically directed biopsy of the cervix prior to any form of therapy. Pap smears were repeated at the time of colposcopy. Histologically, there was evidence of cervical intraepithelial neoplasia in 41% of patients and human papillomavirus infection in 86%. Repeat Pap smears predicted the presence of cervical intraepithelial neoplasia in only 24% of patients. Immediate colposcopic evaluation represents the most prudent approach to the first-time atypical Pap smear in young, high-risk minority women.

Adolescent↗
PubMed1985

Cefmenoxime therapy for gynecologic and obstetric infections.

Cefmenoxime, a new third-generation cephalosporin, was used as a single drug in the therapy for female genital tract infections. Therapeutic response was considered satisfactory in 21 of 22 cases of pelvic inflammatory disease, six of nine tuboovarian abscesses, two of three severe wound infections, and all five cases of endometritis. Overall, 34 of 39 patients responded. The peak serum antibiotic levels in this study ranged from 15.8 to 64 (average 48.7) micrograms/mL, and the trough level ranged from 0.9 to 4 (average 3.1) micrograms/mL. Cefmenoxime was tested in vitro against 424 isolates of anaerobes including 208 strains of bacteroides of which 80 were Bacteroides fragilis. Cefmenoxime inhibited the growth of 90% or greater of the organisms (minimal inhibitory concentration 90) at less than or equal to 64 micrograms/mL. The minimal inhibitory concentration for 75% of B fragilis was 32 micrograms/mL. This study suggests that cefmenoxime as a single-drug therapy is effective in the treatment of female genital tract infections caused by aerobic (including the gonococcus) and anaerobic bacteria.

Abscess↗
PubMed1984

Minocycline prophylaxis in elective hysterectomy.

Minocycline prophylaxis was compared with a placebo in 126 consecutive patients undergoing hysterectomy. The double-blind nature of this study was guarded until the study was completed. Of 95 patients who had abdominal hysterectomies, 32.7% on minocycline and 39.1% on placebo developed infectious complications. Of 31 vaginal hysterectomy patients, 20% on minocycline and 37.5% on the placebo developed septic complications (p less than 0.05). Although minocycline inhibited B. fragilis and E. coli effectively, those organisms colonized increasingly during the postoperative period with similar frequency in both the minocycline- and placebo-treated groups. Minocycline did not produce antibiotic-resistant strains. In our study the parenteral and oral forms of minocycline were found to be safe, and vestibular symptoms were no more common than in the placebo group. These data suggest that antibiotic prophylaxis with minocycline is safe and well tolerated. In addition, minocycline is effective in lowering the infection rate in vaginal, but not abdominal, hysterectomies.

Bacterial Infections↗
PubMed1982

Cyclic changes in cervical microflora and their effect on infections following hysterectomy.

In a prospective study the cyclic changes in the cervical microflora and the endometrial histology were correlated with the incidence of postoperative infections in 99 women undergoing elective abdominal hysterectomy. Escherichia coli and Bacteroides fragilis were isolated more frequently during the proliferative phase than during the secretory phase and, correspondingly, postoperative infections were more frequent when operated during the proliferative phase than during the secretory phase. Moderate to severe infections occurred in 31.6% of the patients operated during the proliferative phase in contrast to 18% during the secretory phase. This suggests increased host susceptibility to infection during the proliferative phase.

Adult↗
PubMed1981

Tuberculosis presenting as a pelvis mass.

Tuberculosis is one of the world's most important communicable diseases. Although it may involve the genital tract and frequently results in infertility, the presentation of the disease as a pelvic mass is uncommon. While the incidence of tuberculosis has declined in the United States, genital tuberculosis should be considered in patients presenting with adnexal mass and a history of infertility. One such case is presented here, and diagnosis and treatment are described.

Adult↗
PubMed1980

Postcoital posthysterectomy vaginal vault disruption with haemorrhagic shock.

Two cases of haemorrhagic shock secondary to partial disruption of the vaginal vault of sexual intercourse occurring 2 and 8 weeks after abdominal hysterectomy are presented. One patient required bilateral hypogastric, bilateral ovarian, and unilateral uterine artery ligation to control the bleeding, and is believed to be the first such case reported.

Adult↗
PubMed1979

Giant condyloma acuminatum of the endocervix and lower uterine segment.

A 34-year-old woman presented with lower abdominal pain, dysmenorrhea, dyspareunia and vaginal discharge. A total abdominal hysterectomy was done for persistent, severe uterine pain unresponsive to medical management. Histologic examination of the surgical specimen revealed a large condyloma acuminatum of the endocervix and lower uterine segment. This represents a rare manifestation of a very common venereal disease.

Adult↗
PubMed1979

Cervical deciduosis and intraepithelial neoplasia.

With the widespread use of routine cervical cytologic screening in pregnancy and the increasing use of colposcopy, the problem of coexistent decidual and neoplastic cervical changes becomes more frequent. This case report illustrates such a problem and discusses its management.

Adult↗