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Biomedical subjects

G B Feldman

Publications and source records attributed to G B Feldman.

11 recordsLinked to original sources

Prospective risk of stillbirth.

Some fraction of any cohort of fetuses alive at a given gestational age will ultimately die before birth. The residual prospective risk of stillbirth as a function of gestational age was calculated from records of the New York City Department of Health covering 370,051 reported births between 1987-1989, including 2454 stillbirths. In the general population, the prospective risk of stillbirth at 26 weeks was one in 150 and, because the time distributions of live births and stillbirths were not proportionate, the risk changed with gestational age. By 40 weeks' gestation, it was one in 475, rising progressively thereafter to one in 375 at 43 weeks. The prospective risk of stillbirth was elevated in certain ethnic groups and increased significantly with advanced maternal age, multiple gestation, and lack of prenatal care. The prospective risk of stillbirth is an important consideration in decisions regarding timing of delivery.

Adult↗

Sacral colpopexy for vaginal vault prolapse.

Sacral colpopexy has become the treatment of choice for post-hysterectomy vaginal vault prolapse at the New York Hospital--Cornell Medical Center. A review of the institutional experience with this technique since 1972 indicates that 20 of 21 patients obtained good vaginal support and preservation of functional capabilities with minimal complications.

Aged↗

Aspiration curettage for asymptomatic patients receiving estrogen.

Recent epidemiologic data suggest that patients treated with exogenous estrogens have an increased risk of developing endometrial carcinoma and support the concept that patients taking estrogens must be monitored with special vigor. The hypothesis that endometrial aspiration curettage might be an appropriate modality to accomplish adequate surveillance was tested from January 1, 1976, to January 1, 1977, on a group of 208 consecutive patients undergoing hormonal replacement therapy. Although no patient in the test group experienced abnormal or unusual bleeding, focal adenomatous hyperplasia or a more severe lesion was found in 16.0% of the specimens. Among these were 4 cases of endometrial adenocarcinoma and 2 of atypical adenomatous hyperplasia. This study demonstrated that routine endometrial aspiration curettage of patients receiving exogenous hormone replacement therapy can not only help diagnose very early lesions which are amenable to definitive and completely corrective treatment, but also can uncover significant endometrial pathology before it becomes symptomatic. It further suggests the possibility that the incidence of such pathology among this category of patients might be higher than previously suspected.

Adenocarcinoma↗

Lymphatic obstruction in carcinomatous ascites.

The i.p. inoculation of C3H mice with 5 times 10-6 cells of a transplantable ovarian carcinoma invariably evokes accumulation of large amounts of ascitic fluid. Histological and pharmacotherapeutic studies indicate that obstruction to peritoneal lymphatic drainage is a key factor in the formation of carcinomatous ascites in this model. In the early stages of ascites formation, an intense inflammatory reaction appears to occlude the condusts that connect the peritoneal cavity to the subdiaphragmatic lymphatic plexus. This inflammatory reaction, elicited by the presence of tumor cells within the peritoneal cavity, can be inhibited with high-dose systemic corticosteroid therapy. Ascitic fluid accumulation in animals so treated is markedly retarded. Tumor cells do not gain access to lymphatic capillaries draining the peritoneal cavity until ascitic fluid accumulation is massive. Systemic anticoagulation with heparin or sodium warfarin does not prevent lodgment of tumor cells within these lymphatic capillaries, nor does it alter the pattern of ascitic fluid accumulation. Various considerations suggest that excess production of ascitic fluid is not a likely pathogenetic factor in murine carcinomatous ascites.

Animals↗