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Biomedical subjects

G M Ryan

Publications and source records attributed to G M Ryan.

At least 19 recordsLinked to original sources
PubMed1991

Method failures of laparoscopic tubal sterilization in a residency training program. A comparison of the tubal ring and spring-loaded clip.

A prospective, randomized study of 365 women undergoing interval laparoscopic tubal sterilization in a residency training program was undertaken to compare method failures. Two occlusive techniques were compared, the spring-loaded clip (Hulka-Clemens) and the tubal ring (Falope Ring). Patients were randomized to either Falope Rings or Hulka-Clemens clips as the primary method. Demographic characteristics, educational level and operator experience were similar in the two groups. Follow-up at an average of 16 months (range, 6-24) revealed eight pregnancies (4.5%) in 176 women in the clip group and five pregnancies (2.6%) in the ring group. The Hulka-Clemens clip and the Falope Ring have similar incidences of method failure when employed by inexperienced operators. We question the usefulness of chromopertubation utilizing methylene blue dye to ensure proper placement of the occlusive device.

Adult↗
PubMed1990

Chlamydia trachomatis infection in pregnancy and effect of treatment on outcome.

The effect of Chlamydia trachomatis on pregnancy outcome and the effect of treatment of positive cervical cultures was studied by culturing 11,544 women for chlamydia at their first prenatal visit. Chlamydia culture was positive in 2433 (21.08%) and prevalence was related to age and race. Of the positive cultures, 1110 were classified as untreated. The untreated group demonstrated a significant increase in the incidence of premature rupture of the membranes and low birth weight and a decrease in survival when compared with either those with positive cultures who received treatment (N = 1323) or those with negative cultures (N = 9111). Screening of populations at high risk of chlamydia is recommended and treatment of chlamydia-positive patients may improve pregnancy outcome.

Anti-Bacterial Agents↗
PubMed1989

An evaluation of red blood cell heterogeneity (increased red blood cell distribution width) in iron deficiency of pregnancy.

A new classification of anemias, which is based on mean corpuscular volume and quantitative anisocytosis (red blood cell distribution width), was evaluated in 331 pregnant women on initial presentation for prenatal care. Seventy-four of them had severe iron depletion (serum ferritin level less than or equal to 10 ng/dl). Contrary to the above classification, early iron deficiency without anemia was infrequently identified by an increase in distribution width (4 of 25 patients). The distribution width was not consistently increased in the 49 anemic, iron-deficient patients; 34 were normal and would have been considered to have thalassemia minor or anemia of chronic disease according to the new classification. The distribution width was no more sensitive than the mean corpuscular volume in suggesting iron deficiency. This study does not confirm the usefulness of the new classification in the diagnosis of iron deficiency in this patient population.

Anemia, Hypochromic↗
PubMed1987

Unemployed youth and health: findings from the pilot phase of a longitudinal study.

Contemporary research perspectives on the impact of unemployment on health and well-being among young people have tended to focus on a rather narrow range of outcomes, typically those in the mental health domain. The impetus for the proposed longitudinal study, the main dimensions of which are described in this paper, reflects the need for a more comprehensive profiling of the health needs and experiences of young people if effective interventions tailored to their short and long term health needs are to be developed. The proposed study includes variables from a wide range of domains and adopts an interdisciplinary perspective. The feasibility of the approach, both in terms of establishing appropriately stratified samples and determining the acceptability and utility of the measures proposed has been examined during an extensive pilot phase. Findings from the database established during this phase are presented. These focus on multi-dimensional comparisons of health and well-being between employed and unemployed young people, the impact of socio-economic status of origin on cardiovascular and other indicators, and the correlates of health and well-being among the unemployed. The results point to the potential complexity of the influences on health status and behaviour and the need to develop comprehensive models of this for research and intervention purposes.

Adolescent↗
PubMed1987

An evaluation of two rapid bacteriuria screening procedures.

Two commercially available rapid bacteriuria screening procedures were evaluated for routine screening for 10(4) or more colony forming units per milliliter of pathogenic bacteria in two female patient populations. In 694 obstetric patients with 56 cases of significant bacteriuria, the sensitivity, specificity, positive predictive, and negative predictive values, respectively, were as follows: for Chemstrip LN, 69.6, 83.4, 26.9, and 96.9%; and for Bac-T-Screen, 96.4, 56.0, 16.1, and 99.4%. In 143 nonpregnant females with 32 cases of significant bacteriuria, these values were: for Chemstrip LN, 71.9, 75.7, 46.0, and 90.3%; and for Bac-T-Screen, 84.4, 65.8, 41.5, and 93.6%. These results indicate that the LN strip did not have acceptable sensitivity in either patient group. The Bac-T-Screen had better sensitivity, particularly for obstetric patients; however, a high false-positive rate and high cost per test may restrict its use in those clinical settings where culture is available and cost-effective.

Bacteria↗
PubMed1986

Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia.

During an 8-year period, 112 severe preeclamptic-eclamptic patients with the above syndrome were studied. The incidence of this syndrome was significantly higher in white patients, in patients with delayed diagnosis of preeclampsia and/or delayed delivery, and in multiparous patients. Twenty-six patients had amniocentesis and 16 received epidural anesthetics. There was one maternal bleeding episode associated with epidural anesthetics. The use of steroids in 17 patients did not improve maternal platelet count. The overall perinatal mortality was 367 per 1000 and neonatal morbidity was significant. There were two maternal deaths and two patients with ruptured liver hematoma, and nine had acute renal failure. Thirty-eight percent had intravascular coagulopathy and 20% had abruptio placentae. On follow-up, 44 patients used oral contraceptives without maternal morbidity and 38 patients had 49 subsequent pregnancies. Only one patient had recurrence of the syndrome in subsequent pregnancies. The presence of a "true" syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) in preeclampsia is associated with poor maternal-perinatal outcome.

Abruptio Placentae↗
PubMed1979

Cellular and humoral immune status in women with chronic Candida vaginitis.

The cellular and humoral immune responses of nine women with chronic Candida vaginitis and 29 control subjects were evaluated. Agglutinating and precipitating antibodies were studied and tests of lymphocyte transformation, lymphokine production, and cutaneous delayed hypersensitivity were performed. The results suggest a lack of cellular immune response to Candida antigens in women with chronic Candida vaginitis.

Adolescent↗
PubMed1979

The impact of regionalization programs on patterns of perinatal care.

A questionnaire developed to assess changes in patterns of perinatal care related to regionalization programs was sent to all 505 members of The American College of Obstetricians and Gynecologists in the state of Massachusetts. Respondents reported changes in facilities, services, educational experience, and referral and transfer patterns. The implications of these changes are discussed.

Child Health Services↗
PubMed1978

The closure of maternity services in Massachusetts. The impact on the obstetricians.

A survey is presented of Massachusetts physicians who were staff members at hospitals which closed their obstetric services. Both personal and practice impacts are presented as well as the physicians' evaluation of their present maternity units in comparison to the closed units. The personal impact on responding physicians was small. Few reported significant financial or patient loss. While significant practice changes were reported, adverse comments were few, and the present obstetric unit was viewed as an improvement over the closed unit in ever one-half the cases. These findings support the concept of consolidation as a component of programs for regional planning of maternity care.

Attitude of Health Personnel↗
PubMed1977

The closure of maternity services in Massachusetts. The causes, process, and hospital impact.

There has been a decline in the number of maternity services in Massachusetts from 120 in 1960 to 65 in 1975. Further consolidation must be carefully thought out with all options and possible outcomes thoroughly explored. The Massachusetts Maternity and Newborn Regionalization Project and the Massachusetts Hospital Association conducted a preliminary survey of Massachusetts Maternity services that had closed to understand the causes, process,, and hospital impact. The findings of this preliminary investigation, in addition to identifying areas for more intensive future research, provide some observations that should be of assistance to those considering a maternity service closure.

Female↗