Biomedical subjects

H L Kent

Publications and source records attributed to H L Kent.

4 recordsLinked to original sources

PubMed1994

Hot-knife conization of the cervix: clinical and pathologic findings from a study introducing a new technique.

OBJECTIVE: To introduce an alternative method for conization of the cervix using a Teflon-coated hot knife and to evaluate thermal distortion, adequacy of excision, operating time, blood loss, and short- and long-term effects of this method. METHODS: Between 1987-1993, 88 patients underwent cervical conization using a Teflon-coated hot knife at temperatures ranging from 110-130C. Histopathologic slides were reviewed simultaneously by two pathologists, who assessed thermal distortion, adequacy of excision, and interpretability of the surgical margins. Clinical information was obtained prospectively, including operating time, blood loss, and depth and volume of the excised cone. In addition, data were accumulated retrospectively from 40 randomly selected patients who underwent cold-knife conization between 1985-1990. Short- and long-term data were assessed for healing and scarring and the adequacy of postoperative Papanicolaou smears in the hot-knife patients. RESULTS: Thermal injury was minimal, with 300 mu or less in 83 patients (92%) and 350-600 mu in four patients. One patient had thermal distortion of 1500 mu. All slides were interpreted adequately. Blood loss was mild to moderate in 84 of 88 patients (95%) in the hot-knife group and in 34 of 40 patients (85%) in the cold-knife group. No patient in the hot-knife group needed blood transfusion or hospitalization. Operating time was reduced by as much as 67% when the hot knife was used. Thirteen percent of the hot-knife patients developed stenosis of the external os. No patient in the hot-knife group developed recurrence within 2 years of surgery. CONCLUSION: Using a Teflon-coated hot knife for conization of the cervix produces adequate surgical margins and reduces blood loss and operating time over that with cold-knife conization. Long-term follow-up reveals no increase in cervical stenosis and demonstrates adequate cytologic smears in the hot-knife patients.

Adolescent↗

PubMed1991

Epidemiology of vaginitis.

Vaginitis is one of the most common problems in clinical medicine, and it is the reason cited most often for visits to obstetricians and gynecologists. This article reviews the epidemiology in the United States and Scandinavia for the three major causes of vaginitis: candidiasis, trichomoniasis, and bacterial vaginosis. The incidence of candidiasis has increased dramatically during the past decade, with an increase in the percentage of non-albicans Candida strains. However, in Scandinavia the incidence of candidiasis has been relatively stable, between 10% and 30%, during the past 5 years. The incidence of Trichomonas has decreased dramatically in both the United States and Scandinavia during the past 15 years, partly attributable to the advent of metronidazole. In the United States bacterial vaginosis continues to be the leading variety of vaginal infection, affecting a broader spectrum of women than gonorrhea. The prevalence of bacterial vaginosis in Scandinavia is about 30%, and this percentage increases with age according to studies of patients at sexually transmitted disease clinics.

Adolescent↗

PubMed1991

Trichomoniasis: trends in diagnosis and management.

The mainstay of the diagnosis of trichomoniasis has been the saline vaginal wet preparation. With a less than desirable sensitivity, the wet preparation may be replaced in the near future by newer methods employing monoclonal antibodies, such as the enzyme immunoassay, which has the potential to become an in-office procedure. The direct fluorescent antibody test also represents an advance in laboratory diagnosis. However, until the sensitivity, specificity, and cost of these newer techniques are defined outside the research arena, the wet preparation will remain the first-line diagnostic tool. Current treatment of trichomoniasis in the United States is with metronidazole, which in repeated or increased dosage can often overcome the organism's resistance to the drug. Other treatments offer little or no chance for cure but may provide some relief of symptoms. Tinidazole (not available in the United States) may be effective in curing refractory cases of metronidazole resistance. Metronidazole treatment during pregnancy should be resorted to only when absolutely essential.

Drug Resistance↗

PubMed1990

Interferon for vulvar vestibulitis.

Eight women with human papillomavirus-associated vestibular adenitis were treated with locally administered alpha interferon, 1 million units, three times weekly for four consecutive weeks. Five patients had a complete remission, and one had a slight, transient improvement, with a relapse after the therapy ceased.

Adult↗