PubMed Health⌕ Search

Biomedical subjects

J Orley

Publications and source records attributed to J Orley.

At least 19 recordsLinked to original sources
PubMed1998

Ovarian cysts in children and adolescents: their occurrence, behavior, and management.

STUDY OBJECTIVE: To evaluate the characteristics and symptoms of ovarian cysts, their connection with the methods of treatment, and the effectiveness of the therapy. METHODS: A retrospective analysis of data on girls with ovarian cysts was performed at a university clinic. Participants included 119 girls in whom 144 ovarian cysts were found by ultrasound examination performed either routinely or for a specific purpose. One group of patients received gestogen to facilitate resolution of the cyst and as treatment of menstrual disorder. Others received clomiphene citrate exclusively as therapy for menstrual irregularity. Aside from this, patients were treated by surgical intervention, or only follow-up sonography was performed. The site, number, size, and type of the cysts were examined. The indications for ultrasonography and the effectiveness of the treatment were analyzed. RESULTS: The ovarian cysts were mostly unilateral, unilocular, and simple, with the size varying between 3 cm and 5 cm in diameter in 90 cases, more than 5 cm in 41 cases, and less than 3 cm in 13 cases. A number of cysts were found incidentally on ultrasound. Girls were scanned most often because of irregular bleeding (80 cases). Hormonal treatment was given in 105 cases, whereas in 35 cases only follow-up sonography was performed. Cysts resolved spontaneously in 4.5 weeks on average, or in 3 weeks after hormonal treatment. Surgical therapy was necessary for nine patients. The indication for surgery was the detection of complex cysts indicative of dermoid type, size of the cysts, severe pelvic pain, or failure of the cyst to resolve or decrease in size spontaneously or in response to treatment as determined by follow-up sonography. All of the cysts were benign on pathological evaluation. CONCLUSION: Most ovarian cysts in girls could be managed conservatively, even the larger ones greater than 5 cm in diameter. Only exceptional cases required surgical therapy. Hormonal treatment shortened the duration of the cysts somewhat, but not significantly, and thus was useful mainly in the treatment of concomitant menstrual disorders.

Adolescent↗
PubMed1998

Sonographic diagnosis of a retroperitoneal dermoid cyst in a young girl.

We describe the detection and management of a retroperitoneal dermoid cyst in a young girl. Transabdominal ultrasound revealed in the pelvis a complex mass with anechogenic and echogenic components characteristic of a dermoid cyst. Initially, it was presumed to be of ovarian origin, because extragonadal dermoid cysts are very rare in adolescence; however, the findings on physical examination were normal. Laparoscopy was performed but failed to identify a cyst. Ultrasound examination was repeated intraoperatively and confirmed the presence of the cyst, which was then removed by laparotomy from the retroperitoneum. This case illustrates the significance of ultrasonography in the diagnosis of a rare condition in adolescent gynecology and demonstrates the possibility of performing ultrasound scanning intraoperatively to confirm the presence of a mass which was not identified by laparoscopy.

Adolescent↗
PubMed1998

WHO and the mental health of children.

WHO's work on child mental health began with John Bowlby's classic on the subject, written for WHO in the early 1950s. In the mid-1970s the Division of Mental Health was created, and this led to major advances in establishing a sound epidemiological and scientific basis for child mental health services. Significant contributions were made to the establishment of "biobehavioural" interventions to tackle the major causes of childhood mortality and morbidity throughout the world, and to provide better care for children with mental disorders at primary level.

Adolescent↗
PubMed1991

Development of a WHO Child Care Facility Schedule (CCFS): a pilot collaborative study.

This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens.

Child Care↗
PubMed1987

Detection of late-onset adrenal hyperplasia in girls with peripubertal virilization.

We investigated the value of serum levels of adrenal steroids (dehydroepiandrosterone sulphate, testosterone, 17-hydroxyprogesterone, cortisol) in the identification in peripubertal females with late-onset congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Among 68 females (age 3-18 years) with virilization in childhood, peripubertally or postpubertally, we selected 21 girls for an ACTH test by measurement of basal blood-spot or serum 17-hydroxyprogesterone (17-OHP) levels. Eight of 21 patients had supranormal post-ACTH serum 17-OHP concentration (57-153 nmol/l) with low normal cortisol concentration. All of them had supranormal basal and post-ACTH 17-OHP to cortisol ratios. These data show a relatively high incidence (about 12%) of mild 21-hydroxylase deficiency among prepubertal and adolescent girls with virilization. It is concluded that the first step in the investigation of peripubertally virilized girls should be the determination of serum 17-OHP and cortisol. Patients with basal morning 17-OHP concentration and 17-OHP to cortisol ratio above reference range should be given an ACTH test.

17-alpha-Hydroxyprogesterone↗
PubMed1986

Levels of expressed emotion and relapse in depressed patients.

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Leff between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations.

Adult↗
PubMed1983

A nonhuman primate model for evaluating the potential of antihypertensive drugs to cause orthostatic hypotension.

The potential of several classes of antihypertensive drugs to cause orthostatic hypotension in man was evaluated in a conscious cynomolgus monkey model. Supine and erect blood pressure and heart rate were continuously monitored before and after administration of chlorisondamine (a ganglionic blocking agent); phentolamine and prazosin (alpha-adrenergic blocking agents); propranolol (a beta-adrenergic blocking agent); and minoxidil (a vasodilator). Substantial validation of the model was accomplished when it was observed that these drugs evoked cardiovascular responses in the animal model which were similar to those which had been described in the clinical literature.

Animals↗
PubMed1981

Tetrahydro-2-benzoxepins: a novel family of hypotensives.

A novel series of 1-(alkylamino)-1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepins shows hypotensive activity. A typical example is 1-[2-(1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepin-1-yl)ethyl]-4-(4-fluorophenyl)piperazine. This compound is an alpha blocker with peripheral and central activities.

Anesthesia↗