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Biomedical subjects

K Radivojevic

Publications and source records attributed to K Radivojevic.

17 recordsLinked to original sources
PubMed1991

[Danazol in treatment of cystic mastopathy].

Numerous endocrine disorders may cause benign breast diseases, such as increased oestrogen and prolactin, decreased progesterone. The antigonadotropic effects of Danazol counteract these hormonal changes. It has been used for a few years in the treatment of benign breast diseases at a dosage of 200-800 mg daily. Treatment of benign breast cysts represents a special problem--after puncture fluid builds up again very often after a short while. In a randomized study we demonstrate the positive effects of Danazol, such as reduction of cyst diameter and prevention of recurrence after puncture. Cysts with a diameter of more than 20 mm were punctured. The test group was treated with 400 mg Danazol daily; the control group was treated conventionally with prolactin antagonist and progesterone We treated 26 patients with Danazol over a 3 months period. In the control group we observed more recurrences after puncture than in the Danazol group. Danazol also proved effective in the reduction of cyst diameter in women with cysts under 20 mm in diameter which had not been punctured. Tolerance of Danazol was good; side effects were cycle irregularities and weight gain.

Bromocriptine↗
PubMed1991

[Delivery of quadruplets after in vitro fertilization: perinatologic and ethical aspects].

Progress in modern reproductive medicine has brought much success to infertile couples. A side effect of IVF procedure are multiple pregnancies with clinical, ethical, perinatal and social problems. We report about the first case of quadruplets after IVF born in Austria and try to illustrate the perinatal, social and ethical problems. The 34 year old woman was treated in our sterility outpatient clinic because of secondary sterility. In 1988 finally she underwent IVF procedure. Four oocytes were retrieved by means of vaginal follicle puncture. 4 embryos were transferred, and after 3 weeks 4 viable embryos were seen at an ultrasound investigation. Due to placental insufficiency a cesarean section had to be performed in the 31st week of gestation. The weights of the premature infants were 1280 g, 1340 g, 1260 g and 1250 g. Two years after birth two infants show neurologic defects and need permanent care.

Adult↗
PubMed1990

[Ante partum monitoring of fetal status by maternal recording of fetal movement].

Perceived fetal activity is the oldest and least expensive technique for monitoring fetal well-being. The mother's awareness of a loss or a significant decrease in propulsive fetal activity has been traditionally regarded as a warning sign, especially when uteroplacental insufficiency is present. Many investigators have reported the value of daily fetal movement charting as a means for signalling fetal jeopardy and possible demise. Discerning between a physiological rest period and an abnormally low activity period is difficult but important. Several definitions of fetal inactivity according to maternal perception are described. The aim of our study was to detect abnormal fetal conditions by registering fetal body movements. For the evaluation we used the "Cardiff count to ten kick chart" developed by Pearson and Weaver. We evaluated 173 pregnant women after the 26th week of gestation in this way. Evidence for fetal inactivity are less than 10 movements/12 hours. 10% of the pregnancies showed fetal inactivity; half of them are expected to have an unfavourable outcome due to placental insufficiency and fetal distress during labour. Daily fetal movement charting is a simple and effective method for the detection of abnormal fetal conditions. It should be used in all high-risk pregnancies, especially in cases of incompatibility in the Rh-system, diabetes mellitus, and placental insufficiency. Our decision to intervene should not be based on fetal activity patterns alone, but the observation of fetal inactivity needs further investigation by ultrasonography (breathing activity, cardiac motion, lower limb and trunk motion, search for malformation, placental morphology and amniotic fluid volume) and cardiotocography.

Female↗
PubMed1990

[The value of curettage in the assessment of abnormal uterine bleeding].

Current practice of investigating abnormal uterine bleeding via dilatation and curettage is sometimes open to question, and outpatient procedures are emphasised. The therapeutic effect of curettage in normalising menstrual patterns is being discussed. In a prospective study we answered the question of diagnostic and therapeutic effects of curettage. Over a period of 6 months, all patients with curettage treated in our department were investigated (history, risk factors, previous hormonal treatment, preoperative haemoglobin value, type of anaesthesia, complications, histology). Curettages performed for the purpose of abortion, as well as in combination with conisation of the uterine cervix, were not included in the study. 234 curettages were carried out. Clinical indications were as follows: in 29% of the cases recurrent preclimacteric metrorrhagia, in 27% climacteric metrorrhagia, in 24% PMB (postmenopausal bleeding). In 19 cases we found an Hb value lower than 10.5 g%. Risk factors (obesity, hypertension, diabetes mellitus) for endometrial cancer were found in 38% of MB and in 20% of climacteric metrorrhagia. In 9 cases, the histological diagnosis was endometrial cancer (clinical indications: 5 PMB, 3 climacteric metrorrhagia, 1 recurrent preclimacteric metrorrhagia). Our study shows, that the indication for curettage should be applied generously, especially in cases of abnormal postmenopausal and perimenopausal bleeding.

Adult↗
PubMed1989

[Simple and clinically useful documentation on the vulva using a personal computer].

We developed a simple menu driven database on personal computer for classification and documentation of vulvar lesions (IBM-PC, dBaseII). Vulvar lesions were classified according to morphologic appearance: red, white, dark, ulcer, small tumor (less than 1 cm), large tumor. The data for each category are entered in multiple choice form and stored in a separate database file. For each category an automated table of the frequencies of the different diagnoses is provided, individual patients and variables can easily be accessed through the database query language.

Documentation↗
PubMed1989

Serum progesterone and human chorionic gonadotropin in very early pregnancy: implications for clinical management.

We studied beta-human chorionic gonadotropin (beta-HCG) and progesterone (P) in maternal serum in 71 patients with a positive urine pregnancy test with a threshold of 50 U HCG/liter urine and an ultrasound examination without demonstrable fetal heart beat. Patients were divided into three groups: ongoing intra-uterine pregnancy of more than 12 weeks duration (n = 23), ectopic pregnancy (n = 14), and abnormal intra-uterine pregnancy (blighted ovum, early spontaneous abortion) resulting in dilatation and curettage (n = 34). We found that both beta-HCG and progesterone levels were significantly lower in abnormal pregnancies but that there was less overlap between the progesterone values in normal, ectopic and abnormal pregnancy as compared to beta-HCG levels. There was a positive correlation between beta-HCG levels less than 5000 mU/ml and serum progesterone in ectopic pregnancies but not in normal or abnormal intra-uterine pregnancies. The size of the gestational sac correlated with serum beta-HCG levels but not with serum progesterone levels in normal intra-uterine pregnancies. We conclude that serum progesterone levels (cut-off point 15 ng/ml) in very early pregnancy can be helpful to differentiate between normal intra-uterine pregnancy and abnormal intra-uterine or ectopic pregnancy.

Chorionic Gonadotropin↗
PubMed1989

[Classification and documentation of vulvar changes: organization of a data bank by personal computer].

We developed a simple menu driven database on a personal computer for classification and documentation of vulvar lesions (IBM-PC, dBaseII). Vulvar lesions were classified according to morphological appearance: red, white, dark, ulcer, small tumor (less than 1 cm), large tumor. The data for each category were entered in multiple choice form or as free text and stored in a separate database file. Overlap between categories was observed in vulvar intraepithelial neoplasia, invasive carcinoma and between large and small tumors. For each category an automated table of the frequencies of the different diagnoses is provided, individual patients and variables can easily be accessed through the database query language. We used the database system in the gynecological outpatient clinic of our department during 6 months and were able to document 117 patients with vulvar lesions. In our experience, the database system permits complete documentation according to clinical criteria of all vulvar lesions seen in gynecological practice.

Diagnosis, Differential↗
PubMed1988

[The urethral pressure profile at rest and in stress following diaphragmplasty].

56 women underwent vaginal repair because of primary genuine stress incontinence. Urodynamic investigation was carried out preoperatively and 10.9 (7-13) months after surgery. At follow-up continence was demonstrable in 44/56 patients (79%). Detrusor instability following surgery for stress incontinence was found in 2/56 patients (4%). Vaginal repair failed to rectify stress incontinence in 21% of the patients. In cured patients the postoperative urethral pressure profile at rest remained unchanged, while the postoperative urethral closure pressure profile during stress significantly increased in these patients. In incontinent patients following surgery the urodynamic parameters of both pressure profiles correlated well with the severity of the incontinence.

Adult↗
PubMed1988

[The older primipara: labor induction and rigidity of the soft tissues].

Textbooks and literature reports frequently view the primipara of advanced age as a group being at increased risk of prolonged labor, dystocia, injuries to the birth canal and fetal distress. Particularly, a rigid cervix and reduced elasticity of the soft tissues of the birth canal are claimed responsible for these risks. Clinically, this view causes a higher frequency of operative deliveries in this group of primipara. The aim of the study was to evaluate the influence of a rigid cervix and/or reduced elasticity of the soft tissues in the birth canal on the course of labor. According to the definition of the FIGO we identified 201 primipara of advanced age as being more than 35 years old in our database. 5966 primipara (age 18-34) served as control. No significant difference was found in regard to Bishop score, progress of labor, vaginal and perineal lacerations, fetal distress and anaesthesia. However, the overall frequency of operative deliveries was increased from 27% to 58% in the primiparas of advanced age. In particular, the incidence of caesarean section increased from 11.5% to 39%. In 66% rigid tissues were called as one of the reasons for operative delivery in this group of aged primipara. However, our analysis of clinical variables does not support the notion that these women in general have an increased frequency of dystocia and/or a more rigid cervix and decreased elasticity of the birth canal. We feel that in a considerable number of patients, the concern of the obstetricians and the women in a safer and less painful delivery by caesarean section are reasons for these increased operative procedures at the end of the reproductive period.

Adult↗
PubMedDate not supplied

[Hormonal pregnancy parameters in the serum following surgery for extrauterine pregnancy].

We did serial determinations of beta-HCG, total-HCG, prolactin, SP-1, and progesterone in maternal serum after operation of an ectopic pregnancy in 38 patients. Prolactin, progesterone and SP-1 rapidly returned to normal values after removal of the ectopic pregnancy. However, the half life of HCG was related to the type of operation: after conservative operation of ectopic pregnancy the half life of HCG was greater than after tubectomy (41.4 +/- 1.9 SEM hours versus 33.4 +/- 2.0 hours), possibly due to lack of complete removal of trophoblast tissue. This fact should be kept in mind when evaluating postoperative HCG levels.

Adult↗
PubMedDate not supplied

[Is there a gestosis weather? Correlation of EPH gestosis with meteorologic conditions].

A historical survey on the subject of weather and eclampsy is given in the introduction, at the beginning of which the names Smellie (1752), Boutteilloux (1816), Lachapelle (1925) and Zangemeister (1900) are mentioned. In the ten-year report the gestosis indices according to Goecke (n = 56,461) in the grouping 0/I-III/ = greater than IV are correlated with six general weather situations in each of the four seasons. From the chi 2 component test according to Krauth a relevant chi 2 limit of 8,95 is established. Only the following four out of altogether (6 x 4 =) 24 weather situations prove to be associated with lower (I-III) and higher (= greater than 4) indices of gestosis. 1. Anticyclonic situations with central high in winter with indices of gestosis I-III; 2. cyclonic flow-patterns in autumn with indices of gestosis I-III; 3. situations with central low in summer with indices of gestosis = greater than IV; 4. low gradient cyclonic situations in summer with fewer indices of gestosis. In spring the indices groups do not reach or exceed the limit of significance in any of the six weather situations. The four weather situations connected with gestosis are demonstrated by means of typical examples of infrared and visual satellite photos. Summing up, the different valence of scientific evidence and clinic relevance of the results is indicated.

Adult↗