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Biomedical subjects

L C Gilstrap

Publications and source records attributed to L C Gilstrap.

137 records · Page 8Linked to original sources
PubMed1977

Evaluation of tetracycline or penicillin and ampicillin for treatment of acute pelvic inflammatory disease.

To evaluate guidelines for outpatient treatment of acute pelvic inflammatory disease recommended by the Center for Disease Control we studied 197 afflicted women. The women were treated either with tetracycline or with procaine penicillin and ampicillin, and 92% were subsequently seen at least once to assess efficacy of clinical and microbiologic treatment. Neisseria gonorrhoeae was isolated from the lower genital tract in 68% of these women, and although they had a quicker symptomatic response than those with nongonococcal infection (P less than 0.01), the two regimens were equally effective in producing clinical cure. However, subsequent identification of a pelvic abscess was 10 times more common in women from whom N. gonorrhoeae was not isolated. Therapy for pelvic inflammatory disease must be empirical since it is impossible to distinguish clinically between gonococcal and nongonococcal infection, and our data indicate that both regimens recommended by the Center for Disease Control are effective.

Acute Disease↗
PubMed1977

Myotonic muscular dystrophy in pregnancy.

Myotonic muscular dystrophy is an autosomal dominant disease inherited with variable penetrance. With pregnancy, the myotonia and muscle weakness may increase. There is also an increased incidence of abortion, prematurity, fetal death, labor dysfunction, and postpartum hemorrhage. A description of two pregnant patients and a review of the literature illustrate the interaction of the disease and pregnancy.

Adolescent↗
PubMed1976

Sipple syndrome and pregnancy.

Sipple syndrome is an unusual entity during pregnancy. To our knowledge, this is the second case report of a pregnant patient with signs of Sipple syndrome. During pregnancy, this syndrome may present unusual complications, which require informed physician expertise for appropriate management. Our patient had a strong family history for Sipple syndrome, which is considered to be transmitted as an autosomal dominant. Thus, other family members, including the patient's offspring must be assessed frequently during their lifetime for any of the developing manifestations of this entity. Genetic counseling should be included in the management of all patients with Sipple syndrome.

Adrenal Gland Neoplasms↗
PubMed1976

Ectopic pregnancy: a review of 122 cases.

Ruptured ectopic pregnancy constitutes a major gynecologic emergency which may result in death. From 1965 through 1973, 122 patients with ectopic pregnancy were treated at Wilford Hall USAF Hospital. Diagnostic procedures, causative factors, and patient management are reviewed and discussed. The most common symptoms were pain (95%), amenorrhea (79%), and abnormal bleeding (76%). An adnexal mass was found in only 40% of the patients. The treatment of choice was salpingectomy, and there were no deaths in this group of patients.

Adolescent↗
PubMed1975

Antibody-coated bacteria in the urine of obstetrical patients with acute pyelonephritis.

The direct immunofluorescence method for the detection of antibody-coated bacteria in urine sediments was used to test urine samples from obstetrical patients with the clinical diagnosis of acute pyelonephritis or cystitis. Antibody-coated bacteria were present in the urine from 12 of 15 patients with acute pyelonephritis, but they were not observed in the urine from 13 patients with cystitis. The clases of antibody coating the bacteria were IgG, IgA, and, in some cases, IgM. A correlation between a high titer of antibody in serum and the presence of antibody-coated bacteria in the urine was noted. These results confirm that the immunofluorescence test can be useful, as previously reported, in distinguishing infection of the kidney from infection of the bladder.

Adolescent↗
PubMedDate not supplied

Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section.

The purpose of this study was to evaluate the effects of a prophylactic intravenous bolus of ephedrine on the incidence and severity of maternal hypotension and on neonatal outcome. Term healthy parturients (n = 122) scheduled for elective repeat cesarean section under regional anesthesia were studied. Ninety-two women received 10 mg ephedrine as a prophylactic intravenous bolus prior to intrathecal epidural local anesthesia. Thirty parturients who served as controls did not receive prophylactic ephedrine. Maternal blood pressures, Apgar scores, and umbilical cord blood acid-base status were evaluated. Sixty-three of 92 women (69%) who received intravenous prophylactic ephedrine prior to regional anesthesia developed hypotension compared to 21 (70%) controls. The mean (+/- SD) lowest systolic blood pressure was similar in both groups (95.6 +/- 12.9 vs. 96 +/- 8.9 mmHg; P = 0.86). The mean (+/-SD) fetal pH was significantly lower with prophylactic ephedrine than controls (7.24 +/- 0.07 vs. 7.28 +/- 0.05; P = 0.001). The frequency of umbilical artery blood pH < 7.20 was 10.6% for the ephedrine group vs. 3.2% for controls (P = 0.024). Among newborns of hypotensive mothers, the frequency of umbilical artery blood pH < 7.20 was 30.2% and 4.6% for the ephedrine and control groups, respectively (P = 0.018). Intravenous prophylaxis with ephedrine did not significantly decrease the frequency of hypotension in women receiving regional anesthesia and resulted in a greater proportion of umbilical artery blood pH values < 7.20.

Anesthesia, Epidural↗
PubMedDate not supplied

Indirect sonographic guidance for epidural anesthesia in obese pregnant patients.

BACKGROUND AND OBJECTIVES: Obesity and edema frequently obscure anatomic landmarks and result in technical difficulties during epidural anesthesia administration. However, the method of indirect sonographic guidance permits identification of the midline by sagittal scan of the laminae of lumbar vertebrae 2, 3, and 4. METHODS: Thirty-six obese women scheduled for elective repeat cesarean delivery were prospectively studied. Use of a 5-MHz transducer positioned with the transducer center site over the second or third interspace allowed measurement of skin-to-lamina distance by the electronic calipers of a Toshiba SAL-32B or RT 3000 GE machine, prediction of needle depth for epidural puncture (EP), and skin marking of the site. After the transducer was removed, a 9.5- or 11.4-cm Tuohy needle was percutaneously advanced perpendicularly from the site until EP was achieved. RESULTS: Needle depth was measured by marker and measure, and epidural anesthesia was successfully administered to all patients. Simple linear regression analysis was performed with strong positive results. Indirect and continuous sonographic guidance studies designed to determine whether sonography reduces complications are planned.

Adult↗