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Biomedical subjects

L Iffy

Publications and source records attributed to L Iffy.

16 recordsLinked to original sources
PubMed1979

Control of perinatal infection by traditional preventive measures.

A 9-year review of nosocomial infections occurring in the department of obstetrics and gynecology of a major teaching hospital demonstrated the dramatic effect of strict asepsis and isolation on postoperative infection rates. With rigidly enforced preventive measures and without the use of prophylactic antibiotics, the rates of wound infection and endometritis and the relative prevalence of gram-negative aerobic organisms cultured from these infections could be reduced substantially. The role of anerobes in these infections was not established, since adequate techniques for the accurate diagnosis of anaerobic infection were not available at the time of this study. The relative importance of the numerous infection-control measures used is unclear. It is apparent, however, that by implementing all traditional methods of asepsis, virtually all types of nosocomial infection could be controlled, and the increased prevalence of gram-negative infections observed during the past decades could be reversed.

Asepsis↗
PubMed1979

Ectopic pregnancy as an etiologic agent in appendicitis.

The association of ectopic pregnancy and acute appendicitis has seldom been discussed in literature. This report presents 2 patients who had simultaneous right tubal pregnancies and acute periappendicitis. The cases reported here suggest the possibility that an ectopic pregnancy can produce an inflammatory reaction of the appendix. Ectopic pregnancy as an etiological stimulus for acute appendicitis is discussed. The advisability of examining the appendix at the time of surgery for pelvic disease, and performing an appendectomy at the same time, if pathology of the appendix is suspected, is emphasized. The use of elective appendectomy in surgery for ectopic pregnancy is reviewed.

Acute Disease↗
PubMed1979

Experimental design for the surgical relocation of the ovary into the vaginal fornix.

After translocation into the vaginal vault while attached to a pedicle consisting of the infundibulo-pelvic ligament, the ovary was found to maintain its function in laboratory primates. In the majority of the baboons the ovulatory pattern returned within a few weeks after the surgical procedure. The only significant complication was a transitory, and self-limited, infection which was evident on inspection and on the biopsy specimens, but caused no clinical symptoms. By comparing the surgical outcome in two primate species, namely Papio Cynocephalus and Macaca Arctoides, it could be deduced that the Homo Sapiens would be a more suitable experimental model than either of the laboratory primates used in this research. Because there are potentially effective methods for reducing the likelihood of postoperative infection in the relocated ovary, the experience gained by this new method suggests the possibility that it could be utilized in the future for the purpose of collecting ova for in vitro fertilization in carefully selected, and otherwise untreatable, cases of female sterility.

Animals↗
PubMed1978

Vaginal transposition of the ovary in primates (Papio cynocephalus and Macaca arctoides).

Experimental data indicate that the time and mechanism of ovulation play a significant role in some cases of infertility and in a broad range of reproductive abnormalities. In order to establish a new experimental model for the study of these phenomena in primates, transposition of the ovary from the pelvis into the vaginal fornix was attempted in 2 species of monkeys: (a) Macaca Arctoides and (b) Papio Cynocephalus. Particularly in the latter species, ovarian relocation into the anterior and the posterior vaginal fornices proved feasible. Most ovaries continued functioning in their new location during the 2-5 months of the follow-up, despite macroscopic and microscopic evidence of infection. Post mortem examination of one of the experimental animals several years after the surgical procedure revealed the presence of an intact functioning ovary still in close contact with the vaginal fornix.

Animals↗
PubMed1977

Ectopic pregnancy.

Explore the source record for details and available documents.

Body Temperature↗
PubMed1976

Ectopic gestation: a consideration of new and controversial issues relating to pathogenesis and management.

In this chapter on ectopic gestation are have attempted to elucidate new and controversial issues in this area. In summary, we identify the following items as "nominative imperatives": I. Meticulous review of the classic etiologic concepts of ectopic gestation indicates that these concepts are no longer tenable although certain of them may be operative in specific instances. Review of certain veterinary work, animal experimentation, and pathologic and clinical observations in primates lends support to the hypothesis that failure of the ovum to implant may be related to delayed (post-midcycle) ovulation followed by shortening of the luteal phase with defective endometrial development and by a bleeding episode that simulates menstruation. II. Review of the literature indicates that the woman who has a tubal pregnancy has about a 50 to 60 percent chance of never becoming pregnant again. Among those who do conceive, at least 10 percent, and possibly more, develop another ectopic gestation. Only one-third of the women who have a tubal pregnancy will ever succeed in delivering a healthy child. Obviously this unhappy prognosis is the basis for many of our recommendations for management. The woman who had had a tubal pregnancy should consider the use of mechanical contraception after the midcycle to prevent recurrent ectopic pregnancy. This is obviously a suggestion based on the etiologic theory that we espouse. The prophylactic use of anti-Rh immunoglobulin is necessary in ectopic gestation in Rh-negative gravidas. III. In terms of the relation of ectopic pregnancy to intrauterine devices, the most authoritative statement than can be found is that of Lehfeldt, who states that the IUD is 99.5 percent effective in preventing intrauterine pregnancy, 95 percent effective in preventing tubal ectopic gestation, and is ineffective against ovarian implantation. Nonetheless, the fact that one in 23 IUD pregnancies is ectopic makes consideration of this diagnosis mandatory. IV. In terms of diagnostic assistance that can be provided by the radiologist, a comprehensive summary of their capabilities is presented. Laparoscopy is considered a valuable aid in establishing the diagnosis of unruptured ectopic pregnancy. A new, highly sensitive radioimmunoassay with specific affinity for the beta subunit of HCG is described that can detect very low levels of HCG when routine pregnancy tests are negative. It appears that this test can be of enormous help in diagnosing the early, unruptured tubal pregnancy. V. In a consideration of the role of conservative operations in the management of tubal pregnancy, we take the position that the modern gynecologist must acknowledge the possibility of conservative operations. It is obvious that success is most likely, when the surgeon is confronted with an early, unruptured ectopic gestation and that the feasibility of a linear salpingostomy must be acknowledged. VI...

Adult↗
PubMed1976

Early intrauterine development: II. The rate of growth in Black and Central American populations between 10 and 20 weeks' gestation.

The application of the growth-rate standards, extablished for Caucasian embryos and fetuses in a previous report, to Black and Central American racial groups has been investigated. Comparison between menstrual age and crown-to-rump length indicated differences in the 10 to 15 weeks' gestation range. However, growth rates for the same groups were practically identical between the 15th and 20th weeks of pregnancy. This finding suggests that the actual rate of growth is closely similar in the respective ethnic groups and that apparent discrepancies reflect erroneous, or purposefully false, menstrual histories rather than dissimilar growth patterns. Largely identical rates of development were suggested by the crown-rump length to foot length to body weight interrelations among the various racial groups. A moderate, but rather predictable, deviation from the earlier established standards was noted in the crown-rump length versus foot length ratios of Black American fetuses, providing the only exception to what appears to be a practically identical rate of growth for the investigated ethnic groups in the first half of gestation. The evaluation of the results was extended to involve the effect of educational and social factors on currently available data of embryonic and fetal growth. It is suggested that heretofore unconsidered factors may affect the validity of widely quoted standards of intrauterine growth.

Anthropometry↗
PubMed1975

Basal body temperature recordings in ectopic pregnancy.

Basal body temperature charts taken during the cycle of conception of tubal pregnancies suggested the presence of luteal phase defect in the background of ectopic implantation and the recurrence of an apparent menstruation at the expected time of the next period. The temperature changes were compatible with the occurrence of a "superovulation" shortly before the occurrence of tubal abortion.

Abortion, Spontaneous↗
PubMed1975

Early intrauterine development: I. The rate of growth of Caucasian embryos and fetuses between the 6th and 20th weeks of gestation.

Liberalization of abortion laws in various countries and states of Europe and America has offered an opportunity for the study of the correlations between menstrual age and the rate of bodily development of human embryos and fetuses. In several institutions where local bylaws mandated the consent of the patients requesting therapeutic abortion to pathological investigation of the products of conception, various parameters of growth were measured systematically. These included crown-rump and foot lengths and body weight. The analysis of the data indicated that in the embryosic stages of development the rate of growth is substantially slower than it had been assumed previously. In the more advanced fetal stages of development the findings supported the validity of the long-established standard of Streeter. Since the current study has been based on apparently normal gestations of healthy women, whereas earlier data had rested, to a great extent, on spontaneously aborted and extopic embryon and fetuses, it seems evident that pathological specimens are not suitable for the purpose of establishing reliable standards of normal intrauterine growth rate. The present data support the suggestion, based on various experimental and clinical observations, that pathological gestations often result from abnormal ovulations that occur at times other than the mid-cycle and that such conceptions are frequently followed by a bleeding episode that simulates menstruation. It is likely that the inclusion of a high number of such cases biased the results of earlier investigations concerning embryonic growth rate on account of the frequent incidence of erroneous menstrual histories. The material available did not permit the extension of the investigation beyond the 20th week of gestation. It appears, however, that the average growth rate in the mid-trimester may be slower than the data adopted by the American Academy of Pediatrics would indicate. The possible causes of some phenomena observed in the course of the investigation, such as unexplained scatter of growth-rate patterns at all developmental stages and discrepancies among various literary data, have been discussed in some detail. While a tentative attempt has been made to correlate the investigated parameters of fetal growth with biparietal diameters of the head, a measurement accessible to direct assessment by sonography during pregnancy, the necessity of improving these standards through a prospective study has been emphasized.

Abortion, Therapeutic↗