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Biomedical subjects

M Saks

Publications and source records attributed to M Saks.

14 recordsLinked to original sources
PubMed2003

Bringing together the orthodox and alternative in health care.

This paper charts the developing historical relationship between orthodox and alternative medicine in Britain, focusing on the work of health practitioners. It begins by defining the concepts of orthodox and alternative medicine, noting that this was not really a meaningful distinction until the mid-nineteenth century with the rise of the medical profession. Before this time there was a relatively undifferentiated playing field. Thereafter doctors gained state-underwritten professional standing, with alternative therapists becoming increasingly marginalised by the mid-twentieth century. However, in the wake of the medical counterculture of the 1960s and 1970s there has been growing public interest in alternative medicine coupled with an associated increase in the numbers of its practitioners, particularly in the private sector. Despite initial resistance, alternative medicine has now gained greater acceptance by medical orthodoxy. The paper concludes by considering how orthodox and alternative health care can be brought together in more integrated fashion in the future-for the benefit of the wider public.

Attitude to Health↗
PubMed2002

Comparison of transvaginal ultrasound, hysteroscopy, and dilatation and curettage in the diagnosis of abnormal vaginal bleeding and intrauterine pathology in perimenopausal and postmenopausal women.

STUDY OBJECTIVE: To compare transvaginal ultrasound, hysteroscopy, and dilation and curettage (D&C) in the evaluation of women with perimenopausal and postmenopausal bleeding. DESIGN: Descriptive study (Canadian Task Force classification II-1). SETTING: Seven outpatient clinics. PATIENTS: One thousand two hundred eighty-six women. INTERVENTION: Transvaginal ultrasound, hysteroscopy, and D&C. MEASUREMENTS AND MAIN RESULTS: Of our patient population, 29 (2.26%) had a histologic diagnosis of endometrial carcinoma; in 2 of them (7.14%) endometrial thickness was 5 mm or less. In 10 women (34.5%), endometrial carcinoma was missed by hysteroscopy (sensitivity 65.52%, specificity 99.92%). Complication rate of D&C was 1.4%. CONCLUSION: In women with perimenopausal and postmenopausal bleeding neither transvaginal ultrasound nor hysteroscopy as a single diagnostic tool is suitable to rule out endometrial cancer.

Dilatation and Curettage↗
PubMed1997

Alternative therapies: are they holistic?

This paper discusses the extent to which alternative therapies are distinctively holistic. It begins by defining what is meant by 'alternative therapies' and 'holism'. In this process, alternative medicine is contrasted with the biomedical basis of orthodox medicine; the critique of which has led to the development of contemporary notions of holistic practice. The historical background to the holistic health movement is then charted with reference to the rise of the medical profession, which has become increasingly unified around biomedicine. The largely holistic nature of alternative health care today is illustrated by case studies of specific alternative therapies and their practice contexts. However, it is argued that not every aspect of alternative medicine can be seen as holistic, nor should it be assumed that all elements of orthodox practice are non-holistic. The paper concludes by emphasizing the opportunities that exist for nurses and other allied professionals to become more involved with alternative therapies in order to extend their holistic approach to health care.

Complementary Therapies↗
PubMed1996

Ambulatory Gynecologic Surgery

A retrospective study evaluated the feasibility and safety of operative gynecologic procedures performed in an ambulatory surgical center. Between July 1993 and December 1995, 5766 women (mean age 36.9 yrs, range 13-95 yrs) who were referred to our center underwent surgery. The most common preoperative diagnoses were dysfunctional bleeding, missed abortion, postmenopausal bleeding, cervical dysplasia, mullerian duct malformation, infertility, endometriosis, adhesions, desire for sterilization, adnexal mass, lower abdominal pain, ectopic pregnancy, and fibroids. A total of 2351 laparoscopies, 2 laparotomies, and 3415 vaginal procedures were performed. The most common procedures were dilatation and curettage, 1455; hysteroscopy, 1051; adnexal surgery, 810; tubal ligation, 679; abdominal myomectomy, 186; operative hysteroscopy, 145; and cone biopsy, 118. The duration of surgery was 10 to 210 minutes. Most patients (99.51%) were discharged between 2 and 8 hours after surgery. Only 28 (0.49%) had to be admitted to the hospital; 18 women had preoperatively planned admissions and 10 were unexpectedly admitted postoperatively. The intraoperative and postoperative complication rate was 0.50% (29). We believe that ambulatory surgery is safe and efficient with proper patient selection and when the surgeon and the anesthetist have significant expertise.

Journal Article↗
PubMed1994

Comparison of minimally invasive surgery and laparotomy in the treatment of adnexal masses.

STUDY OBJECTIVE: To compare the outcome of laparoscopic treatment of adnexal masses with treatment by laparotomy. The procedures, their duration, and associated complications also were evaluated. DESIGN: Women were randomized to undergo either procedure based on the ward to which they were admitted. SETTING: A university teaching hospital. PATIENTS: The 192 patients were admitted with a preoperative diagnosis of adnexal mass. INTERVENTIONS: Surgical procedures were cystectomy, salpingectomy, oophorectomy, and unilateral or bilateral salpingo-oophorectomy. Organ-preserving techniques were used wherever possible. All tissue specimens were examined histologically. MEASUREMENTS AND MAIN RESULTS: The mean duration of surgery was statistically not significantly different between the groups, 96.8 minutes for minimally invasive surgery, and 116 minutes for laparotomy. Organ preservation did reach statistical significance at 65.7% and 17.2% respectively (p <0.001). Postoperative morbidity was statistically lower in patients undergoing minimally invasive procedures. Preoperative tumor marker levels did not correlate well with postoperative histology. One woman in the laparotomy group had histologically proved ovarian cancer. Minimally invasive surgery was converted to laparotomy in three patients in whom malignancy was suspected at the start of operation. CONCLUSIONS: Laparoscopic management of adnexal masses has definite advantages over laparotomy, for example, lower postoperative morbidity. In addition, intraoperative endoscopic diagnosis is highly accurate, and the frequency of unnecessary procedures is lower.

Adolescent↗
PubMed1994

Laparoscopic Treatment of Benign Ovarian Dermoid Cysts

Forty-four women underwent laparoscopic surgery for treatment of 49 benign dermoid cysts in 1992 and 1993. Four patients presented with bilateral ovarian masses and one patient had two teratomas within one ovary. In the majority of cases (78.9%) the correct diagnosis was made preoperatively by pelvic examination and vaginal ultrasound. The average tumor size was 5.5 cm, ranging from 1 to 11 cm. Preservation of the ovary was achieved in most cases (40/81.6%). Uni- or bilateral adnexectomy was the treatment of choice in all postmenopausal women (5); in the remaining four patients salpingo-oophorectomy was performed due to torsion of a cyst (1), extensive adhesions (1) and large tumor size (2). CA 19-9 levels were elevated in 11 out of 20 patients, reaching a maximum value of 3,400 U/ml. No severe complications were encountered: two patients developed fever postoperatively, one of whom was suspected of having a chemical granulomatous peritonitis. We conclude that laparoscopic management of benign dermoid cysts is safe and effective and can therefore be highly recommended.

Journal Article↗
PubMed1993

Laparoscopic therapy for tubal pregnancy using prostaglandins.

Nineteen patients with confirmed tubal pregnancy and constant or rising plasma beta-human chorionic gonadotropin (beta-hCG) levels were treated with laparoscopically guided injection of prostaglandin F2 alpha into the oviduct. Fifteen patients received additional prostaglandin E2 during three consecutive postoperative days. One patient was excluded from the study. The treatment was defined as successful when plasma beta-hCG levels declined below the lower detection limit and no further intervention other than prostaglandin application was required. The treatment was successful in 12 patients (66.7%). Given a beta-hCG level greater than 2,500 mU/mL as an exclusion criterion for treatment with prostaglandin, the success rate was 84.6%. Six patients underwent salpingotomy because of rising beta-hCG levels following treatment. The outcome was not related to the postoperative treatment with prostaglandin E2. None of the treated patients displayed any adverse reactions following prostaglandin F2 alpha application. Postoperative hysterosalpingography was performed on six successfully treated patients, demonstrating bilaterally patent fallopian tubes in all of them. Prostaglandin therapy in tubal pregnancy has been proven effective in selected cases.

Chorionic Gonadotropin↗
PubMed1989

Synergistic effects of cis-platinum and cytosine arabinoside on ovarian carcinoma cell lines, demonstrated by dual-parameter flow cytometry.

Ovarian cancer tends to remain confined to the peritoneal cavity even after widespread dissemination. In order to test the in vitro cytotoxic effect of cis-platinum (CP) and cytosine arabinoside (ara-C), a combination which, in theory, is particularly suitable for intraperitoneal (IP) administration, ovarian cancer cells were exposed to each drug alone and in combination and then sampled serially for 336 hr with cell counts and flow cytometry (FCM). We used dual parameter FCM analysis to study changes in DNA and nuclear protein simultaneously. There was good correlation between the degree of cell kill noted in the counts and the duration of observed cytokinetic disturbances in all the treated series. CP and ara-C alone produced temporary cytotoxic and cytokinetic changes. Together, the two agents produced an enhanced CP effect which lasted 336 hr and was accompanied by continued evidence of cell kill in the counts. We conclude that CP and ara-C in vitro act synergistically on ovarian cancer to achieve a high level of cell kill after a single simultaneous application.

Cell Count↗