PubMed Health⌕ Search

Biomedical subjects

R V Zwaag

Publications and source records attributed to R V Zwaag.

7 recordsLinked to original sources
PubMed1991

Class II radical hysterectomy shows less morbidity and good treatment efficacy compared to class III.

Treatment of 102 patients with cancer of the cervix by class II and III radical hysterectomy was reviewed to compare the operative morbidity and efficacy of class II radical hysterectomy for select cases. Of the 102 patients, 21 had a class II hysterectomy, whereas 81 patients had a class III hysterectomy. The class II operation was performed for those subjects in whom invasive cancer beyond microinvasion could not be excluded after a cone biopsy. The mean age and weight of women having class II and III radical hysterectomies were nearly identical (41.1 and 40.6 years, respectively, and 66 and 65 kg, respectively). However, the mean operative time (3.8 and 4.7 hr, respectively; P = 0.001) and postoperative hospital stay (7.3 and 9.2 days, respectively; P = 0.001) were lower for class II than for class III hysterectomies. No fistulas or recurrent cancer developed following class II hysterectomy, and no patients had metastatic cancer in the nodes or parametrium. Among the 81 women undergoing class III hysterectomy, there were 3 fistulae and 3 recurrences. We conclude that the lesser morbidity, including shorter operative time and shorter postoperative hospital stay and excellent cancer control of the class II radical hysterectomy and lymphadenectomy, recommend the operation for selected early cancers of the cervix especially when a question concerning depth of invasion exists after cone biopsy.

Adult↗
PubMed1988

Subtle appearance of pelvic endometriosis.

This retrospective study demonstrates an increased documentation of subtle appearances of endometriosis. This documentation was associated with an increased emphasis on excising these lesions for histologic examination. Endometriosis was documented in pink, clear, red, white, and puckered black lesions in 106 (97%) of 109 patients. This included 22 (100%) of 22 patients undergoing laparotomy and 84 (97%) of 87 patients undergoing laparoscopy. Subtle lesions were documented at laparoscopy in 32% of patients in the first 5 months and in 72% of patients in the last 5 months of the study. The increased documentation of these subtle lesions appeared to be related to an increased awareness and anticipation of subtle lesions. The ability to detect such lesions increased with experience and was reinforced by histologic confirmation.

Endometriosis↗
PubMed1986

[Density of rapid eye movements during active sleep in preterm newborn infants].

Rapid eye movement (REM) density has been helpful as a reliable index of phasic eye movements activity during REM (active) sleep in adults. We evaluated this index in 28 newborns, at 34 to 39 weeks of conceptional age (CA). The 5 hours polysomnographic recording during sleep included electroencephalogram, electrooculogram, electrocardiogram, pneumogram, nasal thermistor for detecting airflow, and continuous oxygen saturation (tcPO2) monitoring. REM density was measured by two distinct criteria: REM density as the duration of phasic eye movements in relation to REM periods (REMP). Such index varied from 10.6 to 14.1% and was higher in the 36-37 weeks CA group. REM density was calculated as a percentage of 10-second epochs of REM sleep in which phasic eye movements occurred. This criterion confirmed the narrow range of such index in this age bracket (39.9-44.6%), was higher in the first REMP and in the 36-37 weeks CA group. Our data suggest that REM density is a consistent phasic REM sleep feature in preterm newborns with levels close to the adult population, in spite of the gradual decrease of REM sleep duration with age. Higher indices were also found in the first REMP and in the 36-37 weeks CA group by both methods.

Female↗
PubMed1978

Significance of hemolytic streptococci for Nashville school children: clinical and serologic observations.

The results of this study (1969-1971 confirm previous findings that incidence rates for hemolytic and group A streptococci in Nashville school children fluctuate sporadically. During these two years, there was a significant decrease in streptococcal incidence and in typability of group A streptococci. A positive throat culture was not associated significantly more often with symptoms of an infection of the upper respiratory tract than when symptoms were absent. The larger the number of group A streptococci present in the throat culture, the more likely was a streptococcal antibody increase to occur. Nevertheless, some children with small numbers of group A streptococci had an antibody increase, and the degree of positivity of the throat culture was not a very accurate indication of whether an antibody response would occur. Epidemiologic factors such as age, sex, race, or crowding in the home did not seem to play a highly significant role in rates. Seasonal influences were marked in 1969-1970 but not in 1970-1971. Regarding socioeconomic background, the rates were consistently lower in Clemons school, which serves a predominantly black neighborhood of higher socioeconomic level, than in the other two schools. Our findings confirm that the incidence of acquisition of the hemolytic streptococcus is a continually changing, dynamic process among school children.

Antibodies, Bacterial↗
PubMedDate not supplied

The Memphis diabetes continuing care program.

Since 1963 a network of nurse-operated, physician-backed decentralized clinics has provided continuing care for more than 5000 diabetic patients referred from the medical center clinics. Protocols that provide therapy goals and management details are used by the nurses and nutritionists in this network. To reduce fragmentation of care, intercurrent illnesses as well as other chronic diseases are treated using protocols in these clinics or in the home. This study examines certain outcome data in a subset of 556 diabetic patients under continuing care over a 7-yr period in this network, with comparisons being made to care before referral. Blood glucose is maintained at comparable levels in both decentralized and hospital clinics. Blood pressure levels in hypertensive patients are maintained in a satisfactory range. Total hospitalization rates are reduced by 47%. For ketoacidosis and amputation, hospitalization is decreased by 69% compared with the experience before referral. The maintenance care costs are decreased substantially compared with costs before referral due to the less expensive ambulatory services and the reduced need for hospitalization. The data support the concept that decentralization is an effective means of providing continuing care to patients with diabetes mellitus.

Ambulatory Care↗