On the front line. Interview by Chris Serb.
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Attitude↗
Biomedical subjects
S Ambrose
Publications and source records attributed to S Ambrose.
Pregnancy in women with end-stage renal disease: treatment of anemia and premature labor.
There is little experience with the use of various therapies in the end-stage renal disease patient who becomes pregnant. Erythropoietin for the treatment of anemia has become part of the standard treatment regimen of dialysis patients, but experience with its use in pregnancy is limited. We report five cases of its use in dialysis patients during pregnancy. We found no evidence that it crossed the placenta or that it made blood pressure control more difficult. We found that patients required a higher dose of erythropoietin to maintain hematocrit levels than they had before pregnancy. Another therapy involves the treatment for premature labor, which is the most common cause of pregnancy loss in dialysis patients. Two of our patients were successfully treated with indomethacin for premature labor. Both drugs are useful tools in the management of pregnant dialysis patients.
Abnormalities, Drug-Induced↗
Locoregional disease.
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Combined Modality Therapy↗
Survival following intestinal obstruction in ovarian cancer.
A retrospective survey of 38 ovarian cancer patients who developed radiologically confirmed intestinal obstruction was performed. Twenty-six patients underwent surgery. In the surgical treatment group, obstruction was not due to recurrent disease in six cases. The median survival for the group as a whole was 56 days. Patients in the operative group survived significantly longer than those in the non-operative group. There was an operative mortality of 15% and major postoperative morbidity was seen in 42%. Neither the site of the obstruction nor the type of operation influenced survival. No postoperative chemotherapy responses were seen in previously treated patients.
Adult↗
Outpatient measurement of perineal descent.
One hundred and fifty-eight consecutive patients attending a rectal clinic have undergone measurement of perineal descent at rest and during straining by a simple noninvasive method. In nine patients (5.7%) the perineum was assessed as being below the ischial tuberosities at rest, whilst a further nine patients (5.7%) had abnormal descent (greater than 2.5 cm) during straining. Sixteen of the 18 patients with abnormal descent at rest or on straining were female and in ten (56%) a diagnosis of haemorrhoids was made at the initial clinic attendance. Parity of four or more was associated with a greater degree of descent during straining (P less than 0.05) than in women having a single pregnancy only.
Adolescent↗
William T. Sherman.
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History, Modern 1601-↗