Biomedical subjects

S D Spandorfer

Publications and source records attributed to S D Spandorfer.

22 records · Page 2Linked to original sources

PubMed1996

Efficacy of frozen-section evaluation of uterine curettings in the diagnosis of ectopic pregnancy.

OBJECTIVE: This study was undertaken to examine the accuracy of frozen section for the identification of products of conception on curettage of patients undergoing surgery for suspected ectopic pregnancy. STUDY DESIGN: A retrospective analysis of 87 consecutive cases in which frozen-section assessment of an endometrial curettage specimen to identify products of conception was undertaken. A frozen-section diagnosis was considered correct if the final diagnosis concurred with the findings at frozen section. RESULTS: Eighty-one of 87 (93.1%) specimens were correctly identified at frozen section. Frozen section had a sensitivity of 78.3% and a specificity of 98.4%. The positive predictive value of frozen section in this population was 94.7% and the negative predictive value was 92.6%. No significant correlation was found regarding the attending pathologist at frozen section, preoperative human chorionic gonadotropin, or time of day at frozen section. CONCLUSIONS: Frozen section is accurate for the identification of products of conception on endometrial curettage in the evaluation of a suspected ectopic pregnancy.

Chorionic Gonadotropin↗

PubMed1996

Pregnancy outcome in active duty seagoing women.

The effect of working on the outcome of pregnancy has been previously addressed. Very few studies have looked at the effect of specific work conditions on pregnancy, and to our knowledge no studies have reviewed the pregnancy outcomes of women stationed on-board a submarine tender. In order to study the pregnancy outcomes of such women, we performed this study. All women (N = 140) who delivered in the 18 months between February 1991 and August 1992 and were stationed on-board either the USS E.S. Land or the USS Hunley were studied. Their pregnancy, delivery, and newborn records were reviewed. These women received excellent prenatal care. However, many risk factors were identified that were much higher than national averages. We conclude that pregnant sailors stationed on-board submarine tenders are at high risk for certain adverse pregnancy outcomes. Further studies are needed to determine if this difference persists when sailors at sea commands are compared to sailors stationed at shore commands.

Adult↗

PubMed1996

Postcesarean endometritis. Clinical risk factors predictive of positive blood cultures.

OBJECTIVE: To identify peripartum risk factors that are predictive of positive blood cultures in patients with postcesarean endometritis. STUDY DESIGN: A retrospective review of 179 patients diagnosed with postcesarean endometritis was conducted. Patients with positive and negative blood cultures obtained at the time of diagnosis were compared. Patient's charts were reviewed for intrapartum, intraoperative and postpartum factors. Chi-square and nonpaired Student's tests were used when appropriate, with P < .05 considered significant. RESULTS: During this period, 179 (20%) postcesarean patients developed endometritis. One hundred sixty-eight (94%) of those patients had blood cultures. Eleven (6.5%) were positive; however, one of these grew a skin contaminant and was disregarded. When patients with positive blood cultures were compared to those with negative blood cultures, length of labor, number of vaginal examinations, postoperative day when the diagnosis was established, estimated blood loss at the time of cesarean delivery, presence of intrapartum chorioamnionitis, number of hours of ruptured membranes, white blood cell count at the time of diagnosis, use of prophylactic antibiotics, development of wound infection or other infectious etiologies were not shown to be predictive. There were no positive blood cultures among patients with a temperature < 38.5 degrees C. At a temperature < 38.8 degrees C, 1/126 (0.79%) had a positive blood culture. At a temperature > or = 38.8 degrees C, 9/42 (21.4%) had a positive blood culture (P < .001). Approximately $5,890 was spent on obtaining positive blood cultures in patients with temperatures < 38.8 degrees C. In contrast, $218 was spent per positive blood culture obtained from patients with a temperature > or = 38.8 degrees C. CONCLUSION: The traditional practice of obtaining blood cultures at a temperature > or = 38.0 degrees C is not justified but elevating the threshold to 38.8 degrees C is equally effective and less costly.

Anti-Bacterial Agents↗

PubMedDate not supplied

The role of heat shock proteins in reproduction.

Heat shock proteins (HSP) were first identified in cells after exposure to elevated temperature. Subsequently HSP have been identified as a critical component of a very complex and highly conserved cellular defence mechanism to preserve cell survival under adverse environmental conditions. HSP are preferentially expressed in response to an array of insults, including hyperthermia, free oxygen radicals, heavy metals, ethanol, amino acid analogues, inflammation and infection. HSP interact with intracellular polypeptides and prevent their denaturation or incorrect assembly. In addition HSP are also involved in several processes essential for cellular function under physiological conditions. HSP production is enhanced during in-vitro embryo culture and they are among the first proteins produced during mammalian embryo growth. The spontaneous expression of HSP as an essential part of embryo development is well documented and the presence or absence of HSP influences various aspects of reproduction in many species. Finally, HSP are immunodominant antigens of numerous microbial pathogens, e.g. Chlamydia trachomatis, which have been recognized as the main cause of tubal infertility. Many couples with fertility problems have had a previous genital tract infection, have become sensitized to microbial HSP, and a prolonged and asymptomatic infection may trigger immunity to microbial HSP epitopes that are also expressed in man. Antibodies to both bacterial and human HSP are present at high titres in sera and hydrosalpinx fluid of many patients undergoing in-vitro fertilization (IVF). In a mouse in-vitro embryo culture model, these antibodies impaired the mouse embryo development at unique developmental stages. Recent studies indicate an association between a previous infection, immunity to HSP and reproductive failure.

Animals↗