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Biomedical subjects

S Trout

Publications and source records attributed to S Trout.

10 recordsLinked to original sources
PubMed1996

Ovulation induction combined with intrauterine insemination in women 40 years of age and older: is it worthwhile?

The use of ovulation induction combined with intrauterine insemination (IUI) as a treatment for subfertility in women with patent Fallopian tubes has increased in recent years. Little is known regarding the efficacy of this treatment in women aged >/=40 years. We reviewed our data in our ovulation induction with IUI programme for 168 consecutive patients aged >/=40 years undergoing a total of 469 cycles of treatment. Either sequential clomiphene citrate and human menopausal gonadotrophins or daily gonadotrophins were utilized along with timed IUI insemination. In 402 completed cycles, 28 clinical pregnancies occurred. The pregnancy loss rate was 34.4%. The overall ongoing/viable pregnancy rates per initiated and completed cycles were 4.47 and 5.22% respectively. No viable pregnancies occurred in 136 cycles in women aged >/=43 years. The ongoing/variable cycle fecundity rates for women aged 40, 41, and 42 years were 9.6, 5.2, and 2.4% per cycle respectively. When utilized in women aged >=40 years, ovulation induction with IUI is most likely to result in successful pregnancy in women 40-42 years of age. Women >/=43 years should consider other alternatives such as adoption or egg donation.

Adult↗
PubMed1995

Reversible alopecia after single-dose methotrexate treatment in a patient with ectopic pregnancy.

OBJECTIVE: To report a case of a women who received a single 50 mg/m2 dose of methotrexate (MTX) on two occasions for two separate ectopic pregnancies. After both treatments the patient experienced reversible alopecia. DESIGN: Case report. SETTING: Single human patient in a university-run clinic. PATIENTS: A patient with an ectopic pregnancy presenting for treatment on two separate occasions. INTERVENTIONS: A single dose of 50 mg/m2 MTX given to the patient on both occasions. MAIN OUTCOME MEASURE: Loss of scalp hair. RESULTS: On two separate occasions the patient lost a significant portion (33% to 50%) of her scalp hair. CONCLUSION: Even single-dose MTX as used for the treatment of ectopic pregnancy may induce alopecia in a susceptible patient.

Adult↗
PubMed1994

Can We predict patients at risk for persistent ectopic pregnancy after laparoscopic salpingotomy?

To identify factors that may predict patients at increased risk for persistent ectopic pregnancy after linear salpingotomy, we analyzed demographic, surgical, and biochemical variables retrospectively in 60 women who underwent laparoscopic linear salpingotomy, and compared data in those who developed persistent ectopic pregnancy (study group) versus those who were cured (controls). The two groups were similar with respect to demographic features and surgical findings. They did not differ significantly in gestational age and human chorionic gonadotropin (hCG) levels at time of surgery. There was, however, a significant difference in hCG dynamics when the average daily increase in the week before surgery was analyzed. Eleven (18%) women developed persistent ectopic pregnancy. The disorder did not occur in those whose hCG levels were flat or declining, whereas patients whose levels increased more than 40% per day had a significantly greater risk. In addition, at surgery, tubal bleeding was significantly more common in study patients than in controls (55 vs 9%, p <0.001). We conclude that hCG dynamics in the week before salpingotomy, and bleeding activity at surgery may identify patients who are the most likely candidates for persistent ectopic pregnancy.

Adult↗
PubMedDate not supplied

The use of biobrane II and specialty airflow beds (FluidAir Plus and Kinair for effective coverage of extensive posterior donor site wounds.

Posterior skin graft donor sites furnish large areas of skin for wound coverage, but the sites frequently are management problems. The wounds tend to become moist and to develop excessive drainage and fluid accumulation that may interfere with adherence of dressings, including our preferred donor site dressing, Biobrane II (red label, large pore). We studied the use of specialty airflow beds for improving the outcome of posterior donor sites. We evaluated 50 patients aged 1 to 69 years (mean 29.45 years) with posterior skin graft donor sites of the back, thigh, or buttocks that were covered with Biobrane II. Sites ranged in size from 3% to 13% body surface area (mean 8.34%). Forty patients were placed on a FluidAir Plus bed, and 10 were placed on air-filled pillow therapy beds (five on KinAir III, five on Therapulse) (Kinetic Concepts, Inc.) All patients were kept in the supine position. We evaluated six criteria: drainage, fluid accumulation under Biobrane, infection, days until Biobrane separated, days until epithelialization, and days of specialty bed usage. We related these criteria to nursing-care actions that interfere with airflow and prevent the drying action of the bed, such as use of a "linen saver" under the patient in the area of the donor site, a foam wedge under the back, and dressings applied over the Biobrane. Most donor sites had no complications. Donor site infections developed in six patients. Five of these patients had fluid accumulation under the Biobrane, necessitating early removal. Fluid accumulated under the Biobrane in 21 patients; nine of these incidences were related to a nursing-care action that impeded airflow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Home health care and burn care: an educational and economical program.

Changes in health care reimbursement have challenged providers of health care to work smarter instead of harder, with more efficient and effective use of resources. Patients with burn injuries remain hospitalized for dressing changes that could be completed in the home environment by health care professionals. An early discharge for a select group of patients from a resource-intensive hospital stay to a quality, cost-effective home care program was achieved. An educational program was developed to provide home care nurses the necessary knowledge and skill to care for the patient with burn injuries at home. This program combines didactic classroom lectures with a clinical orientation for home care registered nurses. The outcome for patients is a well-integrated continuity of care with a decreased length of hospital stay.

Algorithms↗
PubMedDate not supplied

Influence of head and neck position on endotracheal tube tip position on chest x-ray examination: a potential problem in the infant undergoing intubation.

Complications related to endotracheal tubes are frequent in small children and infants. We report a case of a burned 12-month-old child in whom frequent manipulation of the endotracheal tube was required because of recurrent atelectasis and changing position of the endotracheal tube on chest x-ray film. It was then determined that because of variations in head and neck position while chest x-ray films were obtained, the endotracheal tip changed position in the trachea greater than 2.7 cm (greater than 1 inch), although endotracheal tube position was maintained at the level of the teeth. Airway care and gas exchange were subsequently improved by ensuring that patient care and chest x-ray films were performed with the head and neck in similar (neck slightly flexed, head neutral) position.

Bronchial Spasm↗