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Biomedical subjects

W A Growdon

Publications and source records attributed to W A Growdon.

15 recordsLinked to original sources
PubMed1990

Clavicle fractures in the newborn.

A retrospective review of 21,632 live births from January 1982 to July 1987 was performed to determine the incidence and risk factors associated with fractures of the clavicle in the newborn. Fifty-eight fractures (57 patients) were identified, for an incidence of 2.7 clavicle fractures per 1000 live births. Fractures of the clavicle were associated with heavy neonates and shoulder dystocia. Three patients had concurrent clavicular fractures and Erb's palsy. These findings suggest that the incidence of clavicle fractures in the newborn may be reduced by identifying the macrosomic fetus and by minimizing shoulder dystocia. When clavicle fractures occur, a brachial plexus injury should be ruled out.

Apgar Score↗
PubMed1990

Childhood anogenital lichen sclerosus. A case report.

Childhood lichen sclerosus is a rare disorder. A 4-year-old girl with chronic vulvar pruritus who was initially suspected to be the victim of child abuse was treated. Vulvar biopsy was performed, confirming the diagnosis of lichen sclerosus. The child was treated with 2% progesterone cream, with complete resolution of her pruritic symptoms and signs of traumatic injury to the vulvar skin. The basic condition, lichen sclerosus, has persisted.

Administration, Topical↗
PubMed1988

The clinical implications of retroperitoneal endometriosis.

Over the past 10 years five patients with endometriosis involving only retroperitoneal structures in the pelvis without intraperitoneal involvement have been managed at the University of California-Los Angeles Hospital. These patients have presented difficult diagnostic and therapeutic problems. Moreover, this interesting but uncommon distribution of the disease has led to speculation concerning its pathogenesis. The substantial threat to the urinary tract and rectosigmoid colon is noted. Although a concurrent study at this hospital indicates a low incidence of endometriosis involving pelvic lymph nodes, it is quite apparent from the distribution of these instances of retroperitoneal involvement that its spread from the endometrium very likely takes place through pelvic lymphatics.

Adult↗
PubMed1986

Suppression of recurrent genital herpes simplex virus infection with recombinant alpha 2 interferon.

This double-blind, placebo-controlled study evaluated the efficacy and safety of sc administered recombinant alpha 2 interferon (IFN-alpha 2) in the suppression of frequently recurrent genital herpes simplex virus (HSV) infection. Seventy-six otherwise healthy subjects who had eight or more recurrences during the preceding year received 1 X 10(6) IU of IFN-alpha 2, 3 X 10(6) IU of IFN-alpha 2, or placebo three times per week for 12 weeks. Recipients of the higher dose of IFN-alpha 2, had fewer outbreaks during the study (2 vs. 3), a shorter period of viral shedding (2 vs. 4 days), less itching (1 vs. 3 days), and a faster healing time (6 vs. 8 days). The lower dose of IFN-alpha 2 was not effective. Significant side effects (fever, malaise, myalgia, fatigue, and arthralgia) occurred after the first injection of 3 X 10(6) IU of IFN-alpha 2 in 91% of the subjects, but subsequent injections produced only mild and intermittent side effects that were well tolerated. Mild leukopenia was noted in subjects treated with IFN-alpha 2. Treatment with IFN-alpha 2 resulted in moderate suppression and decreased duration of recurrent genital HSV infection in patients with frequent recurrences.

Adult↗
PubMed1986

Adverse effects of pregnancy on multifocal eosinophilic granuloma.

An unusual case of a patient diagnosed as having the histiocytic proliferative disorder characterized by the lesion eosinophilic granuloma (histiocytosis X) is presented. Fifteen-year follow-up revealed a progression from a solitary eosinophilic granuloma of the bone to multifocal involvement of many body structures including the vulva, vagina, and cervix. This progression occurred after nine asymptomatic years and was temporally related to the patient's first pregnancy. After successful treatment and remission, rapid appearance and growth of observable genital lesions were noted during a second pregnancy. Pregnancy termination in the first trimester was advised due to signs of dissemination and local symptoms.

Abortion, Therapeutic↗
PubMed1986

Modified Pereyra procedure under local anesthesia.

The modified Pereyra procedure, a retropubic urethropexy for the correction of anatomic stress urinary incontinence represents a safe, rapid, and well-tolerated technique for restoration of the normal retropubic position of the urethrovesical junction in selected patients. When general or regional anesthesia seem contraindicated due to age, medical risk, or anatomic factors, the procedure may be performed satisfactorily under local anesthesia. Of ten patients who underwent this procedure, nine reported excellent tolerance of the local technique. The postoperative hospital stay averaged three days. The average time from the injection of anesthesia to the termination of the surgical procedure was 45 minutes. Results were successful in 90%. This dependable surgical procedure for the correction of anatomic stress urinary incontinence may be performed in selected patients under local anesthesia with a high degree of patient tolerance.

Aged↗
PubMed1985

Pruritic vulvar squamous papillomatosis: evidence for human papillomavirus etiology.

The origin of squamous papillae of the vulvar vestibule is controversial. Although some are considered as asymptomatic normal variants of pelvic anatomy, a review of 12 cases of vulvar squamous papillae in patients visiting the Infectious Diseases Clinic at UCLA reveals a distinctly symptomatic variety. A syndrome complex of premonitory vulvar vestibular pruritus, pain or burning, dyspareunia, and progressive development of squamous papillae was noted. Microscopic examination of tissue specimens of the areas of squamous papillae reveals the presence of koilocytic change suggestive of viral infection with human papillomavirus. Furthermore, immunoperoxidase stain revealed human papillomavirus capsid antigen in two cases, which has heretofore not been reported in the literature to the authors' knowledge. Evidence of partner infection on physical examination of sexual partners of these women revealed changes consistent with human papillomavirus in four of six partners who were available for examination. Treatment with podophyllin, cryotherapy, laser, or a combination seems to give predictable resolution of the condition and associated symptoms.

Adolescent↗
PubMed1982

Pubourethral supports in perspective: modified pereyra procedure for urinary incontinence.

The present study supports the thesis that failures in urethral suspensory-type operations in women with anatomic stress urinary incontinence often are caused by pull-out of suspensory sutures attached to attenuated endopelvic fascia around the urethrovesical junction. Thickening of this fascia helps impede suture pull-out. Such thickening is facilitated by detaching the fascia from the pubis to enfold it. Freeing the fascia from the inferior pubis exposes the posterior pubourethral ligaments to direct view. Binding the much stronger posterior pubourethral ligaments and enfolded fascia together with the suspensory sutures provides maximum resistance to suture pull-out. Of 54 women treated with this modified Pereyra procedure as a primary operation for anatomic stress urinary incontinence, 94.5% showed complete cure or marked improvement 4 to 6 years postoperatively.

Adult↗
PubMed1979

Urinary tract endometriosis: enigmas in diagnosis and management.

The diagnosis and management of endometriosis presents several enigmas. This review, of eight patients with endometriosis involving the urinary tract, from three large clinical services in the City of Los Angeles, highlights some very difficult problems. Not only diagnostic errors but also inappropriate conservatism and inadequate surveillance have led to compromised function, resection, and/or destruction of the kidneys, ureters, or bladder. The series indicates those findings which are likely to result in urinary tract destruction and points out those clinical situations in which delays or conservative management must be undertaken only with pressing indications and then only with continued and careful surveillance.

Adult↗
PubMedDate not supplied

Neonatal herpes simplex virus infection occurring in second twin of an asymptomatic mother. Failure of a modern protocol.

A case of neonatal herpes that occurred after vaginal delivery in the absence of genital lesions is presented. The mother had a history of drug addiction and genital herpes. Asymptomatic shedding of herpes simplex virus type 2 from the cervix was noted in the second trimester of pregnancy. Despite being followed with a protocol of close surveillance and serial culturing of the genital tract, the patient gave birth to twins, one of whom developed herpes simplex virus type 2 in the postpartum period. This report presents discussion of this case and herpes surveillance protocols.

Adult↗