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Results for “Pomeroy Method”

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PubMed1982

Minilaparotomy or laparoscopy for sterilization: a multicenter, multinational randomized study. World Health Organization, Task Force on Female Sterilization, Special Programme of Research, Development and Research Training in Human Reproduction.

A multicenter, multinational randomized comparison of minilaparotomy and modified Pomeroy tubal ligation and laparoscopy with tubal electrocoagulation for interval sterilization of women was conducted in eight centers. Results were analyzed for 791 women in the minilaparotomy group and 819 in the laparoscopy group. Major complications occurred in 1.5% of women in the former group and 0.9% in the latter. Technical problems or major anesthetic complications occurred in 0.5% of subjects undergoing minilaparotomy and 0.9% of subjects undergoing laparoscopy. For minor complications the figures were 11.6% and 6.0%, respectively, while for minor complaints the rates were 34.1% and 26.5%, respectively. It is concluded that the two methods of approach to the fallopian tubes are similar in their complication rates. Because of its more simple requirements in terms of equipment and training, minilaparotomy is the preferred approach for services provided away from a major institution.

Adult↗

PubMed1996

[Minilaparotomy tubal ligation in the immediate post-partum after vaginal delivery. A retrospective analysis of 253 cases in the maternity service of the Yaounde University Hospital Center (Cameroon)].

The authors report the results of a retrospective study of 253 cases of tubal ligation collected between January 1985 and December 1989 in the maternity unit of the Yaounde Teaching hospital. The tubal ligations were done through minilaparotomy with local anesthesia using the technique of Pomeroy. The frequency of tubal ligation evaluated at 3,8 per cent did not change during the period of this study. The authors note that the majority of patients in this study wished a tubal ligation only when they have 5 or more surviving children. We had no post-operative death, but our complication rate of 1,6 % can be improved upon by paying more attention to operative details. The authors conclude that because of poorly equipped medical infrastructures in the context of developing countries tubal ligation through minilaparotomy should be promoted as a contraceptive method in family planning programs.

Adult↗

PubMed2003

Magnetic resonance imaging of patched heterozygous and xenografted mouse brain tumors.

Experimental mouse models are emerging as useful systems for the study of human brain tumors. Nuclear magnetic resonance imaging (MRI) methods can noninvasively provide images of complex heterogeneous tissues such as experimental brain tumors. The current report demonstrates the feasibility of longitudinal high-resolution MRI in two mouse brain tumor models: patched heterozygous (ptc +/-) mice with spontaneously arising posterior fossa tumors that resemble human medulloblastoma, and homozygous nude mice implanted with intracerebral xenografts of human medulloblastoma cell lines. Methods were optimized to achieve favorable volumetric comparison with histologic methods and sub-millimeter resolution, improved by contrast enhancement with intravenous administration of a gadolinium-based agent. Results also show that experimental mice, even symptomatic mice, tolerate repeated serial imaging studies over weeks to months to follow tumor progression and to visualize placement of an intracerebral drug delivery system.

Animals↗

PubMed2002

Concept mapping assessment in medical education: a comparison of two scoring systems.

BACKGROUND: Concept mapping has the potential to measure important aspects of a student's evolving knowledge framework in a way that conventional examinations cannot. This is important because development of an elaborate and well-structured knowledge framework is a critical step toward becoming an expert in a particular field. Little is known about the best way to score concept maps in the setting of medical education. Therefore, as a preliminary step in addressing this question, we compared two different scoring systems for validity: a structural method based on the organization of a map's hierarchical structure and a relational method based, not on structure, but on the quality of each individual map component. METHODS: A total of 21 paediatric resident doctors completed concept map training, drew a preinstruction concept map about "seizures", completed a seizure education course, and then drew a postinstruction seizure map. Two raters using both structural and relational methods scored each map. RESULTS: Structural scores increased significantly after instruction and were higher in more experienced residents, but relational scores were not significantly different. Interrater scoring reliability for both methods ranged from moderate to strong, but was greater using the relational scoring method. CONCLUSIONS: These data suggest that scoring systems for evaluating concept maps in postgraduate medical education may need to account for structural features of maps, if scores are to reflect changes in the developing knowledge frameworks of resident doctors. More research to further evaluate reliability and validity is critical prior to any future use of concept mapping assessment in medical education.

California↗

PubMed1991

Detection of flaviviruses by reverse-transcriptase polymerase chain reaction.

RNA sequences of five flaviviruses were detected by a modified polymerase chain reaction (PCR) that incorporated a reverse transcriptase and RNase inhibitor. Oligonucleotide primer pairs were synthesized to amplify sequences from St. Louis encephalitis (SLE), Japanese encephalitis (JBE), yellow fever (YF), dengue 2 (DEN-2), and dengue 4 (DEN-4) viruses. The amplified products were visualized as bands of appropriate size on ethidium bromide-stained agarose gels. The identity of these products was confirmed by restriction endonuclease cleavage to generate fragments of predicted lengths. The reverse-transcriptase PCR (RT-PCR) successfully amplified flavivirus sequences from cell cultures, frozen brain tissue, and formalin-fixed, paraffin-embedded brain tissue. The reactions were highly specific, and the method compared favorably to two conventional assays of viral infectivity. RT-PCR followed by PCR with nesting primers (N-PCR) was 1,000-fold more sensitive in detecting virus than classical infectivity titration by intracerebral inoculation of suckling mice and nearly 1,000-fold more sensitive than amplification of virus in cell culture followed by inoculation of mice.

Aedes↗

PubMedDate not supplied

Anaesthesia for minilaparotomy female sterilization in JUTH, Nigeria: a fourteen-year review.

This is a retrospective study aimed at evaluating the various anaesthetic methods used for minilaparotomy female sterilization. During the fourteen-year period, 2913 clients had minilaparotomy female sterilization. Their mean age was 36.35 +/- 4.19 years. Mean number of living children was 6.82 +/- 1.64. 74.87% of the clients did not have any formal education, but were aware of other contraceptive options. In all 98.42% of the clients were married and in a stable relationships. Local anaesthesia with 1% xylocaine (10-20 mls) was used in 83.69% of the cases. Local anaesthesia with sedation in 13.53% and general anaesthesia in only 2.78%. Above 93.55% (2725) of the sterilization was carried out as an interval procedure, while 6.45% (188) were done postpartum. Pomeroy's technique was used in 96.98% of the tubal ligation. There was no mortality. The morbidity was vomiting and hallucination and it occurred in 0.20% amongst the clients who had sedation or general anaesthesia. Minilaparotomy under local anaesthesia for female sterilization has been found to be safe an effective outpatient procedure, and it is currently and established family planning option in our institution. The use of local anaesthesia alone gradually rose from 1987 up to date. The successful outcome was attributable to psychological and emotional preparation of the clients who also had to learn abdominal breathing exercises (for easy access to the fallopian tubes) from the trained personnel before the procedure.

Adult↗

PubMed2004

Factors influencing wear and osteolysis in press-fit condylar modular total knee replacements.

The purpose of this study was to determine the factors influencing wear and osteolysis in patients who have had total knee arthroplasty with the Press-Fit Condylar modular system. Two-thousand ninety-one primary total knee replacements in 1737 patients were done using the Press-Fit Condylar system at three centers. Radiographic and manufacturing data were obtained for 2016 of the 2091 implants (96.4%). For the 1287 of 2016 knees (64%) with more than 5 years of followup, the prevalence of wear-related failure was 8.3%. The 13-year survivorship for all patients was 82.6%. Cox hazards analysis revealed five variables that were correlated with wear-related failure: patient age, patient gender, polyethylene sheet vendor, polyethylene finishing method, and polyethylene shelf age. We were unable to identify one factor as the defining reason for these wear-related failures. The multiple changes in manufacturing methods during the life of this implant may have precluded such a determination. These results may be specific to inserts sterilized in air with gamma irradiation and should not be generalized to current manufacturing techniques. This study emphasizes the potential deleterious effects that small changes in the manufacturing process may have on the outcome of a prosthesis with an initially favorable survivorship.

Adult↗

PubMed1991

Enzyme-linked immunosorbent assay for the detection of Salmonella enteritidis infection in chickens.

An ELISA was developed and tested for its ability to detect antibodies against Salmonella enteritidis in chickens. Various features of the ELISA were evaluated and optimized. The outer membrane protein antigens selected by use of the protein immunoblotting method made the assay specific and sensitive. The assay was evaluated in chickens experimentally infected with S enteritidis. Blood samples collected at weekly intervals after experimental infection with S enteritidis were analyzed by ELISA. Results of the ELISA were compared with those of conventional serum plate and microagglutination tests. The ELISA was more sensitive and specific in the detection of S enteritidis infection than the other 2 conventional tests.

Animals↗

PubMed2003

Gene expression monitoring accurately predicts medulloblastoma positive and negative clinical outcomes.

Prediction of medulloblastoma clinical outcome is crucial to personalizing treatment, both to identify high-risk patients for aggressive or alternative therapy and to spare those at low risk from excessive treatment. The best predictors [Pomeroy et al. (2002) Nature 415, 436-442], based on gene expression monitoring at diagnosis, have shown much less accuracy in recognizing patients with eventual failed outcomes - <50% for the predictor making fewest total errors - than those who would survive, while a single gene predictor exhibited reverse asymmetry. Such inaccuracy in recognizing one of the outcomes is a problem for clinical use. We hypothesized that a non-linear model could be built to significantly improve prediction of medulloblastoma outcome, thereby promoting use of gene-expression-based predictors in a clinical setting. In fact, this approach resulted in fewer errors and much less asymmetry in prediction, and bidirectional accuracy of about 80% could be obtained via its combination with other methods. Indeed, three combinations of methods were identified that yielded significantly better predictions of clinical outcome than previously attained, making feasible predictors of medulloblastoma treatment response with greatly improved bidirectional accuracy essential for clinical use.

Cerebellar Neoplasms↗

PubMed1998

Preoperative hyperbaric oxygen therapy for radiation induced injuries.

PURPOSE: We present our experience with preoperatively administered hyperbaric oxygen therapy to patients who have sustained significant therapeutic radiation induced soft tissue injuries and subsequently undergo planned abdominal intervention/surgery. MATERIALS AND METHODS: From February 1993 to May 1997, 5 patients with a history of complications following therapeutic radiation were prospectively treated with hyperbaric oxygen before a planned abdominal operation. RESULTS: All patients had uneventful hospital courses. An additional procedure was eventually necessary in 2 patients but with fewer radiation related problems following hyperbaric oxygenation. CONCLUSIONS: Hyperbaric oxygenation may improve postoperative outcomes when given before planned open operations in patients with previous therapeutic pelvic irradiation and a history of radiation related complications.

Adult↗

PubMed1989

Strategies for ultrastructural visualization of biotinated probes hybridized to messenger RNA in situ.

A progressive development of the application of in situ methodology to ultrastructural procedures has resulted in the ability to detect individual molecules of mRNA with high probability. Beginning with whole-mount cells and then developing myotubes, both in culture and detergent extracted before fixation, we were able to progress to methods which allow detection of mRNA in tissue sections. Initial results confirm that the detection of mRNA in thin-sectioned tissue is very similar to observations on the extracted, cultured cells, and that the same methods of data analysis apply. Current work is devoted to the application of the methodology to other cellular structures, such as the nucleus, and to other tissue-probe systems, such as brain. Acknowledgements. The authors appreciate the skilled help from John McNeil and Shirwin Pockwinse in the laborious and time-consuming preparations of material and photography. FS was on sabbatical leave from the Department of Pathology at Southwestern Medical Center.

Animals↗

PubMed1982

Leukocyte migration inhibition in chickens inoculated with Salmonella typhimurium.

Leukocyte migration-inhibition tests were conducted in chickens infected with Salmonella typhimurium. A relatively new and simple method that involves the migration of leukocytes under agarose gel was used. Migration distance was projected onto a white background at 40X magnification, using a microprojector. Quantitation of migration was done by measuring the linear distance the cells had moved from the margin of the agarose wells. The details of the technique and the importance of it in studies of cell-mediated immune response are discussed. Chickens inoculated with S typhimurium had a significant leukocyte migration inhibition.

Animals↗

PubMed1979

Salpingitis associated with the presence of nonmedicated IUDs.

Fallopian tube tissue obtained at Pomeroy sterilization of 75 normally cycling women, 75 women 2 to 3 days postpartum, and 75 asymptomatic women who had used a nonmedicated IUD for at least a year was examined histologically. There was an increased frequency of tissue edema and congestion in the postpartum group only. The frequency and extent of acute inflammatory changes in the three groups was not significantly different.

Adult↗

PubMed1996

Search for viral nucleic acid sequences in brain tissues of patients with schizophrenia using nested polymerase chain reaction.

BACKGROUND: We used polymerase chain reaction to search for nucleic acid sequences of several viruses in DNA and RNA extracted from brain tissues of schizophrenic and control subjects. METHODS: We extracted DNA and RNA templates from frozen brain specimens of 31 patients with schizophrenia and 23 nonschizophrenic control patients with other diseases. The extracts were subjected to polymerase chain reaction with oligonucleotide primers for 12 different viruses (cytomegalovirus, Epstein-Barr virus, herpes simplex virus type 1, human herpesvirus type 6, varicellazoster virus, measles virus, mumps virus, rubella virus, the picornavirus group, influenza A virus, human T-cell lymphotropic virus type I, and St Louis encephalitis virus), several of which have been suspected of involvement in schizophrenia. Nested primers were used to increase the sensitivity of the method. RESULTS: No amplified nucleic acid sequences encoded by the selected viral genomes were detected in extracts of any brain specimens from either schizophrenic or control patients. CONCLUSIONS: These data agree with previous studies that failed to find sequences of a number of viruses in the cerebrospinal fluid or selected areas of the brains of schizophrenic patients. Additional efforts should be undertaken to identify other known and unknown pathogens in schizophrenia, sampling more areas of the brain from subjects with a variety of clinical types of schizophrenia.

Brain↗

PubMed1983

Cellular toxicity of urinary catheters.

The cellular compatibility of each of several brands of urinary catheters available on the Australian market was measured by means of cell-culture methods, a rabbit intramuscular implant test, and the traditional mouse systemic toxicity test. Good agreement was obtained between the in-vitro tests and the rabbit implant tests (although the cell-culture tests were simpler, more rapid, more sensitive, and quantitative). The mouse systemic toxicity test was insensitive, and detected no toxic samples. The cell-culture and rabbit-implant test results indicated that some urinary catheters can release substances harmful to mammalian cells. Such substances may contribute to the clinical reactions of urethritis and strictures after urethral catheterization.

Animals↗

PubMed2026

Select Contemporary Statistical Concepts in Heart Failure Clinical Trials: Insights From the Heart Failure Collaboratory.

Evolving statistical concepts and innovative trial designs for heart failure (HF) clinical trials seek to improve the conduct, efficiency, and likelihood of meaningful evidence generation crucial for advancing therapeutic development and optimizing patient care. HF trials with conventional statistical frameworks often require large sample sizes, long follow-up times, and high cost to generate sufficient evidence. Novel statistical methodologies would be of interest if they could address these issues while retaining or enhancing the clinical relevance and reliability of results. The HFC (Heart Failure Collaboratory), comprising clinical investigators, clinicians, statisticians, patients, government representatives, payors, and industry collaborators, leads efforts to improve HF research methodologies. HFC discussions have included statistical concepts such as the estimand framework, HR drift, and analytic methods, including the win ratio and restricted mean survival time, that have not been used frequently in HF trials. The estimand framework encourages precise definition and alignment of trial objectives with trial design. The win ratio method attempts to incorporate and prioritize multiple clinically meaningful outcomes by using a hierarchy of clinical importance. The restricted mean survival time provides an alternative to the HR as a measure of therapeutic effect by quantifying the mean time gained or lost during a fixed time after randomization. This paper provides a critical review of some evolving HF trial design methodologies and statistical concepts for the HF community as discussed within the HFC. Our goal is to foster collaboration among diverse stakeholders and advance the development of effective treatments and improve patient care outcomes.

Heart Failure↗

PubMed1975

Antibiotic dipping studies in relation to uptake, embryonic development and Arizona hinshawii recoveries from turkey hatching eggs.

Antibiotic dipping with gentamicin sulfate by means of the temperature-differential method was effective in reducing but not completely eliminating Arizona hinshawii (7:1, 7, 8) from artificially infected turkey hatching eggs. Embryonic development was well maintained. The antibiotic dip solution intake was variable from egg to egg. Removal of cuticle by means of either 0.2 N HCl or a 10% disodium salt of ethylene diamine tetraacetic acid enhanced egg weight gains and maintained good embryonic development. Complete elimination of A. hinshawii was achieved in one experiment out of four. Correlation studies between egg weight gains and gentamicin concentrations of the contents of the turkey hatching eggs indicated a statistically significant relationship between these two parameters.

Animals↗

PubMed1980

Technical failures in tubal ring sterilization: Incidence, perceived reasons, outcome, and risk factors.

Six centers participated in comparative studies of female sterilization conducted by the international Fertility Research Program. The incidence of technical failures (or failed attempts) was compared between patients sterilized with the tubal ring and those sterilized with other tubal occlusion techniques. The tubal ring was associated with a higher failure rate than electrocoagulation, the Rocket clip, or the modified Pomeroy technique. Of 1,035 tubal ring sterilizations, there were 38 technical failures. Reasons given by the operators for the failures, by frequency of occurrence, were surgical complications, conditions preexisting in the patients, and problems with the instruments. Most of these failures were remedied by changing to other techniques. In two patients, the procedure was completed by changing the approach from laparoscopy to laparotomy. In five others, sterilization was not completed. Case-control analysis was performed and three risk factors were delineated: obesity, prior use of an intrauterine contraceptive device and previous abdominal operations.

Abdomen↗