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At least 55 records · Page 3Linked to original sources

Late effect of nocturnal mist tent therapy related to the severity of airway obstruction in children with cystic fibrosis.

To evaluate the long-term effect of nocturnal mist tent therapy on the progression of airway obstruction in children with cystic fibrosis (CF) of varying severity, two matched groups each consisting of 24 children with CF were studied during 18 months on mist tent therapy and 18 months of therapy. The progression in airway obstruction was measured by change in serial measurements of maximal midexpiratory flow (MMEF), from which a regression equation of MMEF against time was obtained for each individual. Changes in MMEF value with or without therapy were compared in patients matched for severity of disease as indicated by initial MMEF values. For the group as a whole no differences were found in the progression of the airway obstruction whether the patients received mist tent therapy or not. This therapy failed to benefit any of the groups of children with CF who had early, moderate, or advanced airway obstruction as judged from their initial MMEF value. It is concluded that nocturnal mist tent therapy neither decreases airway obstruction nor prevents its progression in children with CF.

Adolescent↗

Rapid decomposition of permethrin in the outer fly of an experimental tent in Pakistan.

The residual activity of permethrin on the canvas of an experimental tent, used by nomadic refugees in a malarious area in northern Pakistan, was assessed. A permethrin emulsion sprayed on the inner sheet of a pitched double-fly tent (0.5 g/m2) had an effective residue for at least 6 months in bioassays using the local malaria vectors, Anopheles stephensi and Anopheles culcifacies. However, a high concentration of permethrin (2 g/m2) sprayed on the inner surface of the outer tent, simulating single-fly tents, decomposed within 2 months. These findings were confirmed with chromatographic analysis. Under the conditions found in the study area, the shortened residual effect most likely resulted from photodecomposition, not previously reported to affect operational performance of this insecticide.

Animals↗

Placental and decidual u-PA, t-PA, PAI-1 and PAI-2 concentrations, as affected by cervical dilatation with laminaria tents or Hegar dilators.

The effect of cervical dilatation on PA and PAI concentrations was compared in a laminaria tent group and a mechanical dilatation (control) group. In both groups, u-PA and t-PA were found to be present both in decidual and placental tissue. Values for PAI-1 in the decidua were higher in the laminaria tent group than in controls, and those for PAI-2 in the placenta were lower. These findings provide support for the contention that cervical dilatation with laminaria tents may result in partial detachment of the placenta.

Decidua↗

Late midtrimester medical pregnancy terminations: three different procedures with prostaglandin F2 alpha and laminaria tents.

One hundred twenty eight women underwent midtrimester induced abortion with: 1) combined regimen of intramniotic prostaglandin (PG) F2a injection and intracervical laminaria tents (group A, 50 women), 2) intramniotic PGF2a injection only (group B, 51 women) and 3) laminaria tents followed by intracervical PGF2a tablets insertion (group C, 27 women). The mean induction-abortion time (+/- SE) was 24.9 +/- 1.7 hours for group A, 28.2 +/- 2.2 hours for group B (p greater than 0.05) and 42.1 +/- 3.4 hours for group C, significantly longer than goup A and B (p less than 0.001 and p less than 0.01 respectively). In 48 hours 98% of the patients of group A, 90% of group B (p less than 0.05) and 59% of group C (p less than 0.001) completed the abortion procedure. Parous women of group A and B presented similar induction - abortion time, while in nulliparous the use of laminaria shortened the abortion procedure significantly (p less than 0.05). The complications rate was low. In conclusion, the intracervical PGF2a insertion is a simple but very slow abortion procedure with high failure rates. The intramniotic PGF2a injection is a successful method for late midtrimester medical pregnancy termination and the concurrent use of laminaria tents shortens the abortion procedure, particularly in nulliparous, reduces the number of prostaglandins' reinjections and increases the incidence of successful abortion within 48 hours.

Abortion, Induced↗

A comparison of prostaglandin E2 pessaries and laminaria tents for ripening the cervix before termination of pregnancy.

Forty primigravid women aged 15-45 years were randomly allocated to receive either an intravaginal pessary of 3 mg prostaglandin E2 (PGE2) or an intracervical 5-mm laminaria tent (LT) 12-16 h before termination of pregnancy at 6-14 weeks gestation. The degree of dilatation of the cervix at operation and its resistance to further dilatation during the procedure were assessed by a 'blind' operator. Laminaria tents were more effective in achieving dilatation and softening of the cervix than were PGE2 pessaries and in 40% of women no further dilatation was necessary. There were no associated side-effects or complications. A cervical tear occurred in two of 20 patients treated with PGE2 pessaries and all 20 required further dilatation of the cervix. Laminaria tents provide a simple, safe, acceptable and effective means of 'ripening' the cervix prior to termination of early pregnancy.

Abortion, Therapeutic↗

Preoperative cervical dilatation: a trial of laminaria tents and prostaglandin F2 alpha gel.

Surgical damage to the cervix in patients undergoing termination of pregnancy may be responsible for serious complications in subsequent pregnancies. Sixty nulliparous women undergoing first trimester termination of pregnancy were randomly allocated to 3 treatment groups, one using laminaria tents preoperatively, one using intracervical PGF2 alpha gel preoperatively and one using no pretreatment. Results showed clear benefits in the laminaria group, in terms of achieving preoperative cervical dilatation and ease of further operative dilatation. Laminaria tents were superior to PGF2 alpha gel which was, in turn, superior to no pretreatment. There were no differences in blood loss or postoperative complications among the 3 groups. Laminaria tents provide a cheap, effective and safe method of reducing the risk of cervical damage in women undergoing surgical termination of pregnancy.

Abortion, Induced↗

Effect of predilatation of the uterine cervix by laminaria tent on activity of the placenta.

Serum concentrations of hCG were determined in blood samples taken 18-20 h and immediately before vacuum aspiration in 45 women in gestational weeks 7-9, admitted for legal abortion. In 35 of the women, a laminaria tent was inserted for cervical dilatation immediately after the first blood sampling. Serum hCG values decreased significantly in the women pretreated with laminaria tent, but were unchanged in the untreated women. This finding may indicate that pretreatment with a laminaria tent induces a partial placental detachment.

Abortion, Legal↗

Clostridial sepsis after abortion with PGF2alpha and intracervical laminaria tents--a case report.

A case of clostridial endomyometritis and sepsis necessitating total abdominal hysterectomy which occurred 12 hours following abortion induced with intraamniotic administration of prostaglandin F2 alpha and laminaria tent insertion is discussed. Cultures from cervical, blood, and surgical specimens all yielded Clostridium perfringens. Intrauterine contamination with this microorganism most likely followed the insertion of laminaria tents through the cervical os, which was colonized with C. perfringens. Since C. perfringens may be present in the microflora of the lower female genital tract, great care must be taken to cleanse this area prior to intracervical laminaria tent insertion.

Abortion, Induced↗

Biochemical changes in human cervical connective tissue during pretreatment with laminaria tents in legal first trimester abortions.

In 14 legal first trimester abortions, vacuum aspiration was preceded by dilatation of the cervical canal by laminaria tent for 16-20 h. Biopsy specimens obtained from the cervix before insertion and before removal of the laminaria tent were analyzed for biochemical changes in cervical connective tissue. Pretreatment with laminaria tents resulted in a decrease of the total collagen concentration and of the collagenolytic activity, though the differences were without statistical significance. Both these findings and those concerning the subfractions of the hydroxyproline concentration suggest that pretreatment with laminaria induces a certain degree of softening of the cervix, similar to that reported after intracervical application of PGE2 gel.

Abortion, Legal↗

Modified stylet technique for tenting of amniotic membranes.

A modified amniocentesis technique can reduce the failure rate in cases of tenting of the membranes. Failure to aspirate amniotic fluid (AF) because of amniotic membrane tenting may persist after advancement and rotation of the needle. In such cases, the membranes may be pierced by using a stylet that is longer than the length of the needle. With the needle in the middle of a suitable AF pocket, the stylet of the needle is replaced with a longer stylet. Under real-time ultrasonographic guidance, the tip of the stylet is then rapidly advanced 5-10 mm beyond the tip of the needle. During genetic amniocentesis, we have used the longer stylet technique to pierce tented membranes without complications in 21 of 22 cases.

Amniocentesis↗

Prostaglandin release from human cervical tissue in the first trimester of pregnancy after preoperative dilatation with hygroscopic tents.

Preoperative dilatation with hygroscopic tents before first trimester abortion by vacuum aspiration is widely accepted and reduces the risk of early and late complications. A softening effect and a reduced compliance to mechanical dilatation occurs in addition to pure mechanical dilatation of the cervix. If this softening is an effect of local prostaglandin release, however, is unknown. Prostaglandin (PG) release in vitro from cervical biopsies following dilatation in vivo by a synthetic hygroscopic tent (Dilapan) for periods of 4 h and 18 h was compared with that of biopsies from untreated women. No difference was observed between the release of PGE2, PGF2 alpha, or 6-keto-PGF1 alpha. No significant difference was found in the tissue water content between treated and untreated women (83.8% versus 83.2%). Prostaglandins were also extracted from an alternative cervical dilator, Lamicel (a polyvinyl sponge impregnated with magnesium sulfate), and compared with the corresponding values from women pretreated with the cyclooxygenase inhibitor indomethacin before application of the tent. Significantly higher concentrations of PGE2 and PGF2 alpha but not of 6-keto-PGF1 alpha were found in women who had not been indomethacin-treated compared with indomethacin-treated women. Slices of the cervix from non-pregnant women operated upon for benign conditions were divided into an outer stromal layer and an inner layer, including the mucosa, and the PG-release in vitro was measured. The inner layer of the cervix showed a significantly higher release of PGE2 and PGF2 alpha compared with the outer layer. Lamicel treatment before first trimester abortion results in a significant dilatation of the cervix and a reduced compliance to mechanical dilatation, and this study supports the hypothesis that this effect is mediated via a local PG-release from the cervix. It seems reasonable to believe that Dilapan treatment too has the capacity to induce PG-release from the cervix, but this could not be demonstrated in this study, probably because needle biopsies taken mainly from the outer cervical layers were analyzed.

6-Ketoprostaglandin F1 alpha↗

Thermal comfort and clothing insulation of resting tent occupants at high altitude.

Thirty-nine males and 18 females, in six groups, participated in six high altitude treks (each lasting 3-4 weeks and climbing up to 5500m) in the Himalaya and Karakoram. Inverse relationships between mean overnight total insulation (sleeping bag plus clothing) and air temperature in tents were recorded for all treks. Average overnight thermal sensations varied little with air temperature as the subjects modified their clothing insulation to maintain thermal sensations warmer than 'neutral' for all treks. For combined treks, subjects adjusted their mean overnight total insulation up to 7clo for thermal sensations of between 0 ('neutral') and +1 ('slightly warm') on average, measured on the standard seven-point thermal sensation scale developed for everyday low-altitude conditions. Very few subjects (3% of all daily responses, on average) reported 'cool' or 'cold' sensations. General tent discomfort increased with altitude suggesting that subjects interpreted tent comfort predominantly in terms of thermal outdoor conditions.

Adult↗

Successful pregnancies with the use of laminaria tents before embryo transfer for refractory cervical stenosis.

OBJECTIVE: To determine whether laminaria tents are a safe and effective method of cervical dilatation in patients with a history of cervical stenosis and difficult ET. DESIGN: Case reports describing two patients. SETTING: Tertiary care, assisted reproduction practice. PATIENT(S): Two patients with cervical stenosis and a history of multiple failed cycles of IVF. INTERVENTION(S): Laminaria tents were placed intracervically before ET. MAIN OUTCOME MEASURE(S): Presence of a gestational sac and fetal heartbeat on ultrasound. RESULT(S): Successful clinical pregnancies occurred in both patients after laminaria placement and ET. CONCLUSION(S): Laminaria tent cervical dilatation appears to be a safe and effective option to assist ET in patients with a history of cervical stenosis.

Adult↗

A randomized trial of laminaria tents versus vaginal misoprostol for cervical ripening in first trimester surgical abortion.

OBJECTIVE: To compare the use of laminaria tents with misoprostol for cervical ripening prior to first trimester surgical abortion. METHOD: In a prospective, open-label, randomized trial, 70 women were assigned to have either insertion of a 3 mm intracervical laminaria tent or vaginal misoprostol 200 microg on the day prior to suction dilatation and curettage (D and C). Cervical dilatation and operating time were measured at the time of D and C; the surgeon subjectively rated the ease of dilatation. The women were interviewed just prior to the D and C with regard to pain, vaginal bleeding, and dilator preference. RESULTS: Laminaria produced significantly (P < 0.001) greater pre-abortion dilatation of the cervix (34.8 Pratt +/- 6.2) than did misoprostol (28.4 Pratt +/- 5.8). There was no demonstrable difference in ease of dilatation or operating time. Women randomized to use of laminaria reported significantly more pain on insertion than did those who received misoprostol (P < 0.001). Conversely, misoprostol was associated with more vaginal bleeding (P < 0.01). Pain following insertion was similar in each group. Two patients aborted completely after misoprostol alone. Overall, the stated patient preference for cervical dilator was more likely to be misoprostol (P < 0.01). CONCLUSIONS: Laminaria tents are more effective cervical dilators than vaginal misoprostol when inserted the day prior to suction D and C. Vaginal misoprostol insertion is more comfortable, although it is associated with an increased risk of vaginal bleeding and may abort the pregnancy. Patient preference favours misoprostol. In patient-centred care, both laminaria and misoprostol are suitable options for cervical preparation prior to suction D and C.

Abortifacient Agents, Nonsteroidal↗

Use of parent-child tents in pediatric laser surgery.

BACKGROUND: Pediatric pulse dye laser surgery is a low-risk, minimally painful procedure that provides unique challenges to the laser operator. In some centers, all of these procedures are performed under sedation or general anesthesia, which poses a greater risk than the procedure itself. Topical anesthesia has proven to ease the pain associated with these procedures, but anxiety resulting from protective eye wear still poses a major problem in young children. OBJECTIVE: To ease the anxiety of children undergoing brief laser procedures below the head and neck without sedation or general anesthesia by allowing interaction between parents and the patient during the procedure. METHODS: A standard hospital-issue 142 thread, 75% cotton/25% polyester sheet is doubled and clamped above the head of the treatment table. Forming a tent, it is draped over the patient's head and neck area while also covering the parent who is positioned beside the child. All patients also use topical anesthesia 1 to 2 hours before the procedure. RESULTS: The parent-child tent has been used in selected pediatric laser surgery patients at our institution over the past 7 years with great success and without any complications. CONCLUSIONS: For brief laser procedures below the head and neck areas, the parent-child tent, which can be made from readily available materials, reduces the stress to both patient and parent and may obviate the need for further sedation or anesthesia.

Anesthesia, Local↗

Comparative study of cervical laminar tents prior to extra-amniotic injection of ethacridine lactate (Rivanol) and a condom-nelathon catheter method for second-trimester pregnancy interruption in Vietnam.

OBJECTIVE: To determine whether the regimen for termination of second-trimester pregnancies using laminaria tents 12-24 h prior to extra-amniotic ethacridine lactate (Rivanol) instillation, is more effective in shortening the insertion-expulsion interval than the presently used method of abortion induction by a condom/Nelathon catheter. DESIGN: A prospective randomised comparative study was performed at Uong Bi General Hospital in Quang Ninh Province, Vietnam, on 91 women undergoing pregnancy termination in the second trimester. INTERVENTIONS: The subjects were randomly allocated to 2 treatment groups, receiving either the Nelathon catheter-condom method (n = 50) or by insertion of a laminaria tent into the cervical canal for preinduction, 13-29 h before extra-amniotic instillation of ethacridine lactate (n = 34). Seven subjects were not pretreated with the laminaria tent. MAIN OUTCOME MEASURES: The insertion-expulsion intervals and the incidence of side effects were assessed. RESULTS: The mean insertion-expulsion interval in the 2 groups was not significantly different (mean 27.5 +/- 16.1 and 26.4 +/- 16.4 h, respectively), calculating the insertion-expulsion interval from the start of active treatment, i.e. from the instillation of Rivanol or insertion of the Nelathon catheter and condom, until expulsion of the fetus. CONCLUSIONS: The laminaria-Rivanol method for pregnancy interruption is not more advantageous than the existing Nelathon catheter-condom method. Simple, successful and cost-effective methods in achieving second-trimester abortion in the Vietnamese context have therefore to be identified and tested.

Abortifacient Agents↗

Carbon monoxide poisoning in tents--a review.

This review discusses the overlooked problem of carbon monoxide (CO) poisoning within small tents. It summarizes previous case reports, reviews the toxicity of CO, and attempts to draw conclusions from experimental work. Finally, practical recommendations are developed on avoiding CO poisoning within tents. The term carbon monoxide was used in a search of the Medline database covering the years 1966 to 2003. The results were combined with the terms atmosphere or camps or stoves or climbs or mountains or tents or poisons. The resulting articles were reviewed, and those relevant to this problem were obtained. Hard copies were hand searched for further relevant articles until no more citations could be found. Three original articles were impossible to obtain but have been cited to assist others seeking to find them. Other data and articles were obtained from the Ministry of Defence but are unpublished for security reasons.

Air Pollution, Indoor↗

Biochemical changes in the cervical mucus after application of laminaria tent.

BACKGROUND: This research was aimed to study the biochemical changes in cervical mucus after application of laminaria tent. MATERIAL AND METHODS: Cervical mucus was collected before and after insertion of laminaria tent from 20 normal pregnant women in the first and second trimesters. Interleukin-1 beta, IL-8, collagenase activity, elastase activity, PGE2 and PGF2 alpha were measured in the collected samples. Laminaria tent was also inserted in one vaginal cervix of five non-pregnant rabbits and the clinical and histological changes were compared with five non-treated rabbits. Collagen contents were assessed histologically and Leukocyte number was counted. RESULTS: IL-1 beta and IL-8 and elastase activity were significantly increased after insertion of laminaria (p<0.0001 and 0.001 respectively). Collagenase activity was not significantly changed. Whereas concentration of PGE2 and PGF2 alpha in the mucus were markedly increased (p<0.0001 and 0.001 respectively). Collagen contents were significantly decreased in laminaria and opposite side cervices (p<0.0001). No significant changes in leukocyte count could be observed in treated and non treated cervices. CONCLUSIONS: Insertion of laminaria leads to increase concentration of IL-1 beta, IL-8, PGE2, PGF2 alpha and elastase activity. Mechanical stretching of the cervix and biochemical changes in cervical mucus may explain the mechanism of cervical ripening induced by laminaria.

Animals↗