RESUMEN
To determine the validity of the 50-g, one-hour glucose screening test for gestational diabetes in relation to the duration of pregnancy, 101 patients from a high-risk population had the screening test in the first trimester and glucose tolerance tests (GTT) in the second and third trimesters. The sensitivity (88%) and specificity (82%) of the screening test were similar to values reported when the test is performed later in pregnancy. However, immediate follow-up GTTs in the second trimester revealed only 25% instead of 88% of the gestational diabetic patients uncovered by the positive screening tests. Guidelines for screening for gestational diabetes should include follow-up with a third-trimester GTT on all patients who have positive screening tests even in the presence of normal follow-up second trimester GTTs.
Asunto(s)
Glucemia/análisis , Embarazo en Diabéticas/diagnóstico , Reacciones Falso Negativas , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Embarazo , Embarazo en Diabéticas/sangre , Factores de TiempoRESUMEN
Tamoxifen therapy in premenopausal women with breast cancer may be associated with the development of ovarian cysts. In this report, a case of ovarian torsion associated with TAM therapy is described.
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Ciclo Menstrual , Enfermedades del Ovario/inducido químicamente , Tamoxifeno/efectos adversos , Femenino , Humanos , Laparoscopía , Persona de Mediana Edad , Quistes Ováricos/inducido químicamente , Quistes Ováricos/patología , Quistes Ováricos/cirugía , Enfermedades del Ovario/cirugía , Ovariectomía , Anomalía TorsionalAsunto(s)
Medicina Familiar y Comunitaria , Familia , Paraplejía , Complicaciones del Embarazo , Adaptación Psicológica , Adulto , Preescolar , Femenino , Humanos , Lactante , Masculino , Paraplejía/etiología , Paraplejía/psicología , Relaciones Médico-Paciente , Embarazo , Complicaciones del Embarazo/etiología , Complicaciones del Embarazo/psicología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/psicologíaRESUMEN
The range of procedures now routinely done through the laparoscope has continued to expand due to improved equipment for insufflation, hemostasis, and tissue manipulation, and to imaginative approaches to otherwise "routine" gynecologic problems traditionally treated by laparotomy. As with all new technologies, advocates predict that the methodology will prove to have an almost unlimited potential, while established skeptics predict that it will have a narrow applicability. With time and further clinical application, a consensus somewhere between the two positions will be reached. But while this technology develops and experience begins to accumulate, it is necessary to train residents in the technique. We discuss our experience with introducing laparoscopic management of ectopic pregnancy into a residency training program. Our results indicate a rapid learning curve, with minimal patient morbidity, brief hospitalization, and rapid convalescence.