OBJECTIVE: To evaluate prospectively mitral stenosis in pregnancy with emphasis on women with persistent symptoms. SETTING: King Edward VIII Hospital, a tertiary referral obstetric unit. PARTICIPANTS: One hundred and twenty-eight consecutive women with mitral stenosis. DEMOGRAPHICS: The mean age was 27 years and 38 women (30%) were primigravidae. Seventy-eight (61%) ...

A case of 31-year old pregnant lady with severe mitral stenosis who benefited tremendously from multi-track balloon valvotomy is presented. She had history of cardiorespiratory arrest during delivery in the previous pregnancy and presented to the obstetrician pregnant again and symptomatic. After detailed cardiac evaluation, she was managed medically up ...

OBJECTIVES: To assess the impact of a syphilis control programme of pregnant women on pregnancy outcome in Kenya. METHOD: Women who came to deliver to Pumwani Maternity Hospital (PMH) between April 1997 and March 1998 were tested for syphilis. Reactive rapid plasma reagin (RPR) tests were titrated and confirmed with ...

We report of a case of malignant melanoma occurring during pregnancy in a woman whose mother had a melanoma excised during pregnancy. There was no other family history of melanoma. To our knowledge, this has not been previously reported. A review of the recent literature suggests that pregnant women with ...

OBJECTIVE: We reviewed the contrast enema examinations and medical records of six patients with small intestinal obstruction due to omphalomesenteric duct remnant to evaluate for characteristic imaging findings. RESULTS: In five out of the six patients the point of obstruction was demonstrated on the enema; in three patients, the characteristic ...

Myasthenia gravis is characterised by muscle weakness and fatigability, particularly of the facial and extremity muscles, deteriorating during the day. During pregnancy, myasthenia gravis is rare and the course of illness is unpredictable. The present case illustrates that first diagnosed during pregnancy, recurrent exacerbations can appear and lead to life-threatening ...

The problem of intestinal obstruction in pregnancy and puerperium is worsened by the risk it poses not just to the mother, but also to the fetus. In this review of 10 pregnant/puerperium patients the maternal mortality was 10% and fetal wastage 20%. In pregnancy and puerperium, intestinal obstruction carries a ...

The problem of intestinal obstruction in pregnancy and puerperium is worsened by the risk it poses not just to the mother, but also to the fetus. In this review of 10 pregnant/puerperium patients the maternal mortality was 10% and fetal wastage 20%. In pregnancy and puerperium, intestinal obstruction carries a ...

OBJECTIVE: To evaluate prospectively the Centers for Disease Control and Prevention (CDC) recommended regimens for the treatment of antepartum syphilis and prevention of congenital syphilis. METHODS: This was a prospective evaluation of recommended syphilis treatment regimens from September 1, 1987, to August 31, 1989, at Parkland Memorial Hospital, Dallas, Texas. ...

Recent studies of Fukuyama congenital muscular dystrophy have focused on abnormalities of the basement membrane in muscle and brain. The cerebral cortex has a unique basement membrane at the glia limitans, which is intimately related to astrocytes in the developing brain, and the basement membrane may be partially produced by ...

To measure the incidence of syphilis detected in pregnancy and congenital syphilis in the United Kingdom. Surveys through consultants in genitourinary medicine and paediatricians with active surveillance. United Kingdom, 1994-7. Women treated for syphilis in pregnancy, and children with early congenital syphilis born in the United Kingdom. Over 3 years ...

We describe the use of the Inoue balloon to dilate the aortic valve by the physiologic antegrade route during pregnancy. A 27-year-old pregnant woman with severe aortic stenosis presented with progressive dyspnea and presyncope at 26 weeks of pregnancy. She subsequently underwent percutaneous valvuloplasty by the antegrade route utilizing the ...

OBJECTIVE: To define the value of silver-stained nucleolar organizer regions (AgNOR) in the evaluation of uveal malignant melanomas (MM). STUDY DESIGN: Morphometric analysis of AgNORs was performed on 30 uveal MM of spindle A, B, epithelioid and mixed cell types. Findings were compared with cytotype, largest tumor dimension (LTD) and ...

Approximately 40,300 patients are diagnosed with cutaneous melanoma annually in the United States with a disease-related mortality rate of approximately 7,300 per year. Although treatment strategies have been defined for cutaneous melanoma, therapeutic approaches for this hormonally sensitive tumor are difficult in the gravid patient. Epidemiologic studies suggest that there ...

BACKGROUND: Rheumatic mitral valve stenosis contributes to significant morbidity in pregnancy. Surgical commissurotomy has been performed during pregnancy in patients with severe mitral stenosis for several decades, but the efficacy and safety of percutaneous balloon mitral valvotomy (BMV) in this subset has not been clearly defined. STUDY DESIGN: In 1996 ...

There has been considerable interest in the relationship of pregnancy and melanoma. Since 1951, a number of case reports have suggested that pregnancy may induce or exacerbate melanoma. Likewise, there has been concern over the relationship between exposure to oral contraceptives (OCs) or hormone replacement therapy (HRT) and possible increased ...

The authors report on the case of a 33-year-old white woman who developed melanoma during pregnancy, with widespread metastatic disease involving the placenta. The melanoma developed during two consecutive pregnancies and was untreated throughout the course of both. The patient died with widespread metastases shortly after attempted Cesarean delivery of ...

A woman presented at 24 weeks gestation with previously undiagnosed mitral stenosis. She did not respond to conservative management and underwent successful percutaneous balloon mitral valvotomy for refractory congestive cardiac failure, with complete resolution of her symptoms. The remainder of her pregnancy was uncomplicated and she delivered a healthy infant ...

This study investigates the mechanisms of absorption and the role of intestinally localized purine salvage pathway enzymes on the ileal availabilities of 2',3'-dideoxyinosine (ddI), a substrate for purine nucleoside phosphorylase (PNP); 2'-fluoro-2',3'-dideoxyinosine (F-ddI), a non-PNP substrate; and 6-chloro-2',3'-dideoxypurine (6-Cl-ddP), an adenosine deaminase (ADA) activated prodrug of ddI. The potential for ...

In 1893, Unna published his theory of Abtropfung in which he suggested that melanocytic nevus cells originate in the epidermis and drop off into the dermis. We studied 3,534 nevi from patients of all ages to reassess this almost sacred concept. If Unna was correct, one would expect that in ...

A small-diameter vascular prosthesis with potential for clinical use was prepared from a Dacron prosthesis coated with nonthrombogenic polymeric materials. As a coating material, segmented poly(etherurethane) (SPU; Tecoflex 60) was blended with a phospholipid polymer, 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which has excellent blood compatibility. The Dacron prosthesis, 2 mm in ...

BACKGROUND: Intestinal obstruction in pregnancy is rare. The mortality rate is higher during pregnancy than in the general population and applies to fetal as well as maternal survival. Major causes of intestinal obstruction in the pregnant women include adhesions, volvulus and intussusception. CASE: A 27-year-old woman, gravida 2, para 1, ...

BACKGROUND: Development of the small intestine is essential for proper nutrition of the fetus and the neonate. This investigation examines the morphogenesis and cytodifferentiation of developing fetal porcine small intestinal mucosa. METHODS: Fetuses were collected from gilts after hysterectomy. Small intestinal segments were removed and processed for light and electron ...

BACKGROUND: The incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing rapidly. Barrett's oesophagus is the major risk factor. Intestinal metaplasia at the squamocolumnar junction in the absence of Barrett's oesophagus is common but its relation to adenocarcinoma and gastro-oesophageal reflux disease is unclear. AIMS: To study the ...

AIM: The purpose of this study is to determine the outcome and complications of pregnancy in women with pulmonary autograft valve replacement for aortic valve disease. METHODS AND RESULTS: The records of all women who had undergone pulmonary autograft valve replacement at the National Heart Hospital (now Royal Brompton Hospital) ...

A 35-year-old female with mitral stenosis was admitted to hospital in her 23rd week of gestation for management of disabling dyspnea and paroxysmal nocturnal dyspnea. She was in New York Heart Association functional class III and underwent successful percutaneous balloon mitral valvuloplasty with significant improvement of her symptoms. To limit ...

Melanoma during pregnancy represents a difficult problem. Although surgery is a definitive therapy for early-stage disease, rapidly progressive metastatic disease in pregnancy requires a series of more difficult decisions. We report the use of combination chemotherapy with tamoxifen, carmustine, dacarbazine, and cisplatin in a patient with metastatic melanoma during the ...

OBJECTIVE: To evaluate the effectiveness and safety of percutaneous balloon mitral commissurotomy for the treatment of pregnant women with severe mitral stenosis over a period of six years. DESIGN: Analysis of clinical, haemodynamic, and echocardiographic data before and immediately after the procedure, the pregnancy outcome, and the fate of newborn ...

Percutaneous balloon dilatation of combined mitral and tricuspid stenoses was performed successfully in a 22-year-old woman during the 23rd week of pregnancy, using an Inoue balloon catheter. Following valvuloplasty, mean transmitral gradients decreased from 36 to 5 mmHg and the mean transtricuspid gradients from 12 to 3 mmHg. The procedure ...

BACKGROUND: The relation between pregnancy, melanocytic nevi, and malignant melanoma is ambiguous. It has been reported that nevi grow and darken during pregnancy. Several recent studies have shown that malignant melanomas diagnosed during pregnancy are thicker than those not associated with pregnancy. This may be partially due to a delay ...

Syphilis in pregnancy remains a problem despite the availability of adequate diagnostic tests and years of penicillin therapy. During pregnancy, syphilis is compounded by its occurrence among populations that under-use the health care system and by its association with cocaine use and infection with HIV. The potentially devastating effect of ...

Bowen's disease, squamous and basal cell carcinoma, and malignant melanoma occur more frequently on the lower leg of women compared with men, presumably because of increased solar ultraviolet radiation (UVR) exposure as a consequence of dress. While it is apparent from simple observation that stockings are transparent to light, systematic ...

Objective: The purpose of this study was to assess the effect of several maternal variables on the serologic response following the treatment of syphilis in pregnancy.Methods: A 5-year chart review identified 95 patients coded with syphilis at Hermann Hospital. Inclusion criteria were 1) serologically confirmed syphilis infection during the index ...

A 15-year-old boy, whose history revealed an unremarkable pregnancy, birth and neonatal period and who had shown a normal motor and mental development, presented at the hospital with deterioration of cognitive functions since the age of 7. He was bedridden with manifest ataxia involving all limbs, anisocoria and a sluggish ...

The influence of pregnancy on the prognosis of malignant melanoma (MM) is unclear. Since 1951, a number of case reports have suggested that pregnancy may have an adverse effect on the clinical course of MM. We reviewed the literature on pregnancy and MM and focused on the well-controlled studies. Based ...

We sought to determine: (1) the perinatal outcomes in the subsequent pregnancy; (2) the natural history of serologic titers over the course of the two pregnancies; and (3) the incidence and risk factors for delivering an infant with congenital syphilis in the subsequent pregnancy. Over a five-year period, we reviewed ...

Atrioventricular nodal reentrant tachycardia and accessory pathway-mediated tachycardia may have different ages of tachycardia onset. Symptom onset data were obtained in 519 patients (atrioventricular nodal reentrant tachycardia, 231, accessory pathway-mediated tachycardia, 288). The mean age of the patients at the time of evaluation was 47 +/- 17 years (atrioventricular nodal ...

Balloon valvuloplasties for severe mitral stenosis were performed on 11 pregnant patients with excellent results and no complications. The mitral valve area was increased from a mean of 0.9 cm2 to 2.1 cm2. There was no clinically significant mitral regurgitation. The pregnancies proceeded normally to delivery at or near term, ...

The Kock continent ileostomy is a surgical alternative to a Brooke ileostomy after total proctocolectomy. Complications resulting from an improperly functioning nipple valve are not infrequent and when they occur most often require surgical revision. A 19-year-old female with a functioning Kock pouch of 4 years presented at 6 months ...

Previously asymptomatic mitral stenosis can lead to remarkably sudden development of life-threatening pulmonary edema in pregnancy and the patients, often immigrants from the developing world, may be unaware that they have heart disease. Diagnosis and treatment need to be rapid and effective. Left ventricular outflow tract obstruction may also lead ...

Eight patient case vignettes are presented to illustrate the possible relationship between melanoma and pregnancy. We pose 10 questions regarding the risk and prognosis and answer them based on information in the medical literature. Key conclusions are that there is no evidence that the risk for melanoma is influenced by ...

Syphilis has re-emerged as a significant public health problem for pregnant women and their babies in Michigan, US, and in many areas of the world. In the US over 50,000 cases of primary and secondary syphilis were reported to the Centers for Disease Control (CDC) in 1990. Due to the ...

The effects of pregnancy on the pathophysiology of melanoma remain unclear. Although a gender-specific advantage for women vs. men is seen for characteristics such as stage at presentation, site of primary tumour, and survival time, an adverse effect of pregnancy on melanoma development and progression has been reported. In a ...

Although rheumatic diseases are reported to be almost eradicated in the developed countries, they still continue to contribute significantly to maternal mortality in the developing world. Surgical therapies need to be considered for those patients who do not respond satisfactorily to medication. However, valve replacement or valvulotomy during pregnancy carries ...

Descriptive characteristics and clinical information from 322 cases of congenital syphilis were reviewed. The births (318 mothers) included 31 (10%) stillborn and 59 (18%) with clinical evidence of congenital syphilis. Only 60 (19%) had a complete laboratory workup, including radiographs of long bones and spinal fluid analysis. For a subset ...

Primary melanoma is the most malignant and the least frequent of all cutaneous tumors. Its incidence in pregnancy varies from 0.1 to 2.8/1000. Up to today, impact of pregnancy on melanoma's course is still a much debated question in the literature. Some earlier reports suggested a particularly serious prognosis for ...

A 59-year-old man with the diagnosis of endocarditis of the mitral valve due to Streptococcus mitis was treated with penicillin G, gentamicin, and later with clindamycin as inpatient for 3 weeks. Thereafter outpatient therapy with parenteral teicoplanin 3 x per week was initiated. After 17 days of teicoplanin treatment he ...

The incidence of syphilis is increasing, predominantly among urban heterosexuals. Early recognition is important in preventing progression of the disease and transmission of Treponema pallidum to the fetus. Untreated primary syphilis is characterized by intervals of active disease punctuated by periods of latency. Not all patients progress through each phase, ...

The incidence of congenital syphilis is on the rise. Penicillin continues to be the drug of choice for it during pregnancy. A penicillin-allergic woman with primary stage syphilis who was treated initially with erythromycin presented with fever and nonimmune fetal hydrops secondary to an intrauterine syphilitic infection. Following desensitization and ...

Five cases of macerated stillborn fetuses with congenital syphilis were studied. Despite severe maceration with visceral autolysis, spirochetes could be easily detected using Warthin-Starry stains. Clues that led to performing silver stains included the presence of an enlarged liver, spleen, chorioamnionitis, and nucleated red blood cells in villous capillaries. In ...