Abstract:
:This paper reviews the clinical recognition, diagnosis, and management of ectopic pregnancy at the Queen of Angels Hospital for the past 15 years. The incidence of ectopic pregnancy to deliveries is 1:195. Pain is the cardinal symptom of ectopic pregnancy, and amenorrhea of some degree was present in all cases. Pelvic inflammatory disease is a factor in the development of tubal pregnancy in some women. A careful history and thorough physical examination are important in making a careful diagnosis. The only laboratory procedures which are of any value are the blood type and the Rh determination. While examination of endometrial tissue obtained by biopsy or curettage has proved useful in ectopic pregnancy diagnosis, it is not totally decisive. Culdocentesis has proved to be the diagnostic procedure of the greatest value in recognizing intraperitoneal hemorrhage and it increases the correct preoperative diagnosis from 65-70% to 95%. Laparoscopy is useful when the physician is in doubt about the nature of the problem and it has produced an increase in the number of ectopic pregnancies diagnosed. Ultrasound is another useful tool in confirming a diagnosis of ectopic pregnancy; its accuracy ranges from 70-92%. A newly developed pregnancy test is more sensitive than conventional pregnancy tests and would be positive for pregnancy. Women who have had a previous ectopic pregnancy have a higher subsequent incidence of persistent infertility, recurrent ectopic pregnancy, and pregnancy wastage; the risk of another ectopic pregnancy increases 30-50 fold. While extopic pregnancy does recur, it is true that about 1/3 of those women do have successful pregnancies. Where previous induced abortion has occurred, there is a 10-fold increased risk of ectopic pregnancy. Women who become pregnant accidentally with an IUD in place have a greater likelihood of experiencing an extrauterine pregnancy. Abdominal pregnancy is often encountered as an aborting ectopic pregnancy during the 1st trimester. In cases such as this, there can be local excision and hemostasis. Idiopathic thrombocytopenic purpura was another encountered complication. Salpingectomy is inappropriate and even dangerous when used with an ectopic pregnancy. Early diagnosis and prompt surgery can help increase the survival rate. However, conservative surgery which preserves the tube is feasible and practical using salpingotomy and partial salpingectomy. Maternal death resulting from ectopic pregnancy is usually the result of sudden massive hemorrhage. The initiation of therapy prior to rupture is helpful. Ectopic pregnancy rate has remained fairly consistent among the white population but has decreased significantly in the nonwhite population. This is likely tied to an improvement in socioeconomic status, better patient education, and a greater awareness of medical needs. To decrease the maternal mortality rate from ectopic pregnancy, obstetricians and gynecologists must be more aggressive in research and treatment of ectopic pregnancy.
journal_name
J Natl Med Assocjournal_title
Journal of the National Medical Associationauthors
Weekes LRsubject
Has Abstractpub_date
1981-09-01 00:00:00pages
823-33issue
9eissn
0027-9684issn
1943-4693journal_volume
73pub_type
杂志文章abstract::A retrospective study was undertaken to assess the value of three-dimensional computed tomography (3-D CT) in evaluating craniofacial abnormalities. Over a 2-year period, 145 children evaluated with routine two-dimensional (2-D) CT had 3-D CT reformatted images assessing a variety of anomalies including craniosynostos...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::This article describes a required primary care curriculum for all third and fourth year medical students at the Drew/UCLA Medical Education Program. The curriculum is a supplement to the traditional medical school clinical requirements. Key features of the primary care core curriculum in the third year include a weekl...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract::This preliminary study explored the roles of knowledge, attitudes, and significant others on decisions of older African-American women to enroll in a clinical trial involving estrogen and osteoporosis. Sixteen older African-American women (average age 75 years) participated in three focus groups. Twelve of the women h...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract::Collagenous colitis has been associated with autoimmune diseases. Co-occurence of systemic sclerosis and collagenous colitis is particularly rare. Herein, we described a 65-year-old woman with systemic sclerosis whose diarrhea and abdominal cramping were due to collagenous colitis. We have reviewed the clinical and hi...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
abstract::Pulmonary contusions following blunt trauma often are visible roentgenographically immediately after injury. The case presented illustrates the need for prompt x-ray studies of the chest following blunt injury. ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:PURPOSE:To explore why some African-American smokers choose not to use nicotine replacement therapy (NRT) when attempting smoking cessation. DESIGN AND SETTING:Semistructured audiotaped qualitative telephone interviews. PARTICIPANTS:Thirty-three participants who were enrolled in a five-week cessation program were off...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:10.1016/s0027-9684(15)31211-6
更新日期:2008-02-01 00:00:00
abstract::We describe the findings of anhidrotic/hypohidrotic ectodermal dysplasia in three successive generations of a family. All three women had variable alopecia, anhidrosis, hypodontia and malar hypoplasia. Chromosomal studies revealed a defect of the 2q12 region in all three patients. Previous studies have reported rare c...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::Sixteen cytologic endocervical atypias are reported with corroborative tissue analysis. Maternal diethylstilbestrol (DES) history was positive in three patients, one with clear cell adenocarcinoma, one with colposcopy and biopsy proven benign vaginal adenosis, and one with squamous carcinoma in situ of the cervix. Col...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract::A case of pancreatitis that occurred as a complication of a vaso-occlusive crisis in a child with sickle cell anemia is reported. We encourage others to consider pancreatitis as a cause for abdominal pain in children with multisystem diseases, particularly those that may cause ischemic organ injury such as sickle cell...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::A left testicular mass was found in a 34-year-old black man with a history of multisystem sarcoidosis of 7½ years duration. Microscopic examination of the excised testicle revealed noncaseating granulomas throughout, as well as a few such lesions in the epididymis. This is the seventh reported, microscopically proven ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::A large majority of psychiatric outpatients (70 percent) could be diagnosed by nonprofessionals, and an even larger proportion, 80 percent, of 36 patients evaluated could be treated by nonprofessionals. Where the nonprofessional needed professional assistance to diagnose and treat the patient, it was a medical doctor ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract::Arsine gas exposure is a rare occupational event and can be completely prevented with the use of appropriate protective gear. Exposure often occurs when arsine gas is generated while arsenic-containing crude ores or metals are treated with acid. Cases of toxicity require an index of suspicion and a good history. In pa...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章,评审
doi:
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this cross-sectional study was to examine the association between elevated depressive symptoms and the clinical severity of sickle cell disease (SCD) using African-American adults with and without SCD. STUDY DESIGN:The population consisted of 102 African-American adults with SCD, diagnosed usi...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::The FDA approved hydroxyurea for use in adults with sickle cell disease (SCD) in 1998. In 2002, the NHLBI published recommendations for the use of hydroxyurea in this patient population. The purpose of this study was to evaluate providers' awareness of the NHLBI recommendations regarding hydroxyurea prescribing, wheth...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2008-08-01 00:00:00
abstract::Cancer prevention materials such as pamphlets, booklets, and fact sheets play a significant role in reducing cancer disparities. Little is documented in the literature about the cultural sensitivity of materials targeting African Americans. The Cancer Prevention Materials and African Americans project was conducted to...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract::Today, wound management to avoid excessive scar formation is increasingly important, especially in populations with Fitzpatrick 3 or higher skin pigmentation. Medical science and industrial development are devoting more effort toward understanding and offering better therapy to control scars. However, advances in scar...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章,评审
doi:
更新日期:2004-01-01 00:00:00
abstract::The title "Doctor" has an interesting and not commonly understood inception, and those entitled to use the accolade Doctor have had an interesting evolution. The title is now used by a plethora of individuals with a variety of skills and levels of achievement. A random survey of the population reveals that the public ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Although mortality from cardiovascular diseases (CVDs) has been declining, it remains the leading cause of death among urban U.S. blacks. McCord and Freeman reported CVD as the major contributor to excess mortality in Central Harlem. However the disease-specific CVD mortality was not assessed. Thus, it was unclear wha...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract:INTRODUCTION:This book review analyzes the complex and profound impact active religious participation has on relationships and family outcomes among African Americans and Latinos. In Soul Mates, Wilcox and Wolfinger discuss the legacy of slavery and Jim Crow laws and the resulting devastating effects on African America...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章,评审
doi:10.1016/j.jnma.2016.08.007
更新日期:2016-01-01 00:00:00
abstract::A 75-year-old woman with two previous neck operations for follicular carcinoma of the thyroid presented with a breast mass nine years after diagnosis. The mass recurred one month after excisional biopsy. Pathological examination revealed metastatic follicular carcinoma. The breast tumor was weakly positive for estroge...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:ACKNOWLEGMENT:This study was supported by Clinical Research Grant (7-08-CR-27) from the American Diabetes Association and by a contract (58-1950-7-707) with the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University. This article does not necessarily reflect the views or ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:10.1016/S0027-9684(15)30065-1
更新日期:2014-07-01 00:00:00
abstract::Relatively low serum albumin is a predictor of increased mortality and coronary heart disease incidence. To shed light on the likelihood of confounding this association by high-density lipoprotein (HDL) cholesterol or other risk factors, data from the National Center for Health Statistics were examined. Serum albumin ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract::Organizational barriers play a key role in colorectal cancer (CRC) screening disparities in low-income minorities. This is a prospective, randomized trial to determine whether a patient navigator (PN) can help overcome the organizational barriers low-income minorities face in trying to obtain screening colonoscopy. Pa...
journal_title:Journal of the National Medical Association
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0027-9684(15)31240-2
更新日期:2008-03-01 00:00:00
abstract::Splenomegaly, when present as a manifestation of sarcoidosis, may cause pressure symptoms and hypersplenism. Literature reports of giant splenomegaly are few in number and describe the use of aggressive intervention with systemic steroids and splenectomy. However, the natural history of splenic sarcoidosis is not well...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract::Small-bowel obstruction due to foreign bodies is unusual in adults. Intestinal obstruction is occasionally caused by pits, bezoars, endoscopy capsules, and gastrostomy tube buttons. We report a rare case of distal small-bowel obstruction due to dental impression material. Avoidance of this potentially life-threatening...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:10.1016/s0027-9684(15)31143-3
更新日期:2009-12-01 00:00:00
abstract::This article examines the validity of the National Institute of Mental Health Diagnostic Interview Schedule (DIS) relative to three of its measures: alcoholism, depression, and schizophrenia when compared with the clinical interview. Preliminary results indicate that greater diagnostic agreement was observed for alcoh...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that account for 0.2% of all GI neoplasms. We report a case of a 62-year-old male with a large esophageal GIST, and discuss the pathophysiology of the disease and the current management principles. This case is noteworthy because it documents a rar...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:10.1016/s0027-9684(15)30933-0
更新日期:2009-05-01 00:00:00
abstract::This study examined the clinical characteristics and outcome of pulmonary tuberculosis in African Americans hospitalized in a teaching hospital in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tuberculosis were reviewed. Predisposing ...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract::The gastrointestinal tract is the largest lymphoid reservoir of the body and is subject to damage that compromises the cellular and humoral defense mechanism. With the increasing numbers of patients infected with the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), health-care practiti...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Self-monitoring of blood glucose (SMBG) is considered to be 1 of the cornerstones of diabetes self-management. It is unclear whether inadequate health literacy affects SMBG. OBJECTIVE:The objective of this study was to examine the relationship between health literacy and SMBG. METHODS:This was a cross-sect...
journal_title:Journal of the National Medical Association
pub_type: 杂志文章
doi:10.1016/s0027-9684(15)30469-7
更新日期:2010-01-01 00:00:00