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Sulfonamide therapy in gynecology and obstetrics
451
SELECTED ABSTRACTS place because of secondary foci and primary main problem in the treatment.
sources of infection, J.
DOS Pantis, A. F., and Zagmy, S.: Trichomonas An. brasil. de ginec. 8: 167-175, 1943.
Vaginalis
and this is the P. GREENHILL.
and Its Treatment,
The authors treat trichomonas vaginalis vaginitis by means of sulfonamide suppositories. Of 39 women treated by this means, 30 were cured and 9 discontinued the treatment. In 55.5 per cent of the cases, examination of the husband’s urethra This is the source of reinfection revealed the presence of Trichonzo~s vaginalis. according to many authors. The organism was also found in the urethra of 33.3 per cent of the patients. No organisms were found in the rectum. J. P. GREENHILL. O’Sullivan, J. V., and Bourne, L. B.: Supervision Employment, Rrit. M. J. 4333: 108, 1944.
of Pregnant
Women in Factory
The authors describe the British System of caring for pregnant women working in factories. Factory antenatal clinics are advised. Under medical supervision it was found that many women can do suitable work to an advanced stage of pregnancy. Nursing mothers were not advised to recommence work until at least three months after delivery, and day nurseries must be established if a return to work becomes necessary. WILLIAM BERMAN. Dutra, Licinio H.: Sulfonamide Therapy ginec. e d’obst. 37: 277-287, 1943.
in Gynecology
and Obstetrics,
Rev. de
The author finds that the use of sulfonamides is obligatory in the prophylaxis and treatment of puerperal infection. Thus, any wornall who had a prolonged delivery, premature rupture of the membranes, several vaginal examinations, assistance by nonprofessionals or an obstetrical intervention must be given sulfonamides. Whenever possible, their use should be started before the end of labor in doses of 4 to 5 Gm. daily, and after labor, oxytocics and blood transfusions should be administered, if necessary. The slight elimination of the drugs in the milk (2 to 6 centigrams in 24 hours) does not contraindicate breast feeding. According to Speert, intravenous injection of sodium sulfathiazole or sodium sulfadiazine must be used in intercurrent or intrauterine infection during labor, or in cases of gonorrhea of the mother to protect the child. Various sulfonamides have been successively used in the treatment of gonorrhea. Recent work by Douglas, Davis and Shandorf shows that sulfathiazole and sulfadiazine are more specific and rapid and much less toxic than sulfanilamide, and that sulfadiazine seems to be more efficient. Bacteriologic cure is frequently observed between 9 and 12 hours after the use of sulfadiazine and sulfathiazole, while sulfanilamide takes 40 to 50 hours to give the same result. The ideal form of treatment would consist of 4 Gm. of sulfadiazine or sulfathiazole daily for six consecutive days. These facts are being confirmed by the literrtture. In gonococcic vulvovaginitis of infants the author has obtained much better results with estrogen therapy than with sulfanilamide or sulfathiazole. The indications for the intraperitoneal use of sulfanilamide in powder are: peritonitis caused by bacteria or gastrointestinal contents; contamination of the sterile peritoneal cavity by opening of an infected cavity; a drained abscess cavity areas and in me(Douglas) ; to avoid formation of adhesions in nonperitonized
Kirchoff, A. C., Race&, C. A., Wilson, W. M., and David, Like Oxytocic Synthesized From Lysergic Acid, West.
I?. A.: ,I. burg.
An Erganovine52: I!,;, In-+-!.
Sddition ol’ hydroxybutyl amidr 2 111 Iyrergic? acid pro~luwr :L ~wnpund tl,:\t structurally rwcmbles rrgonovine, and prc~duces a motor effwt upon the uterus in every way similar to ergonoviue. Trst f-11 on exc+ed muscle strips of the guin?& pig, wt, dog, and rabbit uterus it gave in wruparablr doaagc, :I motor rewtiou in ever.3 way c~onqiirable to ergonovine. Studies on the human Ikng revealed an in~rrasr~l tone and motor response after a 3-minim 1lo5r by mouth ill :I wvonmn new tm-m. Iu 2ti cases the drug was given in a (IOYC oi 0.2 mg. intravenously as the anterior shoulder was being delivered. The plawnta was clr~livtwtl in an av~r:ige of R.2 nrinutes and the reaction of the utelur in c~vt’ry way par:~llrletl 111~ rwponw following c*ompara,ble doses of ergonovine. ‘I’hr!w is it slight riw in !ilootl prwsurr following but app:wnfl~ no sympathicolytic~ the administration of 3I.F:. 277 (1Methrrpinr), action because it failed to inhibit the epinephrine blood preusuw riw in dogs and tlw epinephrine motor response in the rabbit ~~terus. The synt,hetic preparation of ergot. supply, and the difficulties crude ergot is obtainable.
swh a pwduct is important found in obt.aining p”tent~
hewuse of raw material \vrl,r.i*bl
Leon, Juan: Obstetric A67, 1913.
and Obstetric-Gynecologic
SpeciaHzation,
the limited even where RI(‘KFxS.
Semana
mGd. 2:
The author comments on the controvrwy as to whether obst,etric and ggnecologic practice should be separated or combined. He points out that the r$sentisl funrtion C:j-necologic diseases are Cntimately Ronof the genital apparat~us is reproduction. ntutlg of physiology and cerned with the reproductive function : hence logically, It it; not necessary that, a phypathology of the same organs cannot be separated. sician trained in obstetrics and gynecology should practice both upec*ialties, but he In any ca.w, hbwwill be better prepared to function as rither type of rpeci:tlist. ever, specialization is indispensable. A t,raining program of six years is proposed. necessary to acquire in an orderly, dkiplined form, for practicing obstetrks. Specialization in ohntetrics requires more time, at least ten years.
This is considerw1 the minimum the clinical experiencde necorsxry am1 gynrcologp simnltaneoualy
The suggested program cpomprisw three cycles of two years each. The tirst period has for its objwt the general study of gynecology and everything pertainthe purrperium, and the newborn ing to the physiology of pregnancy, parturition, The second period is devoted to the study of tht> pathology of pregnamy, infant. The third period covers the parturition, the puerperium and the newborn infant. The candidate during ihe first t\vo periods should serve whole field of obstetrics. as second ;t.qaistant, in the clinic, and in the consulting rooms, and should gain surgical experience as second assistant, first at, simple opePdt.ions and normal ik-
SELECTED ABSTRACTS place because of secondary foci and primary main problem in the treatment.
sources of infection, J.
DOS Pantis, A. F., and Zagmy, S.: Trichomonas An. brasil. de ginec. 8: 167-175, 1943.
Vaginalis
and this is the P. GREENHILL.
and Its Treatment,
The authors treat trichomonas vaginalis vaginitis by means of sulfonamide suppositories. Of 39 women treated by this means, 30 were cured and 9 discontinued the treatment. In 55.5 per cent of the cases, examination of the husband’s urethra This is the source of reinfection revealed the presence of Trichonzo~s vaginalis. according to many authors. The organism was also found in the urethra of 33.3 per cent of the patients. No organisms were found in the rectum. J. P. GREENHILL. O’Sullivan, J. V., and Bourne, L. B.: Supervision Employment, Rrit. M. J. 4333: 108, 1944.
of Pregnant
Women in Factory
The authors describe the British System of caring for pregnant women working in factories. Factory antenatal clinics are advised. Under medical supervision it was found that many women can do suitable work to an advanced stage of pregnancy. Nursing mothers were not advised to recommence work until at least three months after delivery, and day nurseries must be established if a return to work becomes necessary. WILLIAM BERMAN. Dutra, Licinio H.: Sulfonamide Therapy ginec. e d’obst. 37: 277-287, 1943.
in Gynecology
and Obstetrics,
Rev. de
The author finds that the use of sulfonamides is obligatory in the prophylaxis and treatment of puerperal infection. Thus, any wornall who had a prolonged delivery, premature rupture of the membranes, several vaginal examinations, assistance by nonprofessionals or an obstetrical intervention must be given sulfonamides. Whenever possible, their use should be started before the end of labor in doses of 4 to 5 Gm. daily, and after labor, oxytocics and blood transfusions should be administered, if necessary. The slight elimination of the drugs in the milk (2 to 6 centigrams in 24 hours) does not contraindicate breast feeding. According to Speert, intravenous injection of sodium sulfathiazole or sodium sulfadiazine must be used in intercurrent or intrauterine infection during labor, or in cases of gonorrhea of the mother to protect the child. Various sulfonamides have been successively used in the treatment of gonorrhea. Recent work by Douglas, Davis and Shandorf shows that sulfathiazole and sulfadiazine are more specific and rapid and much less toxic than sulfanilamide, and that sulfadiazine seems to be more efficient. Bacteriologic cure is frequently observed between 9 and 12 hours after the use of sulfadiazine and sulfathiazole, while sulfanilamide takes 40 to 50 hours to give the same result. The ideal form of treatment would consist of 4 Gm. of sulfadiazine or sulfathiazole daily for six consecutive days. These facts are being confirmed by the literrtture. In gonococcic vulvovaginitis of infants the author has obtained much better results with estrogen therapy than with sulfanilamide or sulfathiazole. The indications for the intraperitoneal use of sulfanilamide in powder are: peritonitis caused by bacteria or gastrointestinal contents; contamination of the sterile peritoneal cavity by opening of an infected cavity; a drained abscess cavity areas and in me(Douglas) ; to avoid formation of adhesions in nonperitonized
Kirchoff, A. C., Race&, C. A., Wilson, W. M., and David, Like Oxytocic Synthesized From Lysergic Acid, West.
I?. A.: ,I. burg.
An Erganovine52: I!,;, In-+-!.
Sddition ol’ hydroxybutyl amidr 2 111 Iyrergic? acid pro~luwr :L ~wnpund tl,:\t structurally rwcmbles rrgonovine, and prc~duces a motor effwt upon the uterus in every way similar to ergonoviue. Trst f-11 on exc+ed muscle strips of the guin?& pig, wt, dog, and rabbit uterus it gave in wruparablr doaagc, :I motor rewtiou in ever.3 way c~onqiirable to ergonovine. Studies on the human Ikng revealed an in~rrasr~l tone and motor response after a 3-minim 1lo5r by mouth ill :I wvonmn new tm-m. Iu 2ti cases the drug was given in a (IOYC oi 0.2 mg. intravenously as the anterior shoulder was being delivered. The plawnta was clr~livtwtl in an av~r:ige of R.2 nrinutes and the reaction of the utelur in c~vt’ry way par:~llrletl 111~ rwponw following c*ompara,ble doses of ergonovine. ‘I’hr!w is it slight riw in !ilootl prwsurr following but app:wnfl~ no sympathicolytic~ the administration of 3I.F:. 277 (1Methrrpinr), action because it failed to inhibit the epinephrine blood preusuw riw in dogs and tlw epinephrine motor response in the rabbit ~~terus. The synt,hetic preparation of ergot. supply, and the difficulties crude ergot is obtainable.
swh a pwduct is important found in obt.aining p”tent~
hewuse of raw material \vrl,r.i*bl
Leon, Juan: Obstetric A67, 1913.
and Obstetric-Gynecologic
SpeciaHzation,
the limited even where RI(‘KFxS.
Semana
mGd. 2:
The author comments on the controvrwy as to whether obst,etric and ggnecologic practice should be separated or combined. He points out that the r$sentisl funrtion C:j-necologic diseases are Cntimately Ronof the genital apparat~us is reproduction. ntutlg of physiology and cerned with the reproductive function : hence logically, It it; not necessary that, a phypathology of the same organs cannot be separated. sician trained in obstetrics and gynecology should practice both upec*ialties, but he In any ca.w, hbwwill be better prepared to function as rither type of rpeci:tlist. ever, specialization is indispensable. A t,raining program of six years is proposed. necessary to acquire in an orderly, dkiplined form, for practicing obstetrks. Specialization in ohntetrics requires more time, at least ten years.
This is considerw1 the minimum the clinical experiencde necorsxry am1 gynrcologp simnltaneoualy
The suggested program cpomprisw three cycles of two years each. The tirst period has for its objwt the general study of gynecology and everything pertainthe purrperium, and the newborn ing to the physiology of pregnancy, parturition, The second period is devoted to the study of tht> pathology of pregnamy, infant. The third period covers the parturition, the puerperium and the newborn infant. The candidate during ihe first t\vo periods should serve whole field of obstetrics. as second ;t.qaistant, in the clinic, and in the consulting rooms, and should gain surgical experience as second assistant, first at, simple opePdt.ions and normal ik-