Volume Number
74 6
SELECTED
New England b’ol.
255,
December
“Gryboski,
1369
ABSTRACTS
Journal
of Medicine
13, 1956.
W.
A.,
and
Spiro,
H. M.:
The
Effect
of Pregnancy
on Gastric
Secretion,
p.
1131.
Gryboski
and Spiro:
Effect of Pregnancy
on Gastric Secretion, p. 1131
The authors used the imlirect measure of gastric secretion by the blood pepsin method secretion in an attempt to evaluate the clinical to stully the effect of pregnancy on gastric impression that pregnancy may alleviate the symptoms of peptic ulcer. Blood pepsin levels parallel gastric pepsin levels, and so can he taken as a reflection of gastric secretory activi ty. The authors’ study indicates that the mean values in the first six months of pregnancy show no significant variation from the normal. A rise in the mean blood pepsin values was observed during the thirtl trimester, ancl the levels reached a peak on the day after delivery, falling to normal values by approximately 120 days post partum. The rise in blood pepsin (luring the last trimester suggests an increase in gastrir secretion, anI the authors point out that these observations suggest that there are data which cast cloul)t on the clinical impression that the symptoms of peptic ulcer are ameliorated during pregnancy.
Vol.
276.5, December *Jackson,
20. 1956.
W. P., and Woolf,
Jackson and Woolf:
N. :
The Natural
The
History
Natural
History
of Prediabetes,
of Prediabetes,
p. 1183.
p. 1183.
The
authors present the case history of a typical so-called ‘(prediabetic” patient. This woman, whose mother was diabetic, experiencetl progressive increase in weight, and there was progressive increase in the weights of successive babies born to her. Her eighth baby was stillborn; her ninth was premature and {lied neonatally; at autopsy there were grossly enlargell islamls of Langerhans in this infant’s pancreas, anI1 the liver showed extramedullary hernotopoiesis. The authors saw the patient in her tenth pregnancy, and performed a glucose tolerance test at 8 months’ gestation which showed an elevation of the blood sugar levels at 3 hours and 2% hours. Cesarean section was performed before term with delivery of an edematous infant who weighed 13 pounils. In the puerperium the patient’s glucose tolerance curve reverted to normal, but on being retested some months later it was again abnormal in a prediabetic manner. Two years later the patient had gross glycosuria and The authors point out that prediabetes should be SUSa true diabetic tolerance curve. pected as the cause of any unexplained stillbirth and tested for by determination of glucose toleranre and examination of the pancreas of the infant. The authors point out that it is strange that, by examining the tissues of her child, one rnrty consistent,ly make the diagnosis of a disease which may not be manifest for years in the mother.
r-07.
256, Jni?unry “Creger,
94, 1957.
W. P., and Strele,
Creger and Steele:
M. R.:
Human Petomaternal
Human
Fetomaternal
PassagE:
Passage of Erythrocytes,
of Ergthrocytes,
p. 158.
p. 15%
The authors’ studies were designed to test the hypothesis that appreciable numbers The of fetal reel cells gain entrance to the maternal circulation in normal pregnancy. rationale of their method was as follows: If the mother and the fetus are of different AR0 groups, fetal red cells that may have gained entrance to the maternal circulation can he counted separately from the mother’s erythrocytes by means of antigenic differences in the two sets of cells. With mothers of group A and infants of group 0, a count was made ot agglutinated red cells left in the maternal blood specimen after maximal agglutination by
Jewett : Changing
Maternal
Mortality
in Massachusetts,
p. 395.
The author reviews statistical data on maternal mortality in the remote past in E:ngIan11 and France and recentI>in Massachusetts. In l!lM, the primar)avoi~lahle factors were inadequate prenatal ears in :lR per rent, delay in 1:) per cent, alill surgical error in 19 per eent. The surgical error.‘; were all aSsociate(l with cesarean section, in itself associatecl with L’i per cent of all maternal (leathn. The most clisturbing cause or contriliutirrg cause of death was sepsis, an<1 the author points nut, t,hat it can tie assumed that this always occurs from a break in trchnirlue unlrss the contrary is proved. The author flrcrirs the indiscriminate rise of so-called prophylactic antiliiotics, which destroy thr suspeetihle a false sense rif organisms, leaving a rlear field for the more virulent ones1 anIl provide security. He conclutles that a i(tully of the current niost common primary a\-oillable factors in maternal mortality stresses liar imperative tlrmar~ds upen t.lre profession: twth ph;vsicians ant1 the public must tm e~lnc*ate~l to realizc the iniportancc of lmtttr prfnatal cared; inst~antanrous transfusion facilities niust IW a\.ailal)lc in hospitals in which otbstctrics is performed; cesarean section sl~onl~l IW avoillc~l unless strictly in(licatell; met’0 rigorous attention to asepsis shollltt tw rt~surne~l to co~~~l.mt the rising prelmrtien of Ilcxths fr~,m sepsis; antI obstetricians must IICIIIXII(I better ancsthvsia. 1 )Ol’(il.‘~S hf. H’A’iNlW
Wiener Vol.
68, Septentbur “Weiss,
II., sages
klinische
Wochenschrift
14, 3956. and Strametz, in Parametritis,
I%.: Concerning p. ‘i20.
Weiss and Strametz: Concerning metritis, p. iSO.
AIterations
Alterations
in
in the Excretory
the
Excretory
Urinary
Urinary
Pas-
Passages in Para-
In the clinical syndrome of acute parametritis, the serious clinical manifestations of the acute disease are predominant, se that thr frelluent urinary complications in the escrptory urinary passages are often trvnlookell. In 2:i.X per cent of all cases of either unilateral or trilateral lmrametritis ~,l~rrvt.~ a 1 l,,\- the authors in the I~iiivrrsit,v G,vnrvologir vliniv in (+raz, nrinar,v t.r:tc*t attPrations of tmth anatoniivat an(l fnrlvt ional type were liiagnost*rl. w:ts thuuglit 11, IW tn~th il,siv antI mfv~tlanival ill origin. The etiology of thrsv alt.rraliolls I’oll~w-up stu~lic*s showe~l that most of this urinary tract (Ianlagt~ was of a revt~rsit~le tylns. The authors empharizr the need for further clinical ntnliirs in a larger group of patients. I)or:cr,ns hf. HAYKES