- Email: [email protected]
Oral contraception
300
Selected
abstracts
ception is the most eff~tivc method available.
and moist acceptal& Schuylcr
G. Kohl
Mears: Methods of Contraception, p. 470. Dr. Mears is medical secretary of the Family Planning Association of Great Britain. She presents a thoughtful and complete review and evaluation of the present methods of contraception in use in Great Britain. Her observation is that the newer methods will stimulate more participation and interest by physicians than has been the situation in the past. She feels especially, that the newer methods have decreased the necessity for sterilization. Schuyler
G.
Kohl
Morris: Oral Contraception, p. 478. Dr. Morris is Professor of Obstetrics and Gynecology at Charing Cross Hospital Medical School. He covers the mode of action, dosage, side effects, subsequent fertility, and dangers of long-term usage. He is convinced that this is the most useful method presently available. Schupler
G.
Kohl
Sandler: Conception after Adoption, p. 505. Dr. Sandler has done a study of patients in an infertility clinic whose examinations classified and who did not conceive. them as “normal” Some of these patients were advised to adopt a child. The subsequent pregnancy incidence was 52 per cent. In a control group of “emotional stress patients” who were treated psychologically, the subsequent pregnancy rate was the same as for the adoption group. Schuyler
Southern Vol.
58, No.
*Wilder,
Medical 4, April,
G. Kohl
.JournaI 1965.
E. M.: The Treatment of Uterine and Vaginal Prolapse in the Elderly Woman, p. 459. Wilder: The Treatment of Uterine and Vaginal Prolapse in the Elderly Woman, p. 459. Chronologically old but functionally young patients should have active treatment towards preservation of their sexual function. Mechanical devices are rarely indicated in management of prolapse and are only recommended for those who do not desire surgery or for those who are poor operative risks. For those in whom coitus is no longer a possibility the author recommends vaginal hysterectomy, anterior and posterior
colporrhaphy with piication of the urethraI besical nrck and closure of the cul-de-sac. For those who still desire marital relations, a similar technique hut with repair permitting coitus is performed. If an enterocele or prolapsed vaginal vault is present, colpectomy with excision of all of the vaginal mucosa is recommended. Of 194 patients, the postoperative results have been excellent with the most troublesome complication being urinary retention. Toby No.
5, May,
Frankel
1965.
*Cavanagh, D., Martin, D. S., and Ferguson, J. H.: Closed Pelvic Perfusion in Advanced Gynecologic Cancer, p. 549. Cavanagh, Martin, and Ferguson: Closed Pelvic Perfusion in Advanced Gynecologic Cancer, p. 549. The authors describe the use of a technique for perfusing anticancerocidal drugs with provisions to prevent leakage in the systemic circulation and have used the method on 12 patients with inoperable carcinoma. The authors used a combination of two antimetabolites and one alkylating agent in each patient. Eight of the cases received a combination of 5-fluouracil, Methotrexate, and uracil mustard, while 4 patients received 5-Huouracil, Methotrexate and cyclophosphamide. All the patients were given citrovorum factor (the metabolite which competes with Methotrexate) in a dose of 5 mg. per kilogram immediately after perfusion and postoperatively as necessary (“as necessary in the face of significant marrow depression”). The authors indicate that 8 of the 12 patients showed evidence of tumor necrosis and regression. In 4 cases, they felt the response was remarkably good but in no case was the tumor mass completely destroyed. It is of interest that in checking Table I, which lists all patients and their responses, 6 of 12 patients died within 3 months of the time that perfusion was performed. As the authors indicate in discussion of their work, the cases included in this study are patients with recurrent carcinoma of the cervix or far-advanced vulvar carcinomas. This is an unrewarding group of patients to work with and certainly any attempt to develop new modalities of therapy is worthy of praise. It should be noted, however, that the technique described by the authors is in itself, a major undertaking. Their procedure involved
Selected
abstracts
ception is the most eff~tivc method available.
and moist acceptal& Schuylcr
G. Kohl
Mears: Methods of Contraception, p. 470. Dr. Mears is medical secretary of the Family Planning Association of Great Britain. She presents a thoughtful and complete review and evaluation of the present methods of contraception in use in Great Britain. Her observation is that the newer methods will stimulate more participation and interest by physicians than has been the situation in the past. She feels especially, that the newer methods have decreased the necessity for sterilization. Schuyler
G.
Kohl
Morris: Oral Contraception, p. 478. Dr. Morris is Professor of Obstetrics and Gynecology at Charing Cross Hospital Medical School. He covers the mode of action, dosage, side effects, subsequent fertility, and dangers of long-term usage. He is convinced that this is the most useful method presently available. Schupler
G.
Kohl
Sandler: Conception after Adoption, p. 505. Dr. Sandler has done a study of patients in an infertility clinic whose examinations classified and who did not conceive. them as “normal” Some of these patients were advised to adopt a child. The subsequent pregnancy incidence was 52 per cent. In a control group of “emotional stress patients” who were treated psychologically, the subsequent pregnancy rate was the same as for the adoption group. Schuyler
Southern Vol.
58, No.
*Wilder,
Medical 4, April,
G. Kohl
.JournaI 1965.
E. M.: The Treatment of Uterine and Vaginal Prolapse in the Elderly Woman, p. 459. Wilder: The Treatment of Uterine and Vaginal Prolapse in the Elderly Woman, p. 459. Chronologically old but functionally young patients should have active treatment towards preservation of their sexual function. Mechanical devices are rarely indicated in management of prolapse and are only recommended for those who do not desire surgery or for those who are poor operative risks. For those in whom coitus is no longer a possibility the author recommends vaginal hysterectomy, anterior and posterior
colporrhaphy with piication of the urethraI besical nrck and closure of the cul-de-sac. For those who still desire marital relations, a similar technique hut with repair permitting coitus is performed. If an enterocele or prolapsed vaginal vault is present, colpectomy with excision of all of the vaginal mucosa is recommended. Of 194 patients, the postoperative results have been excellent with the most troublesome complication being urinary retention. Toby No.
5, May,
Frankel
1965.
*Cavanagh, D., Martin, D. S., and Ferguson, J. H.: Closed Pelvic Perfusion in Advanced Gynecologic Cancer, p. 549. Cavanagh, Martin, and Ferguson: Closed Pelvic Perfusion in Advanced Gynecologic Cancer, p. 549. The authors describe the use of a technique for perfusing anticancerocidal drugs with provisions to prevent leakage in the systemic circulation and have used the method on 12 patients with inoperable carcinoma. The authors used a combination of two antimetabolites and one alkylating agent in each patient. Eight of the cases received a combination of 5-fluouracil, Methotrexate, and uracil mustard, while 4 patients received 5-Huouracil, Methotrexate and cyclophosphamide. All the patients were given citrovorum factor (the metabolite which competes with Methotrexate) in a dose of 5 mg. per kilogram immediately after perfusion and postoperatively as necessary (“as necessary in the face of significant marrow depression”). The authors indicate that 8 of the 12 patients showed evidence of tumor necrosis and regression. In 4 cases, they felt the response was remarkably good but in no case was the tumor mass completely destroyed. It is of interest that in checking Table I, which lists all patients and their responses, 6 of 12 patients died within 3 months of the time that perfusion was performed. As the authors indicate in discussion of their work, the cases included in this study are patients with recurrent carcinoma of the cervix or far-advanced vulvar carcinomas. This is an unrewarding group of patients to work with and certainly any attempt to develop new modalities of therapy is worthy of praise. It should be noted, however, that the technique described by the authors is in itself, a major undertaking. Their procedure involved