Leukorrhea and bacterial vaginosis as in-office predictors of cervical infection in high-risk women.

Objective: To evaluate 1) whether microscopic detection of leukorrhea or bacterial vaginosis identifies patients at high risk for cervical infection with Chlamydia trachomatis or Neisseria gonorrhoeae, and 2) if pregnancy alters the predictive value of these findings.

Methods: Wet-mount screening examination of vaginal discharge was performed on all new patients seen at two resident-staffed clinics serving primarily indigent women. Leukorrhea was defined as >10 white blood cells per high-power field on microscopic examination; Amsel criteria were used to determine the presence of bacterial vaginosis, with a positive clue cell test result defined as >20% of epithelial cells.

Office microlaparoscopy for female sterilization under local anesthesia. A cost and clinical analysis.

Objective: To evaluate the clinical and cost effectiveness of permanent female sterilization using microlaparoscopy and bipolar cauterization. The authors also tested how well the procedure was tolerated when performed under local anesthesia and conscious sedation.

Study Design: Patients undergoing microlaparoscopic permanent sterilization were prospectively followed.

Biomaterials for "tension-free" hernioplasties and principles of their applications.

Although decreasing, there exists an unjustified fear of mesh for the repair of inguinal and incisional hernias. This is due to the negative experience of the past when ideal biomaterials were not available. At the time of introduction of Marlex mesh by Francis Usher, three decades ago, ideal suture material for fixation of the mesh was not available and created undesirable complications.

[Biomaterials and hernia surgery. Rationale for using them].

Unlabelled: A study was made of the distinct biomaterials used in surgery and the requirements to be fulfilled and principles applied for their use in the repair of abdominal wall hernias. The biomaterials most frequently used in hernia surgery are: politetrafluorethylene (PTFE) sheet (Gore-Tex), the multifilament PTFE mesh (Teflon), the multifilament polypropylene mesh (Surgipro), the mono-filament polypropylene mesh (Marlex), the double filament polypropylene mesh (Prolene) and the multi-filament polyester mesh (Mersilene). Requirements for use in hernia surgery: the material must be inert, permanent and non-reabsorbable, resistant to infection, becomes rapidly fixed and incorporated into the host tissues, and not adhere to abdominal viscera.

[Preliminary evaluation of composite materials for the repair of incisional hernias].

Recent investigations have shown that direct exposure of the intestines to currently available absorbable and nonabsorbable biomaterials can result in their adhesion to the bowel. This can then lead to bowel obstruction or migration of the mesh into the intestinal lumen and formation of intestinal fistula. It has been suggested by some authors that an absorbable covering of the peritoneal side of a nonabsorbable mesh would prevent adhesions and biomaterial related intestinal fistula formation.