A medical student elective promoting humanism, communication skills, complementary and alternative medicine and physician self-care: an evaluation of the HEART program.

Objective: In 2002 the American Medical Student Association (AMSA) created a fourth-year medical student elective known as the Humanistic Elective in alternative medicine, Activism, and Reflective Transformation (HEART) that provided the opportunity for students to explore humanism in medicine, self-care, complementary and alternative medicine modalities, communication, activism, and community building in a four-week immersion experience. The educational effects of this elective, and whether it has met its stated goals, are unknown.

Method: The authors conducted a web-based, cross-sectional survey of the first eight cohorts of HEART graduates in 2010.

Nitric oxide as a regulator of embryonic development.

The role of nitric oxide (NO) in activation of cGMP is well established. It has been proposed that the ratio of cAMP to cGMP may be important in the regulation of preimplantation embryonic growth and differentiation. Therefore, we determined the ability of murine preimplantation embryos to produce NO.

The prognostic value of serum progesterone and quantitative beta-human chorionic gonadotropin in early human pregnancy.

Objective: Our purpose was to determine whether serum progesterone, with or without quantitative beta-human chorionic gonadotropin, is predictive of pregnancy outcome within the first 8 weeks of gestation in asymptomatic women.

Study Design: Asymptomatic patients at < 8 menstrual weeks' gestation were prospectively evaluated. The enrollment protocol included history, physical examination, ultrasonographic confirmation, and blood sample collection for beta-human chorionic gonadotropin and progesterone.

Subclinical pregnancy loss in clomiphene citrate-treated women.

Objective: To ascertain the subclinical pregnancy loss rate in clomiphene citrate (CC)-treated infertile women compared with women of normal fertility.

Design: Following a prospective format, serum samples were taken during the luteal phase of 92 menstrual cycles associated with CC treatment and 47 cycles in normal women. Human chorionic gonadotropin (hCG) assay sensitivity was 0.

Preservation of pulsatile luteinizing hormone release during postpartum lactational amenorrhea.

To evaluate the pulsatile mode of immunoactive LH release during physiological lactational amenorrhea, we withdrew blood samples at 10-min intervals for 24 h from breastfeeding women (n = 9) at both 3 weeks and 3 months postpartum. Nonlactating women (n = 7) were sampled similarly in the early follicular phase of the normal menstrual cycle. Objective LH pulse analysis revealed that the mean frequencies of pulsatile LH release were similar at both times postpartum and in menstruating young women.

Dynamics of pulsatile prolactin release during the postpartum lactational period.

To investigate the pulsatile nature of PRL release in the physiologically hyperprolactinemic postpartum period, we sampled blood at 10-min intervals for 24 h in each of 6 healthy lactating women at both 3 weeks and 3 months postpartum. The subsequent immunoactive PRL time series were subjected to episodic peak detection (Cluster analysis) and multiple parameter deconvolution analysis. The 24-h mean serum PRL concentrations were significantly higher at 3 weeks than at 3 months postpartum; viz.

Oocyte retention after follicle luteinization.

Indirect evidence supports the existence of the luteinized unruptured follicle syndrome in infertile women. To seek direct evidence of oocyte retention, infertile and normal women were studied in the early and midluteal phase by visual documentation of ovulation stigma, needle aspiration of ovarian follicles, and peritoneal fluid collection for estradiol and progesterone assay. Luteal phase was confirmed by endometrial biopsy (postovulation day 2 to 8).

Exogenous estrogen therapy for treatment of clomiphene citrate-induced cervical mucus abnormalities: is it effective?

Clomiphene citrate (CC) may have an adverse effect on cervical mucus (CM) quality and quantity. A placebo-controlled study was performed to assess the effect of exogenous follicular phase estrogen (E) on CM. Subjects qualified for inclusion by repeated demonstration of poor CM while on CC therapy as judged by spinnbarkeit, quantity, and viscosity.

Vaginal sonography findings and hCG dynamics of early intrauterine and tubal pregnancies.

Early intrauterine gestational sac recognition by ultrasound is useful for discriminating between intrauterine and tubal pregnancies. Transvaginal ultrasound offers improved resolution in the imaging of the uterus and adnexa. Seventy-four women with normal intrauterine pregnancies, 18 women with spontaneous abortions, and 34 women with tubal pregnancies were evaluated by transvaginal ultrasound and serial hCG determinations.

Subsequent fertility in women who undergo cardiac surgery.

A retrospective review was undertaken on all pediatric and reproductive-aged females who underwent cardiac surgery and required cardiopulmonary bypass from 1958 through 1986. The purpose of this study was to define the fertility of these patients after surgery and to compare their reproductive performance with that in the general population. Analysis was complete for 208 patients.

Acute bilateral diffuse pulmonary shadowing after evacuation of hydatid mole.

Acute bilateral diffuse pulmonary shadowing complicates the resection of hydatid mole approximately 10% of the time. Etiologic factors include trophoblastic emboli, pulmonary emboli, high output congestive failure, and DIC. Prompt recognition and emergency oxygen therapy with PEEP are imperative for survival.

Intravasation during hysterosalpingography using oil-base contrast medium--a second look.

Hysterosalpingography is a study performed commonly to assess the upper reproductive tract in infertile women. A risk with hysterosalpingography is either lymphatic and/or venous intravasation with or without embolization. Of 593 consecutive hysterosalpingograms performed with a low-viscosity oil-base medium, intravasation occurred in 41 cases (6.

Protein synthesis and secretion in human decidua of early pregnancy.

Proteins synthesized and secreted by first trimester decidua in primary culture were identified. Explants were cultured for 24 h, in RPMI-1640 or Dulbecco's Modified Eagles Medium containing the radioactive amino acid 35S-methionine or 3H-proline. Electron microscopy of explants before and after 24 h of culture demonstrated the relative purity of the decidua, maintenance of cell integrity, and ultrastructural features indicative of active protein synthesis and secretion.

Utility of the 24-hour delay hysterosalpingogram film.

Controversy exists regarding the ideal contrast media for hysterosalpingography. A unique property of oil-base contrast media is the availability of a 24-hour delay radiograph for further assessment of tubal patency and adhesions. A review was undertaken of the delay films in 131 cases performed by use of oil-base contrast media with subsequent surgical confirmation of pelvic findings.

Surgical management of distal tubal occlusion.

During the 9-year period ending April, 1985, 103 women had bilateral and unilateral cuff salpingostomy at the University of Virginia Hospital. Currently accepted principles of microsurgery were used as well as an "antiadhesion" regimen consisting of intravenous dexamethasone and antibiotics, intraperitoneal dextran, and postoperative hydrotubations. The postoperative tubal patency rate was 75.

Quantitative effects of intraperitoneal 32% dextran 70 on serum immunoglobulin levels in women undergoing gynecologic surgery.

The use of intraperitoneal 32% dextran 70 results in quantitative postoperative changes in human IgG and IgA levels that are statistically different from the alterations induced by the surgical procedure alone.

Homologous insemination--revisited.

Between July 1, 1969, and December 31, 1983, 1774 patients were evaluated in the private infertility clinic at the University of Virginia Hospital. Homologous artificial insemination was performed in 158 patients for the following indications: male factor (75.3%), cervical factor (16.

Reproductive performance of patients treated with clomiphene citrate.

From 1967-1980, 488 infertile women underwent induction of ovulation with clomiphene citrate at the University of Virginia Hospital. Conception occurred during treatment cycles in 209 women (group 1), but 279 women (group 2) failed to conceive. The outcome of pregnancy was defined in group 1, and the pregnancies that occurred in both groups after treatment was discontinued were analyzed.

Upper reproductive tract radiographic findings in DES-exposed female offspring.

Earlier reports implicated the association of adenosis and adenocarcinoma of the vagina in offspring exposed in utero to diethylstilbestrol (DES). Subsequently attention was directed to the structural abnormalities of the müllerian system in the same females. In this report, the hysterosalpingographic findings in 11 DES-exposed women are presented.

Effects of intraperitoneal 6% dextran 70 on serum immunoglobulin levels, peripheral cell populations, and lymphocyte subpopulations in women undergoing gynecologic surgery.

Twelve women underwent elective major gynecologic surgery for benign, non-pregnancy-related conditions. No perioperative or postoperative "anti-adhesion" adjuvants were used. Serum immunoglobulin levels (IgG, IgM, IgA) and peripheral cell counts, including lymphocyte subpopulations, were measured in each patient during the immediate preoperative and postoperative periods as well as 5 to 8 weeks later.

Hypergonadotropic ovarian failure in young women.

The purpose of this study is to evaluate 13 patients with primary ovarian failure (POF). All patients were less than 35 years of age. Serum FSH, performed by RIA, was in the post-menopausal range in all patients.