The dosage of immune globulin was incorrect in the article "Guillain-Barre Syndrome: A Team Approach to Diagnosis and Treatment" (July 1996, page 197). The correct dosage of immune globulin in the treatment of Guillain-Barre syndrome is 0.4 g per kg per
The answer to Question 25 in the August 1996 "Clinical Quiz," pertaining to the article "Alcohol Withdrawal Syndrome," was incorrect as published. The correct answers to the question are B, C and D.COPYRIGHT 1996 American Academy of Family Physic
The affiliation of Sajiv Sharma, M.D., author of "Monitoring Pulmonary Artery Wedge Pressure in Medical Patients" (September 1, 1996, page 1039) was incorrect as published. Dr. Sharma is a fellow in cardiology at the West Los Angeles Veteran Affairs Med
Carefully performed skin biopsies are essential in the evaluation of many dermatologic conditions and lesions. Microscopic examination may reveal features that aid in the diagnosis of neoplasms, inflammatory conditions and, occasionally, systemic diseas
The red eye has various underlying etiologies and is usually benign (Table 1).[1] Causes that are not vision-threatening include subconjunctival hemorrhage, stye, chalazion, blepharitis, conjunctivitis, dry eyes and superficial corneal abrasions. Vision
Idiopathic thrombocytopenic purpura (ITP), also known as primary immune or autoimmune thrombocytopenic purpura, is a common cause of thrombocytopenia and bleeding complications in children and adults. ITP is defined as isolated thrombocytopenia (low pla
Azelaic acid is a naturally occurring substance derived from cereal grains. It was first investigated in Europe in the 1970s for the treatment of pigmented lesions such as melasma and tinea versicolor. One researcher noted that patients treated with aze
Gastroesophageal reflux is defined as passive retrograde movement of gastric contents into the esophagus above the lower esophageal sphincter.[1] Manifestations of gastroesophageal reflux range from the infant who "spits up" frequently after meals to ch
An estimated 13 million Americans have diabetes mellitus; of these, approximately 90 percent have type II (non-insulin-dependent) diabetes and 10 percent have type I (insulin-dependent) diabetes.[1] Neuropathy is a common cause of morbidity in patients
After decades of decline in the United States, the incidence of tuberculosis began to rise in 1985. Between that year and 1991, the number of new tuberculosis cases exceeded the expected cases by approximately 39,000.[1] In 1991, 26,283 new cases of act
Author: Carrie Morantz, Brian Torrey
Date: March 1, 2004
The risk of uterine rupture from vaginal birth after cesarean delivery is relatively low, according to findings from the Agency for Healthcare Research and Quality (AHRQ). "Vaginal Birth After Cesarean" is available online at http://www.ahrq. gov/clinic/epcsums/vbacsum.htm.
Nearly 23 percent of births in the United States in 2000 occurred by cesarean delivery; this is the highest rate reported since data collection began in 1989. The rate of vaginal deliveries in women with previous cesarean deliveries decreased 27 percent from 1996 to 2000.
A meta-analysis by the AHRQ found that rates of vaginal delivery in women with a previous cesarean delivery who attempt a trial of labor range from 60 to 82 percent. Although data on the effects of labor induction and augmentation are limited, oxytocin use is associated with a 10 percent reduction in the likelihood of vaginal delivery.
A randomized controlled trial showed that radiographic pelvimetry is not able to reliably predict the route of delivery. Imaging studies that combine measurements of the pelvis and fetus show promising results but are limited by their failure to control for confounding factors.
Maternal mortality rates do not differ between women who attempt labor and women who choose to undergo a repeat cesarean delivery, and evidence suggests that hysterectomy rates also do not differ between the groups. Infection rates are higher in women who have cesarean deliveries; evidence is inconsistent about the effects of labor induction on infection rates. The risk of perinatal death in infants of women attempting labor is unclear, and there is insufficient evidence to make conclusions about the effect of route of delivery on Apgar score and respiratory comorbidity.
The rate of asymptomatic uterine rupture is equal in women attempting labor and women who choose a repeat cesarean delivery. However, symptomatic uterine rupture is significantly more common in women attempting labor. Based on severity and frequency of symptomatic uterine rupture, the risk of perinatal death from rupture of a uterine scar is 1.5 per 10,000; the risk of maternal hysterectomy is 4.8 per 10,000.
COPYRIGHT 2004 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group