ABSTRACT
UNLABELLED: Cardiotocography (CTG) is widely used despite the fact that its diagnostic accuracy is far from satisfying. This is due, among other reasons, to the great intra- and interobserver variation in reading the fetal heart rate tracings. Computerized analysis might be a means to overcome the latter problem. OBJECTIVE: the present study was designed to assess the reproducibility of CTG readings among observers and between observers and a computer system. STUDY DESIGN: 63 fetal heart rate tracings were read by 4 clinicians (2 experienced and 2 inexperienced) and by the 2CTG computerized system. The variables considered were: baseline fetal heart rate (FHR), long-term variability (amplitude bandwidth around the baseline), number of large accelerations and number and type of decelerations. RESULTS: the agreement among observers, assessed by means of kappa coefficient, ranges from fair to good. The agreement between each of the observers and the computer readings, ranges from 0.18 to 0.48 for FHR baseline, from 0.16 to 0.74 for variability, from 0.37 to 0.64 for the number of accelerations and from 0.41 to 0.54 for the number of decelerations. The agreement on the type of decelerations is very low (0.01-0.25). CONCLUSION: it is concluded that interobserver variability between experienced observers, inexperienced observers and 2CTG is considerable and that the use of a computer system should overcome this problem.
Subject(s)
Cardiotocography/methods , Heart Rate, Fetal , Cardiotocography/statistics & numerical data , Computers , Female , Humans , Observer Variation , Pregnancy , Reproducibility of ResultsABSTRACT
A randomized clinical trial has been performed to evaluate the efficacy of intravaginal 1 mg Gemeprost for pre-operative cervical dilatation prior to vacuum aspiration and curettage for endometrial biopsy. Eighty-nine patients were evaluated, 51 treated with Gemeprost and 38 with placebo: in the first group biopsy was possible in 94% of cases vs 86% in the second group. Pain was significantly reduced with Gemeprost improving the success rate and the patient compliance.
Subject(s)
Alprostadil/analogs & derivatives , Uterine Diseases/diagnosis , Dilatation and Curettage , Drug Evaluation , Female , Humans , Placebos , Prostaglandins E, SyntheticSubject(s)
Fetal Monitoring , Labor, Obstetric/physiology , Female , Fetal Monitoring/methods , Humans , PregnancyABSTRACT
The activity of 2-beta-D-ribofuranosylthiazole-4-carboxamide (tiazofurin) was determined in nine untreated human ovarian cancer specimens, using the murine subrenal capsule xenograft assay. Tumor cytotoxic effect was demonstrated in seven out of the nine tumors implanted. The drug was well tolerated by the test animals. Tiazofurin may prove to be an effective chemotherapeutic agent in the treatment of ovarian cancer.
