Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: a prospective, randomized, blinded, controlled study in a rabbit model.

OBJECTIVES: To determine, in a rabbit model, whether peritoneal exposure to dermoid cyst material produces inflammation and adhesions above control levels and whether saline lavage reduces the degree of peritoneal reaction. DESIGN: A prospective, randomized, blinded, controlled study of adhesion formation. Thirty New Zealand white female rabbits were assigned randomly to five experimental groups: [1] laparoscopy with intraperitoneal injection of human dermoid material, [2] laparoscopy with intraperitoneal injection of human dermoid material and subsequent lavage to clear all visible dermoid material, [3] laparoscopy with saline lavage, [4] laparoscopy with intraperitoneal injection of human follicular fluid (antigenic control), and [5] laparoscopy alone. MAIN OUTCOME MEASURES: Six weeks after initial laparoscopy, inflammation and adhesions were scored in several categories via visual assessment (range 0 to 15) and histologic microscopic evaluation (range 0 to 24). Data were evaluated using Kruskal-Wallis and Mann-Whitney U nonparametric tests. RESULTS: For groups 1, 2, 3, 4, and 5, respectively, mean +/- SEM total inflammation-adhesion scores were 13.85 +/- 0.55, 2.90 +/- 1.15, 0 +/- 0, 1.50 +/- 1.00, and 0 +/- 0 for clinical evaluation and 16.83 +/- 1.22, 7.33 +/- 1.76, 0 +/- 0,0 +/- 0, and 0 +/- 0 for histologic evaluation. Using nonparametric tests, significant differences were found between groups in clinical and histologic scores. CONCLUSIONS: Dermoid material produces a significant peritonitis. Results of the clinical evaluation demonstrate that saline lavage brings inflammation and adhesion formation close to control levels. However, results of the histologic evaluation suggest that the decrement in inflammation as a result of lavage may be less dramatic than that found by clinical evaluation.

Onset of fertility-related events during adolescence: a prospective comparison of Mexican American and non-Hispanic white females.

Ethnic differences in the first occurrence of fertility-related events are assessed for non-Hispanic White and Mexican American female adolescents. A community-based sample of 1,023 females ages 13 to 19 years was interviewed in 1984-85; 874 (85.4 percent) were reinterviewed approximately two years later. Mexico-born Mexican Americans have the lowest rate of early sexual intercourse, but the highest rate of early births because they are most likely to become pregnant if sexually active, and most likely to have a birth if pregnant. Non-Hispanic Whites have the highest rate of early sexual intercourse, but the lowest rate of early births because pregnant non-Hispanic Whites terminate pregnancies most often. US-born Mexican Americans are intermediate between the other two groups. Delays in the onset of sexual activity among Mexican Americans are not converted into corresponding delays in first pregnancies and births. Early marriage among Mexico-born Mexican Americans, however, accounts for much of the ethnic difference in early fertility.

Fertility and fertility-related behavior among Mexican-American and non-Hispanic white female adolescents.

Ethnic differences in fertility-related behavior are examined in a community-based probability sample of 706 Mexican-American and 317 non-Hispanic white females aged 13 through 19 years. Mexican-Americans are more likely than whites to have had a live birth, but are no more likely to have been pregnant and are less likely to have had sexual intercourse. Sexually experienced Mexican-Americans, however, are twice as likely as whites to have been pregnant. Among those ever pregnant, Mexican-Americans are more likely to have had a live birth, while whites are more likely to have had an abortion. Ethnic differences remain strong when socioeconomic status and indicators of social instability are controlled statistically, lending more support to the "minority status" hypothesis than to the "characteristics" hypothesis concerning the fertility-related behavior of minority group members.