This study was performed to determine how a long-acting, slow-release preparation of norethindrone (NET) affects the hypothalamic-pituitary-ovarian axis of normal ovulatory women. Ten women were ...studied during the luteal phase of their menstrual cycle, and again at six and twelve weeks following intramuscular administration of 100 mg NET microencapsulated in poly-D,L-lactide-co-glycolide. Serial LH samples, serum E, P, and NET were followed by a GnRH stimulation test. Compared to luteal phase values, six and twelve weeks of treatment with NET inhibited serum E2 and P while mean serum LH remained unchanged and mean serum FSH increased significantly (p < 0.05). LH pulse frequency after NET treatment was twice the rate (p < 0.01) as that of the luteal phase, whereas LH pulse amplitude was decreased significantly (p < 0.05). Finally, although there was no significant change in pituitary LH secretion in response to GnRH, NET treatment augmented FSH responsiveness to GnRH at the times studied. Preserved pituitary responsiveness to GnRH in NET-treated patients suggests that inhibited ovarian function results in an increase in GnRH pulse frequency but not GnRH pulse amplitude. Since the progestational milieu is maintained in these patients by NET treatment, the decrease in serum E2 may be responsible for the increase in GnRH pulse frequency. The presence of a critical level of E2 may be necessary for progestins to affect the hypothalamic GnRH pulse generator.
Seventy-five women admitted with the symptom complex suggestive of pelvic inflammatory disease( PID) were started on a penicillin-aminoglycoside antibiotic regimen. An aminoglycoside, gentamicin or ...netilmicin (Schering-Plough), was chosen randomly and given parenterally. Forty-two patients received netilmicin and 33 received gentamicin for 5 days. Therapeutic response to the 2 antibiotic regimens was similar. Aminoglycosides have been associated with both nephrotoxicity and ototoxicity. Blood chemistries were studied in all patients. The only manifested toxicity was in 2 patients treated with gentamicin. Endometrial-endocervical cultures were obtained before and after therapy. The microbacteria isolated by standard culture techniques before therapy revealed Neisseria gonorrhoeae in 69% and 51% of the netilmicin and gentamicin groups, respectively; anaerobic organisms were cultured in about 75% of each group.
In 1991, shortly after Norplant became available in the United States, 678 women who had received the implant from 17 providers in Texas were surveyed. Forty-five percent of these women were under 21 ...years old. The majority (56%) had tried the implant because they were dissatisfied with their previous contraceptive method. Forty-four percent of the sample indicated that the implant was one of the first contraceptive methods they had used and that they had only recently decided to prevent unplanned pregnancy. The average number of children per woman was 1.2, and one-third of the sample had had at least one abortion. While 37% of the women said they wanted no more children, 63% said they were using the implant as a spacing method. The reasons for choosing the implant and concerns about it varied according to the user's age, educational level and race or ethnic group.
This prospective cohort study was carried out in a university-based Infertility clinic to determine the profile of insulin-like growth factor binding proteins (IGFBPs) in patients with mild ...endometriosis and no obvious mechan ical factor contributing to infertility. A total of 26 patients with minimal and mild endometriosis and 10 controls contributed peritoneal fluid at surgery. The variety, expression and levels of IGFBPs were determined by radio inununoassay and Western ligand blots (WLBs) with quantitation by laser densitometer. A 27 kDa species was significantly lower and a 31 kDa species tended to be lower in patients with endometriosis as determined by quantitative laser densitometer. The levels of IGFBP-3 detected by radioimmunoassay and by WLB were correlated in the control group and in the patients with endometriosis in the follicular phase but not in patients with endometriosis in the luteal phase. The level of 27 kDa species seen on WLBs did not appear to correspond to IGFBP-1 determined by radiomimunoassay and IGFBP-3 levels in luteal phase endometriosis patients also departed from values determined by radioimmunoassay. These dis crepancies suggest a complex system to control levels of IGF in the peritoneum involving multiple binding proteins and proteases. The IGFBPs of patients with endometriosis may contribute to reproductive dysfunction and be able to serve as markers.
These investigations were concerned with the response of squirrel monkey sperm to freezing. A procedure involving preincubation at 37° C, progressive cooling combined with a two-step dilution, and ...freezing on Dry Ice was applied to semen samples collected by electroejaculation from two animals. Sperm concentrations in these samples were 321.8×106/ml (±204.1 SD) and 532.8×106 ml (±117.1 SD), respectively. Sperm motility prior to freezing was 68.1% (±15.9 SD) and 63.6% (±14.8 SD). Following freezing and thawing, motilities of 53.8% (±17.1 SD) and 51.8% (±22.9 SD) were observed. The freezing procedure increased sperm motility in approximately 30% of samples from both animals. Changes in the motile behavior of sperm were not observed after freezing. Serum testosterone measurements, the first made in the squirrel monkey, gave values similar to those obtained for other primates. A progressive decline in testosterone concentration, seen in both animals during the course of these investigations, did not affect semen characteristics or the response of sperm to freezing.
Pelvic adhesions in intrauterine device users Kirshon, B; Poindexter, 3rd, A N; Spitz, M R
Obstetrics and gynecology (New York. 1953),
1988-February, Letnik:
71, Številka:
2
Journal Article
Recenzirano
A thorough inspection of the pelvis for adhesions was made at the time of laparoscopic tubal sterilization in 2131 patients. Contraceptive use was then compared in women with adhesions (cases) and ...those without adhesions (controls). Current or previous intrauterine device (IUD) use was not associated with a statistically significant increased incidence of adhesions (odds ratio = 0.98, 95% confidence limits 0.58-1.64). This risk was reduced to 0.62 for current IUD users. The IUDs removed at the time of laparoscopy included the Lippes Loop, Copper 7, and the Saf-T-Coil. These findings support the use of the IUD in the appropriate patient by demonstrating no increased risk for the development of adhesions in multiparous IUD users.
The efficacy, tolerance, and safety of cefotetan--a new 7-alpha-methoxy cephalosporin--was assessed in controlled and uncontrolled evaluations involving 131 evaluable patients hospitalized with ...obstetric and gynecologic infections. The 99% satisfactory clinical response rate obtained with this drug was equivalent to that obtained with either moxalactam or cefoxitin, yet the mean amount of cefotetan given was lower than that of the other two drugs. Cefotetan was well tolerated and produced no major adverse reactions. In this era of Diagnosis Related Groups and cost containment, the twice-daily dosage schedule of cefotetan is a decided cost benefit.
To characterize the growth of individual fetuses, serial measurements of the crown-rump length (CRL), biparietal diameter (BPD), head circumference (HC), and abdominal circumference (AC) were made at ...specified intervals of 2 to 3 weeks (between 6 to 8 weeks conceptual age and delivery) in 20 normal fetuses with known dates of conception. Values for the HC-AC ratio and the estimated fetal weight were also obtained from these data. Measurements of CRL were similar to those reported previously, except in those cases in which the follicular phase was prolonged or the fetal growth potential was reduced. Mathematical modeling demonstrated that the linear-cubic model was optimal for the BPD and HC growth curves, the linear model for the AC, and the linear-quadratic model for fetal weight. The HC-AC ratio could not be modeled adequately because of significant individual variability. Optimal models for average longitudinal growth curves were determined for the BPD, HC, AC, and fetal weight from individual growth curves. These average longitudinal curves were similar in shape, mean values, and variability to those obtained in previous cross-sectional studies. Statistical analysis indicated that the coefficients of the average longitudinal curves are not likely to change by more than 5% to 15% if the size of the sample is increased very significantly. These results indicate that the average longitudinal growth curves are good estimators of the true population growth curves.
Previous data have shown that intravaginal dehydroepiandrosterone (DHEA, prasterone) improved all the domains of sexual function, an effect most likely related to the local formation of androgens ...from DHEA.
To confirm in a placebo-controlled, prospective, double-blind and randomized study the benefits of daily intravaginal DHEA for 12 weeks on sexual function using the Female Sexual Function Index (FSFI) questionnaire.
Placebo was administered daily to 157 women while 325 women received 0.50% (6.5mg) DHEA daily for 12 weeks. All women were postmenopausal meeting the criteria of vulvovaginal atrophy (VVA), namely moderate to severe dyspareunia as their most bothersome symptom of VVA in addition to having ≤5% of vaginal superficial cells and vaginal pH>5.0. The FSFI questionnaire was filled at baseline (screening and day 1), 6 weeks and 12 weeks. Comparison between DHEA and placebo of the changes from baseline to 12 weeks was made using the analysis of covariance test, with treatment group as the main factor and baseline value as the covariate.
The six domains and total score of the FSFI questionnaire were evaluated.
The FSFI domain desire increased over placebo by 0.24 unit (+49.0%, P=0.0105), arousal by 0.42 unit (+56.8%, P=0.0022), lubrication by 0.57 unit (+36.1%, P=0.0005), orgasm by 0.32 unit (+33.0%, P=0.047), satisfaction by 0.44 unit (+48.3%, P=0.0012), and pain at sexual activity by 0.62 unit (+39.2%, P=0.001). The total FSFI score, on the other hand, has shown a superiority of 2.59 units in the DHEA group over placebo or a 41.3% greater change than placebo (P=0.0006 over placebo).
The present data show that all the six domains of the FSFI are improved over placebo (from P=0.047 to 0.0005), thus confirming the previously observed benefits of intravaginal DHEA on female sexual dysfunction by an action exerted exclusively at the level of the vagina, in the absence of biologically significant changes of serum steroids levels.
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