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Biomedical subjects

B Kaplan

Publications and source records attributed to B Kaplan.

At least 199 records · Page 11Linked to original sources
PubMed1998

The impact of intrauterine contraceptive devices on cytological findings from routine Pap smear testing.

OBJECTIVE: To evaluate the impact of intrauterine contraceptive device (IUCD) use on the interpretation of routine Pap smears. STUDY DESIGN: A retrospective case-control study. PATIENTS AND METHODS: During a 2-year period, we evaluated the Papanicolaou (Pap) tests of 452 consecutive asymptomatic women of childbearing age who used a copper IUCD (study group), and 452 matched controls who practiced no contraceptive methods (control group). RESULTS: Inflammatory exudate, inflammatory epithelial changes or extensive metaplastic cells were more commonly encountered among the IUCD user as compared with non-users (p < 0.05). No difference was noted in the detection rates of cervical squamous intraepithelial lesions in the two study groups. CONCLUSIONS: It can therefore be concluded that the use of an IUCD does not increase the incidence of squamous intraepithelial lesions. Any abnormal Pap smear in an IUCD user should first be repeated after local vaginal treatment, if only to temporarily palliate the inflammatory cellular reaction which impedes unequivocal interpretation of the routine Pap smear.

Adult↗
PubMed1998

Flexible starting schedule for oral contraception: effect on the incidence of breakthrough bleeding and compliance.

OBJECTIVE: To compare the effect of starting oral contraceptives on the first day of menses with the effect of starting on the day of menses' cessation (but no later than the 5th day following its onset), on the incidence of early breakthrough bleeding. METHOD: Oral contraceptives containing 30 micrograms ethinylestradiol and 75 micrograms gestodene were prescribed to 200 consecutive healthy women in whom oral contraceptives were found to be the most suitable method of contraception. In the first 100 women, treatment was started on the 1st day after the onset of menses (Day 1 group), and in the remainder, treatment was started on the day of menses' cessation, but no later than the 5th day following its onset (Flexible group). RESULTS: The Flexible group had better compliance and a reduced incidence of breakthrough bleeding. No differences were observed between the two groups for age, parity and gravity, or contraceptive failure. CONCLUSIONS: Oral contraceptives may be initiated on the day of menses' cessation, but no later than the 5th day following its onset. This regimen might increase patient compliance and lower the incidence of breakthrough bleeding, probably without adversely affecting contraceptive efficacy.

Adolescent↗
PubMed1998

Sonographic characteristics of various types of intrauterine contraceptive devices.

OBJECTIVE: We sought to demonstrate the usefulness of ultrasonography for the in utero identification of different types of intrauterine contraceptive devices. METHODS: We used sonography to differentiate among types of intrauterine contraceptive devices. RESULTS: Each type of intrauterine contraceptive device had typical sonographic characteristics, in most cases, best demonstrated in the axial plane. Photographs of each type are shown and their sonographic appearance is discussed. CONCLUSION: Sonographic identification of intrauterine contraceptive devices is accurate and specific. Sonography may serve as a useful method for determining the time to change the device and to identify those types that are more prone to complications.

Equipment Design↗
PubMed1998

Prospective investigations of concentration-clinical response for immunosuppressive drugs provide the scientific basis for therapeutic drug monitoring.

The performance of prospective concentration-clinical response investigations during the early stages of the development of new therapeutic agents can provide a more rigorous basis for therapeutic drug monitoring than the traditional retrospective review of drug concentrations vs clinical outcome. Here we discuss the application of the multicenter randomized concentration-controlled clinical trial study design, and related study designs, as applied to older commonly used and monitored drugs and to two new immunosuppressant drugs, mycophenolate mofetil and tacrolimus. Such studies can provide a more rigorous basis for assessing the risk/benefit associated with a target drug concentration in the individual patient and for designing future prospective pharmacokinetic and therapeutic drug monitoring investigations.

Clinical Trials as Topic↗
PubMed1998

Tumescent anesthesia for dermatologic surgery. Cosmetic and noncosmetic procedures.

BACKGROUND: Tumescent anesthesia was originally described by Klein and Lillis for liposuction surgery. Its extension to many other interventions in dermatologic surgery (cosmetic and noncosmetic) has provided a significant contribution in the performance of safe, ambulatory, and simplified procedures. OBJECTIVE: To demonstrate the validity of the technique in various procedures. METHODS: Over the course of 1 year all large reconstruction or cosmetic surgery was performed using tumescent anesthesia. In a total of 242 cases performed, the advantages and disadvantages of the procedure were analyzed. RESULTS: Tumescent anesthesia was found to be very effective in achieving adequate anesthesia for performance of the reconstructive or cosmetic procedures. Good patient compliance was achieved with no serious sequelae. CONCLUSION: Tumescent anesthesia is one the most substantial progressions in the field of cosmetic and reconstructive surgery, with advantages that by far outnumber the few disadvantages.

Ambulatory Surgical Procedures↗
PubMed1998

Compliance with hormone replacement therapy in postmenopausal women. A comparative study.

OBJECTIVE: To assess compliance with hormone replacement therapy in postmenopausal women. METHOD: Two groups were compared prospectively: 100 women who sought treatment for menopausal symptoms, and 82 women who had undergone a total abdominal hysterectomy with bilateral salpingo-oophorectomy and were using estrogen replacement therapy. RESULTS: Compliance rates after 6 months were 81.0% and 84.1% in the two groups, respectively, and after 12 months, 73.0% and 80.5%. CONCLUSIONS: The high rates are attributed to our investment in patient education of the benefits of treatment and repeated and close follow-up.

Adult↗
PubMed1998

Abnormal sonographic endometrial findings in asymptomatic postmenopausal women: possible role of antihypertensive drugs.

OBJECTIVE: The purpose of this study was to evaluate the possible effect of the antihypertensive agent nifedipine (a calcium channel antagonist) on the endometrium of asymptomatic menopausal women by using transvaginal sonography, hysteroscopy, and endometrial sampling. DESIGN: Eighty-five asymptomatic postmenopausal women with an ultrasonographically detected endometrial thickness of more than 7 mm were examined. The study group comprised 43 women treated with nifedipine (30-60 mg/day) for mild to moderate hypertension for at least 1 year, and the control group comprised 42 normotensive women. All participants underwent transvaginal sonography, hysteroscopy, and, if necessary, endometrial biopsy. RESULTS: Of the 85 patients, 53 were found to have atrophic endometrium, 36 (83.7%) in the study group and 17 (40.5%) in the control group. The difference between the groups was statistically significant (p < 0.05). There were three cases of hyperplasia and three cases of carcinoma of the endometrium, with similar rates in the two groups. CONCLUSIONS: Among asymptomatic postmenopausal patients with sonographically thickened endometrium, atrophic endometrium was found to be significantly more prevalent in those using calcium channel antagonists to control hypertension than in those who were normotensive controls. The presence of endometrial hyperplasia and malignancy in the study group underscores the importance of meticulous endometrial evaluation whenever sonographically thickened endometrium is encountered.

Aged↗
PubMed1998

Ultrasonographic evaluation of hysterectomized patients with and without concomitant adnexectomy?

OBJECTIVE: To present our experience with the use of ultrasonography in the evaluation of hysterectomized patients. METHODS: The study group was comprised of 100 consecutive women referred to our ambulatory unit for pelvic sonographic evaluation between April 1, 1996 and March 31, 1997. Inclusion criteria were previous hysterectomy for a benign condition with or without concomitant bilateral salpingo-oophorectomy and available medical and gynecological histories. RESULTS: No significant difference was observed in the rate of abnormal ultrasonographic findings among the patients who had had bilateral salpingo-oophorectomy 5/50 and those who had not (8/50). There was also no significant difference in pelvic mass rate between the patients who were receiving hormone replacement therapy and those who were not. The sensitivity of sonography in our study was 100% and the positive predictive value, 84.5%. CONCLUSIONS: Sonography is a useful diagnostic tool in the follow-up and management of post-hysterectomy patients.

Aged↗
PubMed1997

Isolation and purification of two major serum amyloid A isotypes SAA1 and SAA2 from the acute phase plasma of mice.

A new procedure was developed for isolation of two major serum amyloid A (SAA) isotypes SAA1 and SAA2 from acute-phase plasma of mice. The procedure included preparation of high-density lipoproteins (HDLs) and their separation by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). The SAA proteins (Mr 12,000) were electroeluted and afterwards purified from SDS by gel permeation chromatography on a Fractogel TSK-40F column in aqueous 50% acetonitrile-0.1% TFA. Finally, the SAA proteins free from SDS were fractionated by high-performance liquid chromatography on a Vydac 214TP54 column (250 x 4.6 mm I.D., particle size 5 microm), yielding two major fractions with k=5.2 and k=5.5. The N- and C-terminal sequence analyses and mass spectrometry demonstrated the purity of these two major fractions and their identity with apo SAA1 (k=5.2) and apo SAA2 (k=5.5). The developed procedure is applicable to small amounts of pooled murine plasma (6-7 ml) and could be readily modified from small to large scale preparations.

Acute-Phase Reaction↗
PubMed1997

Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature.

BACKGROUND: Human ehrlichiosis, a newly described zoonotic infection, can be classified as human monocytic ehrlichiosis (HME) or human granulocytic ehrlichiosis (HGE). Although the clinical manifestations of HME and HGE are similar, the type of leukocyte infected, the etiologic agent, and the tick vector are distinct. METHODS: We report the first case of HGE in a solid organ transplant recipient and review the literature on HGE. RESULTS: Our patient displayed typical epidemiological, clinical, and laboratory features and responded promptly to therapy with doxycycline. CONCLUSIONS: Although opportunistic infections are relatively common in the posttransplant population, one must always consider other infections that occur in normal hosts as well. Human ehrlichiosis should be included in the differential diagnosis for transplant patients with fever, cytopenias, and hepatitis, especially if exposure to ticks in endemic areas has occurred.

Aged↗