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Biomedical subjects

C W Tyler

Publications and source records attributed to C W Tyler.

At least 163 records · Page 9Linked to original sources
PubMed1976

The intrauterine device and deaths from spontaneous abortion.

To evaluate the intrauterine device as a risk factor for mortality associated with spontaneous abortion, we analyzed all deaths from spontaneous abortions reported in the period 1972-1974. Women dying from spontaneous abortions with a device in place were more likely to be young, white and married than those not wearing a device. Risk of death from spontaneous abortion was over 50 times greater for women who continued their pregnancy with a device in place than for those who did not. The Dalkon shield carried an increased risk of death, as compared to other devices, even after rates were adjusted for duration of use. However, pregnant women with either a loop or a coil in place also had a higher risk of dying from spontaneous abortion than those without any device. The results support the clinical recommendation that any device should be removed when pregnancy is first diagnosed.

Abortion, Spontaneous↗
PubMed1976

An association between the Dalkon Shield and complicated pregnancies among women hospitalized for intrauterine contraceptive device--related disorders.

A nationwide mail survey of virtually all physicians likely to be involved with intrauterine contraception resulted in 3,502 unduplicated reports of intrauterine contraceptive device (IUD)--related hospitalizations during the first six months of 1973. Dalkon Shield use was significantly more frequent among women hospitalized for a complicated pregnancy than those hospitalized for a non-pregnancy-related disorder. Although the observed association was not substantially altered by stratifications of the mail survey reports by the patient's age, race, or geographical region, the association did not apply to those women whose IUD's were explicitly reported to be of the nulliparous size. Interviews conducted with a probability sample of physicians who had not responded to the survey confirmed that the association between the Dalkon Shield and complicated pregnancy also existed in their experience. An association between the standard Dalkon Shield and complicated pregnancies might reflect an increased rate of pregnancy with this device, an increased rate of complications occurring after zygotic implantation, or perhaps both. Whatever the explanation, the observed association is sufficiently widespread to require further investigations.

Adolescent↗
PubMed1976

Contraceptive choice and prevalence of cervical dysplasia and carcinoma in situ.

Whether use of oral contraceptives is associated with subsequent development of cervical neoplasia is an important public health question. Before evaluating this issue, we must determine if choosing oral contraceptives identifies a woman who is intrinsically at high risk of developing cervical neoplasia. We have examined the demographic and reproductive characteristics as well as cervical premalignant changes manifest by 15- to 44-year-old black women who enrolled in a public family-planning clinic. When compared to IUD acceptors, oral contraceptive acceptors did not have a disproportionately large number of women with traits which predicted for high risk of developing cervical neoplasia. Oral contraceptive acceptors, compared to IUD acceptors, did not have a higher prevalence rate of carcinoma in situ. Oral contraceptive acceptors with no Pap smears prior to initial choice of contraceptive method did have a 1.4-fold higher prevalence rate of cervical dysplasia than IUD acceptors. These results suggest that the deicision to use oral contraceptives, per se, does not identify a group of women at higher risk to develop cervical carcinoma in situ. Such a decision may, however, identify a group with a small increased propensity for developing cervical dysplasia.

Adolescent↗
PubMed1975

IUD-related hospitalizations. United States and Puerto Rico, 1973.

In a mail survey of physicians likely to be involved with intrauterine contraception in the United States and Puerto Rico, 49.2% of the physicians responded, describing 3,502 unduplicated reports of hospitalizations related to the use of intrauterine contraceptive devices (IUDs) during the first six months of 1973. We estimate from this response that approximately 7,900 IUD-related hospitalizations occurred during that period. Interviews with a probability sample of nonrespondents demonstrated that their IUD complication experience was not substantially different from that reported through the mail survey. Estimates of the number of IUDs worn in 1973 permit rate calculations of three to ten IUD-related hospitalizations per 1,000 woman-years of IUD use. The rate of hospitalizations attributable to the IUD is probably higher that that attributable to combination oral contraceptives.

Adolescent↗
PubMed1975

Mortality associated with use of IUDs.

Five deaths associated with the use of an intrauterine contraceptive device (IUD) were reported during the first half of 1973 through a nationwide mail survey of physicians whose practices were likely to be involved with intrauterine contraception. Four of the five reported deaths involved serious infections, and two of these four occurred in relation to a pregnancy. Use of an IUD prior to death ranged from seven months to 3 1/2 years. The mortality attributable to IUDs is estimated to be lower than that attributable to combination oral contraceptives.

Adolescent↗
PubMed1975

The epidemiology and interrelationship of cervical dysplasia and type 2 herpesvirus in a low-income housing project.

This report examines the association between cervical dysplasia and herpes simplex virus type 2 antibodies in a low-income housing project, Atlanta, Georgia. We established a clinic in this project at which women could receive a breast examination and Papanicolaou smear and have blood drawn to be tested for herpesvirus type 2 antibodies. Prevalence of herpesvirus rose sharply as age increased. There was a significant absence of antibodies in young, nulliparous women. Dysplasia showed a tendency to be related to age, age at first pregnancy, and total number of pregnancies. None of these associations was significant. The major finding of the study was that the 15- to 24-year-old women with herpesvirus had a relative risk of 5.44 of having cervical dysplasia compared to women without herpesvirus antibodies. these data are consistent with the concept that herpesvirus infections may be etiologically related to the initiation of cervical neoplasia. However, a cohort study is needed to determine whether herpes infection precedes or follows the earliest neoplastic changes.

Adolescent↗
PubMed1975

Cervical neoplasia in residents of a low-income housing project: an epidemiologic study.

In 1969, a published report estimated that the incidence of cervical cancer in a low-income housing project in Atlanta, G Georgia, might be of epidemic proportion. In 1971, we surveyed this housing project to determine if the prevalence rate of cervical neoplasia was unusually high during the period January, 1969, through September, 1971. From the survey we determined the number of women at risk for cervical neoplasia, and we determined the number of women who had cervical neoplasia from the Tumor Registry at Grady Memorial Hospital. The over-all cervical dysplasia rate was 63/1,000. The over-all prevalence rate of cervical carcinoma in situ was 11/1,000. These rates were compared with rates in two studies which also dealt with the prevalence of cervical neoplasia in low-income black populations. The rates in all three studies were comparable. We conclude that the high rates do not necessarily signify an epidemic, but we suspect that the prevalence of cervical neoplasia in low-income black women is much higher than previously estimated.

Adolescent↗