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Biomedical subjects

D A Edelman

Publications and source records attributed to D A Edelman.

At least 37 records · Page 2Linked to original sources
PubMed1989

Uterine perforation and use of the Multiload IUD.

The English language literature on IUDs was reviewed to evaluate the uterine perforation rate associated with use of the Multiload. No reports of cervical perforation were found, and the uterine perforation rate was 0.12/1000 insertions compared to a rate of 0.68/1000 insertions for other copper-bearing IUDs. This lower rate may reflect an under-reporting of uterine perforations in the medical literature, or may represent a truly lower perforation rate due to factors related to the Multiload design and/or its insertion technique.

Female↗
PubMed1989

The accumulation of nickel in human lungs.

Using data from published studies, lung concentrations of nickel were compare for persons with and without occupational exposure to nickel. As expected, the concentrations were much higher for persons with occupational exposure. To estimate the effects of nickel-containing tobacco smoke and nickel in the ambient air on the amount of nickel accumulated in lungs over time, a model was derived that took into account various variables related to the deposition of nickel in lungs. The model predicted nickel concentrations that were in the range of those of persons without known nickel exposure. Nickel is a suspected carcinogen and has been associated with an increased risk of respiratory tract cancer among nickel workers. However, before the nickel content of cigarettes can be implicated in the etiology of lung cancer, further studies are needed to evaluate the independent effects of smoking and exposure to nickel.

Air Pollutants↗
PubMed1989

Treatment of bacterial vaginosis with intravaginal sponges containing metronidazole.

A small clinical trial evaluated the safety and effectiveness of intravaginal sponges containing metronidazole for the treatment of bacterial vaginosis (BV). Twenty women were treated with sponges containing 250 mg metronidazole (two sponges per day for two days), and 32 were treated with sponges containing 1,000 mg metronidazole (one sponge per day for three days). After four weeks there was a significantly higher cure rate (P less than .10) for women using the higher-dose sponge (88.0% vs. 57.1%). Although not significantly different (P greater than .10), the rates of side effects and complications were somewhat more frequent for women using the higher-dose sponge. Additional clinical trials are being conducted to further evaluate the 1,000-mg-metronidazole sponge for the treatment of BV.

Administration, Intravaginal↗
PubMed1988

Asbestos exposure, pleural plaques and the risk of lung cancer.

Studies which have evaluated the relationship between pleural plaques and smoking have found a higher prevalence of smokers among persons with pleural plaques. Pleural plaques are a relatively frequent finding among persons with occupational exposure to asbestos. Some studies, but not others, have shown that persons with pleural plaques have a higher risk of lung cancer. None of these studies controlled for the effects of smoking, and since smoking is more prevalent among persons with pleural plaques, it is unlikely that the increased risk of lung cancer to persons with pleural plaques, found in some studies, is due to the pleural plaques.

Asbestos↗
PubMed1988

Effects of intrauterine devices on the surface ultrastructure of human endometrium before and after removal.

The effects of copper-releasing IUDs on the endometrial ultrastructure were evaluated in 101 women. Endometrial samples were obtained in the secretory phase of the menstrual cycle, both during and after IUD use, and were evaluated using both scanning and electron microscopy. The degree and extent of changes to the surface ultrastructure of the endometrium were found to be related to the copper surface area of the IUD. Regardless of the duration of IUD use, by one month after IUD removal the endometrial ultrastructure had returned to its normal state. The results of this study show that the effects of copper-releasing IUDs on the endometrial ultrastructure are essentially limited to the time the IUD is in utero.

Adult↗
PubMed1988

Fifteen years' experience with the Multiload IUD.

The Multiload IUD with an exposed copper surface area of 250 mm2 (MLCu250) was developed in 1972 and has become one of the most widely used IUDs. Modifications to the MLCu250 include an increase in the area of exposed copper wire to 375 mm2 (the MLCu375) and an increase in the diameter of copper wire from 0.3 to 0.4 mm. The Multiload has been evaluated extensively in noncomparative and comparative clinical trials. In these latter studies the MLCu250 performed better than the Cu-7 and TCu-200, and the MLCu375 performed better than the Fincoid or Nova T and about equally as well as the TCu380. Pooled data from over 26,000 insertions of the MLCu250 gave the following 3-year cumulative event rates (per 100 women): pregnancy, 2.0; expulsion, 3.1; removal for pain/bleeding, 7.1. Comparative studies of the Multiload and other IUDs have shown all IUDs in current use are associated with similar rates of pelvic inflammatory disease. IUDs such as the MLCu375 that have larger copper surface areas appear to be associated with lower ectopic pregnancy rates. Follow-up studies of women who have had their Multiloads removed indicate that use of the device does not impair future fertility or affect pregnancy outcome. All IUD users, regardless of the type of IUD used, are at risk of complications. On balance, the benefits of IUD usage far exceed the associated risks.

Clinical Trials as Topic↗
PubMed1988

Contraception for women exposed in utero to diethylstilbestrol.

Although the effects of in utero exposure to diethylstilbestrol (DES) have been extensively documented, there is an absence of information on the suitability of different contraceptives for use by DES-exposed women. This paper briefly describes some of the effects associated with DES exposure. Use of various contraceptive methods by DES-exposed women are considered in light of these effects.

Adolescent↗
PubMed1988

Medical removals of the Multiload IUD.

In a follow-up evaluation of 3721 Multiload IUD users, the removal rate for medical reasons other than bleeding/pain was only 2.6 per 100 women at three years. Most of these removals were for reasons that appeared to be unrelated to IUD use. The removal rate for pelvic inflammatory disease was 0.3 per 100 woman years. Women were followed up for up to three years after removal of their IUDs. Among women with PID at least 70% of those who desired pregnancy subsequently became pregnant, a rate similar to that of women who had their IUDs electively removed to become pregnant. The study provides further data on the safety of intrauterine contraception.

Adult↗
PubMed1988

The use of intrauterine contraceptive devices, pelvic inflammatory disease, and Chlamydia trachomatis infection.

With the same epidemiologic approach taken in a recent study that suggested that oral contraceptive use may not protect against chlamydial pelvic inflammatory disease, the risks of chlamydial pelvic inflammatory disease were evaluated for intrauterine contraceptive device users. Compared with women using no method of contraception, intrauterine contraceptive device users were not found to be at any higher risk of cervical chlamydial infection. Whether this places intrauterine contraceptive device users at no increased risk of chlamydial pelvic inflammatory disease cannot be ascertained from the available data. Further research is needed before any conclusions can be made regarding the risks of chlamydial pelvic inflammatory disease to users of intrauterine contraceptive devices, oral contraceptives, and other contraceptive methods.

Chlamydia Infections↗
PubMed1988

Exposure to asbestos and the risk of gastrointestinal cancer: a reassessment.

In 1964 it was first reported that asbestos workers had a higher risk of gastrointestinal cancer. This notion has persisted despite several studies that have found no increased risk. The risks of gastrointestinal cancer to workers exposed to asbestos were reassessed, based on the results of published studies on 32 independent cohorts of asbestos workers. Not all studies provided risk estimates (SMRs) for all gastrointestinal sites (ICD codes 150-159). No consistent evidence was found to indicate that exposure to asbestos increases the risk of gastrointestinal cancer. Generally, the higher SMRs came from studies conducted in the United States or Canada and might reflect factors not related to exposure to asbestos. In studies in which asbestos exposed and non-asbestos exposed workers were evaluated the SMRs were not consistently higher for the group exposed to asbestos. There was no apparent dose response relation between accumulated asbestos dose and the risk of gastrointestinal cancer. It is concluded that there is no dose response relation between exposure to asbestos and risk of gastrointestinal cancer, and asbestos workers are not at an increased risk of gastrointestinal cancer.

Asbestos↗
PubMed1987

Parity and the effectiveness of the Today contraceptive sponge.

A comparative study of the Today sponge and diaphragm conducted in the United States found a significantly higher pregnancy rate for parous compared with nulliparous sponge users. The results of other studies of the sponge failed to confirm this finding. Studies of other vaginal contraceptive methods conducted in the United States also have reported a higher pregnancy rate for parous users. None of these studies have evaluated adequately motivational and other factors that affect contraceptive choice and use. We conclude that the higher pregnancy rate among parous sponge users is unrelated to the sponge per se, and most likely reflects motivational factors related to future childbearing intentions.

Actuarial Analysis↗
PubMed1987

The future of intrauterine contraception.

In this review paper some guidelines for IUD use are presented that if followed should reduce the incidence of IUD-related complications. Recent IUD developments are discussed including the levonorgestrel-releasing T, a new variation of the Multiload, and IUDs designed for postpartum insertion. Since significant improvements in IUD safety will most likely result from a better understanding of IUD-related side-effects and adverse reactions, the paper includes recommendations for future IUD research that could enhance the safety, effectiveness and acceptability of available IUDs.

Adolescent↗
PubMed1987

Intrauterine administration of methyl cyanoacrylate as an outpatient method of permanent female sterilization.

Results are presented of multicenter studies on the intrauterine delivery of 0.6 ml methyl cyanoacrylate with the FEMCEPT device (BioNexus Inc., Raleigh, North Carolina) for the purpose of causing permanent obstruction of the fallopian tubes. The studies included 1279 women and were conducted under several different protocols that required either one or two methyl cyanoacrylate application procedures. Based on hysterosalpingograms obtained about 16 weeks after the last methyl cyanoacrylate application, one procedure resulted in a tubal closure rate of 71.4% and two procedures resulted in a tubal closure rate of 89.4%. Complications of the procedure were infrequent and none required surgical treatment. Cumulative pregnancy rates among women with hysterosalpingogram-demonstrated bilateral tubal closure were similar for the one- and two-application procedures that used nonradiopaque methyl cyanoacrylate and were significantly lower (p less than 0.05) compared with a single application of radiopaque methyl cyanoacrylate. The 3-year pregnancy rate for two applications of nonradiopaque methyl cyanoacrylate was 1.7 +/- 1.2 per 100 women.

Ambulatory Care↗
PubMed1987

The intrauterine device and ectopic pregnancy.

Based on data given by case-control and cohort studies the relationships between current and past IUD use, duration of IUD use and the type of IUD were evaluated to determine the risk of ectopic pregnancy among IUD users. The results of this review indicate that current and past IUD users do not have an increased risk of ectopic pregnancy. No relationship was found between the duration of IUD use, for either current or past IUD users, and the risk of ectopic pregnancy. Pooled data from clinical studies of different types of IUD showed that the lowest risk of ectopic pregnancy was for users of copper-bearing IUDs, and the highest risk was for users of progesterone-releasing IUDs. Further research is needed to evaluate the ectopic pregnancy risks to past IUD users, especially in view of recent studies which have shown that these women may be at a higher risk of infertility.

Female↗
PubMed1987

IUD complications in perspective.

All methods of contraception are associated with the risk of pregnancy and complications. Although there is extensive literature on complications associated with the use of IUD, there are some aspects of IUD use that require further study including pelvic actinomycosis, pelvic inflammatory disease, and tubal infertility. Each of these are reviewed briefly. Ways in which the use of currently available IUDs may be made safer are discussed.

Actinomycosis↗
PubMed1987

Updated pregnancy rates for the Today contraceptive sponge.

Pregnancy rates (method and user) were evaluated for 2245 women who participated in the phase III clinical trials of the Today contraceptive sponge. User and method pregnancy rates were similar for women of different ages and parities. The 1-year method and user pregnancy rates (life table per 100 women) were 8.2 and 5.6, respectively.

Clinical Trials as Topic↗
PubMed1986

Pelvic inflammatory disease and contraceptive practice.

Analyses of data from the Women's Health Study suggest that the relative risks of hospitalization for PID were lower for women with tubal sterilizations and women whose partners had been sterilized (p less than 0.05), compared to sexually active non-contraceptors or women using oral or barrier methods. Further studies should be conducted to evaluate this non-contraceptive benefit of sterilization.

Adolescent↗