Search PubMed⌕ Search

Biomedical subjects

D C Cumming

Publications and source records attributed to D C Cumming.

At least 37 records · Page 2Linked to original sources
PubMed1991

Towards a definition of PMS.II: A factor analytic evaluation of premenstrual change in women with symptomatic premenstrual change.

We have examined the value of the Premenstrual Assessment Form (PAF) in 109 women with prospectively validated symptomatic premenstrual change. Results were compared with those of non-complaining women previously published (J Psychosom Res 1990; 34: 439-446.), there was considerable overlap in categorical and numerical scales so that selection of homogeneous populations of complainers could not be achieved. However, fewer than 7% of complainers had a total PAF numerical score in the normal range (defined as 2 SD above the mean total score of controls). Factor analysis of numerical scores in women with symptomatic premenstrual change suggested three factors similar to but not identical with those of non-complaining women. These were physiological depression, anxiety-volatility and increased well-being. While the negative syndromes are compatible with clinical experience, prospective investigation will be required to assess their homogeneity.

Adaptation, Psychological↗
PubMed1991

Menstrual mythology and sources of information about menstruation.

Surveys suggest that, despite extensive scientific knowledge of the biologic rhythms and physical changes associated with reproduction and despite the availability of excellent educational material about sexuality including menstruation, young peoples' knowledge of reproductive physiology is inadequate. Superstitions, illogical beliefs, and misinterpretations are more common than accurate understanding. The present article reviews menstrual mythology and describes sources of information for young people. Family and specialist physicians as well as educators in school or in the community need to recognize the limitations of the present methods of sexuality education, must realize that understanding of reproductive processes may be very incomplete, and should be prepared to work cooperatively with informal sources of information (peers, parents, and commercial companies). In addition, menstrual education needs to move away from the focus on hygienic management to that of healthy sexuality and acceptance of self.

Adolescent↗
PubMed1991

Frequency and severity of premenstrual symptoms in women taking birth control pills.

A retrospective study of a wide range of premenstrual symptomatology using the Premenstrual Assessment Form found little difference between women taking a low-dose birth control pill and non-pill-takers. These data are in keeping with older, but narrower, studies of women taking high-dose pills and raise questions about mechanisms of symptomatic and subclinical premenstrual changes.

Adult↗
PubMed1991

Assessment of premenstrual complaint using the Premenstrual Assessment Form: comparison of two populations.

The Premenstrual Assessment Form (PAF) provides frequencies of diagnoses for subjects meeting the criteria for typological classifications which are similar in New York and Edmonton, suggesting that the instrument is stable in assessing premenstrual complaint. However, the frequency with which an unselected population meet the criteria suggests that more strict criteria and/or a "severity index" would be appropriate. It seems likely that a modified form of the PAF could fulfil some of the intentions of its originators.

Adult↗
PubMed1991

Endurance training decreases serum testosterone levels in men without change in luteinizing hormone pulsatile release.

Cross-sectional studies have suggested that total and bioavailable testosterone levels are reduced in some male athletes. Such changes may be related to loss of body weight, increased serum cortisol, and/or alterations in LH pulsatile release. To determine how endurance training may affect androgen levels, we measured serum total testosterone, sex hormone-binding globulin, free androgen index, LH, FSH, PRL, cortisol, and weight in 15 previously sedentary males. We also examined pulsatile LH release in a subset of 5 subjects. Over 6 months of training, the men increased weekly running mileage to an average of 56 km/week. Total testosterone and free androgen index levels decreased significantly. PRL and cortisol also decreased, while single sample LH and FSH remained unchanged. There was a significant reduction in weight, which did not correlate with changes in serum testosterone levels. LH pulsatile release was not altered by training in the subset of 5 runners. These data confirm previous findings of physiological reduction in serum testosterone and PRL levels and suggest that the testosterone decrease is not related to changes in LH pulsatile release, weight, or increased serum cortisol levels.

Adult↗
PubMed1990

Towards a definition of PMS: a factor analytic evaluation of premenstrual change in non-complaining women.

Symptomatic premenstrual change remains enigmatic and much disputed. To establish baselines in a non-complaining population, we administered the Premenstrual Assessment Form (PAF) to 133 volunteers not seeking or using treatment for premenstrual symptoms. The PAF, a 95-item self report questionnaire, provides categorical, bipolar and quantitative data on a wide range of premenstrual symptoms. Only 27 women (20.3%) failed to meet criteria for at least one of the negative PAF syndromes suggesting that the criteria are lax for clinical investigative purposes. Most common syndromes were minor and major depressive syndromes (87, 65%) with atypical and hostile subtypes most common, general physical discomfort syndrome (82, 61.7%) and fluid retention syndrome (71, 53.4%). Factor analysis was used with the quantitative data to group symptoms. The analysis suggested three factors: a physiological depression (depression with physical change), an anxiety-volatility, and an increased well-being unrelated to other changes. The clearer delineation of premenstrual changes in non-complaining women will define the control group in research with premenstrually symptomatic complainers.

Adult↗
PubMed1990

Premenstrual anxiety and depression: comparison of objective psychological tests with a retrospective questionnaire.

Increased anxiety and depression are among the most frequently reported psychological problems in women seeking help for severe symptomatic premenstrual change, but there has been little objective evaluation of these symptoms. We therefore examined the results of objective psychological testing in 40 women with no apparent psychiatric or psychological disorder who had reported moderate to extreme increased anxiety and depression on a retrospective assessment form. Scores on the State-Trait Anxiety Inventory and Institute of Personality and Ability Testing (IPAT) Depression Scale increased from the low symptom intermenstrual phase of the cycle (days 5-10) to the premenstrual phase (within the last 6 days of the cycle), suggesting that retrospective complaints of increased premenstrual anxiety and depression can be confirmed on objective psychological assessment. However, it was observed that the distribution of intermenstrual IPAT depression scores was bimodal. Cyclic changes varied among the tests depending upon the IPAT depression score. The study suggests that 2 populations may exist in this screened sample; one population appears to have "pure PMS" and the second groups manifests a premenstrual exacerbation of subclinical depression.

Adult↗
PubMed1990

Use of spironolactone in treatment of hirsutism.

Spironolactone (Aldactone), 100 mg to 200 mg daily, has antiandrogenic effects that may enhance treatment of androgen-excess syndromes, particularly severe hirsutism. Combination therapy with an oral contraceptive or with dexamethasone appears to have a beneficial effect. Side effects are transient. The drug should be avoided during pregnancy and in women who have a family history of breast cancer, although there is no proven association between spironolactone and breast malignancy.

Contraceptives, Oral↗
PubMed1989

The effects of acute exercise on pulsatile LH release in high-mileage male runners.

Evidence suggests that acute exercise and endurance training has a suppressive effect on the hypothalamic-pituitary-gonadal (HPG) axis in men and women. To determine if training and acute exercise influence the neuroendocrine regulation of the HPG axis in men we examined pulsatile LH release in six male endurance runners with a training volume of at least 80 km per week, and compared this with values in six age-matched sedentary controls. Blood samples were obtained through an indwelling i.v. cannula from the subjects at 15-min intervals for 6 h following 24 h without significant physical activity and again in the runners, following 60 min of running at a speed equivalent to 5% below the anaerobic threshold. Mean LH pulse frequency and amplitude, as well as areas under the LH pulses and total LH curve, were calculated but only the mean post-exercise area under the total LH curve area was significantly lower than basal values (P less than 0.05) following exercise compared with the resting values in runners. Other measures of LH release did not change with acute exercise. Basal and pre-exercise testosterone levels were also measured and found to be at the lower end of normal men. The mean pre-exercise serum testosterone levels were significantly higher than basal levels. Mean testosterone levels, mean pulse amplitude, and mean area under the LH curve were significantly lower in resting runners than in the controls. The data suggest that exercise induces a general lowering of LH levels but does not inhibit LH pulsatile release. An anticipatory increase in serum testosterone occurred before exercise.

Exercise↗
PubMed1989

The effects of exercise on reproductive function in men.

Physical activity has a range of effects on male reproductive function depending upon the intensity and duration of the activity and the fitness of the individual. In general, it appears that relatively short, intense exercise increases serum testosterone levels, but there is debate to what degree haemoconcentration, decreased clearance and/or increased synthesis are involved. It is clear from the promptness of the testosterone increment that the mechanism does not involve gonadotrophin stimulation of the testes. There is suppression of serum testosterone levels during and subsequent to more prolonged exercise (and to some extent in the hours following intense short term exercise). Again the mechanisms are not clear: a variety of systems could influence the decrease of testosterone synthesis, including decreased gonadotrophin, increased cortisol, catecholamine or prolactin levels, or perhaps even an accumulation of metabolic waste materials. Endurance training induces changes in the function of the reproductive axis in men in a manner which appears similar to the changes in women. As in women, there is a subclinical inhibition of normal reproductive function but it is unclear whether clinical expression of reproductive suppression is common in men. The long term, physiological suppression of the hypothalamic-pituitary-gonadal axis in men is probably not of major significance but it is clear that further investigation in several areas is essential to provide continuing reassurance that 'exercise is good for you'.

Exercise↗
PubMed1989

Pituitary testing with and without bromocryptine in an aspermic man with elevated serum prolactin/FSH levels.

Pituitary testing is reported in an aspermic man with elevated serum FSH levels and hyperprolactinemia. Responses to clomiphene administration were normal. Serum LH responses to a double bolus of GnRH were substantially increased during bromocryptine therapy but FSH responses were similar with and without bromocryptine. These findings suggest that the elevated prolactin levels inhibited the GnRH-LH axis in this patient even in the presence of elevated serum FSH levels.

Adult↗
PubMed1988

Significant difference in the frequency of out-of-phase endometrial biopsies depending on the use of the Novak curette or the flexible polypropylene endometrial biopsy cannula ('Pipelle').

A statistically significant difference in the frequency of out-of-phase biopsies was found on comparison of day dating in two sequential series of late luteal endometrial biopsies taken with the standard 4-mm stainless steel Novak curette and a polypropylene cannula ('Pipelle'). Since the only variable in these two series was the type of biopsy instrument used, it is suggested that the diagnosis of inadequate luteal phase can be affected by an extrinsic non-biological factor, i.e., the type of biopsy instrument used. This technical 'artifact' deserves further study.

Biopsy↗
PubMed1988

Uterine adenomyoma associated with infertility. A report of three cases.

Adenomyosis and its localized, tumorlike variant, the adenomyoma, usually afflict multiparous, perimenopausal women and are not considered to cause infertility. Three cases of adenomyoma occurred in young, infertile women. The adenomyoma was not deemed solely responsible for the infertility, although in two cases it could have been contributory. The preoperative diagnosis was leiomyoma, and adenomyoma was not even considered; it was recognized during "myomectomy" in one case. Adenomyoma should be included in the differential diagnosis of a localized uterine tumor in an infertile woman. This preoperative recognition allows the gynecologist to discuss the lesion with the patient, pointing out that the operation may be technically difficult and may result in incomplete removal or hysterectomy and that excision of the tumor may not cure her infertility. It also prepares the gynecologist for the technical problems that may arise intraoperatively. Additional cases of adenomyoma in infertile women need to be reported on before light is shed on its causal relationship to infertility as well as on its diagnosis and management.

Adult↗
PubMed1987

Decrease in serum testosterone levels with maximal intensity swimming exercise in trained male and female swimmers.

Circulating testosterone levels have generally been reported to increase during short term, intense running or bicycle ergometer exercise. Swimming differs from such activity because of the strenuous arm activity and because it is conducted in a liquid medium in the horizontal position with the weight totally supported. To investigate whether such differences modify the serum testosterone response to exercise, we measured serum testosterone levels before and after a maximal intensity swimming test in ten elite male and ten elite female swimmers. Levels of circulating testosterone fell in 19 of 20 swimmers in contrast to previous reports of exercise in the vertical position. In women mean testosterone levels declined by 39.4% from baseline values and in males, mean testosterone levels declined by 19.0%. Since the incremental protocol was similar to in design to maximal intensity tests conducted on a treadmill or bicycle ergometer, these data suggest that the differing physical circumstances of swimming lead to a qualitatively different testosterone response to exercise.

Adolescent↗
PubMed1987

Reproductive hormone responses to resistance exercise.

To investigate if changes in circulating testosterone levels during isokinetic resistance exercise in women were similar to those during intense aerobic exercise and to examine concomitant changes in hemoconcentration, specific binding protein (sex hormone binding globulin-binding capacity), non-sex hormone binding globulin bound testosterone, luteinizing hormone, follicle-stimulating hormone, cortisol, and lactate, blood samples were obtained through an indwelling cannula at 30 and 15 min before exercise, after each of six exercises on upper and lower body muscle groups, and at 15 and 30 min after exercise in seven normal menstruating women. Investigations lasting approximately 60 min were performed in the early follicular phase beginning at 3.30 p.m. after two months of training with isokinetic ("Nautilus") equipment. Baseline testosterone and non-sex hormone binding globulin bound testosterone levels were significantly higher in subjects than in a control group. Increased total and non-sex hormone binding globulin bound testosterone was observed immediately prior to exercise with further increases late in exercise, then with proportional increases in cortisol and lactic acid. Sex hormone binding globulin-binding capacity increased before exercise. The testosterone increments exceeded hemoconcentration. Luteinizing hormone and follicle-stimulating hormone levels increased during exercise. The data suggest that origins of the exercise-associated testosterone increment are complex, resulting from hemoconcentration and specific gonadal and adrenal responses.

Adolescent↗
PubMed1987

Subacute focal endometritis. Association with cervical colonization with ureaplasma urealyticum, pelvic pathology and endometrial maturation.

Subacute focal endometritis (SFE) has been associated with cervical Ureaplasma urealyticum colonization and is considered a significant indicator of pelvic adhesions or endometriosis. A retrospective analysis was performed comparing cervical isolation rates, endometrial maturation patterns and laparoscopic findings in 64 patients with SFE and in a control group of 70 unselected patients with no histologic evidence of SFE at endometrial biopsy. The data suggest that although the prevalence of pelvic damage of various types is high, SFE cannot be used as a reliable marker for pelvic adhesions or endometriosis; that SFE does not interfere with normal endometrial maturation; and that SFE is not invariably associated with cervical U urealyticum but may represent resolving infection. It is also possible that SFE represents endometrial autoimmunity either following mycoplasma infection or arising spontaneously.

Cervix Uteri↗