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Biomedical subjects

E Hardy

Publications and source records attributed to E Hardy.

At least 73 records · Page 4Linked to original sources
PubMed1994

Identification of main risk factors for tubal infertility.

OBJECTIVE: To determine the relationship between some reproductive variables and infertility caused by tubal obstruction. DESIGN: A retrospective, case-control study. SETTING: A tertiary care university hospital that is a referral center for infertility patients. PARTICIPANTS: Subjects were interviewed between March 1990 and December 1991. Cases were 215 consecutively recruited infertile women with either evidence of tubal obstruction found at laparoscopy or hydrosalpinx diagnosed by hysterosalpingography. Women with a history of surgical sterilization were excluded. Controls, selected in the same hospital, were women in the puerperium who had no history of infertility. Two controls were matched by age at the time of tubal obstruction diagnosis to each case. RESULTS: History of pelvic surgery and use of alcohol were significantly associated with the risk of infertility caused by tubal obstruction. The use of barrier, oral, and medroxyprogesterone acetate (MPA) contraceptives was associated with a protective effect. When only women with secondary infertility were analyzed, history of pelvic surgery and number of lifetime sexual partners were significant risk factors, and the previous use of oral contraceptives was the only protective factor. CONCLUSIONS: History of pelvic surgery was the most important risk factor for tubal infertility. All precautions must be taken to avoid infection and adhesion formation when pelvic surgery is performed. In addition, women can be protected from tubal infertility by using barrier, oral, or MPA contraceptive methods.

Adult↗
PubMed1993

TP53 gene mutation profile in esophageal squamous cell carcinomas.

Esophageal squamous cell carcinoma is a form of cancer occurring most commonly in males, particularly those living in some areas of Asia, Africa, and western Europe. In some of these tumors, a sequence alteration has been identified in the coding region of the TP53 gene which is known to inactivate the tumor suppressor function of its product. Using a GC clamp (i.e., a GC rich domain) denaturing gradient gel electrophoresis assay we have been able to identify sequence modifications in 27 of the 32 tumor samples analyzed (84%). Most of the mutations occur in exon 6, a region of the gene which has not previously been reported as being a hot spot for the mutations of other cancers. Twelve of the mutations reported here have not been described in other types of tumors and these consist mostly of frameshift or splice mutations. The distribution of mutations [transitions (45%), transversions (34%), and frameshift (21%)] suggests that the etiological contribution of genotoxic factors might be complex and might associate different exogenous and endogenous mutagen exposures.

Adult↗
PubMed1993

[Factors associated with prenatal care among low income women in the State of São Paulo, Brazil].

This paper presents the results of a study carried out in 1988 in the State of S. Paulo, with the purpose of evaluating the Program for Women's Integral Health Care. A total of 3.703 low income women of 15-49 years of age were interviewed using a structured, pre-tested form. The data in this paper relate to 669 women who had been pregnant during 1987 or 1988 and who were asked about pre-natal, delivery and post-partum care. The association between some of their socio-demographic characteristics and the pre-natal care received, months pregnant at the time of first visit and total number of visits, were analysed. Results showed an association between socio-economic characteristics and pre-natal care received. The greatest percentage of pregnant women who had had pre-natal care was found among those with more than elementary education. The highest percentage of women who started prenatal care before the third month of pregnancy was found among those who had no living children (74%), were in union (70%), had at least some high school education (88%) and lived in the interior of the state (71%). The results show that it is necessary to increase the coverage and quality of pre-natal care so as to improve perinatal results.

Adolescent↗
PubMed1993

[Abortion among female students and employees of a Brazilian university].

In Brazil, the subject of induced abortion is controversial and considered by some to be a serious public health problem. On the other hand there are little data available as to its frequency and general characteristics. The difficulty encountered in obtaining reliable information is to be explained by the illegality of abortion that inhibits women from talking about their experience, and most studies are carried out in hospitals and thus succeed in identifying only those women who have complications. A study was carried out in 1990, involving all the female graduate students and employees of a Brazilian university. Data was obtained through a questionnaire that was returned by mail, anonymously. This paper presents some of the results relating to the frequency of miscarriage and abortion in this population. Significantly more students than employees were less than 25 years old (85% and 13.7% respectively); fewer students were married or in a common-law union (11% of students as against 56% of employees) and four times fewer students than employees had never been pregnant (15% and 65%). Nine percent of the students and 14% of the employees had had at least one abortion. When only sometime pregnant women were taken into consideration, over half the students (59%) and 20% of the employees had had an abortion. Differences between the two groups were maintained when considered by age, both for miscarriage and abortion. Students of less than 25 years of age presented the highest percentage of abortion.

Abortion, Induced↗
PubMed1992

[Demonstration of clonal heterogeneity in adenocarcinomas on Barrett's esophagus by flow cytometric study of cellular DNA content].

Flow cytometry was used to examine the spatial distribution of nuclear DNA content in Barrett's mucosa, in one patient with high grade dysplasia and in 6 patients with Barrett's adenocarcinoma. All tumors were aneuploid. Each adenocarcinoma but the most advanced seemed to arise from a single clone of aneuploid or near-tetraploid cells which was found in all biopsy specimens taken from the tumor. Multiple aneuploid populations of cells were seen in the larger tumors. Eight clones were individualized in the most advanced case of cancer. In all patients with carcinoma, the mucosa surrounding the tumor was aneuploid. Some areas were characterized by the same DNA index as in the tumor, others contained distinct aneuploid cell populations. The spatial distributions of aneuploid clones and dysplastic areas were not perfectly superimposed. These data suggest that neoplastic progression in Barrett's esophagus is associated with genomic instability preceding the development of malignancy. Clonal heterogeneity in Barrett's adenocarcinoma is more marked when compared to other tumors and suggests a majoration of genomic instability during tumor progression.

Adenocarcinoma↗
PubMed1991

Factors associated with the acceptance of Norplant or IUD among women with similar socio-demographic characteristics.

The purpose of this study was to identify factors that explain why women who consulted at the same clinic, went through the same counseling procedure and who had no contraindications for using Norplant decided to use another long-acting method, the IUD. Subjects were women who consulted at the Family Planning Clinic, State University of Campinas Hospital. One hundred Norplant acceptors and 100 IUD acceptors were interviewed at home, by trained interviewers who were not related to the clinic. Four out of five Norplant acceptors and all IUD acceptors had learned about the method chosen before attending the clinic. Results suggest that among IUD users there were more women who did not like the idea of taking a hormone or medicine to prevent pregnancy, while Norplant acceptors were more willing to try new experiences. Half the Norplant acceptors had learned about the method through TV, compared to 12% of IUD acceptors. Counseling at the clinic was not a determining factor, though it is important to clarify clients' doubts.

Adult↗
PubMed1991

Association between contraceptive method accepted and perception of information received: a comparison of Norplant and IUD acceptors.

In the present study Norplant(R) and IUD acceptors who attended the same counseling sessions have been compared on their perception of the information received at the family planning clinic. The study covered 100 acceptors of each method quota matched by parity and years of schooling. Data were obtained through home interviews. The two groups presented no significant differences when selected socio-demographic characteristics were analyzed. Norplant users recalled more information on this method than did IUD acceptors, and the content of what they remembered was different. This included concepts as important as risk of pregnancy, menstrual and health effects, and method of removal. The results suggest that the intrinsic qualities of the new method and the presence of a group of women motivated to use one with its general characteristics, are not sufficient conditions for its acceptance.

Contraception↗
PubMed1991

A cross-sectional study of platelet cyclic AMP in healthy and hypertensive pregnant women.

1. Platelet activation in vivo occurs in healthy pregnant women and is more marked in women with preeclampsia. During pregnancy platelets have also been shown in vitro to be less susceptible to the inhibitory effects of prostacyclin. The cyclic nucleotide cyclic AMP has a key role as an inhibitory second messenger in platelets and mediates the inhibitory effects of prostacyclin. 2. We have studied cyclic AMP in relation to platelet behaviour in healthy pregnant women in the third trimester and in women with pregnancy-induced hypertension and pre-eclampsia. Non-pregnant young women were used as controls. 3. Pharmacological agents which increase levels of cyclic AMP were significantly less effective as inhibitors of platelet activation during pregnancy, but there was no difference between the healthy and hypertensive pregnant subjects. 4. Basal platelet cyclic AMP levels were the same in all three groups. However, the production of cyclic AMP in response to a range of adenylate cyclase stimulators was reduced during pregnancy, but again there was no difference between healthy and hypertensive pregnant subjects. 5. The reduction in platelet cyclic AMP levels in pregnancy occurred not only with those adenylate cyclase stimulators which operate via surface receptors, but also on direct stimulation of the enzyme with forskolin. 6. The most likely explanation of these observations is a reduction in the ability of the platelet adenylate cyclase enzyme to respond to stimulation of the third trimester of pregnancy. The consequent reduction in formation of the inhibitory second messenger cyclic AMP may in part be responsible for platelet activation in vivo during pregnancy. There does not appear to be a further difference in platelet cyclic AMP production in hypertensive pregnant women.

Adenylyl Cyclases↗
PubMed1991

[Flow cytometric analysis of cellular DNA content in Barret's esophagus. A study of 66 cases].

Dysplasia is the only marker for malignant potential in Barrett's esophagus. The histologic interpretation of dysplasia is sometimes difficult, particularly when attempting to distinguish dysplastic changes from those of a regenerating and inflammatory mucosa. In order to find an objective marker to identify patients with high risk of malignant transformation, the authors evaluated 497 biopsies from 66 patients with Barrett's esophagus with flow cytometry. The aim of the study was to correlate DNA content and proliferative abnormalities with histology. All biopsies classified histologically as negative for dysplasia had a diploid DNA content. The percentage of biopsies with an aneuploid DNA content increased with the histologic grade of dysplasia: 2 percent of indefinite dysplasia, 11 percent of low grade dysplasia, 44 percent of high grade dysplasia and 78 percent of biopsy specimens with cancer biopsies were aneuploid. Mean S and G2M fractions of diploid biopsy specimens increased with the severity of histologic changes. The S and G2M fraction threshold values that could differentiate patients that were negative for dysplasia from those with high grade dysplasia or cancer were 9 percent and 6 percent, respectively. Aneuploidy or G2M fraction greater than 6 percent was the best discriminating criteria between those two distinct groups of patients. All 6 patients with high grade dysplasia or cancer had aneuploid cell populations or increased G2M fraction, whereas none of the 35 patients whose biopsies were histologically negative for dysplasia had evidence of genomic instability or increased G2M fraction. Flow cytometric abnormalities were found in 10 out of 25 patients whose biopsies were classified as indefinite for dysplasia or low grade dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1991

Incorporating nursing diagnoses in the postanesthesia care unit record.

The staff in the PACU at Community Memorial Hospital in Menomonee Falls, WI decided to revise the PACU record using nursing diagnoses. We wanted our new record to reflect our standards of care. We identified three standard nursing diagnoses in our standards and used these as the basis for our new form. The three nursing diagnoses were: potential for ineffective airway clearance, potential for pain, and potential for injury. We also provided an area for nonstandard nursing diagnoses to address individual care if needed. We are currently revising this record after using it for 1 year, and we plan to include one more nursing diagnosis: Potential for fluid imbalance will cover intake and output as well as nausea and vomiting, a common problem in the PACU.

Forms and Records Control↗
PubMed1990

A comparison of a short half-life marker (low-dose isoniazid), a long half-life pharmacological indicator (low-dose phenobarbitone) and measurements of a controlled release 'therapeutic drug' (metoprolol, Metoros) in reflecting incomplete compliance by volunteers.

1. Although, long half-life compounds appear to be more appropriate pharmacological indicators of compliance with treatment, short half-life markers or measurements of short half-life therapeutic drugs are frequently used. 2. We have compared the usefulness of low-dose phenobarbitone (a long half-life indicator), low dose isoniazid (a short half-life marker) and controlled release metoprolol (Metros) (a controlled release formulation of a short half-life 'therapeutic' drug) in seven volunteers with simulated partial (two thirds) compliance. 3. Detection of isoniazid metabolites in urine had an 83% sensitivity and 94% specificity for detecting ingestion within the previous 24 h and 100% sensitivity and 82% specificity for detecting ingestion within the past 6 h but gave no indication of the longer term pattern of compliance. 4. At 28 days (a time when steady-state would be obtained for all three drugs) phenobarbitone plasma levels were 70% (66-76%)--median and interquartile range--of the expected steady-state level if compliance had been complete. Corresponding figures for metoprolol were 82% (37-100%). 5. Measurement of phenobarbitone was much superior to isoniazid or metoprolol measurements in reflecting partial compliance over the previous 1 to 4 weeks.

Administration, Oral↗
PubMed1990

[Wild rabbit, Oryctolagus cuniculus L., and arboviruses in southeast France. Results of two serologic investigations].

Sera from 269 wild rabbit (Oryctolagus cuniculus L.) trapped in 1985 and 1986 in Camargue and Vaucluse, France, were studied for antibody against 9 arboviruses. By inhibition haemagglutination test, positive reactions were found only against West-Nile (0.37%). By complement fixation test, antibodies were detected against Eyach (0.92%) and Tribec (0.46%). These results are discussed according to arboviruses isolated in France, to previous serosurveys in rabbits and other mammals and to potential vectors known to occur in France. Potential impact on rabbit population is also discussed.

Animals↗