Biomedical subjects

E R Plunkett

Publications and source records attributed to E R Plunkett.

At least 19 recordsLinked to original sources

PubMed1994

Early effects of continuous low-dosage all-norgestrel administered alone or with estrogen.

Twenty-six postmenopausal women participated in a double-blind trial involving treatment according to a Latin square design with either (i) dl-norgestrel alone (0.075 mg/day) continuously for two cycles, (ii) estradiol-17 beta alone (1 mg on 25 of 28 days) for two cycles, or (iii) the combined hormones for six cycles. A placebo control cycle followed each hormonal treatment. Plasma triglycerides decreased by an average 22% during treatment with either dl-norgestrel alone (123 +/- 11 vs. 160 +/- 10 mg/dl, n = 25, P < 0.005) or combination therapy (126 +/- 11 vs. 162 +/- 11, n = 25, P < 0.005) as compared with control. Plasma total cholesterol fell by 5% during two cycles of treatment with either dl-norgestrel alone (229 +/- 11 vs. 242 +/- 10 mg/dl, n = 25, P < 0.02) or combination therapy (233 +/- 11 vs. 246 +/- 10, n = 25, P < 0.05) versus placebo. During the fifth and sixth cycles of combination therapy 94% of cycles were free of flushing (vs. 31% for control, P < 0.01), 64% of cycles were free of spotting not requiring protection (control 75%), 96% of cycles were free of vaginal bleeding (control 100%), endometrial biopsy showed inactive endometrium in nine of the 10 subjects re-biopsied, fasting blood pyruvate decreased by 20% (P < 0.05) and diastolic blood pressure fell by 4% compared with control (P < 0.05), whereas glucose tolerance was unchanged. There was a significant reduction in vasomotor flushing beginning with the third to fourth cycles of combination therapy.

Biopsy↗

PubMed1992

Prolonged effects of a novel, low-dosage continuous progestin-cyclic estrogen replacement program in postmenopausal women.

OBJECTIVE: Our objective was to ascertain long-term tolerability and effects of a novel, low-dosage continuous progestin-cyclic estrogen regimen on vasomotor flushing, vaginal bleeding patterns, bone density, and plasma lipoprotein lipids. STUDY DESIGN: Eighteen postmenopausal women with climacteric symptoms received low doses of dl-norgestrel (0.075 mg/day) continuously and 17 beta-estradiol (1 mg/day) intermittently (25 of 28 days) for 3 years. The results were compared with baseline values. RESULTS: The hormonal regimen was well tolerated. Vaginal bleeding, vaginal spotting, and vasomotor flushing occurred in only 0.4%, 4.2%, and 7.7% of cycles, respectively. Bone density was stable. Mean fasting plasma total cholesterol concentration fell 19%, low-density lipoprotein cholesterol 23%, high-density lipoprotein cholesterol 13%, and triglycerides 31% (p less than 0.01) over the 3-year period, while the ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol decreased by 14% and 10%, respectively. CONCLUSION: Long-term compliance with female hormonal replacement is feasible once vaginal bleeding is essentially eliminated, allowing for potentially better prophylaxis against coronary heart disease, osteoporosis, endometrial cancer, and stroke.

Blood Pressure↗

PubMed1986

Antisperm antibodies and circulating immune complexes of vasectomized men with and without coronary events.

We compared antisperm antibody and circulating immune complex (CIC) levels in serum samples from 101 vasectomized and 101 normal age-matched nonvasectomized men; 31 of each group had histories of coronary heart disease (CHD). Vasectomy and CHD status were treated as categorical independent variables in the two-way analysis of variance. Elevations of both systolic and diastolic blood pressures were significantly associated with age and body mass index but not vasectomy. Antisperm antibodies (immobilizing and agglutinating) were significantly associated with vasectomy (P less than or equal to .001); the incidences were similar in men with and without CHD. The CICs were significantly associated with vasectomy in a Staphylococcus aureus (FcSa) CIC assay (P less than or equal to .001) and a Raji cell CIC assay (P less than or equal to .05). A third CIC assay, the Clq binding assay, did not reveal a difference between any subgroups. Generally, CICs occurred more frequently in the CHD group by the FcSa assay and particularly the Raji cell assay (P less than or equal to .001). In summary, vasectomized men had a higher incidence and higher levels of circulating antisperm autoantibodies and CICs than did age-matched controls.

Antigen-Antibody Complex↗

PubMed1982

Contraceptive Steroids, age, and the cardiovascular system.

There is evidence that women who use oral contraceptives may be at slightly greater risk of cardiovascular complications as their age increased beyond 35 years. Popular opinion has held that these risks were largely estrogen-related. At the same time, however, postmenopausal women taking natural estrogen alone or in association with minimal amounts of progestogen have not exhibited these increased risk when compared with untreated control subjects. New clinical data indicate that there is a progestogen dose-related decrease in high-density lipoprotein cholesterol. There is also some evidence that relates progestogen dosage to morbidity rates from circulatory disease. Therefore the smallest dose of both estrogen and progestogen consistent with contraceptive efficacy and reasonable cycle control must be sought for all steroid combinations. This applies particularly to oral contraception for the woman beyond 35 years of age.

Adult↗

PubMed1981

Pharmacokinetics of ethynyloestradiol in women for different populations.

The pharmacokinetics of a dose of 50 microgram ethynyloestradiol administered orally was studied in fourteen centres. Absorption was rapid and the highest serum concentrations of total ethynyloestradiol were found in most subjects at 1 h and by 24 h concentrations were less than 250 pg/ml. Calculation of the half-lives for absorption, distribution and elimination showed wide variations between subjects, the half-life of elimination varying from 2.5 h to more than 30 h. Bioavailability as measured by the area under the serum ethynyloestradiol concentration-time curve also showed more than a ten-fold variation. Intra-centre differences in the various parameters measured were as large as the inter-centre differences.

Biological Availability↗

PubMed1979

Rate of metabolism of norethisterone in women from different populations.

The rate of metabolism of orally administered norethisterone was compared in fourteen centres by measuring plasma levels of the steroid by radioimmunoassay at varying times after oral administration of a 1 mg dose. The inter-centre differences were of the same order as the intra-centre differences. Variations in metabolism appeared not to be due to variations in body size.

Adult↗

PubMed1979

Pituitary function testing in amenorrhea-galactorrhea-hyperprolactinemia.

Fifteen patients, age 16 to 55, presented with amenorrhea-galactorrhea-hyperprolactinemia. Pituitary function was evaluated by bolus injections of insulin, luteinizing hormone-releasing hormone (LHRH), and thyrotropin-releasing hormone (TRH) in 13 and by LHRH and TRH in 2. Responses to growth hormone (GH), thyroid-stimulating hormone (TSH), cortisol (F), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin were measured. GH, TSH, and F responses were normal in most cases. LH responses were decreased (P less than 0.025) in patients with abnormal sellar tomography, whereas FSH responses tended to decrease with elevated prolactin levels. Prolactin responses were absent in five of the seven cases which could be evaluated. The clinical value of such testing appears to be limited to an individualized basis, although some prognosis of ovulatory response to bromocriptine therapy may be obtained from the gonadotropin response.

Adolescent↗

PubMed1977

Are embalmer's at risk?

Explore the source record for details and available documents.

Acute Disease↗

PubMed1975

Preliminary evidence of a role for prostaglandin F in human follicular function.

Animal studies have shown that LH causes an increased synthesis of PGF by ovarian follicles both in vivo and in vitro. In lower animals, there is strong evidence that PGF acts as a mediator of certain LH effects, including maturation and extrusion of the ovum. Ovarian follicular tissue of 12 patients was halved or quartered and maintained in organ culture. Part of each follicle was exposed to gonadotropins throughout the culture period, while controls received no treatment. All tissues continued to synthesize PGF but in 11 cases the amount was greater in the gonadotropin-treated. It is concluded that PGF probably plays a role in human follicular function, including ovulation, and may act as a mediator of certain LH functions.

Adolescent↗

PubMed1975