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Biomedical subjects

G R Huggins

Publications and source records attributed to G R Huggins.

At least 37 records · Page 2Linked to original sources

Benefits and risks of menopausal estrogen and/or progestin hormone use.

Current evidence is reviewed here on risks and benefits of estrogen and progestin use by peri- and postmenopausal women in relation to the following conditions: endometrial cancer, breast cancer, osteoporosis, and coronary artery disease (CAD). On balance, estrogen therapy appears to be beneficial for menopausal women, as it probably reduces the risks of CAD and osteoporosis, two of the major causes of mortality and morbidity. Although unopposed estrogen therapy increases the risk of endometrial cancer, that cancer is relatively rare and is not fatal in the vast majority of cases associated with estrogen use. Definitive conclusions about the relation of menopausal estrogens to breast cancer cannot be drawn due to inconsistent evidence to date. Although evidence from randomized controlled trials is lacking, biochemical and clinical evidence suggest that progestin supplementation is associated with a reduction in endometrial cancer risk in women taking menopausal estrogens. Progestin supplementation also may augment the beneficial effects of estrogens in providing protection against osteoporosis, although this effect is not yet well established. There is little direct evidence bearing on the relation of menopausal progestins to breast cancer. Although studies of CAD per se are lacking at present, progestins probably unfavorably alter lipoprotein profiles, thereby increasing a user's risk of CAD. Given the relatively high incidence and mortality of CAD in postmenopausal women, any negative effects on CAD risk could potentially counterbalance beneficial effects on other causes. We conclude that estrogen replacement therapy is of potential benefit to postmenopausal women, but that the question of progestin supplementation requires further study, particularly for CAD risk.

Breast Neoplasms↗

Sexual and reproductive risk factors for invasive squamous cell cervical cancer.

A case-control study of 418 women with invasive squamous cell cervical cancer and 704 population controls enabled evaluation of risk factors for this relatively rare cancer. Consistent with an infectious etiology was a pronounced effect of multiple sexual partners, with those reporting 10 or more partners being at a significant threefold excess risk. Early first intercourse also was associated with some residual effect on risk, although the relationship was not linear, nor the explanation readily apparent. Those with multiple births were at significantly elevated risks, even after adjustment for sexual parameters. Menstrual and hygiene factors, including use of tampons, vaginal deodorants, and douching products, were not consistently related to risk. Histories of specific infections involving the genital tract were poor predictors of risk, since few women provided positive responses, but those with nonspecific diseases were at a significant twofold excess risk.

Adult↗

Long-term use of oral contraceptives and risk of invasive cervical cancer.

To evaluate the relationship between use of oral contraceptives and risk of invasive cervical cancer, a case-control study involving 479 patients and 789 population controls was undertaken in 5 geographic regions of the US. Initially, the relationship was obscured by confounding variables, particularly the interval since last Pap smear. Control for this variable as well as for sexual and sociodemographic factors revealed an RR of 1.5 overall, with long-term users (5 or more years) being at a 2-fold higher risk than non-users. Pill associations prevailed for both adenocarcinomas and squamous-cell tumors, and risks were highest for those using pills containing high estrogen potencies. In addition, there was some evidence that pill associations were most pronounced among women who had never used barrier methods of contraception or who had histories of genital infections, suggesting that oral contraceptives may act as co-carcinogens with transmissible agents. Our findings provide further evidence that long-term use of oral contraceptives may have a carcinogenic effect on cervical epithelium, but emphasize the need for careful evaluation of confounding influences.

Adenocarcinoma↗

Human axillary secretions influence women's menstrual cycles: the role of donor extract from men.

Menstrual cycle lengths of 29.5 +/- 3 days ("normal cycles") are more frequent in women who have weekly coital activity than in women who do not. In order to investigate potential mechanisms controlling the association between heterosexual activity and menstrual cycle length, and in light of the nonhuman literature suggesting that a chemical signal from males could be involved, menstrual cycle lengths of nulliparous women were evaluated following regular application of axillary extract from donor males. Compared to controls receiving only blank/ethanol applications, women receiving axillary extracts for 12.5 to 14.5 weeks showed the following changes: a reduced incidence in variability of cycle lengths; and a reduced proportion of aberrant length cycles.

Adult↗

Human axillary secretions influence women's menstrual cycles: the role of donor extract of females.

Menstrual synchrony in human females has previously been demonstrated among women attending a predominantly female university as well as among women attending coeducational universities. In each of these studies, women who spent the most time together were most likely to show the menstrual synchrony. In this experiment, the possibility that substances in axillary secretions might mediate this effect was tested using a prospective, double-blind research design and a combined axillary extract from a group of female donors. Female subjects who reported themselves to have normal (29.5 +/- 3 day) cycles were exposed to the axillary extracts or blank/ethanol for 10 to 13 weeks. Recipients of the axillary extracts showed a significant reduction in "days' difference in menses onset" relative to the donor cycle, no change was evident for recipients of blank/ethanol. These results demonstrate that constituents from the axillary region of donor females can shift the time of menstrual onset of another group to conform with the donors' cycle and that this effect can occur even in the absence of social contact.

Adult↗

Sexual behavior and steroid levels among gynecologically mature premenopausal women.

Twenty-seven gynecologically mature young women who participated in a 14-week study prospectively recorded daily sexual behavior and basal body temperature data. In addition, they supplied plasma three times during the last cycle of participation. Plasma was analyzed for estradiol (E2), testosterone (T), and progesterone (P) by radioimmunoassay. The levels of circulating sex steroid hormones during the luteal phase were examined in relation to measures of menstrual cycle length, sexual frequency, and coital total. The results indicated the following: (1) women who had weekly sex with men had higher levels of estrogen than women who did not; (2) total amount of coital behavior was not related to any of the hormones assayed; (3) neither T nor P were distinguished by the consistency of sexual behavior or by coital total; and (4) women with aberrant-length cycles tended to have lower levels of E2. Thus, E2 consistently showed relationships to sexual behavior and cycle length, whereas P and T did not.

Adolescent↗

Sexual behavior frequency and biphasic ovulatory type menstrual cycles.

College students whose menarche had occurred 7 years previously, prospectively recorded menstrual and sexual behavior history for 14 weeks as well as basal body temperatures. Regular weekly coital activity associates with the highest incidence of fertile type cycles in this sample of young women as follows: (1) Regular weekly heterosexual behavior was associated with 29.5 +/- 3 day menstrual cycle length. Less frequent sexual activity (sporadic) and celibacy were associated with an increased frequency of aberrantly short and long cycle lengths. (2) Either of two heterosexual behaviors (coitus and/or genital stimulation by a man) were behaviors which were adequate as associates of 29.5 +/- 3 day cycles. (3) Self-stimulation (masturbation to orgasm) was inadequate as an associate of the above-described pattern of menstrual cyclicity. (4) Women with regular weekly coital activity had the highest incidence (90%) of fertile type basal body temperature (BBT) rhythms. Sporadically active women had the next highest incidence (55%) of fertile type BBT rhythms. Celibate women had the lowest incidence (44%) of fertile type BBT's.

Adolescent↗

Complications of female sterilization: immediate and delayed.

Surgical sterilization in women has changed dramatically over the past 20 years. The development of laparoscopy and minilaparotomy have made the procedure readily available even in developing countries. In the United States, changing social values and changes in hospital regulations have done as much as technology to account for the tremendous increases in the number of women undergoing sterilization. Improved sterilization procedures have resulted in lower costs for sterilization and lowered morbidity and mortality rates. Hysterectomy for sterilization alone carries unacceptable morbidity and mortality rates. Originally, laparoscopic techniques utilized unipolar cautery. However, bowel burns, a rare but serious complication, were reported, and this led to newer techniques. These techniques, using bands, clips, and bipolar cautery, have gained increasing popularity and have eliminated many of the serious complications of female sterilization. Historically, there has been concern that tubal sterilization by any method produces, in significant numbers of patients, the subsequent gynecologic and psychologic problems called "post-tubal ligation syndrome." A review of earlier literature indicates that many of these studies have serious methodologic problems, including recall bias, inappropriate control groups, failure to elicit prior history of gynecologic or psychologic problems, and failure to account for the use of oral contraceptives or IUDs. More recent large prospective epidemiologic studies that have controlled for prior gynecologic problems and contraceptive usage have failed to show increased incidence of gynecologic sequelae in large numbers of women. However, there are some data to support the concept that in certain individuals, sterilization may result in disruption of ovarian blood or nerve supply, producing gynecologic sequelae. Additional data from these ongoing large-scale studies and others should help to elucidate this problem in the future. Pregnancy after sterilization (even excluding pregnancies present at the time of the procedure) is more common the first year after the procedure with the risk decreasing in subsequent years.(ABSTRACT TRUNCATED AT 400 WORDS)

Electrocoagulation↗

Intranasal administration of RA 27/3 rubella virus vaccine. A clinical trial in young adults.

Of the vaccines and inoculation routes studied for the prevention of rubella, only the RA27/3 vaccine, administered intranasally, has the ability to stimulate a humoral antibody pattern very similar to that evoked by wild rubella infection. Because information about intranasal (IN) vaccination has only been obtained using the RA 27/3 vaccine manufactured in Europe, we conducted a trial of IN vaccination among young adults using Meruvax II which is manufactured in the USA. Of 597 family planning clinic patients screened in 1980-1981, 71 (11.9%) were susceptible to rubella; forty-one subjects were randomly assigned to receive IN or subcutaneous (SC) vaccine. All 20 SC vaccinees, but only 8/21 (38%) IN vaccinees, were successfully immunized. We conclude that standard doses of commercially available RA 27/3 vaccine are insufficient for IN immunization against rubella. Additional study of the dose-response relationship is needed if IN vaccination is to be recommended.

Administration, Intranasal↗

Urban black adolescents who obtain contraceptive services before or after their first pregnancy. Psychosocial factors and contraceptive use.

This paper compares three groups of urban black teenagers at their enrollment in a contraceptive program and at a one-year follow-up. The groups comprise 263 never-pregnant, postabortion, and postpartum teens ages less than or equal to 17 years at their initial family planning visit. Self-report questionnaires examined attitudes and information about pregnancy and contraceptive use, sources of contraceptive information, sexual and contraceptive experience, family and partner support for contraceptive use, and demographic background factors. Emotional, personality, and psychosocial factors were assessed with standard measures. Age, partner relationships, and items relating to the mother's communication about contraception and pregnancy were significant variables in the outcome of never-pregnant and delivery of pregnancy. Self-esteem was highest in the never-pregnant group. Personality factors, emotional distress, and social adjustment scores were in the normal ranges and did not differ between the groups. Contraceptive use at follow-up was most consistent in the never-pregnant group. These data suggest the need for earlier family involvement in educating and guiding teens together with access to contraceptive services in preventing unwanted adolescent pregnancies.

Abortion, Induced↗

Physiologic and psychologic profiles in a survey of women runners.

The purpose of the present study is to report physiologic and psychologic factors in a survey of women runners. Psychologic factors were used in an investigation of differences in perceived emotional distress within a group of women runners. The psychologic information was compared with the results of two groups of infertility patients and a group of fertile control subjects. Among the physiologic factors, there was a significant difference in the mean weight and the height/weight ratio between amenorrheic and regularly cycling runners (P less than 0.001) and amenorrheic runners and runners with irregular cycles (P less than 0.01). The psychologic data showed no difference between runners and fertile control subjects. When runners were divided according to menstrual intervals or miles run per week, there were differences in perceived emotional distress.

Body Composition↗

Mild cervical dysplasia. Experience in a family planning clinic.

To evaluate mild cervical dysplasia, the results of Papanicolaou smears were reviewed for a six-month period in an inner-city family planning program. Papanicolaou smear evidence of mild dysplasia was consistent with the biopsy diagnosis in most cases. A single Papanicolaou smear is not a reliable indication of condylomata, nor is a single normal Papanicolaou smear in this setting completely reassuring. Persistent mild dysplasia is an indicator of high risk for cervical dysplasia and cervical infection. Aggressive initial cervical surgery is not indicated, but close follow-up is required.

Adolescent↗

Never-pregnant adolescents and family planning programs: contraception, continuation, and pregnancy risk.

Four hundred urban Black teenagers enrolling in a family planning program before pregnancies occurred were followed for one year to assess factors influencing continuation of contraceptive use. Over half the follow-up respondents claimed to always use contraception. Program discontinuers were less likely to use contraception, but nearly half had no sex activity when contacted at follow-up. Sex frequency reported in the sample was low. Background factors of age, grade, and household were associated with contraceptive use and with pregnancy. Girls who had pregnancies were significantly more likely to live in a single-parent household, to have sex more frequently, and to have stated at enrollment that they wanted their first child before age 20. A majority of the sample, nearly all of whom obtained oral contraception, did not know at the one year follow-up how to use any alternative methods for preventing conception, hence many would again be at risk of pregnancy when sex activity resumed.

Adolescent↗