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Biomedical subjects

H Gaskin

Publications and source records attributed to H Gaskin.

4 recordsLinked to original sources
PubMed1997

Factors associated with elective Norplant removal in black and white women.

Premature removal of contraceptive implants (Norplant [levonorgestrel implants], Wyeth-Ayerst Laboratories, Philadelphia, Pennsylvania) is a cause of a sizable national medical expenditure in the United States. Understanding the factors that influence the decision to remove the implants and being able to predict which users are likely to elect discontinuation prematurely could provide useful information for counseling patients as they are considering contraceptive implants so that potentially enormous long-term savings could be achieved. This study surveyed 98 women who had Norplant inserted and removed between January 1991 and December 1994. Data were collected from chart review, and when necessary, a questionnaire was used to extract information not found in the chart. The chi-squared statistic and t-test were used to compare demographic variables. All but one subject received comprehensive pre-implant counseling. The main reason given for electively removing the Norplant prematurely was irregular menstrual bleeding (60%). Pre-implant counseling did not influence the decision for removal. These results indicate the importance of clarifying patients' doubts regarding menstrual bleeding irregularities during follow-up visits rather than relying on the information patients received during preimplant counseling.

Adult↗
PubMed1989

Clinical risk factors for proliferative vitreoretinopathy.

We reviewed the records of all patients with rhegmatogenous retinal detachments examined and treated by a single surgeon (B.P.C.) at the University of Virginia, Charlottesville, between 1978 and 1984. Of the 607 eyes that satisfied the selection criteria, a preliminary chart review of outcomes found that 65 (10.7%) had proliferative vitreoretinopathy and 34 had macular puckers. From the remaining 508 eyes, 325 controls were randomly selected to match each case from within a time window. Thirty-six (55.4%) of the 65 patients with proliferative vitreoretinopathy had had unequivocal reattachment after a single procedure before the onset of proliferative vitreoretinopathy, and the only clearly identified technical difficulty that was significantly more common in the patients with proliferative vitreoretinopathy was the inability to identify a retinal break. Several other features of the rhegmatogenous retinal detachments that correlated with the development of postoperative proliferative vitreoretinopathy were identified, and stepwise discriminant analysis was used to ascertain which of these were more important. The strongest predictor was use of vitrectomy in management of the detachment. Following this in order of importance were the presence of preoperative proliferative vitreoretinopathy, preoperative choroidal detachment, and the amount of cryopexy required. Vitrectomy remained a strong predictor even when considered after adjustment for all other characteristics. These data suggest that proliferative vitreoretinopathy is not simply an iatrogenic disease, but it is more likely to occur in association with certain detachment features that either by themselves or through their management require prolongation of the retinal wound healing process.

Cryosurgery↗