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Biomedical subjects

J A Fortney

Publications and source records attributed to J A Fortney.

At least 55 records · Page 3Linked to original sources
PubMed1988

Cervical cancer risk and use of depot-medroxyprogesterone acetate in Costa Rica.

The relationship between cervical cancer and the use of depot-medroxyprogesterone acetate (DMPA) was examined in a nationwide case-control study in Costa Rica. Cases were women ages 25-58 years of age with invasive squamous cell cancer (N = 149) or carcinoma in situ (CIS, N = 415) reported by the National Tumor Registry during 1982-84. Controls (N = 764) were randomly selected during a nationwide household survey. Using logistic regression, we adjusted for known risk factors for cervical cancer. DMPA use was associated with a risk of CIS of 1.1 (95% confidence interval 0.6-1.8) and a risk of invasive cancer of 1.4 (95% confidence interval 0.6-3.1). The slightly elevated risks observed may be the result of chance or a detection bias. One limitation of this study is that few women had used DMPA for longer than two years.

Adult↗
PubMed1986

Time to conception after IUD removal: importance of duration of use, IUD type, pelvic inflammatory disease and age.

Some investigations of IUD use have demonstrated impaired ability to become pregnant after removal, while others have not. None of these studies, however, have adequately considered such potentially influencing variables as age and a history of pelvic inflammatory disease (PID). To study the effect of length of IUD use, IUD type and the modifying influences of age and PID history on time required to conceive, we followed women trying to become pregnant after removal of their IUD. Five hundred forty women in Ljubljana, Yugoslavia who were first fitted with an IUD between 1964 and 1972 and had their IUD removed in order to become pregnant were followed through 1980. We found no relationship between the duration of IUD use or type of IUD used, but increasing age and a history of PID each decreased the monthly probability of conception. These findings, along with other recent work, indicate that IUDs are a safe and efficacious contraceptive for women at low risk for sexually transmitted diseases.

Adult↗
PubMed1986

Hospital deaths in a high risk obstetric population: Karawa, Zaire.

Three thousand four hundred thirteen consecutive deliveries at a rural hospital in Zaire are examined. 85% of patients had goiters and 5% were cretins. Twenty maternal deaths occurred, or 5.9 per 1000 deliveries. Risk factors for maternal death included late presentation, advanced age (greater than or equal to 35 years), no education and presence of goiter or cretinism. Ninety percent of women who died were in critical condition at admission, 45% had labored greater than or equal to 48 h and 70% had uterine rupture.

Adolescent↗
PubMed1986

Accidental burn deaths to Egyptian women of reproductive age.

Among women of reproductive age in Menoufia, Egypt, deaths from burns constitute a major public health problem. Burns account for 9 per cent of the deaths occurring to women aged 15-49, and were the third cause of death (after disease of the circulatory system and complications of pregnancy and childbirth). Nearly two-thirds of the burns were caused by kerosene cooking stoves. The data were obtained from a population-based survey of all deaths to women of reproductive age. There were 1691 deaths from all causes during the 3 years of the study, 152 of these were due to burns. Information on the cause of death was gathered from interviews with surviving family members; interviews were reviewed by physicians and a cause of death established. Although hospital-based studies provide valuable information for the management of burn injuries presenting for treatment, establishing rates of injury, comparing the incidence in one population group relative to another, or comparing the incidence of burns relative to other forms of injury requires a population-based study.

Accidents, Home↗
PubMed1986

Reproductive mortality in two developing countries.

Reproductive mortality includes mortality attributable to pregnancy, termination of pregnancy, childbirth and its sequelae, and contraception. Reproductive mortality has been estimated for the United Kingdom, the United States, and for states of the US. However, it has not previously been measured for developing countries, where maternal mortality often remains distressingly high. This paper reports on data from one governorate of Egypt, where reproductive mortality was 46 per 100,000 married women ages 15-49 (2.2 per cent of this was attributable to contraception), and one province of Indonesia, where reproductive mortality was 70 per 100,000 (of which 1.4 per cent was due to contraception). In both locations, complications of pregnancy and childbirth were a leading cause of death in the age group studied (the first cause in Indonesia, second in Egypt). Contraceptive prevalence was 24 per cent of married women ages 15-49 in Egypt and 48 per cent of this age group in Indonesia.

Adolescent↗
PubMed1986

Delivery type and neonatal mortality among 10,749 breeches.

Data on 10,749 breech presentations were analyzed for the effect of delivery type on neonatal mortality. Most of the data are from developing countries, and most of the hospitals have higher mortality than is found in Europe or the United States. The simultaneous effect of type of hospital where the delivery occurred, type of breech, birthweight, and parity were examined. The benefit of cesarean delivery was greater for nulliparae than multiparae, greater for footlings than for frank or complete breeches, and greater for larger babies than smaller ones. This last finding probably reflects the quality of neonatal care in developing country hospitals rather than the value of cesarean section. Maternal mortality and morbidity was higher among women delivered abdominally than among those delivered vaginally.

Adult↗
PubMed1983

A new approach to measuring menstrual pattern change after sterilization.

Methodologic problems with previous research on menstrual changes after sterilization have resulted in conflicting results. This research overcomes these problems by restricting the categories of patients and by minimizing recall difficulties. When the methodologic approach is improved, the result is that the majority of women experience no change, and among those who do, changes in one direction are counterbalanced by changes in the other direction. Three cycles preceding sterilization were compared with three cycles 12 months after the operation for four menstrual parameters. The parameters were examined separately and simultaneously by means of an index of menstrual pattern changes. Rings and spring-loaded clips were associated with less change than other methods of occlusion. The most important variable was the patient's menstrual pattern at the time of admission. Women defined as having abnormal patterns were three times more likely to experience change than women with normal cycles, and many of the former experienced change in the direction of normality.

Adult↗
PubMed1982

The development of an index of high-risk pregnancy.

Presented is a scheme by which an index of high-risk pregnancy can be evaluated. The proposed scheme is applied to a risk index developed for the purpose of illustration. The usefulness of risk indices (or any other predictive measure) can be judged in clear statistical terms. The illustrative model developed here behaves similarly with each of the two sets of data on which it is tested, except to the extent that it is influenced by the incidence in the test population of the outcome to be predicted. The conclusion reached is that unreasonable demands are made of high-risk indices, that no index can satisfy all requirements. However, if the requirements are reasonably stated in advance, indices of high-risk pregnancy can be extremely useful.

Female↗
PubMed1981

Cesarean section in four Rio de Janeiro Hospitals.

Data collected on maternity patients at four hospitals in Rio de Janeiro, Brazil, show that their rates of cesarean section vary considerably, ranging from less than 15% of all deliveries at the hospital serving women from the lowest socioeconomic group to over 80% at the one restricted to private patients. Virtually none of the conditions usually considered as indication for cesarean delivery were universally managed in this manner. On the other hand, in many instances, there was no recorded indication for abdominal delivery. While mortality and morbidity rates are low, exposure of mothers and infants to the additional risks associated with surgery for no apparently valid reason is unwarranted.

Adult↗
PubMed1980

Disposable menstrual regulation kits in a non-throw-away economy.

The directions for use that are packaged with plastic menstrual regulation kits state that the kits are designed to be durable for approximately 50 procedures when used as directed. However, in much of the developing world, directions for use are ignored, equipment is not maintained properly and nothing (including disposable medical equipment) is discarded until it is unless. Therefore, it is of interest to know for how many procedures the disposable menstrual regulation kit can safely be used. This paper describes a study conducted in Singapore to determine the durability of three menstrual regulation kits manufactured by different companies and comments on how cleaning and sterilizing affects the durability of these kits.

Developing Countries↗