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Biomedical subjects

J A Fortney

Publications and source records attributed to J A Fortney.

69 records · Page 4Linked to original sources
PubMedDate not supplied

Maternity record: initial report on a national experience (Colombia).

The International Fertility Research Program, in cooperation with the Government of Colombia, drew a random sample of urban hospitals in which obstetric deliveries take place. Data were collected on a sample of the deliveries. Hospitals were divided into six types: university, university maternity, social security and three sizes of general hospitals. These groups of hospitals are compared with respect to the proportion of high-risk patients admitted, intervention rates and perinatal mortality rates.

Adolescent↗
PubMedDate not supplied

A dosing study of nonoxynol-9 and genital irritation.

The objective of the study was to assess the symptoms and signs of genital irritation produced by different frequencies of nonoxynol-9 (N-9) use. Thirty-five women were randomized to each of 5 groups and used a vaginal suppository for 2 weeks. Group 1: N-9 once every other day; Group 2: N-9 once a day; Group 3: N-9 twice a day; Group 4: N-9 4 times a day; and Group 5: placebo 4 times a day. Study women were examined at admission, one week and 2 weeks with a colposcope for erythema and epithelial disruption, and were interviewed about vaginal itching and burning. The rates of reported symptoms for N-9 users were not significantly different from that of placebo users. The rate of epithelial disruption for women using N-9 every other day was essentially the same as that of women using placebo. The rates of epithelial disruption for women using N-9 1/day and 2/day were 2.5 times greater than that of placebo users. The rate of epithelial disruption for women using N-9 4/day was five times greater than that of placebo users. Genital irritation was located primarily on the vagina or cervix, and vulvitis was not a significant problem. Women who infrequently use N-9 products may not experience an increase in genital irritation. Women who choose to use N-9 frequently may experience an increase in epithelial disruption.

Adolescent↗
PubMedDate not supplied

Contraceptive use and HIV infection in Kenyan family planning clinic attenders.

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

Adolescent↗
PubMedDate not supplied

Oral contraceptives and life expectancy.

Life expectancy for women in the United States is 77.34 years; women who take oral contraceptives (OCs) for five years before the age of 30 can expect to live about four days longer. This is due primarily to protection against ovarian and endometrial cancers. For women taking pills for five years in their thirties there is a maximum loss of 18 days on the average that is attributable to OC use, and for women over 45 this rises to 80 days. The decreased life expectancy is due mainly to the increased mortality from myocardial infarction and stroke. This is substantially less than life lost due to use of a variety of other substances, most notably tobacco.

Adolescent↗
PubMedDate not supplied

Menstrual patterns after female sterilization: variables predicting change.

Previous studies of the changes in menstrual pattern characteristics following sterilization have been flawed by methodologic errors. As a result, contradictory findings have been reported. Appropriate methodologic approaches to the study of poststerilization menstrual patterns are presented, and a new methodologic approach-an index of menstrual pattern change-is offered, which evaluates four menstrual parameters simultaneously. A carefully controlled study using this index indicates that most women report no change in menstrual pattern at 12 months poststerilization, and among those who do experience change, changes in one direction are balanced by changes in the other direction. The changes reported include improvements as well as changes for the worse. The best predictor of whether a woman would experience menstrual pattern change after sterilization is whether her pattern had any abnormal characteristics during the three months prior to the procedure. Surgical variables and special subgroups of women are also evaluated.

Adult↗
PubMedDate not supplied

Oral contraceptives and reproductive cancers: weighing the risks and benefits.

The hypothetical incidence of reproductive cancers resulting from oral contraceptive use was estimated in several models comparing the cumulative lifetime incidence of cancer of the breast, cervix, ovary and endometrium expected in pill users with the incidence expected in nonusers. The potential number of cancer-free days that would be gained or lost by pill users was compared with similar estimates among nonusers. If five years or more of pill use were associated with a 20% increase in the risk of breast cancer being diagnosed before age 50, a 20% increase in cervical cancer risk and a 50% reduction in the risks of ovarian and endometrial cancers, then every 100,000 pill users would experience 44 fewer reproductive cancers during their lifetime than would nonusers, and would gain one more day free of cancer. If higher estimates of the five-year pill-associated risks of breast and cervical cancer are used--a 50% increased risk of each, for example--then pill users would experience more reproductive cancers than nonusers and would have 11 fewer cancer-free days of life.

Adult↗