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Biomedical subjects

J D Tiemstra

Publications and source records attributed to J D Tiemstra.

9 recordsLinked to original sources
PubMed1996

The association of urinary tract infection with a recent pelvic examination in women.

We tried to determine whether women with a urinary tract infection (UTI) were more likely to have had a recent pelvic examination than were women seen for other reasons. We compared 56 women who were diagnosed as having a UTI with 49 controls who had an unrelated complaint (sinusitis). Significantly more women with UTIs had received a pelvic examination within the preceding 2 months (43% vs 16%, P = .01). We conclude that having a pelvic examination is associated with an increased risk of a UTI developing within the following 2 months. This may be due to physical factors related to the examination or to risk factors related to the patients' reasons for obtaining a pelvic examination. Further study is needed to determine if the pelvic examination is an independent risk factor. If so, established preventive measures could reduce this risk.

Adolescent↗
PubMedDate not supplied

Hormonal therapy in the management of premenstrual syndrome.

BACKGROUND: Premenstrual syndrome (PMS) is characterized by any of a number of physical and psychological symptoms consistently occurring in the late luteal phase. Progesterone therapy is often recommended based on anecdotal evidence, although controlled studies have shown it to be ineffective. Oral contraceptives are more often used with mixed results. When hormonal therapy for PMS is indicated, the most appropriate choice remains a challenge. METHODS: We describe a case report of successful hormonal therapy for PMS and a review of the literature on the effectiveness of hormonal therapies. RESULTS AND CONCLUSIONS: Estrogen is clearly effective in relieving symptoms of PMS, whereas progesterone is ineffective and might even worsen symptoms. Combination oral contraceptives are effective, undoubtedly as a result of the estrogen component. While little comparative data exist to guide choice of an oral contraceptive, maximizing the relative estrogenic potency of the oral contraceptive seems logical. Depressive symptoms might not respond to hormonal treatment, and new research suggests that selective serotonin reuptake inhibitors might be particularly effective.

Adult↗
PubMedDate not supplied

Factors affecting the circumcision decision.

BACKGROUND: Studies from more than 10 years ago have shown that most parents choose circumcision for their infant sons for nonmedical reasons. Since then a wealth of data has accumulated on the relative risks and benefits of the procedure, although the medical community remains divided on the appropriateness of the procedure. Whether the ongoing research effort and medical debate have had an effect on parental decision making is unknown. METHODS: A survey of parents of 55 male infants was conducted to determine when the parents made their decision regarding circumcision, whether discussions with providers affected their decisions, and what the reasons were for their decisions. RESULTS: Eighty percent of parents made the circumcision decision before provider discussions. Seventeen percent reported changing their mind based on their provider's discussion, although it did not significantly affect the circumcision rate. Eighty-three percent of parents reported their provider's attitude as neutral, including 7 of 8 patients who changed their mind based on the discussion; only 1 patient was circumcised based on the provider's recommendation. Predominant reasons for circumcision were ease of hygiene (67 percent), ease of infant circumcision compared with adult circumcision (63 percent), medical benefit (41 percent), and father circumcised (37 percent). Reasons for no circumcision included unnecessary (73 percent), painful (36 percent), and father uncircumcised (18 percent). CONCLUSIONS: Most parents have made a decision on circumcision before physicians discuss it, and physician discussions appear to have little impact on the decision. Ease of cleanliness is still the most common reason parents choose circumcision.

Adult↗