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Biomedical subjects

J Guillebaud

Publications and source records attributed to J Guillebaud.

At least 109 records · Page 6Linked to original sources
PubMed1983

Side effects of danazol compared with an ethinyloestradiol/norgestrel combination when used for postcoital contraception.

A postcoital contraceptive with a lower incidence of nausea and vomiting than oestrogen-progestogen combinations would be a significant advance. During a nine-month period, 101 women were treated at the Margaret Pyke Centre in London with either an oestrogen-progestogen combination or with danazol. A comparison of the side effects of each drug is reported. Those treated with danazol were six times less likely to experience nausea and none vomited. With the exception of breast symptoms, other side effects were five times less common in women receiving danazol. These differences give danazol a clear advantage in terms of patient acceptability. Further experience will enable the efficacy of danazol to be evaluated and so determine whether this drug should become the preferred hormonal postcoital treatment.

Adult↗
PubMed1983

The 150/30 formulation. Experience in the United Kingdom.

Oral contraceptive agents (OCs) containing levonorgestrel, 150 micrograms, and ethinyl estradiol, 30 micrograms, account for almost half the sales of such agents in the United Kingdom. The remarkable success of this formulation has occurred primarily because it provides extremely low doses of both hormonal constituents yet still gives most users a very acceptable bleeding pattern: the incidence of breakthrough bleeding is about 6% and of amenorrhea, less than 3%. Approximately 90% of users have cycle lengths of 28 +/- 3 days. The risk of serious side effects is significantly lower than with formulas containing higher doses of progestogen and/or estrogen. Minor side effects occur in only a small percentage of cycles. Headache is reported in approximately 10% of all cycles and should be regarded as a potential indicator of increased risk. If it presents as focal migraine, use of the combined OC should be discontinued. The contraceptive effectiveness of the 150/30 formulation is similar to that of the 50 micrograms formulations among compliant women; in less compliant women the margin of error is reduced, and the possibility of an increased risk of accidental pregnancy must be considered.

Adult↗
PubMed1982

Paired cervical smears: a method of reducing the false-negative rate in population screening.

Cervical smears taken by the wooden Ayre spatula (widely used in the United Kingdom) and by a plastic spatula (Armovical) were compared for their ability to detect dysplastic cervical epithelium and endocervical cells. At the same time, the value of taking duplicate smears was assessed. Paired cervical smears were obtained at a single attendance from 21,352 women, using the 2 types of spatulas in 4 different sequences. Although individually the Armovical proved superior to the Ayre spatula for the collection of endocervical epithelial material, this advantage was not complemented by any marked improvement in its detection of cervical dysplasia. Paired smear sampling, however, was clearly more rewarding in this respect and also allowed the introduction of laboratory quality control, as each preparation of any given pair was examined by a different screener. The false-negative rate was 18.5%: it comprised 11.1% sampling error and 7.4% screening error. It is concluded that paired smear sampling in population screening would significantly reduce the false-negative rate.

Carcinoma in Situ↗
PubMed1980

Intrauterine devices: present and future.

Although the mortality associated with the use of intrauterine contraception is low, its morbidity is probably higher than that associated with oral contraception. Much anxiety has been generated and whole programs prejudiced by lack of attention to detail during counseling, the fitting of intrauterine devices and follow-up. This paper draws attention to the shared etiology of many of the important adverse effects of the method, the fact that several become increasingly rare with increasing age of the user, and other factors that can assist in choosing the right device for the right woman. Likely future trends are also predicted.

Abortion, Spontaneous↗
PubMed1979

Plasma ferritin levels as an index of iron deficiency in women using intrauterine devices.

Forty-seven women were studied before and for one year after insertion of an intrauterine contraceptive device (IUCD). The menstrual blood loss increased in 44 subjects (94 per cent), and this was related to the surface area of the IUCD. Plasma ferritin levels in the iron deficient range (below 16 microgram/l) were present in 9 subjects (19 per cent) before insertion of the IUCD, whereas by the end of one year, 21 subjects (45 per cent) had reached these levels. The incidence of depressed ferritin levels was highest in subjects with a monthly blood loss exceeding 80 ml. The haemoglobin, mean corpuscular haemoglobin and mean corpuscular volume measurements declined progressively, but were less sensitive predictors of iron deficiency. These findings indicate the need to monitor iron status and administer oral iron replacement therapy in subjects with an IUCD.

Female↗
PubMed1978

Very early abortion by prostaglandins.

309 women whose menstruation was delayed by 3-35 days were treated with intrauterine or vaginal prostaglandins. Of 275 confirmed pregnancies, 229 were successfully terminated without further abortifacient therapy. A successful outcome was often associated with episodes of vomiting, diarrhoea, and uterine cramps in the 24 hours after prostaglandin administration, but the incidence was related to prostaglandin dosage and gastrointestinal side-effects were more common after vaginal administration. The best results were achieved by the analogue 16:16 dimethyl P.G.E2 as a vaginal pessary. 14 patients (6.1%) required uterine curettage for escessive or prolonged bleeding, while 2 patients required blood transfusion. One patient, who had an intrauterine contraceptive device left in situ during treatment, developed acute pelvic sepsis. No deleterious side-effects occurred in 34 patients who were subsequently proven not to be pregnant at the time of treatment. Treatment by intrauterine or vaginal prostaglandins offers promise as a method of pregnancy termination which avoids much of the physical and emotional trauma associated with surgical termination, and has the advantage of not requiring hospital admission in the majority of cases. The present study shows the safety of the method, and its potential as a self-administration technique.

Abortifacient Agents, Nonsteroidal↗
PubMed1978

Longer though lighter menstrual and intermenstural bleeding with copper as compared to inert intrauterine devices.

A randomized serial study of uterine blood loss was made of 281 women fitted with one of three intrauterine contraceptive devices (IUCDs): a Lippes loop D, a Dalkon shield or a Copper 7. The increase in the amount of blood loss was greatest with Lippes loop D users and least with Copper 7 users. However, the duration of menstrual and intermenstrual bleeding and of spotting was significantly greater among Copper 7 users than with the two inert devices. Thus the mechanisms whereby IUCDs increase the duration as opposed to the volume of uterine bleeding may be different. Previous users of oral contraceptives were found to have significantly less bleeding before IUCD insertion, but showed a similar pattern of increase of uterine bleeding after IUCD insertion to those who had not used oral contraceptives. For all three IUCDs, the increment in amount and duration of uterine bleeding after insertion decreased between the first and the sixth period, on average by about 15 ml and one to two days. No subsequent improvement was found and after 12 cycles the Copper 7 users had longer but less heavy uterine blood loss than users of the Lippes loop D.

Contraceptives, Oral↗
PubMed1977

Group B streptococci in women fitted with intrauterine devices.

A survey was made of group B streptococcal carriage at various sites in 100 women attending a clinic for the insertion of an intrauterine contraceptive device (IUD). Twenty-three women carried streptococci at one or more sites at the preinsertion visit, the vaginal carriage rate being 16%. Six months after insertion changes in carrier status were noted and there was evidence of a change of strain in four patients. Twenty-nine women were carriers at one or more sites at some stage of the study. There was no evidence that symptoms attributable to infection in patients fitted with an IUD were caused by group B streptococci.

Cervix Uteri↗