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Biomedical subjects

J H Check

Publications and source records attributed to J H Check.

At least 253 records · Page 14Linked to original sources
PubMed1985

Serum estradiols versus pelvic sonography in monitoring HMG therapy.

Therapy with human menopausal gonadotropin (HMG) conventionally has been monitored by estrogen measurements. Pelvic sonography may offer a more accurate method of monitoring HMG therapy. In this study 67 anovulatory patients were treated with HMG until at least one follicle had a diameter of 17 mm. The serum estradiol level was noted at the time a mature follicle was achieved. There was a correlation between the ultrasound data and the serum estradiol range in 57% of the cases. However, in 24% it was necessary to push the estradiol level above the allowable maximum of 2000 pg/mL. Twenty percent of the patients attained a 17-mm follicle before reaching the minimum required estradiol level of 500 pg/mL. Sonographic monitoring should improve the efficacy of HMG therapy.

Anovulation↗
PubMed1985

Decreased abortions in HMG-induced pregnancies with prophylactic progesterone therapy.

A study was designed to see if progesterone support of the luteal phase could reduce the increased incidence of spontaneous abortions seen in HMG-induced pregnancies. Fifty milligrams per day of progesterone suppositories beginning on the third day of the temperature rise or the demonstration of ovum release by ultrasound was employed. The incidence of spontaneous abortions in the untreated control group was 28% (28 of 100) as compared to 16% (21 of 130) of the progesterone-supported patients. The decrease in abortions cannot be attributed to losses of multiple gestations since there were larger numbers of multiples in the progesterone-supported group (1.3 babies per patient) versus the controls (1.2 babies per patient).

Abortion, Spontaneous↗
PubMed1984

Pelvic sonography to help determine the appropriate therapy for luteal phase defects.

In some series the most appropriate therapy for luteal phase defects is supplemental progesterone in the luteal phase. Clomiphene's efficacy is more controversial since in one series only 8% achieved a successful pregnancy versus 45% in another study. Pelvic sonography was used to evaluate follicular development and release of the ovum in 50 infertile women with luteal phase defects. The results showed that only 40% had "pure" luteal phase defects whereas 52% had immature follicles and 8% had unruptured follicles. Sixty-two percent of the patients had previous therapy for a luteal phase defect and failed to conceive. Sixty-eight percent of this group did conceive when ultrasound was used to determine the appropriate therapy. Thus ultrasound can be employed to determine if the women with a luteal phase defect should be treated with a fertility drug, e.g., clomiphene or just with luteal phase progesterone support. Supplemental progesterone might still be needed with clomiphene based on repeat endometrial biopsy results.

Bromocriptine↗
PubMed1984

Improvement of cervical factor by high-dose estrogen and human menopausal gonadotropin therapy with ultrasound monitoring.

Conventional treatment of the cervical factor has proved unsuccessful, with fertility rates under 30% usually quoted. Low-dose estrogen has been one of the main therapies but carries the complication of ovulation interference. It is hypothesized that higher doses of estrogen would improve mucus but would have an even greater adverse effect on ovulation. However, the latter could be obviated by concomitant use of human menopausal gonadotropin (hMG). The hMG would then be monitored by pelvic ultrasound because the ingested estrogen would interfere with estrogen assays. Eighty-two percent of 34 infertile women with no motile sperm on baseline postcoital tests improved their levels after therapy with this high-dose estrogen hMG technique. To date, 56% of these women for whom therapy had previously failed have conceived. Nevertheless, simpler and less expensive techniques should be used initially.

Cervix Mucus↗
PubMed1984

Sympathomimetic amines in the treatment of chronic urticaria: two case reports.

Two patients are presented whose chronic urticaria had previously failed to improve with antihistamine therapy or glucocorticoids. Both demonstrated marked improvement with dextroamphetamine sulfate. Both patients also had idiopathic orthostatic edema for which the treatment of choice is amphetamines. When treatment was discontinued the urticarial lesions returned, only to decrease significantly again when therapy was resumed. Whether the response to amphetamines in chronic urticaria is unique to patients with idiopathic orthostatic edema or will also prove to be effective in treating typical idiopathic urticaria will be determined by future research.

Adult↗
PubMed1982

Prenatal treatment of thyrotoxicosis to prevent intrauterine growth retardation.

A woman with hypothyroidism and Graves ophthalmopathy was treated with propylthiouracil during her second pregnancy. This was employed because her first pregnancy resulted in an infant with severe intrauterine growth retardation and neonatal thyrotoxicosis. The antithyroid drug used during the second pregnancy crossed the placenta and treated the infant in utero. The infant was delivered by elective cesarean section at 36 weeks and was a live-born male with appropriate height and weight without evidence of thyrotoxicosis. The therapeutic benefit of propylthiouracil during this second pregnancy seems likely, based on the development of neonatal thyrotoxicosis after 4 days of life and on the presence of high thyroid-stimulating immunoglobulin levels in the mother and the infant.

Adult↗
PubMed1980

Improved semen quality in subfertile males with varicocele-associated oligospermia following treatment with clomiphene citrate.

Varicocelectomy has been found to improve the spermogram in many subfertile men. However, there still remains a sizable group of subfertile men whose counts fail to improve sufficiently following surgery. Clomiphene citrate, which has been shown to improve fertility in idiopathic oligospermia, was similarly tried in men with varicoceles. The counts of 71% were raised to the low-normal range, and 36% achieved pregnancies. Medical therapy with clomiphene citrate may prove not only to be a useful adjunct to varicocelectomy but may prove to be first-line therapy for counts under 10 million/ml (8 of 13 improved to over 20 million/ml) when surgical therapy has not been successful.

Clomiphene↗