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PubMed1995

Relation of sodium-lithium countertransport activity to markers of cardiovascular risk in normotensive subjects.

A study was undertaken in 298 normotensive, normolipidaemic and normoglycaemic subjects to define the range of erythrocyte sodium-lithium countertransport activity in this cohort and to determine the associations between countertransport activity and markers of vascular risk. Countertransport activity showed a positively skewed non-normal distribution with a median (95% confidence interval) of 0.197 (0.123-0.271) mmol Li/L erythrocytes per hour. Countertransport activity was elevated in women who were taking oral contraceptives (median (95% CI) mmol Li/L erythrocytes per hour, 0.270 (0.162-0.320) vs. 0.147 (0.110-0.201)). Countertransport activity was also found to be elevated in subjects who had alcohol intakes greater than the recommended weekly maximum (median (95% CI) mmol Li/L erythrocytes per hour, 0.193 (0.139-0.211) vs. 0.260 (0.148-0.317)). Positive correlations with sodium-lithium countertransport activity were noted with resting diastolic blood pressures (n = 298; P = 0.004) and maximal systolic blood pressure at peak exercise (n = 123; P = 0.003). In respect of serum biochemical variables, positive correlations were only found with triglycerides (P = 0.025) and creatinine (P = 0.005). These results support the view that elevation of erythrocyte sodium-lithium countertransport activity may reflect an alteration in the behaviour of cell membrane proteins through the influence of environmental factors associated with vascular risk.

Adult↗
PubMed1995

Women's health.

Although women live longer than men, new evidence indicates women bear a disproportionately heavy burden of disease. The effect of disease on economic productivity of women in developing countries has been largely ignored. Infections are often causes of disease in women, including those that affect reproductive health. Although men and women usually experience similar rates of many diseases, rates of exposure and treatment vary between men and women. If untreated, factors adversely affecting women's health in one stage compound women's ill health in succeeding stages.

Abortion, Legal↗
PubMed1992

Sexual behaviour among youth clinic visitors in Sweden: knowledge and experiences in an HIV perspective.

OBJECTIVE: To study the knowledge and experience of sexuality, contraception and sexually transmitted diseases among sexually active adolescents in Sweden. SUBJECTS: Youth clinic visitors. SETTING: Seventy-four youth clinics from all over the country of Sweden. METHODS: A questionnaire with 17 multiple choice and nine open questions was distributed to all visitors at participating youth clinics during a 2-month period. RESULTS: A total of 9277 young persons answered the questionnaire. Their mean age was 17.5 years. Ninety-three percent were females. Knowledge on STD and STD protection was wide-spread and good. Chlamydia and HIV was recognised as STDs by 90% and 87% respectively. More than 99% knew of the condom method as a means for STD protection. Knowledge on contraceptive methods for pregnancy protection was also good. Ninety-three percent of the investigated adolescents had had coitus. Nine percent had experienced pregnancies and 17% STDs. The mean number of life-time sexual partners was 3.2. CONCLUSIONS: In spite of good knowledge on preventive measures among Swedish youth clinic visitors their sexual behaviour carriers risks for future health. Further interventions are needed to minimise these risks.

Adolescent↗
PubMed1976

Heparin metabolism and heparin-release lipase activity during long-term estrogen-progestin treatment.

Short-term oral contraceptive therapy has been reported to decrease postheparin lipolytic activity (PHLA). Resistance to heparin has been held responsible for this effect. To test several alternative explanations, we studied both PHLA and heparin concentrations in nine control women and nine women receiving long-term estrogen-progestin therapy after they were given heparin intravenously (10 units/kg). There were no significant differences in the concentration of heparin, its rate of disappearance, or calculated space of distribution between control and treated groups. PHLA was depressed (p less than 0.05) by approximately 50% during long-term estrongen-progestin therapy. PHLA disappearance was similar in both groups. Thus, reduced PHLA in women receiving long-term oral contraceptive therapy cannot be related to altered heparin metabolism or to accelerated enzyme disappearance from plasma. Long-term estrogen-progestin administration may decrease the heparin-facilitated release of individual triglyceride hydrolase activities or enhance the affinity of enzyme binding to tissues.

Contraceptives, Oral↗
PubMed1982

The distribution of Down's syndrome.

A recent increase in the incidence of Down's syndrome has been found, mainly affecting young mothers. It is concluded that this increase is due to the environment, and an association with the contraceptive pill is sought. The cause of non-disjunction is discussed and the probability of prevention suggested.

Abortion, Spontaneous↗
PubMed1976

A report on a contraceptive social marketing experiment in rural Kenya.

There is a recognized need for the development of nonmedical, grassroots family planning delivery systems. This report describes the results of a two-year experiment in rural Kenya in which local marketing resources were utilized to promote and distribute condoms through village stores. The impact of the extensive advertising campaign on the test market area was measured by comparison with a control area and by before, during, and after sample surveys. In addition to achieving a condom sales level of 0.21 pieces per capita after 12 months, the program had a marked impact on family planning knowledge and practice, although not on attitudes. The authors assess the program's performance in relation to its goals and suggest how such social marketing programs could have far-reaching significance in most developing countries.

Community Participation↗
PubMed2004

Determinants of gallbladder kinetics in obesity.

Obese subjects are at risk of developing gallstones both by being overweight and by reducing their body weight. The aim of the present study was to investigate factors related to disturbances in gallbladder emptying measured by ultrasound. Detailed information about weight loss attempts, age at onset of obesity, parity, presence of menopause, use of contraceptive or hormonal replacement drugs, and phase of menstrual cycle was obtained. Smoking habits, alcohol use, dietary intake, and physical activity were recorded. Body composition and fat distribution were assessed by anthropometry. Blood samples were taken for CCK, lipids, glucose, and insulin. Mean (SD) fasting gallbladder volume was 30.0 (12.6) ml. The residual volume was 12.5 (9.8) ml 90 min after a test meal. CCK levels increased from a basal 1.64 (0.8) pM to a peak value of 2.9 (1.0) pM. Fasting gallbladder volumes were closely related to residual and ejection volumes. Body weight and fasting insulin levels explained 35.2% of the variance in fasting volume, lean body mass and insulin explained 28.1% of the residual volume, and waist circumference 23.6% of the ejection volume. None of the other factors were related to gallbladder emptying. Subjects with the largest fasting gallbladders had the largest residual and least emptying gallbladders, scored the highest in every aspect of body size, composition, and fat distribution, and also had the highest insulin levels. Body weight, lean body mass, central fat distribution, and insulin levels were the main determinants of gallbladder kinetics. Fasting and residual gallbladder volumes were closely related and both determined by obesity and its metabolic complication of hyperinsulinemia.

Adipose Tissue↗
PubMed1990

Relationship of mammographic parenchymal patterns with breast cancer risk factors and risk of breast cancer in a prospective study.

A prospective study has been conducted on 4954 female volunteers from the Island of Guernsey between 1977 and 1985 to examine risk factors for breast cancer and their relationship to mammographic parenchymal patterns as assessed by Wolfe's method of grading. Up to September 1988, 69 women had developed breast cancer, 11 of whom were prevalent cases being diagnosed within six months of mammography. The remaining incident cases were diagnosed six to 126 months (median 65 months) after entry to the study. Univariate analysis showed that the distribution of Wolfe grades in the population was significantly associated with menopausal status, age, parity, adiposity, age at menarche, age at first childbirth and use of oral contraception, but not with a family history of breast cancer. Multivariate analysis of the data for these variables from either pre- and/or post-menopausal women indicated that age, parity and adiposity were significantly related to Wolfe grade pattern. Age had an opposite effect in pre- compared with postmenopausal women thus the probability of either a P2 or DY pattern increased with increasing age in premenopausal but decreased in postmenopausal women so that incidence peaked around the menopause. Other variables did not achieve significance in the multivariate analysis. Odds ratios (ORs) were calculated for women with P2 or DY patterns using those with N1 or P1 grades as the reference group. The ORs were determined at two censoring times; one at five years and the other to include the most recent follow-up of this cohort. The ORs were adjusted for years of follow-up, age and adiposity and in postmenopausal women adjustment was also made for age at menarche.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Androgenic adult granulosa cell tumor in a 13-year-old prepubertal patient: a case report and review of the literature.

We report the clinicopathologic findings of an unusual case of adult granulosa cell tumor with androgenic manifestation in a 13-year-old prepubertal girl. The patient had never had a menstrual period and presented with a 1 year history of hirsutism. Physical examination was only remarkable for an increase in facial and abdominal hair, both with a male pattern of distribution. A pelvic ultrasound demonstrated a 6.0 cm right adnexal cyst. Plasma testosterone and 17-hydroxyprogesterone levels were elevated. The patient initially was treated with monophasic oral contraceptive pills for 3 months and owing to lack of response, she underwent an exploratory laparotomy in which a left ovarian tumor, 7.0 cm in greatest dimension, and a 6.5 cm right paratubal cyst were found. A wedge biopsy of the left ovary and subsequent left oophorectomy with right salpingectomy were performed. No gross evidence of disease outside the ovary was noted. Microscopic examination of the left ovarian tumor revealed the typical features of an adult granulosa cell tumor. No tumor was seen outside the ovary. Six days after surgery, plasma testosterone and 17-hydroxyprogesterone levels were in the normal range. Nine months postoperatively, the patient shows no evidence of disease. To our knowledge, this represents the first case of a prepubertal patient with an adult granulosa cell tumor with androgenic manifestations reported in the English literature.

17-alpha-Hydroxyprogesterone↗
PubMed1985

The relation between vaginal pH and the microbiological status in vaginitis.

The vaginal pH, microbial flora and presence of clue cells were investigated in 89 women who were seen at a sexually transmitted diseases clinic with a vaginal discharge or because they were contacts of men with gonococcal or non-gonococcal urethritis or because they were seeking a routine examination. None of the women had received antibiotics for at least 4 weeks before examination. A clinically normal vaginal secretion was found in 21 (55%) of 38 women who had a vaginal pH of 5.0-5.5, while such a secretion was found in only 7 (14%) of 51 women who had a pH value of 6.0-7.5. Clue cells, Chlamydia trachomatis and Mycoplasma hominis were found two to three times more often in women with the higher pH value than in those with the lower value and Ureaplasma urealyticum and Trichomonas vaginalis also occurred more frequently in the former group. Furthermore, large numbers of M. hominis organisms (greater than or equal to 10(6) colour changing units/ml) were associated significantly with the higher pH value. However, there was no appreciable difference in the distribution of Candida albicans between the two groups. C. trachomatis but not the other micro-organisms was isolated most often from women who were taking oral contraceptives. The results indicate that a pH of greater than or equal to 6.0 is strongly predictive of infection and may be more useful than the type of discharge in suggesting a need for confirmatory microbiological tests.

Candida albicans↗
PubMed1986

Breast cancer risk factors in Italian women: a multicentric case-control study.

To evaluate the importance of several risk factors for breast cancer in the Italian female population, a large multicentric case-control study was conducted in 10 breast clinics in Italy. The study included 1,556 women affected by breast cancer, histologically and/or cytologically confirmed. Controls were 1,505 women admitted to a hospital in the same town, matched with cases for residence and with the same age distribution of the Italian female population. The risk factors considered in this study were family history of breast cancer, reproductive history, height and weight, use of oral contraceptives, other hormonal therapies and smoking history. The results of this study confirm the significant role of a positive family history of breast cancer (RR = 2.37); the relative risk was even higher when a first-degree relative was affected or the breast cancer was bilateral. The analysis of the reproductive history showed a significant trend of increasing risk with increasing age at first birth and, although less evident, with increasing number of children. Quetelet's index (kg/m-2) was positively correlated with breast cancer risk, mostly in postmenopausal women. Among other studied factors, only late age at menopause confirmed an increased risk for breast cancer, whereas age at menarche, use of oral contraceptives and smoking histories did not show any significant correlation with breast cancer risk. These results are in substantial agreement with other international studies, but represent an interesting contribution to studies about the Italian female population.

Abortion, Spontaneous↗
PubMed1999

Knowledge and use of birth control methods in active duty Army enlisted medical trainees.

This study was designed to determine the familiarity of medical advanced individual training (AIT) students with current methods of birth control and to evaluate the accessibility of these methods. A survey was distributed to 578 medical specialist AIT students assigned to Fort Sam Houston, Texas, for training. Results obtained show a lack of knowledge concerning the newer forms of contraceptives available. This study also indicates that barriers may exist that limit a soldier's ability to acquire prescription forms of contraception while in training.

Adult↗
PubMed2001

[Insertion/deletion polymorphsim of the angiotensin I converting enzyme gene and pulmonary thromboembolism in Chinese population].

OBJECTIVE: To investigate whether there is an association between the insertion deletion polymorphsim of human angiotensin I converting enzyme gene (ACE) and pulmonary thromboembolism and whether D allele increases the risk of pulmonary thromboembolism in Chinese population. METHODS: Seventy-two patients with pulmonary thromboembolism and 72 sex and age matched healthy controls were recruited in this study, all patients were diagnosed by lung ventilation/perfusion scan and/or ultrafast CT as well as medical history. Risk factors of venous thrombosis and pulmonary thromboembolism were inquired. Genome DNA was extracted from whole blood using phenol-chloroform. Subjects were genotyped for the I/D polymorphism of ACE gene using polymerase chain reaction based restriction fragment length polymorphism analysis. RESULTS: (1) The incidences of trauma, operation, phlebitis and venous varicose were significant higher in the patient than in controls. No significant difference were found in the family history of pulmonary thromboembolism and cardiovascular diseases, personal history of oral contraceptive, cigarette smoking and alcohol drinking between the patient and controls. (2) Frequencies of allele I and D in the controls were 0.66 and 0.34 respectively, the distribution of genotypes met the in Hardy-Weinberg equilibrium. No significant differences were found in the frequencies of genotype II, ID and DD between patients and controls. (3) The recessive allele model was informative and the odds ratio of DD genotype was 2.51 (P < 0.05) compared with the other two genotypes. (4) After further stratification, we found DD genotype was bound to be associated with an 2.64-fold risk of pulmonary thromboembolism for those individuals without existing traditional environmental risk factors and 3.36-fold risk for individuals with medical history of venous thrombosis (P < 0.05). CONCLUSION: This study shows that I/D polymorphism of ACE gene is associated with pulmonary thromboembolism in Chinese population and allele D is recessive. Our results indicate that DD genotype increases the risk of pulmonary thromboembolism for individuals who have no traditional risk factors of venous thrombosis or pulmonary thromboembolism and also for those with personal history of venous thrombosis.

Alleles↗
PubMed2002

Risk of breast cancer in post-menopausal women using hormone replacement therapy.

OBJECTIVE: To study the relationship of hormone replacement therapy (HRT) in post-menopausal women and risk of breast cancer. PATIENTS AND METHOD: The authors conducted a case-control study comparing the proportion of HRT used between breast cancer and non-breast-cancer women. Cases were breast cancer patients who had natural menopause (excluded hysterectomy) and aged > or = 50-years-old from the Siriraj Breast Cancer database (1983-1996). Controls were post-menopausal volunteers aged 50 year or older who visited Siriraj Hospital for other purposes such as elderly clinics, health check, etc. After informed consent, well-trained surgeons examined the women in the control group to exclude any potential breast cancer. Patient characteristics and risk factors were collected. RESULTS: Of 1,913 patients in the database, 623 were included as the cases. Data from 679 volunteers were collected for controls from May to December 1999. Among 1,302 of the study population 58 women had ever used HRT (4.5%), which distributed to 3.2 per cent (20/623) in cases and 5.6 per cent (38/679) in controls. From univariate analysis, age, age at menopause, number of children, habitat, education, contraceptive pills, familial history of breast cancer and HRT usage were associated with breast cancer (p-value<0.05). After multivariate forward stepwise logistic regression analysis, there was no association between HRT use and breast cancer (adjusted odds ratio (OR) = 0.61, 95% CI = 0.31-1.20). In subgroups analysis, women who had older age, higher education level, history of taking contraceptive pills, or positive familial history of breast cancer in second degree relatives had a decreased risk of breast cancer, while those living outside Bangkok had an increased risk. CONCLUSION: Hormonal replacement therapy in post-menopausal women was not associated with increased risk of breast cancer.

Breast Neoplasms↗
PubMed1977

Prevalence, goals and complications of heterosexual anal intercourse in a gynecologic population.

In a prevalence study of 526 consecutive gynecologic patients, a history of heterosexual anal intercourse (AI) was elicited in 25% and was a regular means of sexual gratification in 8% and was thus deemed active, pleasurable, and intercourse (APAI). The prevalence of AI and APAI was similar in patients of Mexican-American, Black-American and Anglo-American background and in patients older or younger than 30 years. The APAI participants were evenly distributed between cancer detection, family planning, free clinic and private consultant populations. The goals of the APAI group associated with heterosexual anal intercourse were pleasure, orgasm and contraception. The reported complications were infrequent and were related to infectious diseases, local irritation and trauma. Although the average duration of APAI was two years, no unusual pelvic or rectal characteristics were noted in these patients.

Adolescent↗
PubMed1977

Governmental population incentives: ethical issues at stake.

Governmental incentives to influence population-related decisions are examined in terms of the ethical issues at stake. A typology of incentive schemes is presented, and ethical implications of various incentives are discussed. It is argued that, in a just scheme, a progressive, negative incentive or fee, calculated as a surtax on a modified income tax or an equivalent standard, would distribute burdens equally. A set of guidelines for ethical evaluation of incentive schemes is proposed.

Contraception Behavior↗