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Biomedical subjects

A N Poindexter

Publications and source records attributed to A N Poindexter.

13 recordsLinked to original sources

Risk factors for infection with human immunodeficiency virus among low-income women undergoing voluntary sterilization.

Data regarding risk for infection with human immunodeficiency virus (HIV) were collected from 486 women who presented in 1989 for tubal sterilization through a clinic operated by a medical school. This clinic was participating in a blind surveillance project administered by the local health department. The project was designed to estimate the prevalence of seropositivity for HIV among women seeking family planning services within the department's catchment area. The expectation was that the population of women choosing voluntary sterilization would be of relatively low risk for HIV infection. Surprisingly, however, when they were examined, nearly 25% of these women reported at least one identified risk factor for HIV infection. The rates for certain specific risk factors are no lower among these women than among the general population.

Family Planning Services

Hysterosalpingographic diagnosis of Crohn's disease. A case report.

A woman presented with abdominal pain, weight loss and a pelvic mass. At the time of laparotomy she had a lower abdominal abscess from perforation of the ileum. Two years later she returned with a tender uterus and purulent cervical discharge. A hysterosalpingogram demonstrated an uteroileal fistula secondary to Crohn's disease, and the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.

Adult

Laparoscopic tubal sterilization under local anesthesia in women with cyanotic heart disease.

Laparoscopic tubal sterilization under local anesthesia with intravenous sedation has been shown to be a safe procedure. However, the use of laparoscopy in patients with cyanotic cardiovascular disease is controversial and is generally contraindicated. Five women were referred with uncorrectable cyanotic heart disease and pulmonary hypertension. The mean preoperative arterial oxygen pressure was 56.2 +/- 5 mmHg (N = 5). After cardiology and cardiovascular anesthesia consultation and clearance, the patients underwent laparoscopic sterilization with Silastic rings under local anesthesia using direct trocar entry. Continuous hemodynamic monitoring and pulse oximetry were employed. The patients were kept in the intensive care unit or the hospital for 24 hours for monitoring, and all did well. This hospital for 24 hours for monitoring, and all did well. This small retrospective series demonstrates that laparoscopic sterilization under local anesthesia is a sterilization technique that may be suitable and safe for such patients when appropriate monitoring is performed. Tubal sterilization may be the contraceptive method of choice in women with heart disease when pregnancy is contraindicated.

Adult

Laparoscopic tubal sterilization under local anesthesia.

Laparoscopic tubal sterilization has been performed under local anesthesia in the United States since 1971. Pilot studies suggested that local anesthesia was as adequate and as safe as general anesthesia. Since 1980, the senior author has performed more than 3000 outpatient laparoscopic tubal sterilizations with the silastic ring under local anesthesia. A retrospective descriptive study was conducted on 2827 cases. The technical failure rate was 0.14%. There were no unintended laparotomies due to complications. The mean operative time was 10.0 +/- 5.1 minutes. The mean anesthesia time was 23.3 +/- 6.9 minutes. The hospital cost for the patient was reduced by 68-85%. This study demonstrates that laparoscopic tubal sterilization can be performed adequately, safely, and quickly under local anesthesia.

Adult

Endometriosis in multiparous women.

The incidence of endometriosis in the general population has been reported to range from 4% to 32%. A more realistic figure is probably 7.5%. An incidence of 7.4% was found in 42 of 566 multiparous women undergoing tubal sterilization at Baylor College of Medicine, Houston. Twelve of the 42 (29%) were less than five months postpartum. Hispanics had an incidence of endometriosis similar to that of whites and blacks. Indigent status had no bearing on the presence of endometriosis. A higher incidence of spontaneous abortion was found in patients with endometriosis, but the difference was not statistically significant.

Abortion, Spontaneous

Prolactin receptors in the ovary.

The binding of prolactin (PRL) to the plasma membranes of bovine and human ovaries was investigated using both homologous and heterologous 125I-prolactin. Saturation and Scatchard analysis demonstrated that human prolactin binds to human ovarian membranes with a Kd of 2 x 10(-10) M; to bovine ovarian membranes with a Kd of 1.9 x 10(-10) M; and to bovine corpora lutea membranes with a Kd of 1.9 x 10(-10) M. The concentrations of binding sites in bovine and human ovaries were 2.9 x 10(-15) moles/mg of protein and 2.0 x 10(-15) moles/mg of protein, respectively. The number of bindings sites in the bovine corpora lutea was 1.5 x 15(-15) moles/mg of protein. Specificity studies with bovine PRL, ovine PRL, human luteinizing hormone, human follicle-stimulating hormone, and bovine growth hormone showed this binding to be specific. Comparison of binding of PRL to membranes of other target and nontarget tissues suggests that the ovary is one of the primary target tissues. These data suggest that prolactin plays a role in the ovarian cycle.

Animals

A comparison of netilmicin and gentamicin in the treatment of pelvic infections.

Seventy-five women admitted with the symptom complex suggestive of pelvic inflammatory disease( PID) were started on a penicillin-aminoglycoside antibiotic regimen. An aminoglycoside, gentamicin or netilmicin (Schering-Plough), was chosen randomly and given parenterally. Forty-two patients received netilmicin and 33 received gentamicin for 5 days. Therapeutic response to the 2 antibiotic regimens was similar. Aminoglycosides have been associated with both nephrotoxicity and ototoxicity. Blood chemistries were studied in all patients. The only manifested toxicity was in 2 patients treated with gentamicin. Endometrial-endocervical cultures were obtained before and after therapy. The microbacteria isolated by standard culture techniques before therapy revealed Neisseria gonorrhoeae in 69% and 51% of the netilmicin and gentamicin groups, respectively; anaerobic organisms were cultured in about 75% of each group.

Acute Disease

Functional and dysfunctional uterine bleeding.

The patient who comes to the physician with abnormal bleeding represents an enormous responsibility. The various causative factors represent defects in numerous physiologic systems. The diagnosis of DUB still requires further investigation of the hormonal imbalance. Only when specific causes are known can the treatment be tailored to the particular patient. Recent scientific advances regarding possible cellular mechanisms for DUB make it mandatory that the primary physician be aware of available tests that may indicate the relative appropriateness of and prognosis for a particular therapy. The treatment is substitutional. If progesterone is missing, therefore,the treatment should replace it. Progesterone may be obtained endogenously by ovulation induction or exogenously by oral or parenteral progestogens.

Adolescent

Circulating prolactin levels. I. Normal females.

A specific, homologous radioimmunoassay was used to quantitate circulating levels of prolactin in females in various stages of life. They were grouped in periods of newborns to peripubertal females, reproductive, gravid and puerperal, and postmenopausal females. The results reveal dynamic changes of prolactin throughout various stages of life and support the mounting evidence that prolactin's role in humans might mimic that of animals. The role of prolactin in the ovarian cycle is unclear and will have to be ascertained at the molecular level.

Adolescent

Freeze preservation of squirrel monkey sperm for use in timed fertilization studies.

These investigations were concerned with the response of squirrel monkey sperm to freezing. A procedure involving preincubation at 37 degrees C, progressive cooling combined with a two-step dilution, and freezing on Dry Ice was applied to semen samples collected by electroejaculation from two animals. Sperm concentrations in these samples were 321.8 X 10(6)/ml (+/-204.1 SD) and 532.8 X 10(6) ml (+/-117.1 SD), respectively. Sperm motility prior to freezing was 68.1% (+/- 15.9 SD) AND 63.6% (+/-14.8 SD). Following freezing and thawing, motilities of 53.8% (+/-17.1 SD) and 51.8% (+/-22.9 SD) were observed. The freezing procedure increased sperm motility in approximately 30% of samples from both animals. Changes in the motile behavior of sperm were not observed after freezing. Serum testosterone measurements, the first made in the squirrel monkey, gave values similar to those obtained for other primates. A progressive decline in testosterone concentration, seen in both animals during the course of these investigations, did not affect semen characteristics or the response of sperm to freezing.

Animals

Characteristics and attitudes of early contraceptive implant acceptors in Texas.

In 1991, shortly after Norplant became available in the United States, 678 women who had received the implant from 17 providers in Texas were surveyed. Forty-five percent of these women were under 21 years old. The majority (56%) had tried the implant because they were dissatisfied with their previous contraceptive method. Forty-four percent of the sample indicated that the implant was one of the first contraceptive methods they had used and that they had only recently decided to prevent unplanned pregnancy. The average number of children per woman was 1.2, and one-third of the sample had had at least one abortion. While 37% of the women said they wanted no more children, 63% said they were using the implant as a spacing method. The reasons for choosing the implant and concerns about it varied according to the user's age, educational level and race or ethnic group.

Adolescent