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Biomedical subjects

A Victor

Publications and source records attributed to A Victor.

At least 37 records · Page 2Linked to original sources
PubMed1991

Diagnosis and prevalence of persistent chlamydia infection in infertile women: tissue culture, direct antigen detection, and serology.

Specimens for chlamydial culture, direct fluorescent antibody (DFA) test, two enzyme immunoassays (EIA) for antigen detection, and serum for chlamydial antibodies were collected from 256 infertile women. Specimens were taken from the tubes during tuboplasty and from the cervix and endometrium during laparoscopy or tuboplasty. Antibodies to Chlamydia trachomatis were found four times more often in patients with signs of prior pelvic inflammatory disease (PID) than in infertile women with normal pelvic findings. Only 48 (37%) of 131 patients with signs of prior PID had a history of PID. Ten or more C. trachomatis elementary bodies (EBs) per smear were found in 21 (8.2%) of 256 patients. Six patients had a positive culture or a positive antigen EIA test. All six had high numbers of EBs in the DFA test. We conclude that routine culture and EIA antigen tests detect only a minority of persistent chlamydia infections in this population, but subjective factors in the interpretation of DFA methods must be considered.

Adult↗
PubMed1990

Pad weighing test--a simple method to quantitate urinary incontinence.

This paper reviews the litterature on pad weighing tests designed to measure urinary incontinence. These can be divided into short-term (one to two hours), as suggested by the International Continence Society, or long-term (12 to 48 hours). Apart from practical disadvantages the short-term tests have a low sensitivity and require retrograde filling of the bladder to reach acceptable reproducibility. The long-term tests have practical advantages, better sensitivity and acceptable reproducibility. The validity of the long-term test as a measure of the symptom of incontinence is evident, whereas it is unclear what the short term test measures. An evaluation of the value of pad-weighing tests in different kinds of incontinence is lacking.

Clothing↗
PubMed1988

Micturition patterns in a healthy female population, studied with a frequency/volume chart.

A 48-hour frequency/volume chart was completed by 151 women without micturition complaints. The distribution of the parameters of the chart are presented. The chart was found to be a valuable and reliable instrument for assessment of micturition patterns. The mean voided volume, which takes into account both frequency of micturition and total voided volume, showed the best reproducibility of the parameters and is suggested as the parameter of primary importance. Attention should be paid to the circumstances under which the chart is applied, as normal micturition behaviour seems to be highly dependent on social factors.

Adult↗
PubMed1987

A simple patient-administered test for objective quantitation of the symptom of urinary incontinence.

A pad-weighing test for the quantitation of urinary loss, performed by the patient during 48 hours of daily activities, was evaluated. All patients (n = 46, age 21-73 years) were able to perform the test. The precision of their weighing was good and the reproducibility of the results equal or better than that of previously published tests. There was no correlation between the results of the 48-hour test and a standardized one-hour test, indicating that these two tests measure different aspects of incontinence. Of the two tests the 48-hour test likely gives a more valid measure of the symptom of urinary incontinence. Other advantages over the standardized short term tests are that no hospital staff is involved in the testing and that the test is independent of the physical capacity of the patient.

Adult↗
PubMed1987

Oral contraceptive absorption and sex hormone binding globulins in obese women: effects of jejunoileal bypass.

Plasma levels of two oral contraceptive gestagens were studied during 24 hour oral challenges in seven morbidly obese women after jejunoileal bypass comparing the results to unoperated normal controls. To study binding and transport of the gestagens, sex hormone binding globulin levels were determined in these patients, in normal-weight controls, and in unoperated morbidly obese patients. The unoperated morbidly obese patients had significantly decreased levels of sex hormone binding globulin, compared to normal-weight controls and to the jejunoileal bypass patients, whose levels were similar to the controls. The jejunoileal bypass patients had a reduced capacity to absorb oral contraceptive gestagens, although the plasma levels were of the same magnitude found in normal subjects using lower doses of gestagens. However, the gestagen to sex hormone binding globulin ratio was lower in jejunoileal bypass patients, implying reduced biologic activity and thus reduced contraceptive efficiency of the gestagen. There were no enzymatic or morphologic signs of liver dysfunction. No correlations were found between plasma gestagen levels and number or volume of stools, fecal fat excretion, or intravenous C-cholic acid load. It is concluded that caution must be exercised in prescribing oral contraceptives to jejunoileal bypass patients.

Administration, Oral↗
PubMed1985

Absorption of an oral contraceptive gestagen in ulcerative colitis before and after proctocolectomy and construction of a continent ileostomy.

Plasma 1-norgestrel (1-Ng) levels after administration of a common oral contraceptive in fertile women (mean age 29 +/- 5 yrs) with mild ulcerative colitis before or after proctocolectomy with a conventional ileostomy or a continent ileostomy reservoir were determined and compared to those of a group of healthy volunteers serving as controls. Before operation, peak and 10-hour levels of 1-Ng were not statistically different from control. Levels in patients with either type of ileostomy were slightly lower than controls, but were only statistically significantly lower in patients with continent ileostomy (p less than 0.05). In a subgroup of patients studied both before and after proctocolectomy with construction of a continent ileostomy, there was a slight reduction in peak and 10-hour levels compared to control. After administration of the pill directly into the reservoir, significant levels of 1-Ng in plasma were found with peak and 10-hour levels approximately one-half of those achieved after oral administration. Although the material is small, it suggests that patients with mild ulcerative colitis and with small ileal resections (8.8 +/- 8 cm) can use combined contraceptive pills containing 1-norgestrel with confidence. Caution should be exercised, however, in prescribing "mini-pills" to patients after proctocolectomy and ileal resection.

Adult↗
PubMed1984

Pharmacodynamics of a contraceptive vaginal ring releasing norethindrone and estradiol: ovarian function, bleeding control and lipoprotein patterns.

A new contraceptive vaginal ring (CVR), releasing approximately 700 micrograms of norethindrone (NET) and approximately 140 micrograms of estradiol (E2) daily, was studied in eleven women for a total of 61 21-day cycles. Ovarian function, as judged by plasma progesterone (P) and E2 levels, and plasma NET levels were studied by weekly blood samples in 30 cycles. The lipoprotein pattern was studied before, after two and six months of treatment and one month after completed treatment. The CVR gave rise to stable plasma NET levels which however varied considerably between individuals. Signs of luteal activity/ovulation were encountered in 4/30 cycles, all in subjects with the lowest NET plasma levels. E2 levels above 250 pmol/l, indicating follicular activity, were encountered in 22/30 cycles. Breakthrough bleeding and spotting appeared in 40/61 cycles and in 12 per cent of the treatment days. Bleeding control was significantly better in the same subjects when using a CVR releasing levo-Norgestrel and E2. Serum and HDL cholesterol concentrations decreased significantly by 10-12 per cent during treatment. The ratios between apolipoproteins A-I and A-II on one hand and HDL cholesterol on the other increased significantly and the ratio apolipoprotein A-I:A-II decreased significantly, indicating a change in the lipoprotein composition. These changes are qualitatively similar but quantitatively not as pronounced as with the more extensively studied 1-Ng/E2 CVR. The difference in clinical performance and in the effects on the lipoprotein pattern between the presently studied CVR and the 1-Ng/E2 CVR is most likely the result of not using equipment doses of gestagen in the CVRs.

Adult↗
PubMed1983

Ovarian function, bleeding control and serum lipoproteins in women using contraceptive vaginal rings releasing five different progestins.

Ovarian function, bleeding patterns and serum lipoproteins were studied in women using contraceptive vaginal rings (CVRs) of dimethyl-polysiloxane impregnated with steroids. The different CVRs were used for about 10 cycles each. The following groups were studied, with the daily steroid dosage given in parentheses. Women using CVRs delivering levonorgestrel (290 micrograms), norethisterone (850 micrograms), medroxyprogesterone acetate (700 micrograms) or megestrol acetate (1.9 mg), all of which were in combination with estradiol (200 ug). Women using CVRs delivering progesterone (5.2 mg). Women taking megestrol acetate orally (15 mg/day) for three weeks. In all women except those using the levonorgestrel CVR, there were indications of incomplete suppression of ovarian activity as shown by elevated levels of progesterone and/or estradiol peaks. Bleeding control seemed to be good with the levonorgestrel CVR and rather poor with the others. Levonorgestrel treatment was associated with a decrease in high density lipoprotein cholesterol (32%) and triglycerides (25%) and a 16% decrease in apolipoprotein A-I. Norethisterone induced a 10% decrease in A-I and a reduction of cholesterol in very low density lipoprotein. All other lipid and apolipoprotein B, A-I and A-II values were unaltered with the administration of the CVRs and with oral megestrol acetate. Levonorgestrel was given in a higher dose than the other progestins, but the absence of effects of the high oral dose of megestrol acetate on the serum lipoproteins indicates that the progesterone-derived progestins in adequate doses probably would not alter the lipoprotein metabolism. Higher doses of progestins are needed to achieve acceptable control of ovarian activity and bleeding patterns than seen with these CVRs.

Cholesterol↗
PubMed1983

Effects of contraceptive vaginal ring treatment on vaginal bacteriology and cytology.

The presence of aerobic and anaerobic bacteria, yeasts and mycoplasma/ureaplasma was investigated in seventeen women before and after six months use of a contraceptive vaginal ring releasing levo-Norgestrel and estradiol and in 16 women using an oral contraceptive containing levo-Norgestrel and ethinylestradiol. Apart from an increase in yeasts in both groups, no significant changes in the vaginal bacteriology could be found. Vaginal smears were examined before and during treatment for up to two years in a group of 120 women participating in a clinical trial of the contraceptive vaginal ring. No changes in the squamous epithelium or cylinder cells were found. The amount of leucocytes increased in the smears. The results indicate that use of the contraceptive vaginal ring does not affect the bacterial ecology of the vagina. The increase in leucocytes indicates a weak inflammatory reaction which might explain the increase in vaginal discharge often observed by women using the contraceptive vaginal ring.

Bacteria↗
PubMed1983

Interaction between phenytoin and norethisterone in the rhesus monkey.

The effects of phenytoin treatment on plasma concentrations of norethisterone (NET) was studied in 7 healthy female rhesus monkeys. Before phenytoin treatment was started each monkey received an oral dose of 0.5 mg NET and 2 weeks later the same dose was given intravenously. On both occasions, plasma concentrations of NET were measured at frequent intervals during 24 hours. The monkeys were given phenytoin daily orally for more than 4 weeks. The absorption of phenytoin was confirmed by plasma determinations of phenytoin. While still on phenytoin treatment, the monkeys were again given 0.5 mg NET orally and 2 weeks later i.v. and blood sampling was repeated. During phenytoin treatment, plasma NET concentrations were always below those found before treatment. Both at iv and oral administration, the areas under the plasma concentration vs time curve (AUC) were reduced to 55% of the pretreatment AUCs. No difference in plasma half-life was found during phenytoin treatment. The results of this study may suggest that women on antiepileptic treatment with phenytoin should be given an oral contraceptive with a comparatively high dose of the steroids to provide contraceptive efficacy.

Administration, Oral↗
PubMed1982

Plasma protein binding of norethisterone.

Norethisterone (NET) is transported in the blood stream bound to plasma proteins. It is generally believed that only the part of the hormone that is not bound to plasma proteins can exert biological activity. NET binds to albumin and, like other 19-nortestosterone derived progestins, it also binds to sex hormone binding globulin (SHBG). The binding of NET to SHBG was studied in five women during a 21-day treatment cycle with an oral contraceptive containing 3 mg NET-acetate and 50 microgram ethinylestradiol. The total and SHBG-bound concentrations of NET increased in parallel with SHBG during treatment. The fraction not bound to SHBG and the free fraction of NET increased proportionately less, indicating that the total concentrations of NET measured by radioimmunoassay only in part reflect the biologically active fraction of the steroid.

Adult↗
PubMed1982

Plasma androgenic activity in women with acne vulgaris and in healthy girls before, during and after puberty.

The possible relationship between plasma androgenic activity and acne vulgaris was investigated. Plasma testosterone and sex hormone binding globulin (SHBG) levels were determined in healthy girls during different stages of puberty, in healthy adult women and in women with acne vulgaris. Testosterone increase during puberty, whereas SHBG decreased during the early stages before it increased and stabilized plasma concentrations of testosterone and SHBG. Women with severe acne vulgaris had testosterone levels in the same range but the SHBG levels were significantly lower than those of healthy women and women with mild acne. These results show a high androgenic activity in the intermediate stages of puberty, when acne vulgaris is a common complaint and an increased androgenic activity in adult women with severe acne vulgaris.

Acne Vulgaris↗
PubMed1982

Effects of oestradiol on sex hormone binding globulin.

Sex hormone binding globulin (SHBG) levels were studied for possible effects of oestradiol-17 beta on SHBG. No change in SHBG plasma was recorded during normal menstrual cycles or during treatment with oestradiol-17 beta to menopausal women. However, gonadotrophin treatment to amenorrhoeic women to induce ovulation resulted in high oestradiol concentrations and a pronounced increase in SHBG was found during the luteal phase of these cycles. A marked increase of SHBG was also recorded in a woman with pronounced fluctuations of oestradiol during treatment with levonorgestrel sc implants for contraception. In conclusion, effects on SHBG were only found when extraordinarily high levels of plasma oestradiol were recorded.

Adult↗