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Biomedical subjects

B V Caldwell

Publications and source records attributed to B V Caldwell.

At least 19 recordsLinked to original sources
PubMed1989

Monitoring gonadotropin therapy.

In the private clinical setting the use of Pergonal or Metrodin is a safe and efficient method of inducing ovulation; however, the known risks of those agents must be kept in mind at all times. By adhering to the guidelines listed here and administering Pergonal and then human chorionic gonadotropin in the prescribed manner, an ovulation rate of greater than 90% should be achieved. A six-month course of therapy with Pergonal should yield a pregnancy rate of 60-70%, provided that the fallopian tubes are normal, the sperm count is adequate and cervical mucus function is intact. Patients who do not become pregnant in six to nine months should be referred to tertiary centers for other procedures, such as in vitro fertilization and/or gamete intrafallopian transfer.

Chorionic Gonadotropin↗
PubMed1985

LRFD6a has a dose-related stimulatory or inhibitory effect on the ovary in normal luteal phase women.

A dose response curve for LRFD6a-a potent LRF agonist-was established in normal midluteal phase women. At low doses (3-10 micrograms) an acute stimulatory effect on gonadotropins and ovarian steroidogenesis of estradiol and progesterone was observed. Despite large increases in circulating gonadotropins following the highest dose (30 micrograms LRFD6a), no acute changes in plasma steroids were noted. A sharp drop in progesterone was present after 3 days, with significant shortening of the cycle in 3 of 4 subjects in the group. While the stimulatory effect may be due to gonadotropin release and local action, the luteolytic effect observed is suggested to be a consequence of the direct inhibitory effect of the analog on ovarian function.

Adult↗
PubMed1985

Efficacy of fenoprofen in the treatment of primary dysmenorrhea.

We compared fenoprofen calcium, 200 mg; fenoprofen calcium, 400 mg; aspirin, 650 mg; and a placebo in 85 women for the relief of primary dysmenorrhea in a double-blind, clinical trial. The usefulness of these drugs was judged from data obtained over four consecutive menstrual periods on: restriction of daily activity, pain intensity scores, need for rescue analgesics, withdrawal due to lack of efficacy, and adverse events. Both fenoprofen, 200 mg, and fenoprofen, 400 mg, offered significant (P less than .01) pain relief when compared to placebo and aspirin. Analyses of data on 1, 2 and 3 indicated that aspirin was not significantly different from placebo. The aspirin-treated group reported the greatest number of adverse reactions, but the differences between the four groups were not statistically significant. Our study lends support to the concept of a "plateau analgesic effect" of nonsteroidal antiinflammatory drugs (NSAIDs): fenoprofen, 200 mg, appears to be as effective as fenoprofen, 400 mg. When this type of drug fails to provide relief for a woman suffering from primary dysmenorrhea, switching to another NSAID may be more appropriate than increasing the dosage and the probability of dosage-related side effects.

Adolescent↗
PubMed1984

Treatment of seizures with medroxyprogesterone acetate: preliminary report.

Medroxyprogesterone acetate (MPA), a synthetic progesterone, was added to the antiepileptic drug regimen of 14 women who had uncontrolled seizures. Of the 11 women who developed amenorrhea, 7 reported fewer seizures during MPA therapy. Overall reductions in seizure frequency averaged 30% (n = 11), declining from a baseline 8.3 +/- 5.8 seizures per month to 5.1 +/- 4.1 seizures per month (p = 0.02). No serious side effects were encountered, but spotting was common. These preliminary data suggest further evaluation of MPA for catamenial seizures.

Epilepsy↗
PubMed1982

Abnormal ovarian cycles as diagnosed by ultrasound and serum estradiol levels.

A significant portion of human infertility is presumably due to defective ovulation, including patients who fail to conceive despite medical induction of ovulation, those who fail despite repeated timely donor inseminations, and those with "infertility of unknown etiology". All point out the inadequacy of standard criteria for normal ovulation. This investigation correlates preovulatory serum estradiol and gonadotropin concentrations with dominant follicle growth measured ultrasonographically and serum progesterone levels. The data indicate a 35% incidence of cycles with significantly abnormal serum estradiol levels, decreased dominant follicle size, and abnormal progesterone levels despite biphasic basal body temperature curves and normal cycle length. If these cycles represent inadequate or abnormal ovulation, they can be distinguished from adequate cycles prior to follicle rupture and may benefit the treatment of human infertility.

Adult↗
PubMed1981

Alpha subunit in gestational trophoblastic disease.

Alpha HCG, estimated after evacuation of hydatidiform mole, was found to follow the decline of beta-HCG. In patients with low-risk non-metastatic gestational disease the alpha-subunit values also followed the beta-HCG values. This indicates no additional value in following alpha-HCG in such patients. Whether alpha-HCG elevation may portend recurrence in treated high-risk cases of metastatic disease in remission with non-detectable beta-HCG remains unresolved by this study.

Chorionic Gonadotropin↗
PubMed1981

A method of screening for ectopic pregnancy and its indications.

The possibility of distinguishing between normal intrauterine and ectopic pregnancies by determining the lower limit of the rate of human chorionic gonadotropin (hCG) increased in early pregnancy was investigated. This can be expressed as the slope of the log hCG-time curve or as the percent increase in hCG over a given sampling interval. For practical purposes, the rate is most easily determined from 2 samples drawn 48 hours apart. The differences between the 2 hCG values obtained is expressed as a percentage of the initial value, and should be 66% or greater for this sampling interval. Approximately 15% of normal intrauterine pregnancies screened in this way will appear abnormal, and the diagnosis in 13% of ectopic pregnancies will be delayed beyond 48 hours.

Chorionic Gonadotropin↗
PubMed1980

Comparative study of high-dose chorionic gonadotropin on the human and rat corpus luteum and effect of gonadotropin-releasing hormone on human luteal function.

Human chorionic gonadotropin (hCG) was administered to pseudopregnant rats with 4-day-old corpora lutea and to normal women on days 16 to 18 following onset of menses. In the rat serum progesterone levels fell by 90% within 8 hours as did unoccupied luteal luteinizing hormone (LH) receptors following treatment with hCG (100 IU). Total receptor number for LH, however, remained unchanged until after 12 hours. In the woman 20,000 or 40,000 IU of hCG given on day 16 and day 18 of the cycle did not reduce serum progesterone or serum estradiol levels although the serum hCG level was similar to that achieved in the rat. In fact, serum progesterone levels rose and the cycle length was extended by hCG treatment in the human. Conversely, treatment of the woman with gonadotropin-releasing hormone (GnRH, 500 microgram on day 16 and on day 18) caused an initial rapid rise, then a fall in serum progesterone levels and the cycle length was shortened. It was concluded that the human corpus luteum may be resistant to densensitization by hCG but possibly not to LH. However, the possibility cannot be excluded that GnRH may compromise luteal function through mechanisms independent of effects on pituitary gonadotropin secretion or action.

20-alpha-Dihydroprogesterone↗
PubMed1976

Estrogen-induced luteolysis in the rhesus monkey: reversal with indomethacin.

Normally cycling Rhesus monkeys were treated with diethylstilbestrol (25 mg/day) alone or in combination with indomethacin (25 mg/day) for five consecutive days beginning in the early luteal and mid-luteal phase of the menstrual cycle. Blood specimens were obtained daily to monitor corpus luteum function (progesterone), and the length of each menstrual cycle was recorded. Diethylstilbestrol alone cause premature luteolysis as indicated by decreasing plasma progesterone and shortened menstrual cycle, and indomethacin effectively blocked the luteolytic action of diethylstilbestrol. These results suggest that the probable mechanism of diethylstilbestrol action in causing luteolysis is mediated via the prostaglandins.

Animals↗