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Biomedical subjects

E B Connell

Publications and source records attributed to E B Connell.

At least 19 recordsLinked to original sources
PubMed1999

Contraception in the prepill era.

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians in favor of contraception to provide advice and methods of birth control to their patients. By the early 1900s, a constellation of factors--in particular, the large influx of poor immigrants, and feminist groups advocating women's rights--helped to move forward a birth-control movement in this country and abroad. In the early 20th century, Margaret Sanger became one of the most avid proponents of contraception in the United States. By 1950, she and Katharine McCormick had contracted with biologist Gregory Pincus to develop an effective birth control pill. A collaborative effort by Pincus and other researchers led to trials of the pill in Puerto Rico, Haiti, and Mexico between 1956 and 1957, which provided the basis for an application to the Food and Drug Administration for approval of the first oral contraceptive.

Animals↗
PubMed1998

The exploitation of autoimmune disease: breast implant litigation and its dire implications for women's health.

Men, women, and children are subject to a number of disease conditions that have been documented over many centuries. Among the most recently described and the least understood of these conditions are autoimmune diseases. As we unfortunately have seen in recent years, the obscure nature of autoimmune disorders has allowed scientific distortion by individuals who stand to profit by claiming a cause-and-effect relationship among some types of autoimmune conditions and a number of medical products, resulting in a rapidly expanding use of "junk science" in our courtrooms. Attempts have been made recently to implicate a number of environmental factors in the development of autoimmune disorders, most notably silicone gel-filled breast implants. The controversies surrounding these alleged relationships have proved to be among the most contentious, costly, and dangerous events ever to occur in women's health care.

Autoimmune Diseases↗
PubMed1997

Transdermal estrogen therapy.

Estrogen replacement therapy is becoming an important weapon in the fight against osteoporosis and heart disease in postmenopausal women, in addition to its original role of alleviating many of the symptoms associated with menopause. Dr. Connell discusses the many benefits of estrogen replacement therapy and the advantages that transdermal administration of estrogen appear to offer over other routes of administration.

Administration, Cutaneous↗
PubMed1993

Rational use of oral contraceptives in the perimenopausal woman.

Oral contraceptives have undergone extensive revision in their labeling over the past 10 years to remove warnings about cardiovascular and other risks and to highlight their noncontraceptive benefits. While these changes are becoming better known, the potential bone-sparing effects of oral contraceptives in the premenopausal and perimenopausal woman remain under-appreciated. Osteoporosis is a major health care problem worldwide in terms of both its associated morbidity and mortality and its economic impact. Although the benefits of postmenopausal hormone replacement therapy for the prevention and treatment of osteoporosis are generally recognized, little attention has been paid to strategies that might be used to maintain bone mass up to the time of menopause, at which time bone loss accelerates. An additional noncontraceptive benefit of oral contraceptives may be to maintain and build bone mass up to the time of menopause.

Contraceptives, Oral↗
PubMed1992

Patient counseling.

The success or failure of oral contraceptive (OC) use depends very heavily on the type and extent of the counseling a woman is given both before and during pill administration. If she selects the OC as her method of choice after considering all the options, a clear, detailed, and accurate discussion should ensue about its proper use; any fears that she may have should be explored; and great emphasis should be placed on the advantages and effectiveness of our current pills and, above all, on their numerous health benefits. All her questions should be answered in a thorough and emphatic fashion, and she should be encouraged to ask for additional answers at any time in the future. Finally, if her history reveals that she is at risk for sexually transmitted diseases (STDs), she must be informed that the pill, while highly protective against unplanned pregnancy, will not provide protection against most STDs or HIV infections, and that she should also use condoms and/or a female barrier contraceptive with each act of intercourse.

Communication↗
PubMed1991

Barrier contraceptives, spermicides, and periodic abstinence.

Although barrier contraceptives were among the first methods of preventing unwanted pregnancy ever described for human use, with the advent of the non-coitally related oral contraceptives and intrauterine devices, they gradually fell into relative disuse. However, for a variety of reasons, this is no longer the case. There is a renewed interest in these techniques both as a major form of birth control and also as our best protection against the transmission of sexually transmitted diseases, many of which are now occurring in epidemic form. This latter reason has stimulated fresh approaches to both physical barriers and spermicidal agents. In addition, attempts have also been made to assess the true effectiveness of periodic abstinence and ways in which to make its use more accurate and acceptable.

Contraceptive Devices↗
PubMed1987

Oral contraceptives. The benefits and the cardiovascular risks.

For healthy women under 25 years of age, the benefits of oral contraceptive (OC) use far outweigh the risks. Because the agents protect against such life-threatening conditions as ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy, the number of deaths they prevent is larger than the number they cause. For nonsmokers up to age 40, OCs may offer more benefits than other available fertility-control methods, although for smokers 35 years of age or older, the risks of OC use outweigh the benefits. When risk factors for cardiovascular disease are taken into account in selecting OC users and when an appropriate agent is chosen, the likelihood of a cardiovascular accident is greatly reduced. The formulations containing low-dose estrogen and low-dose, low-potency progestins appear to be safest, as they have fewer adverse effects on serum lipids and lipoproteins.

Adolescent↗
PubMed1986

Minimizing the metabolic risks of oral contraceptives through patient counseling and monitoring.

Before selecting a method of contraception, it is necessary to obtain a careful medical, family and personal history. In addition, a physical examination and basic laboratory studies must be done. It is important to properly counsel all patients who wish to use an oral contraceptive (OC), particularly if they have one or more risk factors. This counseling should include the rationale for using a low-dose, low-potency OC, what side effects to look for and what the follow-up schedule will be so that the patients are monitored adequately.

Cardiovascular Diseases↗
PubMed1984

Oral contraceptives. The current risk-benefit ratio.

When oral contraceptive (OCs) first became available, they were thought to be close to the ideal method of contraception. However, by the late 1960s, reports of cardiovascular complications were beginning to appear. The risks of four cardiovascular diseases increased: (1) hypertension, (2) venous thromboembolism, (3) stroke and (4) myocardial infarction. First, hypertension is now accepted as one of the proven side effects of OC use. It also contributes to the morbidity and/or mortality resulting from stroke, myocardial infarction, and cardiac and renal failure. Second, the risk of a previously normal woman's developing venous thromboembolism is increased by OC use, but the absolute risks vary considerably. Third, the risk of stroke is greater among OC users, and the risk persists after one discontinues OC use. Finally, there is an association between Pill use and coronary heart disease, but heart attacks occur mainly in women who have additional risk factors, such as increasing age and smoking.

Cerebrovascular Disorders↗
PubMed1977

Side effects of intrauterine devices.

Problems in determining and quantifying side effects of intrauterine device (IUD) use are reviewed. The types and incidences of major side effects are discussed, as well as methods of treatment. The author concludes that IUD use remains a safe and effective method of family planning.

Bacterial Infections↗