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Biomedical subjects

E J Lamb

Publications and source records attributed to E J Lamb.

9 recordsLinked to original sources
PubMed1992

Local anesthesia with conscious sedation for laparoscopic intrafallopian transfer.

Local anesthesia with conscious sedation is well accepted by patients and provides scheduling flexibility, cost containment, patient safety, and ease of recovery. We believe the technique should be offered to selected patients undergoing intrafallopian transfer. By adhering to specific guidelines for surgical technique and monitoring, the procedure is a safe and acceptable alternative to general anesthesia for laparoscopic intrafallopian transfers.

Adult↗
PubMed1990

Improved prediction of postovulatory day using temperature recording, endometrial biopsy, and serum progesterone.

The use of basal body temperature (BBT) recording and a single progesterone (P) level at the time of the endometrial biopsy in the late luteal phase improved our ability to predict the onset of the next menstrual period (NMP) and determine the postovulatory day (POD) in 124 regularly menstruating infertile women. We determined BBT shift using a microcomputer program, analyzed P levels by radioimmunoassay, and evaluated endometrial biopsies both prospectively (blinded) and retrospectively (with knowledge of the other variables). Serum P levels were within the normal range for the luteal phase and prospective and retrospective histological diagnoses closely agreed (82% within 2 days). The best correlation with the NMP was the BBT shift (r = 0.493) followed by P (r = 0.426) and prospective histologic dating (r = 0.390). Multiple regression analysis confirmed that use of all of the variables markedly improved the ability to estimate the POD (R2 = 0.51).

Biopsy↗
PubMed1979

Does adoption affect subsequent fertility?

A hypothesis derived from the old wives' tale that adoption increases subsequent fertility was tested by analysis of follow-up data obtained from 895 couples who were "at risk" of pregnancy and of adoption after they had registered in the Stanford Infertility Clinic between 1963 and 1977. Of the 767 couples who did not adopt, 329 later conceived; of the 128 who did adopt, 41 later conceived. Simple comparison of the percentages or, indeed, of the life tables suggests reduced fertility after adoption. However, this is probably a spurious effect related to a number of factors which differ between two groups. These differences were controlled in the statistical analysis by methods which take into account the length of time each couple was at risk of either conception or adoption and the presence or absence of explanatory variables. The relative risk of conception estimated by the Cox model was not significantly different from 1 and the Mantel-Haenszel statistic (m = 0.208) indicates no significant difference in subsequent conception rates between adoptive and not-adoptive couples. The same methods were used to control for seven covariates, including age and duration of infertility, which could affect conception rates. In each instance, the estimate of relative risk of conception for adoptive versus not-adoptive couples was not significantly different from 1. Therefore, our data do not support the hypothesis that adoption affects subsequent fertility.

Adoption↗
PubMed1976

Pituitary tumors in patients with secondary amenorrhea.

This study was undertaken to determine the prevalence of radiologically detectable pituitary tumors among patients seen initially in a gynecology clinic for a complaint of secondary amenorrhea. In a group of 144 women with secondary amenorrhea of more than 6 months' duration, 13 had radiologic abnormalities of the sella turcica detectable with standard skull films without tomography. These gynecologic patients composed more than half of the women in the reproductive age group who were diagnosed at this medical center as having a pituitary tumor. Only one patient with oligomenorrhea or secondary amenorrhea of less than 2 years' duration had a detectable tumor. Thus, for patients with short-term amenorrhea, the risk of having a pituitary tumor is small, especially in the absence of galactorrhea, headache, or changes in vision. However, 12 of 71 patients with amenorrhea longer than 2 years (17%) had detectable tumors and the risk appears to increase progressively with time. Assay of adrenal and thyroid hormones did not discriminate between patients with and without pituitary tumors. Early detection of these tumors is aided by serial sella x-rays, tomograms, prolactin assays, and newer pituitary function tests. Patients presenting with postpill amenorrhea and postpartum amenorrhea illustrate the hazard of interpreting a temporal relationship as a causal one.

Adolescent↗
PubMed1975

Separate inguinal incisions in the treatment of carcinoma of the vulva.

A modified surgical technique, using separate incisions for vulvectomy and for each groin, resulted in a low morbidity rate, with no increase in tumor recurrence and no reduction in length of survival time in comparison with previously reported methods of treatment of invasive squamous carcinoma of the vulva. The clinical staging adopted by the International Federation of Gynaecology and Obstetrics accurately predicted survival time for patients in this series as in others. However, in instances in which the histologic status of the nodes differs from the clinical assessment, postsurgical staging with primary importance attached to the histologic evaluation more accurately predicts prognosis.

Adult↗