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Biomedical subjects

F Benjamin

Publications and source records attributed to F Benjamin.

At least 19 recordsLinked to original sources
PubMed1990

Serum estradiol as an aid in the diagnosis of ectopic pregnancy.

The value of serum beta-hCG measurement in the diagnosis of ectopic pregnancy is well established, and there have been recent studies on the use of serum progesterone levels. However, we have been unable to find any reports on the potential application of serum estradiol (E2) assays in the diagnosis of ectopic pregnancy. We therefore concurrently measured serum E2, progesterone, and beta-hCG in 100 women with ectopic pregnancies, as well as in 69 controls with normal intrauterine pregnancies and 36 women with threatened abortion. The mean (+/- standard deviation) E2 levels for ectopic-pregnancy patients, the normal controls, and the women with threatened abortion were 281.1 +/- 115.6, 788.2 +/- 45.5, and 788.8 +/- 40.6 pg/mL, respectively; the mean levels in the ectopic group were significantly different (P less than .0001) from those of the other two groups. All but one of the ectopic pregnancies had values below 650 pg/mL for E2 and 23 ng/mL for progesterone, and all but one of the normal intrauterine pregnancies had values above these levels. Our data suggest that the addition of the estradiol assay, with or without progesterone, to the early evaluation of patients suspected of having an ectopic pregnancy may be helpful in diagnosis.

Chorionic Gonadotropin↗
PubMed1990

Treatment of pulmonary endometriosis with a long-acting GnRH agonist.

We report the case of a patient who was successfully treated with a long-acting GnRH agonist for pulmonary endometriosis. This 28-year-old woman had symptomatic pleural endometriosis, documented by biopsies, as well as symptomatic pelvic endometriosis. Two surgical procedures, consisting of excision of pleural endometriotic tissue and partial pleurectomies, failed to relieve her chest symptoms. Little relief was achieved with pseudopregnancy treatment. Satisfactory symptomatic improvement was obtained with danazol, but this medication had to be discontinued because of severe side effects. Trial of a GnRH agonist, leuprolide acetate, achieved complete remission of her chest symptoms; in addition, the patient became pregnant immediately after cessation of therapy. Gonadotropin-releasing hormone agonist therapy may be an important therapeutic alternative for women with pulmonary endometriosis who cannot tolerate danazol treatment and in whom surgical therapy fails to relieve the chest symptoms.

Adult↗
PubMed1990

Breast-feeding and the potential for human immunodeficiency virus transmission.

There is evidence to suggest that the human immunodeficiency virus (HIV) can be transmitted from mothers to their uninfected offspring via infected breast milk. The quantitative risk of transmission by this route is unknown. We must urge all individuals at risk for HIV infection to be tested. In the United States, it is recommended that women who are known to be HIV-positive be discouraged from breast-feeding. In certain regions of the United States, such as high-risk areas of New York City, HIV infection may be present in more than 3% of reproductive-age women, most of whom do not know they are infected. Women who either live in areas of the United States in which acquired immunodeficiency syndrome (AIDS) is endemic or are living in other parts of the country and are at high risk for AIDS, yet refuse to be tested, should be counseled regarding the potential for transmission of the virus to uninfected offspring via breast-feeding.

Breast Feeding↗
PubMed1989

First prenatal visit glucose screening.

In order to determine the benefit of glucose screening at different stages of pregnancy, a prospective study of 999 patients was performed. All the patients underwent a nonfasting glucose screen at their first prenatal visit. This screen consisted of an oral 50 gm glucose load followed by a 1 hour serum glucose determination. If the glucose result was 130 mg/dl or higher, a 3-hour oral glucose tolerance test was performed at that time. There were 228, 354, 122, and 295 patients with gestational ages less than 14 weeks, 14 to 23 weeks, 24 to 28 weeks, and more than 28 weeks, respectively. The group less than 24 years of age had a significantly lower mean screening glucose value (106.1 +/- 35.9 mg/dl) than the group whose age was 24 years or older (117.4 +/- 35.9 mg/dl). There were significantly fewer patients with elevated screening glucose values when the patients were less than 24 years of age. Nevertheless, in the final analysis, 13% of the gestational diabetics diagnosed were in the age group younger than 24 years. Although the majority of the diagnosed gestational diabetic had elevated screening glucose values after 23 weeks of gestation, 33% had positive screening tests before 24 weeks. Earlier glucose screening, regardless of maternal age or gestational age, can lead to an earlier diagnosis of gestational diabetes. Cost of universal screening, regardless of maternal age, is only slightly more expensive than a screening protocol with a minimum age limit.

Adult↗
PubMed1989

Teenagers' awareness of the acquired immunodeficiency syndrome and the impact on their sexual behavior.

One hundred female teenagers attending a teenage pregnancy program were studied to determine the extent of their awareness about acquired immunodeficiency syndrome (AIDS) and the impact of such knowledge on their sexual behavior. Ninety-eight knew that AIDS is a disease, 45 stated that it is fatal, and all knew that it can be transmitted by sexual intercourse. After becoming aware of AIDS, 59 changed their sexual habits, 41 decreased their number of sexual partners, and 13 who had not used condoms started using them. However, only seven obtained more information about their partners' sexual and social histories, and half of those who decreased their number of partners still continued relationships with more than one. The survey showed that the publicity about AIDS has resulted in a favorable change in the sexual practices of these teenagers. However, it also indicated a need for further improvement in specific areas of education, such as the value of obtaining more information about sexual partners, more awareness of the importance of multiple-partner relationships in the spread of AIDS, and more emphasis on the important role of condoms in preventing AIDS virus transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Comparison of the adrenocorticotropic hormone stimulation test with and without prior dexamethasone suppression in the diagnosis of congenital adrenal hyperplasia.

A comparison was made of the ACTH stimulation test with and without prior dexamethasone suppression in 10 patients, each of whom served as her own control. It was found that it is not necessary to administer DEX before the test, the specificity and sensitivity of both tests being the same in the diagnosis of CAH, although the calculated values are lower when DEX is given. Further investigation with HLA typing and ACTH stimulation testing is necessary to establish whether either or both types of ACTH stimulation tests are capable of discriminating between the heterozygotic and homozygotic varieties of CAH.

Adrenal Hyperplasia, Congenital↗
PubMed1987

The correlation of serum estrogens and androgens with bone density in the late postmenopause.

A pilot group of 16 women in the late postmenopause were evaluated for bone density by computerized axial tomography (CT) scanning and for hormonal milieu. A highly statistically significant positive correlation between lumbar-3 spongiosum density and both dehydroepiandrosterone-sulfate (DHEA-S), r = 0.67; P less than 0.005 and androstenedione (A), r = 0.56; P less than 0.03 was found. No such correlations were observed with estradiol (E2), estrone (E1) or an array of other hormones. The results of this preliminary report indicate a clear association of weak androgens with bone density in the late postmenopause.

Aged↗
PubMed1987

Maternal serum levels of estradiol, progesterone and human chorionic gonadotropin in ectopic pregnancy and their correlation with endometrial histologic findings.

Plasma levels of estradiol 17-beta (E2), progesterone (P) and beta-human chorionic gonadotropin (b-HCG) were measured in 59 patients with ectopic pregnancy and in control patients made up of ten women with normal intrauterine pregnancies and five patients with threatened abortion. The gestational ages of the three groups were not statistically different, the means being 6.6, 6.5 and 6.7 weeks, respectively. The endometria in the patients with an ectopic pregnancy were examined histologically and the correlation with the hormonal levels was studied. Mean levels of b-HCG, E2 and P in patients with ectopic pregnancies (4,893 +/- 5,435 S.E.M. milli-international units per milliliter, 311 +/- 191 S.E.M. picograms per milliliter and 8.3 +/- 5.5 S.E.M. nanograms per milliliters, respectively) were significantly lower than those measured in normal pregnant control patients (b-HCG = 22,173 +/- 2,696 S.E.M. microunits per milliliter, p less than 0.00001; E2 = 769 +/- 81 S.E.M. picograms per milliliter, p less than 0.0001 and p = 37.8 +/- 6.1 S.E.M. nanograms per milliliter, p less than 0.0001), and in patients with threatened abortion (b-HCG = 20,310 +/- 1,688 S.E.M. milli-international units per milliliter, p less than 0.0001; E2 = 803 +/- 91 S.E.M. picograms per milliliter, p less than 0.001 and P = 29.7 +/- 2.9 S.E.M. nanograms per milliliter, p less than 0.001). Mean levels of P in ectopic pregnancies with secretory type endometria (10.4 +/- 6.0 S.E.M. nanograms per milliliter), were significantly higher than those with proliferative endometria (5.0 +/- 3.2 S.E.M. nanograms per milliliter, p less than 0.001). Data is provided not previously known, on the levels of E2 and P in ectopic pregnancy and correlation with endometrial histologic factors.

Chorionic Gonadotropin↗
PubMed1986

Prevalence of and markers for the attenuated form of congenital adrenal hyperplasia and hyperprolactinemia masquerading as polycystic ovarian disease.

To determine the prevalence of the attenuated form of congenital adrenal hyperplasia (CAH) and hyperprolactinemia (HPPN) relative to polycystic ovarian disease (PCOD), 100 consecutive women presenting with the classic clinical features of PCOD were evaluated by basal hormonal profiles and subsequent adrenocorticotropic hormone (ACTH) stimulation tests. The study also sought biochemical markers for CAH other than ACTH stimulation. The prevalences were found to be as follows: PCOD, 65%; PCOD with HPPN, 9%; HPPN, 3%, end-organ hypersensitivity (EOH), 4%; homozygotic CAH, 4%; and heterozygotic CAH, 15%. Other than the differential response to ACTH, the only other biochemical markers observed for homozygotic CAH were significantly higher basal levels of testosterone (T) and 17 alpha-hydroxyprogesterone (17-OHP). Luteinizing hormone/follicle-stimulating hormone ratio, androstenedione, and dehydroepiandrosterone sulfate all showed no significant differences between homozygotic CAH, heterozygotic CAH, HPPN, PCOD, and EOH. This study establishes the relative prevalences of the syndromes commonly mimicking PCOD. We also conclude that the observed low incidence of CAH does not justify routine ACTH testing on all patients presenting with features of PCOD--however, our data suggest that patients with basal serum levels of T and 17-OHP greater than 50% above the upper limit of normal should undergo this dynamic test, especially if there are also certain clinical features suggestive of CAH.

17-alpha-Hydroxyprogesterone↗
PubMed1986

Effect of advancing pregnancy on the glucose tolerance test and on the 50-g oral glucose load screening test for gestational diabetes.

To determine the validity of the 50-g, one-hour glucose screening test for gestational diabetes in relation to the duration of pregnancy, 101 patients from a high-risk population had the screening test in the first trimester and glucose tolerance tests (GTT) in the second and third trimesters. The sensitivity (88%) and specificity (82%) of the screening test were similar to values reported when the test is performed later in pregnancy. However, immediate follow-up GTTs in the second trimester revealed only 25% instead of 88% of the gestational diabetic patients uncovered by the positive screening tests. Guidelines for screening for gestational diabetes should include follow-up with a third-trimester GTT on all patients who have positive screening tests even in the presence of normal follow-up second trimester GTTs.

Blood Glucose↗
PubMed1976

Plasma levels of fractionated estrogens and pituitary hormones in endometrial carcinoma.

Plasma levels of estrone (E1), estradiol-17beta (E2), and estriol (E3), as well as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were measured in 30 control subjects and in 20 postmenopausal patients with adenocarcinoma of the endometrium. Within the sensitivity of the assay (5 to 10 pg.), no E3 was found. Mean levels of E1 and E2 in the patients with carcinoma (42.64+/-3.8 (S.E.M.) and 17.3+/-1.7 (S.E.M.) pg. per mililiter) were significantly higher than those measured in the control subjects (E1=26.97+/-2.4 (S.E.M.) pg. per mililiter, p less than 0.001; E2=12.08+/-1.2 (S.E.M.) pg. per milliliter, p less than 0.02). Effects of age, diabetic status, and obesity were taken into consideration. Significant differences in FSH and marginally significant differences in prolactin levels were observed between the two groups. Mean levels of FSH, LH, and prolactin in the control group and the group with adenocarcinoma, respectively, were as follows: FSH=152.3+/-7.0 (S.E.M.) versus 98.1+/-8.9 (S.E.M.) mI.U. per milliliter, p less than 0.001; LH=64.7+/-3.1 (S.E.M.) versus 66.5+/-5.2 mI.U. per milliliter, difference not significant; and prolactin=14.3+/-0.9 (S.E.M.) versus 17.8+/1.7 (S.E.M.) ng. per milliliter, p less than 0.06. These results, as well as previously reported alterations in human growth hormone secretion, suggest aberrations in hypothalamic function in endometrial carcinoma.

Age Factors↗