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Biomedical subjects

H Pastides

Publications and source records attributed to H Pastides.

28 records · Page 2Linked to original sources
PubMed1985

Diaphragm method contraceptors: implications for service organization and delivery.

Despite dissemination of modern contraceptive techniques among college women, unplanned pregnancy and pregnancy termination rates remain a major health issue. An investigation of 495 college women who use the diaphragm method of contraception was conducted in order to estimate pregnancy occurrence, to better understand factors related to successful use, and to profile service utilization patterns. Data were collected by medical record audit and client survey. Fifteen percent of the diaphragm clients reported a diaphragm-related pregnancy; clinical effectiveness was estimated to be 88% with a rate of 9.75 pregnancies per 100 woman years of diaphragm use. A variety of demographic, personal history, and behavioral variables were found to be related to three dependent variables: pregnancy, consistent diaphragm use, and accurate diaphragm use. Review of clinic service utilization for this group of patients demonstrated considerable resource use, including frequent switching of prescription contraception methods. Considering all pregnancies, diaphragm related or not, 27% of the study subjects reported at least one unplanned pregnancy. Abortion was elected in 98% of these cases. There is general agreement about the need to focus on education, information, and service measures to reduce the incidence of unintended fertility. Many universities have family planning services available, yet unsuccessful outcome continues to be a concern. Specific and practical protocols for service implementation need clearer definition. Thus, the implications of this research for the content and organization of clinic services are discussed with reference to counseling and education and other systems strategies.

Abortion, Induced↗
PubMed1985

Uses of the case-control and cohort epidemiological approaches in pediatric practice and research.

Increasing reliance is being placed on the use of quantitative epidemiological methods in the conduct and evaluation of pediatric research. The basic design features of two common types of observational studies, the case-control study and the cohort study, are reviewed. Advantages and disadvantages of these two study designs are discussed with emphasis on aspects such as the selection of comparison groups, avoiding selection and recall bias, gathering exposure information, controlling for potentially confounding factors, and methods of analysis. Appreciation of the salient features of these study design approaches should aid the clinician/researcher in the conduct of research endeavors as well as in critically reviewing the medical literature.

Adolescent↗
PubMed1984

Cancer mortality among workers exposed to formaldehyde.

Proportionate mortality among workers exposed to formaldehyde was analyzed among employees of a large chemical plant in Western Massachusetts. Twenty-four such decedents, all males, were identified through union records, reports of former co-workers, and a systematic review of obituaries in local newspaper. Work histories were obtained from seniority lists. Race-age-sex-adjusted proportionate mortality ratios ( PMRs ) were significantly elevated for cancer of the colon based on United States, county, and county cancer mortality proportions (PMR = 702, 424, 333, p less than or equal to .05), as were PMRs for the category buccal and pharyngeal cancer (PMR = 870, 952, 833, p less than .05). This study provides evidence of formaldehyde's carcinogenicity. These findings are at variance with a previous report of the mortality experience of workers at the same plant from an earlier period.

Aged↗
PubMed1983

Oral contraceptive use and fibrocystic breast disease with special reference to its histopathology.

The relationship between use of oral contraceptives and fibrocystic breast disease was examined in a hospital-based case-control study undertaken in New Haven, Connecticut, from 1977 to 1979. Particular emphasis was placed on the extent of epithelial atypia and other histopathologic characteristics found in the biopsy specimens from the cases. Women who had ever used oral contraceptives were at a somewhat decreased risk for fibrocystic disease as a whole. Cases with high atypia and controls had similar patterns of oral contraceptive use, whereas cases with low and intermediate atypia had less oral contraceptive use than controls. Cases with intermediate atypia reported the lowest oral contraceptive use. Subjects with biopsy specimens exhibiting gross cysts, microscopic cysts, or papillomatosis were about 50% less likely to have used oral contraceptives than controls.

Adult↗
PubMed1981

Injuries to the upper extremity: patterns of occurrence.

Injuries to the upper extremity, as reported in home interviews, physician office records, and hospital records, are a problem of great magnitude. Upper extremity injuries not only are responsible for a great deal of disability and for a large number of visits for medical care, but also, because they often affect people of working age, have a great impact on society because of loss of productivity. However, regardless of the age at which they occur, these injuries can have an impact on the quality of life of the injured, both in the short term and in the long.

Adolescent↗
PubMed1979

The impact of musculoskeletal disorders on the population of the United States.

Musculoskeletal disorders constitute such a large component of impairments of individuals in the working and geriatric population that good statistical data on them are essential for planning health care. We have collected the pertinent data, with references to recent source material, to determine the incidence, effect on the quality of life, and associated costs of these disorders in the United States.

Adult↗
PubMedDate not supplied

Comparison of sufentanil, bupivacaine, and their combination for epidural analgesia in obstetrics.

BACKGROUND AND OBJECTIVES: We postulated that epidural sufentanil alone would provide adequate analgesia for labor and delivery. We also considered the possibility that a combination of epidural sufentanil and bupivacaine would demonstrate superior analgesia and fewer side effects when compared with either agent alone. METHODS: Using a randomized, double-blind design, parturients were prospectively assigned to receive intermittent 10-ml doses of 3 micrograms/ml sufentanil in saline (Group S), 1.5 micrograms/ml sufentanil in 0.125% bupivacaine (Group SB), or 0.25% bupivacaine (Group B). Lumbar epidural catheters were placed during the first stage of labor, and a test dose (3 ml 2% lidocaine with 15 micrograms epinephrine) was given, followed by coded study solution. Subsequent doses of study solution were given at the patient's request. Those parturients who remained uncomfortable after 30 minutes were given 10 ml 2% lidocaine and were designated efficacy failures. Patients were evaluated for quality and duration of analgesia for each dose. Neonates were assessed using Apgar scores and the neonatal behavioral assessment scale. Maternal and umbilical venous sufentanil concentrations were measured at the time of delivery. RESULTS: All patients received satisfactory analgesia of similar duration after the first epidural dose. After subsequent doses, women in Group S experienced more efficacy failures (Groups S, SB, and B, respectively, 12 of 26, 5 of 22, and 1 of 25; p less than 0.005) and received briefer, less intense analgesia compared to the other groups. Instrumental delivery was performed more frequently for women in Group B (Groups S, SB, and B, respectively, 0 of 14, 2 of 17, and 7 of 24; p = 0.04). No serious maternal side effects occurred. Apgar and neurobehavioral scores were comparable for all groups, with the exception that Group B infants had higher irritability scores at 1 hour of age (p = 0.003). Neither maternal nor umbilical venous sufentanil concentrations bore a consistent relationship to clinical outcomes. CONCLUSIONS: Epidural sufentanil alone does not reliably provide satisfactory analgesia for labor and delivery. Addition of small amounts of local anesthetic to bolus doses of sufentanil enhances and prolongs the analgesic effect.

Adult↗
PubMedDate not supplied

Estrogen replacement therapy and fibrocystic breast disease.

In a hospital-based case-control study conducted in New Haven, Connecticut, women experiencing estrogen replacement therapy were found to be at twice the risk of nonusers for histologically confirmed fibrocystic breast disease (odds ratio = 2; 95 percent confidence limits = 1-3.9) if their menopause was natural. No excess risk was found for women experiencing a surgical menopause. The highest risk for fibrocystic disease was observed for women with more than three years of estrogen replacement therapy. When therapy occurred was not significantly related to the risk of disease once duration of use was controlled for. These results suggest an etiologic role of estrogen replacement therapy in the development or promotion of fibrocystic breast disease.

Adult↗
PubMedDate not supplied

Iron deficiency anemia among three groups of adolescents and young adults.

This study was initiated in order to estimate and compare the occurrence of nutritional anemia in three groups of adolescents and young adults. The first group comprised 159 individuals aged 14-21, who had been previously screened for thalassemia in three Connecticut cities. The second group was made up of 163 Derby High School students, aged 14-18, who had also been previously screened for thalassemia. The third group consisted of 118 Yale undergraduate students, aged 16-21, who were monitored for nutritional anemia while undergoing routine physical examinations at the Yale University Health Service. The prevalence of nutritional anemia varied from 0.0 percent to 5.5 percent among the three female groups, and from 4.4 percent to 17.9 percent among the three male groups. Only the Yale undergraduate male group was found to be from this condition. The Yale undergraduate females were discovered to have the highest prevalence. Mean hemoglobin levels of the male and female groups we also compared.

Adolescent↗