PubMed Health⌕ Search

Biomedical subjects

J A Perlman

Publications and source records attributed to J A Perlman.

5 recordsLinked to original sources
PubMed1990

HIV risk difference between condom users and nonusers among U.S. heterosexual women.

Using data from the National Survey of Family Growth, we estimate that among 3,498,060 U.S. reproductive-age women least likely to be protected from HIV, 12% rely on condoms for birth control. We have modeled the risk difference between condom users and nonusers and projected the number of preventable and nonpreventable HIV infections likely to occur among the 419,201 condom users as a function of 50 HIV-incidence/relative risk assumptions. Results of the attributable-risk model suggest that at the current low HIV-incidence level in U.S. women, condom-user failure rates will be less than 1% per year, substantially lower than the 10% condom-user failure rate for pregnancy. As few as 1% but up to 11% of all new HIV cases may be prevented by the current low level of condom use, depending on the exact degree of condom effectiveness in this population at risk. However, the model further projects that up to 45% of all new HIV cases may be prevented if condoms are maximally effective and far more widely used. Women with seropositive partners may enjoy the same protective benefits of condoms, but the costs in terms of condom-user failures will be much higher than in the remainder of the population at risk. Among serious and reliable users, condom-user failure rates for HIV may approach those for pregnancy, but only in women who have known seropositive partners.

Adolescent↗
PubMed1988

Effects of estrogen dose and smoking on lipid and lipoprotein levels in postmenopausal women.

The joint effects of conjugated estrogen use, age, body mass index, and smoking on plasma lipid and lipoprotein levels were assessed in 585 women who used oral estrogen and 1093 women who did not who participated in the Walnut Creek Contraceptive Drug Study. Whether administered daily or cyclically, conjugated estrogen was associated with reductions in low-density lipoprotein cholesterol levels and increases in high-density lipoprotein cholesterol and triglyceride levels. The adjusted mean low-density lipoprotein cholesterol concentration was 132 mg/dl for women who used conjugated estrogen in a dose greater than or equal to 1.25 mg/day; the adjusted corresponding mean concentration was 147 mg/dl for postmenopausal women who did not use estrogen. A dose-response pattern was demonstrated between conjugated estrogen and low- and high-density lipoprotein cholesterol levels. A maximum low-density lipoprotein cholesterol level reduction was reached at a dose of 1.25 mg, suggesting a saturation phenomenon. Stepwise dose-response increases in high-density lipoprotein cholesterol levels were also found with estrogen therapy, with a maximum increase of 8 to 10 mg/dl observed with the 1.25 mg dose. Estrogen-related rises in low-density lipoprotein cholesterol levels and decreases in high-density lipoprotein cholesterol levels were offset by 2 to 3 mg/dl in women who smoked. It may be concluded, therefore, that among postmenopausal women, low-risk lipoprotein profiles as assessed by low- and high-density lipoprotein cholesterol levels are found in nonsmokers whose postmenopausal hormone therapy includes the equivalent of a conjugated estrogen dose of 1.25 mg.

Cholesterol↗
PubMed1977

Corpus luteum hemorrhages complicating chronic anticoagulation.

A 29-year-old patient with prosthetic replacement of two cardiac valves who was receiving chronic anticoagulation therapy presented with sequential corpus luteum hemorrhages. The problems of reproductive system hemorrhage from chronic anticoagulation therapy are discussed, as well as the specific problemsof women of reproductive age with heart valve replacements. Issues and therapy are considered.

Adult↗
PubMedDate not supplied

Nonmenstrual toxic shock syndrome associated with barrier contraceptives: report of a case-control study.

Use of barrier contraceptives has been hypothesized to be a risk factor for nonmenstrual toxic shock syndrome (TSS). This association was evaluated in a case-control study of nonmenstrual TSS; cases were identified through an active surveillance system for TSS during 1986 and 1987. Potential risk factors for nonmenstrual TSS were compared for 28 patients and 100 age-matched controls. Use of barrier contraceptives was associated with a significantly increased risk of nonmenstrual TSS, with matched odds ratios of 10.5 and 11.7 for contraceptive sponge and diaphragm use, respectively. Use of nonbarrier contraceptive methods was unrelated to nonmenstrual TSS. Despite the elevated odds ratio, the incidence of nonmenstrual TSS in barrier contraceptives users and the risk of nonmenstrual TSS attributable to barrier contraceptive use are low. Clinicians and women who use barrier contraceptives should be aware of this rare but potentially fatal complication; however, other considerations, such as efficacy and complications associated with other types of contraception, may be more important in the choice of a contraceptive method.

Adolescent↗