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J C Caillouette

Publications and source records attributed to J C Caillouette.

13 recordsLinked to original sources
PubMed2005

The role of an over-the-counter vaginal pH self-test device package insert: can subjects learn what the device is for and how to use it?

OBJECTIVE: This study was undertaken to determine whether subjects could read and understand the package insert of a vaginal pH self-test device to improve self-diagnostic accuracy. STUDY DESIGN: This study was performed at 8 clinic locations with 206 women of varying ages, ethnicity, and education. A package insert explaining the indications and clinical facts associated with the use of a vaginal pH self-test device was used. A 16-item questionnaire was administered to assess comprehension. RESULTS: The cumulative probability of having 12 or more correct answers of 16 was P = .038, significantly different than by chance alone, representing 200 (97.1%) of subjects in this trial. CONCLUSION: The package insert for the vaginal pH self-test device was read and understood by subjects. Indeed, they correctly understood the role of vaginal pH as an aid in the diagnosis of vaginal symptoms while improving decisions to use an over-the-counter antifungal medication or to see a health care provider.

Adolescent↗
PubMed2004

Vaginal pH is similar to follicle-stimulating hormone for menopause diagnosis.

OBJECTIVE: This paper is intended to demonstrate whether vaginal pH value is associated with menopausal status and symptoms, to review the sensitivity of follicle-stimulating hormone or vaginal pH to diagnose menopause, to compare these findings to a group of practice patients, and to determine whether vaginal pH could be used in place of follicle-stimulating hormone as an initial screen to determine menopause. STUDY DESIGN: Sixteen studies regarding vaginal pH and menopausal symptoms before and after estrogen administration were analyzed. Two epidemiologic studies that reported follicle-stimulating hormone or vaginal pH with menopause were reviewed. These findings were compared with similar data from the practice of one of the authors (J.C.C.). RESULTS: Menopausal women who do not receive estrogen therapy have a weighted average vaginal pH of 6.0, which is reduced significantly to 4.5 with estrogen therapy. To diagnose menopause, follicle-stimulating hormone >or=15 or >or=20 mIU/mL in the Third National Health and Nutrition Examination Survey had a sensitivity of 65% to 68%. In a study in Costa Rica, where 3 definitions of menopause were used, a pH of >5.0 had a sensitivity of 64% to 67%. From the practice patients, the 95% confidence interval sensitivities and positive predictive values of vaginal pH and follicle-stimulating hormone to diagnose menopause overlapped, while a pH 4.5 indicates menopause, because it demonstrates a similar sensitivity as follicle-stimulating hormone in epidemiologic studies. In the practice patients, the sensitivity of follicle-stimulating hormone was no different than vaginal pH in the diagnosis of menopause. Furthermore, with estrogen therapy, a vaginal pH of <or=4.5 indicates a mid follicular phase estradiol.

Adult↗
PubMed1997

Vaginal pH as a marker for bacterial pathogens and menopausal status.

OBJECTIVE: Our purpose was to confirm the elevation of vaginal pH expected in patients with bacterial pathogens in premenopausal women and to examine the relationship of serum follicle-stimulating hormone and estradiol levels to vaginal pH in menopausal patients without and with hormone replacement therapy. STUDY DESIGN: Vaginal pH was determined by phenaphthazine (Nitrazine) pH paper in 253 patients seen in a solo private practice for routine speculum examination. None of the patients were pregnant. Measurements were made of serum levels of follicle-stimulating hormone and estradiol for 172 patients and vaginal cultures were taken from 82 patients. Vaginal pH was correlated with vaginal cultures and serum follicle-stimulating hormone and estradiol levels by use of statistical analysis. RESULTS: Vaginal pH was elevated in all premenopausal patients with documented bacterial pathogens. Serum estradiol levels showed an inverse and serum follicle-stimulating hormone levels a direct statistical correlation with vaginal pH in menopausal patients. CONCLUSIONS: Measurement of vaginal pH is useful, effective, and inexpensive for screening purposes. A vaginal pH of 4.5 is consistent with a premenopausal serum estradiol level and the absence of bacterial pathogens. An elevated vaginal pH in the 5.0 to 6.5 range suggests a diagnosis of either bacterial pathogens or decreased serum estradiol. In patients with an elevated pH, vaginal culture should establish the diagnosis. In the absence of bacterial pathogens, a vaginal pH of 6.0 to 7.5 is strongly suggestive of menopause. Titration of estradiol level by vaginal pH during estrogen replacement therapy may help menopausal women avoid side effects or cessation of therapy.

Adult↗
PubMed1993

Ruptured splenic artery aneurysm in pregnancy. Twelfth reported case with maternal and fetal survival.

Ruptured splenic artery aneurysm during pregnancy is a rare event with catastrophic consequences. This presentation is the twelfth case during pregnancy reporting survival of both mother and fetus. The literature reports a 25% mortality rate for ruptured splenic artery aneurysm. The mortality rate among pregnant women is disproportionately high at 75% with a fetal mortality rate of 95%. Gestational alterations that increase with parity are significant in the pathophysiologic characteristics of this condition. A unique double-rupture phenomenon may provide temporary tamponade with resolution of symptoms. A diagnosis of ruptured splenic artery aneurysm should be considered in any pregnant patient who complains of the sudden onset of severe left upper-abdominal pain regardless of whether pain or shock is prominent at the time of evaluation. Early consideration of a diagnosis of ruptured splenic artery aneurysm significantly increases the likelihood that the mother and fetus will survive.

Adult↗
PubMed1987

Phasic contraceptive pills and functional ovarian cysts.

This seven-case anecdotal report is presented to alert physicians to the possibility of the formation of functional ovarian cysts during use of phasic contraceptive pills. The patients were studied by the combination of history, physical examination, ultrasound examination, and in two cases surgery. The occurrence of functional ovarian cysts during the use of phasic contraceptive pills is well established while not well appreciated by practicing physicians. This seven-case presentation strongly suggests that phasic contraceptive pills may be a threat to patient health and safety. It is suggested that further studies be undertaken to better understand the pathophysiology.

Adult↗