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Biomedical subjects

J S Sanfilippo

Publications and source records attributed to J S Sanfilippo.

At least 19 recordsLinked to original sources
PubMed2001

Is there a seasonal variation in gonorrhea and chlamydia in adolescents?

STUDY OBJECTIVE: To determine if a seasonal variation exists in gonorrhea and chlamydia in female adolescents. DESIGN, SETTING, PARTICIPASNTS: We conducted a retrospective chart review of 604 sexually active adolescent females 21 years of age and younger in a teen pregnancy prevention clinic in a small Midwestern city. Positive gonorrhea and chlamydia tests were evaluated for seasonal variation. Chi-square, odds ratios, and 95% confidence intervals were calculated. RESULTS: A greater percentage of tests were positive in the fall than in other seasons (P = 0.028), and there was a trend towards more cases in the summer than winter and spring. CONCLUSIONS: Increased emphasis should be placed on prevention and screening during summer and fall.

Adolescent↗
PubMed2000

Alterations in humoral immune responses associated with recurrent pregnancy loss.

OBJECTIVE: To investigate the reactivity of maternal antibodies with endometrium-derived antigens and to correlate their association with recurrent pregnancy loss (RPL). DESIGN: Prevalence study. SETTING: Academic research center. PATIENT(S): Nulliparous women (n = 10), women with RPL (n = 15), pregnant women (n = 8), and multiparous women with a normal obstetric history (n = 20). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Reactive antibodies were analyzed by Western immunoblot techniques and quantitated by densitometry. RESULT(S): Antibodies from women with RPL and multiparous women recognized antigens ranging from 10-120 kd on normal endometrium and endometrial tumors. Antibodies from most women with RPL (10/15) and from multiparous women (15/20) recognized 65-kd and 80-kd proteins in normal endometrium. Antibodies from women with RPL recognized 21-kd and 28-kd antigens (12/15 and 13/15, respectively) in endometrial tumors at a significantly greater rate (than did antibodies from multiparous women (5/20 and 8/20, respectively). Women with RPL had significantly lower levels of asymmetric IgG compared with controls. CONCLUSION(S): Recurrent pregnancy loss may be linked with the failure to elicit asymmetric IgG and a unique immunologic recognition of endometrial antigens.

Abortion, Habitual↗
PubMed2000

Correlation between glycemic control and menstruation in diabetic adolescents.

OBJECTIVE: To determine if a correlation exists between the degree of glycemic control in insulin-dependent diabetic adolescents and menstrual regulation. STUDY DESIGN: A retrospective review of charts of diabetic girls aged 10-18 was performed. Office visits were scheduled every three to six months, at which time pubertal development, menstrual function, growth and diabetic control, including hemoglobin (Hgb) A1C, and complications were assessed. Forty-six patients were eligible for data analysis. Descriptive and inferential statistics, including chi 2 and Student t tests, were applied. RESULTS: Thirty-seven (81%) patients had regular menstrual cycles, and nine (19%) had menstrual disturbances, including secondary amenorrhea (one), oligomenorrhea (seven) and primary amenorrhea followed by oligomenorrhea (one). There were two pregnancies. Six patients used hormonal contraception but none for menstrual regulation. There was a statistically significant difference (P < .05) in mean Hgb A1C concentrations between those with menstrual disturbances (11.4) and those with regular menses (9.7). As Hgb A1C values increased, the percent of patients with menstrual disturbances increased, becoming statistically significant when the Hgb A1C was > 10 (odds ratio 7.3, 95% confidence interval 1.5-35.6). There was no difference (P > .05) between the two groups with respect to age at menarche (156 vs. 152 months), age at onset of diabetes (144 vs. 108 months) and interval between diabetes onset and menarche (54 vs. 41 months). There were no patients in either group with diabetic retinopathy or nephropathy. Four patients were hypertensive, but there was no statistically significant difference (P > .05) between groups. CONCLUSION: Tighter glycemic control, as measured by Hgb A1C concentrations, corresponded to improved menstrual regulation in adolescent insulin-dependent diabetics.

Adolescent↗
PubMed1999

Dysmenorrhea and pelvic pain in adolescents.

Dysmenorrhea and pelvic pain are common complaints in the adolescent population. Although most cases are primary dysmenorrhea and easily treated with NSAIDs or OCPs, pathologic causes should be considered, especially in cases not responding to standard medical management. Endometriosis is the most common finding in teenagers who do not respond to this regimen, but müllerian anomalies and musculoskeletal causes must also be considered.

Adolescent↗
PubMed1999

Emergency contraception: lack of awareness among patients presenting for pregnancy termination.

STUDY OBJECTIVE: Emergency contraception, otherwise known as postcoital contraception, refers to a group of birth control modalities that, when used after unprotected intercourse within defined time constraints, can markedly reduce the risk of a resultant unintended pregnancy. The English literature, using British and American awareness data, consistently claims that these contraceptive options are underutilized in the United States because of a lack of patient and physician awareness of their existence. The objective of this study was to determine the level of awareness of postcoital contraceptive techniques in a population of American women who were presenting for pregnancy termination. The secondary goal was to calculate (theoretically) how many of these surgical terminations could have been prevented through the use of postcoital contraception. METHODS: A questionnaire was administered to patients presenting to an abortion clinic. It was intended to anonymously identify patient demographics and knowledge of the various emergency contraceptive options and, in hindsight, to determine what percentage of these women would have been willing candidates for one of these medical modalities. On completing the questionnaire, all patients received an emergency contraceptive information sheet for future consideration. RESULTS: Eighty-three patients completed the study. They ranged in age from 15 to 44 years (mean, 24 years). Forty-six percent of the patients were 21 years of age or younger. A total of 71% of all patients had no real knowledge of the existence of emergency contraceptive options; 26% had some limited knowledge, and only 3% had somewhat complete and valuable information. Fifty-one percent of the patients would have been appropriate, realistic, and willing candidates for at least the emergency contraceptive pill. Assuming at least a 75% effectiveness rate for the emergency contraceptive pill, 38% of the surgical pregnancy terminations performed on this population of women could have been avoided. CONCLUSION: Our data confirm that emergency contraceptive options are underutilized because of a lack of patient awareness. Contraception education, especially directed toward adolescents, should include disseminating enhanced information about postcoital contraception options.

Abortion, Legal↗
PubMed1999

Implications of not treating hyperprolactinemia.

When a patient with hyperprolactinemia is not treated, a number of ramifications can result, the most significant of which is osteoporosis. Evidence-based analysis shows that bone mineralization also can be affected by such problems as gonadal dysgenesis and possibly adrenal dysfunction. The hypoestrogenism associated with hyperprolactinemia is commonly assumed to be a potential cause of osteopenia in premenopausal women with this disorder, just as decreased estrogen is associated with bone loss following menopause. A number of studies also have shown that hyperprolactinemia decreases bone density independently of the hypoestrogenic state. In most, but not all, such women, bone density may be reestablished if one is successful in restoring normal menstrual function with dopamine agonists. With the availability of safe dopamine agonists like bromocriptine and now cabergoline, it seems prudent to attempt to normalize serum prolactin levels early on, before long-term pathologies set in.

Decision Making↗
PubMed1998

Laparoscopic surgery in girls and female adolescents.

The realm of laparoscopic surgery has extended to include the neonate as well as the pediatric patient. The advent of new and smaller instrumentation has facilitated this goal. Previous procedures exclusively relegated to laparotomy can now be accomplished as outpatient procedures. Removal of the acute appendix, correction of torsion of an adnexa, as well as the appropriate diagnosis and initial treatment of acute pelvic inflammatory disease are now well established laparoscopic procedures. This article provides insight into the laparoscopic evaluation and management of a number of challenging clinical problems for the endoscopic surgeon, thus providing a minimally invasive approach for patients ranging from neonates to adults.

Adnexal Diseases↗
PubMed1996

Quantitative analyses of epidermal growth factor receptors, HER-2/neu oncoprotein and cathepsin D in nonmalignant and malignant uteri.

BACKGROUND: Hormone receptors and oncoproteins are receiving increased attention as possible prognostic factors in different carcinomas. Few data are available regarding quantification of their levels of expression in gynecologic malignancies. METHODS: Epidermal growth factor (EGF) receptor specific binding capacities and affinities were measured by ligand binding assay using [125I]EGF in a competition mode with Accufit software (Lundon Software, Inc., Middlefield, OH). HER-2/neu oncoprotein was extracted from membranes and measured using an enzyme-linked immunosorbent assay. Cathepsin D was measured by an immunoradiometric assay using cytosols for steroid receptor analyses. RESULTS: EGF receptors in 23 nonmalignant uteri ranged from undetectable to 50 fmol/mg membrane protein (median, 0), with dissociation constant values of 1.2 x 10(-9) M to 8.5 x 10(-10) M, compared with EGF receptors in 76 endometrial cancers that ranged from undetectable to 7674 fmol/mg (median, 52). HER-2/neu oncoprotein ranged from undetectable to 2.9 HER-2/neu units (HNU)/microg protein (median, 0.6) in 41 nonmalignant uteri and from undetectable to 5.8 HNU/microg protein (median, 2.5) in endometrial cancers (n = 53). Cathepsin D ranged from 5 to 32 pmol/mg cytosol protein (median, 11) in 42 nonmalignant uteri and 18 to 144 pmol/mg protein (median, 42) in 29 endometrial cancers. CONCLUSIONS: Determination of the frequency and levels of EGF receptors, HER-2/neu protein, and cathepsin D in uteri with and without cancer and the availability of reference materials developed in our laboratory, will allow evaluation of their prognostic value in cancers of the uterus.

Cathepsin D↗
PubMed1996

Novel presence of luteinizing hormone/chorionic gonadotropin receptors in human adrenal glands.

It has been well documented that a significant proportion of chronic anovulatory patients have elevated levels of dehydroepiandrosterone sulfate (DHEAS) and luteinizing hormone (LH) and normal levels of adrenocortiocotropic hormone (ACTH). We tested the hypothesis that the zones of human adrenal cortex that secrete DHEAS may contain LH/human chorionic gonadotropin (hCG) receptors. In situ hybridization showed the presence of hybridization signals representing LH/hCG receptor mRNA transcripts in the zona reticularis. Immunocytochemistry demonstrated that the zona reticularis also contained LH/hCG receptor protein. The receptor transcripts and receptor protein are also present in the deeper layer of the zona fasciculata which can also secrete DHEAS. Double immunostaining revealed that LH/hCG receptors are present in the same cells that contain cytochrome P450 side chain cleavage enzyme, suggesting that the receptor containing cells are steroidogenic. These findings may potentially explain higher DHEAS levels in chronic anovulatory women who have normal ACTH and elevated LH levels.

Adrenal Glands↗