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Biomedical subjects

L J Petry

Publications and source records attributed to L J Petry.

11 recordsLinked to original sources
PubMed1996

Effectiveness of breast self-examination prompts on oral contraceptive packaging.

BACKGROUND: The purpose of this study was to determine if a breast self-examination (BSE) "prompt" on oral contraceptive pill (OCP) packages would improve the frequency and timing of BSE among women who use OCPs. METHODS: Women between 13 and 40 years of age who were initiating, restarting, or continuing use of OCPs completed a baseline survey that assessed health behavior and practices. All received BSE education, and then were randomized to take either OCPs with a BSE prompt or regularly packaged OCPs (without BSE prompt) for three cycles. Three months later, subjects completed a follow-up survey that assessed BSE frequency and timing. A telephone survey of randomly selected subjects conducted 6 months after the baseline survey assessed BSE compliance after discontinuation of the prompt. RESULTS: Of the 907 subjects at baseline, 49.3% performed BSE monthly but only 24.5% performed BSE during the correct time of the menstrual cycle. Among subjects who never performed BSE prior to the study, 40.3% of prompt subjects and 36.4% of the education-only subjects began BSE by the 3-month survey. Among subjects who performed BSE less than once per month at baseline, 50.9% of prompt subjects and 45.5% of education-only subjects increased the frequency of BSEs to a monthly basis by the 3-month survey. More women performed BSE during the correct time of the menstrual cycle at the 3 month follow-up survey (68.1% prompt, 62.2% education only) and 6-month survey (57.4% prompt, 48.9% education only) when compared with the baseline survey (24.7% prompt, 24.1% education only). Ninety-one percent of women in this study expressed a preference for a BSE prompt on OCP packaging. CONCLUSIONS: An increased frequency of BSE was observed when women were exposed to an OCP package prompt, particularly for women who at baseline were already partially compliant with performing monthly BSE. A small but significant improvement was observed for correct BSE timing and this effect continued after the prompt was removed, although at a reduced level. The innovative BSE prompt was overwhelmingly well received by women in this study.

Adolescent↗
PubMed1995

Age differences in attitudes toward menopause and estrogen replacement therapy.

The purpose of the present study was to develop and test attitude scales for menopause and estrogen replacement therapy (ERT) using 116 college-aged and 136 mid-aged women. Factor scores indicate that mid-aged women view menopause in a more benign fashion than college-aged women and are more likely to view ERT as positive while recognizing side effects. Restricted variability on ERT attitude items suggests limited knowledge or opinions and a need for education across ages. Women's perceptions of ERT are in terms of a solution for immediate relief of symptoms in contrast to current medical recommendations that emphasize ERT as long-term disease prevention therapy.

Adolescent↗
PubMed1993

Cervicography: adjunctive cervical cancer screening by primary care clinicians.

BACKGROUND: Cervicography is an adjunct method of cervical cancer screening intended to complement cervical cytologic sampling, ie, Papanicolaou (Pap) smear. Cervicography involves obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the screening use of cervicography as an adjunct to clinical cytologic screening. METHODS: Women presenting at four clinical sites for annual cervical cytologic screening or for follow-up evaluation after receiving an abnormal Pap smear result were enrolled in the study. Each patient received a Pap smear and a cervigram. Those women in whom abnormalities were detected by either test subsequently underwent colposcopy, and when appropriate, histologic specimens were obtained. RESULTS: Pap smear and cervigram data were obtained for 1449 women. When premalignant or malignant histologic test results were considered as a true positive, the Pap smear correctly identified 25.6% of subjects with dysplasia and 37.5% with severe dysplasia. The Pap smear failed to identify the one patient with invasive cancer. The cervigram detected 50.5% of the subjects with dysplasia and 77.8% of the subjects with severe dysplasia, and it identified the one patient with invasive cancer when a positive cervigram was considered a true positive. When the results were combined, the two tests identified 62.9% of subjects with histologically confirmed dysplasia, 81.3% of subjects with severe dysplasia, and 100% (one patient) with cancer. CONCLUSIONS: The cervigram detected twice the number of patients with premalignant disease as the Pap smear alone, and correctly identified the invasive cancer. Cervicography improved the detection of cervical disease.

Adolescent↗
PubMed1992

The optimal technique for obtaining a Papanicolaou smear with the Cervex-Brush.

BACKGROUND: The Cervex-Brush (Rovers, The Netherlands; Unimar, Wilton, Conn) is a cervical cytologic sampling device used to simultaneously collect endocervical and ectocervical cells. The optimal method for using this device to collect cervical epithelial cells for a Papanicolaou smear has not been described in the medical literature. METHODS: Using the Cervex-Brush, Papanicolaou smears were collected from 516 women in a prospective randomized study to evaluate five different clockwise rotation techniques: 180 degrees rotation of the brush, 360 degrees, 720 degrees, 1080 degrees, and 1800 degrees. The Bethesda System of classifying Papanicolaou smears was used to report cytologic results. Endocervical cell presence as an indicator of smear adequacy was quantitated from 0 to 4+. RESULTS: As the number of rotations was increased, the number of endocervical cells collected also increased (P less than .05). Abnormal epithelial cells were found in 22.3% of the smears obtained by rotating the brush 1080 degrees and 1800 degrees. This was compared with abnormal cells found in 8.2%, 4.5%, and 11.5% of the smears collected by rotating the brush 180 degrees, 360 degrees, and 720 degrees, respectively (P less than .001). Two smears that identified high-grade squamous intraepithelial lesions were collected using the 1800 degrees rotation. Unsatisfactory smears were obtained in 39 (7.5%) of the 516 smears. The percentage of slides containing hemorrhagic artifact was greatest (16.4%) in the 1800 degrees rotation group, but the likelihood of the Papanicolaou smear being considered unsatisfactory was not increased (P less than .05). CONCLUSIONS: Using a clockwise 1800 degrees rotation of the Cervex-Brush to obtain a Papanicolaou smear maximized the collection of endocervical cells, detected the greatest percentage of abnormal cells, and did not statistically exceed the acceptable limit for hemorrhagic artifact.

Adolescent↗
PubMed1991

Relationship of stress, distress, and the immunologic response to a recombinant hepatitis B vaccine.

BACKGROUND: Many studies have investigated the relationship between psychosocial factors and the susceptibility to infectious diseases. Fewer studies have investigated the relationship between stress and the immunologic response to vaccines. A follow-up study was designed to investigate the relationships between stress, distress, and the antibody response to a recombinant hepatitis B vaccine. METHODS: Eighty-one seronegative medical students received a standard immunization protocol of a recombinant hepatitis B vaccine. Six months after the first dose, corresponding to the induction phase of immunization, each subject completed both the Survey of Life Experiences and the Symptom Distress Check List to assess levels of stress and distress during that period. Three months after the third dose, corresponding to the booster phase of immunization, each subject completed the same questionnaires and was also tested for a quantitative hepatitis B surface antibody titer. Correlations were statistically analyzed using Pearson's correlation coefficient and stepwise multifactorial regression analysis. RESULTS: Higher levels of negatively perceived stress, irascibility, depression, and anxiety during the induction phase of immunization were significantly associated with higher peak antibody titers. Together these psychosocial factors accounted for 5.8% of the variance, and were as strong a determinant of peak antibody titer as was age. CONCLUSIONS: In addition to the known vaccine-related and biological factors, psychosocial factors appear to affect the immune response to a recombinant hepatitis B vaccine. The positive direction of the correlation raises the question of whether the effect of psychosocial factors on antibody formation is different from their effect on antibody function.

Adult↗
PubMed1990

A comparison of rapid enzyme immunoassay tests for the detection of Chlamydia trachomatis cervical infections.

Two rapid enzyme immunoassay test kits were compared with culture for the detection of Chlamydia trachomatis endocervical infections. Endocervical samples for C trachomatis culture and the two enzyme immunoassay tests were evaluated from 502 county health department and Planned Parenthood patients. The prevalence of infection in this population was 12%. Sensitivity and specificity of the Abbott TestPack Chlamydia were 51.7% and 99.5%, respectively, and of the Kodak Surecell Chlamydia were 76.7% and 98.6%, respectively. The positive and negative predictive values for TestPack were 93.9% and 93.8%, and for Surecell were 88.5% and 96.9%, respectively. Additionally, an in vitro investigation was used to evaluate whether typical office staff (physicians, nurses, medical technicians, receptionists, and radiology technicians) were able to perform competently the tests in each kit. Office personnel tested 12 dilutions of a C trachomatis stock sample or negative control sample as unknowns for each kit in the in vitro investigation. There were no differences among office staff in performance when compared for each test kit. Selective use of these enzyme immunoassay tests for high-risk patients in a family practice population that has a high prevalence of patients with C trachomatis infection may be helpful when rapid test results are required and cultures are not feasible. After appropriate training, most physician office personnel were equally able to perform the enzyme immunoassay tests evaluated.

Adult↗
PubMedDate not supplied

Longitudinal teaching of obstetrics in family practice residency programs.

Family practice residency programs teach obstetrics using both hospital service block rotations and longitudinal management of family practice center pregnant patients. A national survey was conducted to identify characteristics and outcomes of residencies using family physicians and/or obstetricians as preceptors for the longitudinal teaching of obstetrics. Obstetricians were used as preceptors in both outpatient and delivery room settings in 18% of residencies. Family physicians were used in the outpatient setting and obstetricians in the delivery room in 27% of programs. The 37% of programs using family physician faculty as preceptors in both outpatient and delivery room settings differed from other programs in four significant ways: they were most likely to be medical school or military residency programs; they were most likely to be located in the north central and mountain states; they reported greater general satisfaction with their preceptors; and more of their graduates practiced obstetrics after residency.

Ambulatory Care Facilities↗