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Biomedical subjects

L S Doyle

Publications and source records attributed to L S Doyle.

7 recordsLinked to original sources
PubMed2001

Contraceptive dispensing and selection in school-based health centers.

PURPOSE: To determine whether initiation of on-site dispensing of hormonal contraceptives (oral contraceptive pill, Depo-provera, and Norplant) in six urban school-based health centers reduced time to initial selection, and increased their consistent use among sexually active females. METHODS: Participants were sexually active females who received family planning care in a school year before (1994-1995 cohort) or after (1996-1997 cohort) the initiation of on-site dispensing. Data on contraception and sexual behavior were collected at each family planning visit. Cohorts were compared using Student's t-tests and Chi-square tests, analysis of covariance, and logistic regression. RESULTS: About 59% of the 1994-1995 cohort selected hormonal contraceptives at the first or second visit; this increased to 72% of the 1996-1997 cohort (chi(2) = 11.3; p <.001). After adjustment for cohort differences, the 1996-1997 cohort consistently selected hormonal contraceptives a longer period of time, although the difference did not reach statistical significance (adjusted means: 1994-1995 cohort = 73 days, 1996-1997 cohort = 81 days; t = 1.6, p <.10). CONCLUSION: Sexually active females receiving family planning care select methods of hormonal contraception sooner and somewhat more consistently when the clinics in their high schools can dispense contraceptives on-site.

Adolescent↗
PubMed1990

Location of impaired sensory conduction of the median nerve in carpal tunnel syndrome.

Sensory conduction of the median nerve at the carpal tunnel for eight consecutive 1 cm segments of the nerve was evaluated in 217 hands of 153 of our patients with carpal tunnel syndrome. Impairment was found to be highly focal and often confined to a single 1 cm segment of the nerve. The section of the nerve at or just distal to the distal margin of the carpal tunnel was affected most frequently, the section within the tunnel was affected less often, and the section proximal to the tunnel at the level of the mid-carpal and radio-carpal joints was affected least. The greatest contrast between frequencies of slowing at adjacent segments occurred at the proximal and distal margins of the carpal tunnel. The distribution of the nerve impairment was similar between the sexes; however, among the men the segment affected most frequently was located 1 cm distal to the segment affected most frequently among the women. The general pattern of slowing which we found does not substantiate some commonly-held opinions about the aetiology of carpal tunnel syndrome.

Adult↗
PubMed1989

Comparison of sensory latencies of the median nerve at the carpal tunnel among juveniles and adults.

Five hundred and ninety-three juveniles and adults were studied to determine if there was an age-related trend in the occurrence of sensory nerve conduction latencies of the median nerve at the carpal tunnel. Latencies were found to increase with increasing age in both the dominant and nondominant hands of the subjects. A significant and positive correlation was found between the latencies of both hands, indicating that an increased value in one hand is likely to be associated with an increased value in the other. Among the adults, the latencies were found to be consistently greater for the dominant hand.

Adolescent↗
PubMed1988

Relationship of age and sex to sensory conduction of the median nerve at the carpal tunnel and association of slowed conduction with symptoms.

A cross-sectional study of 471 randomly selected employees from 4 industries was performed to assess the prevalence of slowing of sensory conduction of the median nerve at the carpal tunnel as well as the effect of age and sex on slowing. The association between slowed conduction and symptoms of carpal tunnel syndrome (CTS) was also evaluated. Slowing was identified in 17% of the subjects and in 11% of the hands. The prevalence and the severity of slowing increased with increasing age of the subjects. Slowed conduction occurred more often among the women in the study, but this was shown to be an effect of age and not of sex. Slowing occurred six times more often in hands with symptoms of CTS than in those not reporting symptoms.

Adult↗
PubMed1988

Occupation as a risk factor for impaired sensory conduction of the median nerve at the carpal tunnel.

471 industrial employees from 27 occupations in four industries were surveyed to evaluate the role of occupational hand activity as a risk factor for slowing of sensory conduction of the median nerve at the carpal tunnel. After age-adjusting the latency values, slowing of the sensory fibres of the median nerve was found in 39% of the subjects and in 26% of the hands. No consistent association was found between the type and the level of occupational hand activity and the prevalence or the severity of slowing. In addition, the prevalence of bilateral slowing of conduction of the median nerve was not associated with bimanual occupational hand activity, and the length of employment of the subjects in the current industry did not influence the occurrence of impaired sensory conduction of the median nerve at the carpal tunnel.

Carpal Tunnel Syndrome↗
PubMed1988

Sensory segmental latency values of the median nerve for a population of normal individuals.

Seventy hands of 38 individuals without carpal tunnel syndrome (CTS) were compared with 54 hands of 30 age- and sex-matched patients with a clinical diagnosis of CTS. The comparison was performed in order to determine the limits for normal-usual values for sensory nerve conduction latency values of the median nerve in the area of the wrist, using the segmental stimulation technique in 1 cm increments described by Kimura. Kimura has recognized 0.5msec as the criterion for abnormality. In this study the segmental latency value of 0.4msec was also found to fall outside the range of normal-usual values. Although 0.5msec provides a higher degree of specificity (97%), its sensitivity is limited (54%). By contrast, 0.4msec provides an enhanced sensitivity (81%) while maintaining what we feel is an acceptable amount of specificity (81%). Although the predictive accuracy of 0.4msec (77%) is less than that of 0.5msec (93%), both values have merit in confirming CTS. With 0.5msec the clinician can be assured that relatively few normal individuals will be included in the CTS group; however, use of this value may result in a high number of false negative results. In contrast, 0.4msec affords the clinician the increased sensitivity needed to make a diagnosis of CTS in those cases where the conduction deficit is subtle and highly localized; but associated with its use is the possibility of false positive results. In both cases, a thorough history and clinical examination are necessary to ensure correct interpretation of the nerve conduction study results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗