Preoperative testing for HIV: a survey of surgeons' attitudes and practices.
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AIDS Serodiagnosis↗
Biomedical subjects
M E Pawson
Publications and source records attributed to M E Pawson.
Endometrial thickness: individual and mean growth profiles for different hormone replacement regimens.
Currently, there is a paucity of data describing endometrial growth, with most studies concentrating on endometrial thickness immediately prior to implantation or embryo transfer. This study looked at the individual and combined growth profiles of 67 volunteers receiving three different hormone replacement regimens. Each treatment regimen was in excess of that considered necessary for optimal growth, and all promoted an endometrial thickness that would be considered satisfactory for embryo transfer. Three patterns of growth were identified, but overall there was a decrease in the rate of endometrial growth with duration of treatment. As expected, analysis of variance did not show a significant difference between the mean growth profiles for the three hormone replacement regimens. The correlation (r = 0.45, P < 0.0001) between rank order on day 3 and day 10 of treatment indicates that interim analysis during early treatment cannot accurately predict later thickness, but a doubling of endometrial thickness can be expected in most cases. A relationship between endometrial thickness and either the treatment dose or serum concentrations of oestradiol was not found. These findings suggest that manipulation of endometrial growth is not possible by adjustment of either the treatment dose or serum concentration. The findings indicate that treatment beyond 12 days does not promote either a clinically significant increase in endometrial thickness of an excessive thickness, suggesting that maintenance of an oocyte recipient in a pseudo-follicular phase is unlikely to be disadvantageous to implantation.
Adult↗
Birth weight: nature or nurture?
OBJECTIVE: To investigate the relative role of environmental and genetic factors in the determination of birth weight following ovum donation. METHODS: Data from 62 cases of ovum donation were used to examine the relative influence of donor and recipient on birth weight. RESULTS: The only discernible factors that significantly influenced birth weight were gestational age and recipient's weight. Donor weight, her own birth weight, and the birth weight of the donor's own children were not significantly correlated with the birth weight of the child following ovum donation. CONCLUSIONS: It is concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.
Adult↗
The role of chronic anovulation in the polycystic ovary syndrome: normalization of sex-hormone-binding globulin levels after clomiphene-induced ovulation.
A group of anovulatory patients with polycystic ovaries (PCO) was given clomiphene citrate and compared with three control groups: normal women having spontaneous, ovulatory cycles, patients with PCO having spontaneous, regular, ovulatory cycles, and anovulatory patients without PCO. Comparisons were made at precise points of the menstrual cycle (taking the day of ovulation as day 0), using ultrasound estimates of mean follicular diameter, uterine volume, and endometrial thickness, and biochemical measurements of LH, FSH, oestradiol (E2), testosterone (T), progesterone (P) and sex-hormone-binding globulin (SHBG). Before clomiphene treatment, the anovulatory patients with PCO had significantly lower levels of SHBG and higher follicular phase concentrations of LH than all three control groups. After two cycles of clomiphene-induced ovulation, the serum LH concentration fell significantly and levels of SHBG increased significantly to levels similar to those found in spontaneously ovulating women with normal ovaries. It is likely that the loss of the usual considerable rise in E2 in both the follicular and luteal phases of ovulatory cycles is the main reason for the low SHBG found in the PCO syndrome. The loss of the normal P-induced gonadotrophin suppression may be a factor in allowing LH levels to rise.
Adolescent↗
The diagnosis of polycystic ovaries in subfertile women.
Laparoscopy was used to identify the polycystic ovary (PCO) in a group of subfertile women. A third were found to have PCO. These patients had higher levels of luteinizing hormone (LH), testosterone (T) and a higher free androgen index (FAI) than those with normal ovaries. Only 15% of patients with laparoscopic evidence of PCO were obese, hirsute and oligomenorrhoeic. Within the PCO group, hirsutism was strongly associated with obesity and a high FAI. A group of subfertile women with PCO and regular cycles was found who had no other identifiable cause for their infertility. These women had higher follicular phase concentrations of LH and higher FAI than ovulatory women with normal ovaries.
Adult↗
The effect of clomiphene citrate on follicular phase increase in endometrial thickness and uterine volume.
Fifteen ovulating women had serial ultrasound scans to measure follicular, endometrial, and uterine growth, as well as biochemical indices including estradiol (E2) and the free androgen index, throughout a natural and a clomiphene-citrate-induced cycle. Despite higher E2 levels in the 5 days preceding ovulation, the clomiphene cycles were characterized by absence of the normal increase in uterine volume and an inhibition of endometrial thickening. It is proposed that the anti-estrogen effect of clomiphene inhibits the normal cyclical growth of the uterus and endometrium.
Adult↗
What are the ultrasound and biochemical features of impending ovulation?
Thirty-two ovulatory women had serial ultrasound measurements of uterine volume, endometrial thickness and leading follicular diameter compared with serum oestradiol, testosterone and sex-hormone binding globulin. Follicular diameter, endometrial thickness and uterine volume were significantly correlated with serum oestradiol. The day before ovulation was characterized by maximal values for oestradiol, testosterone, luteinizing hormone, endometrial thickness, uterine volume and leading follicular diameter. Leading follicular diameter and endometrial thickness in particular, appear to be useful parameters to indicate impending ovulation.
Endometrium↗
Routine induction of labour by amniotomy and simultaneous Syntocinon (synthetic oxytocin) infusion.
Of 2,272 deliveries between 1 October, 1967 and 31 December, 1968 290 were induced by simultaneous intravenous Syntocinon (synthetic oxytocin) at amniotomy. The hazards of induction of labour are greatly reduced when this method is used routinely. Only 4 of the 13 caesarean sections were thought to be due to failure of method. Within 12 hours 221 patients were delivered, and this short induction-delivery interval resulted in an extremely low maternal and fetal morbidity. It is believed that with proper safeguards and in the light of present knowledge this is the method of choice.
Acid-Base Equilibrium↗