PubMed Health⌕ Search

Biomedical subjects

S R Killick

Publications and source records attributed to S R Killick.

49 records · Page 3Linked to original sources
PubMed1992

Patient education and understanding: a critical review.

In the United Kingdom, family planning services are readily available to all women, regardless of economic status. Oral contraceptives play an important role in this effort, yet studies suggest that many patients still do not understand how to use these agents appropriately. Specifically, poor patient compliance is much more prevalent than initially thought. Factors influencing compliance in UK populations include age, socioeconomic group, education, side effects, packaging, and health care delivery. In order for these medications to be effective among various female populations, there is a need for greater emphasis on patient education about oral contraception. Several possible approaches are discussed.

Age Factors↗
PubMed1991

Voluntary antenatal HIV testing--results of a pilot study.

Voluntary testing for antibody to human immunodeficiency virus (HIV) was offered to 4929 antenatal patients attending two hospitals in South Manchester during a 12 month period in 1989/90 in order to assess the feasibility of obtaining seroprevalence data by this method. Of these patients, 1728 (35%) agreed to a named test, 1396 (28%) to an unlinked anonymous test and the remaining 37% declined to be tested. The proportion of women tested increased from 22% to 88% over the period, and was similar in those with and without an identified risk factor for infection. One HIV antibody positive patient was found; she was tested anonymously and had no identified risk. The substantial cost in time and money required to establish the universal voluntary testing programme and the incomplete patient compliance confirm the importance of the unlinked anonymous surveys currently being established in the UK to monitor seroprevalence in sentinel populations.

AIDS Serodiagnosis↗
PubMed1990

Extending the duration of the pill-free interval during combined oral contraception.

The effect of increasing the duration of the pill-free interval from 7 to 9 and 11 days during the first 4 months of combined oral contraceptive therapy was studied by hormonal, ovarian follicle and mucus changes. Increasing the pill-free interval allowed more follicular development and more estradiol production. In some cases, pre-ovulatory values were achieved although ovulation did not occur. No differences could be detected between different types of combined oral contraceptive, including monophasic, triphasic, levonorgestrel-containing and gestodene-containing. The variation between individuals in the group of 28 was far greater than any variation in dose.

Adult↗
PubMed1990

The effect of prostaglandin synthetase inhibitors on human preovulatory follicular fluid prostaglandin, thromboxane, and leukotriene concentrations.

This study evaluates the eicosanoid concentration in luteinized unruptured follicles (LUFs) on the ovaries of patients who had been treated with inhibitors of prostaglandin synthetase. Indomethacin, bromfenac, or azapropazone (or a placebo) was administered orally to 41 women during the periovulatory period. Follicular development was monitored by serial ultrasound examinations, and the onset of ovulation was regulated by an injection of hCG. Follicular fluid was aspirated during sterilization by minilaparotomy, which was performed just before the expected time of ovulation. Prostaglandin E2 and PGF2 alpha levels in the fluid were significantly reduced by indomethacin and bromfenac compared to those after placebo treatment. Bromfenac also reduced the follicular fluid leukotriene B4 level. Therefore, the development of luteinized unruptured follicles after treatment with nonsteroidal antiinflammatory drugs appears to be associated with a significant decrease in the synthesis of ovarian eicosanoids.

Adult↗
PubMed1989

Pituitary-ovarian activity when switching from various monophasic pills to a triphasic pill.

This study was prompted by the various recommendations given by different oral contraceptive manufacturers to women who wish to switch from a monophasic to a triphasic formulation. Ten women who switched from a variety of monophasic pills to a levonorgestrel triphasic pill formulation after a 7-day pill-free interval were studied. Follicular maturation was monitored by ultrasound scan, and the levels of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P) and estradiol (E2) measured. Pituitary-ovarian activity was suppressed in six of the ten women studied, while in the remaining four women there was some pituitary-ovarian activity during the first 10 days on the triphasic pill. These findings suggest a shorter pill-free interval, as advised in USA data sheets, may be less likely to result in pill failures when women switch from a monophasic to a triphasic preparation.

Adolescent↗
PubMed1989

Ovarian follicular fluid eicosanoid concentrations during the pre-ovulatory period in humans.

Prostaglandins are involved in ovulation and in every mammal studied so far, ovulation has been inhibited by prostaglandin inhibition. Information regarding the role of leukotrienes and thromboxanes in ovulation is more limited. In order to study the production of eicosanoids in human pre-ovulatory follicular fluid, follicular aspiration was timed by means of serial ultrasound scans and human chorionic gonadotrophin (hCG) to be immediately pre-ovulatory. 11 women were studied and the eicosanoids measured by radioimmunoassay (RIA). The follicular fluid was found to contain leukotrienes (LT) B4, LTC4 (D4, E4), prostaglandin (PG) E2, PGF2 alpha 6 keto PGF1 alpha k and thromboxane (TX) B2. This is the first published report of leukotrienes in human follicular fluid in spontaneous cycles, and is one of the few reports showing prostaglandins and thromboxanes. The significance of demonstrating leukotrienes in human follicular fluid is discussed as is the correlation between individual eicosanoids in the human ovary.

Dinoprostone↗
PubMed1989

Ovarian follicles during oral contraceptive cycles: their potential for ovulation.

Ovarian follicles of a preovulatory size were encouraged to develop by extending the pill-free period of combine, triphasic oral contraceptive (OC) cycles. Despite recommencement of OC therapy, most follicles continued to grow and then respond to gonadotropin administration by both rupture and luteinization. It is concluded that follicles developing during OC cycles have the potential for ovulation, but this is of doubtful clinical significance for the vast majority of women.

Chorionic Gonadotropin↗
PubMed1987

The relative bioavailability of levonorgestrel and ethinylestradiol when administered in tablet and capsule form.

The relative bioavailability of levonorgestrel (LNG) and ethinylestradiol (EE2) administered as a conventional tablet (150/30) or capsule has been assessed in a randomized two-period crossover study in 9 healthy volunteer women. Serum concentrations were monitored for 24h post-dosing. There was no significant difference in any of the pharmacokinetic parameters determined for either steroid. Hence the relative bioavailability is similar after tablet and capsule formulations.

Adolescent↗
PubMed1985

A comparison of prostaglandin E2 pessaries and laminaria tents for ripening the cervix before termination of pregnancy.

Forty primigravid women aged 15-45 years were randomly allocated to receive either an intravaginal pessary of 3 mg prostaglandin E2 (PGE2) or an intracervical 5-mm laminaria tent (LT) 12-16 h before termination of pregnancy at 6-14 weeks gestation. The degree of dilatation of the cervix at operation and its resistance to further dilatation during the procedure were assessed by a 'blind' operator. Laminaria tents were more effective in achieving dilatation and softening of the cervix than were PGE2 pessaries and in 40% of women no further dilatation was necessary. There were no associated side-effects or complications. A cervical tear occurred in two of 20 patients treated with PGE2 pessaries and all 20 required further dilatation of the cervix. Laminaria tents provide a simple, safe, acceptable and effective means of 'ripening' the cervix prior to termination of early pregnancy.

Abortion, Therapeutic↗
PubMedDate not supplied

Uterine junctional zone contractions during assisted reproduction cycles.

This study was designed to assess junctional zone contractions (JZ) during cycles of in-vitro fertilization (IVF) and embryo transfer in oocyte donors exposed to a long protocol regime for ovarian stimulation. Real-time transvaginal ultrasound and advanced audio-visual and computer technology were used to evaluate the contraction pattern, frequency and velocity. At the time of down-regulation JZ contractions were not observed. After 7 days of superovulation all patients displayed cervico-fundal, fundo-cervical and random contractions. Cervico-fundal waves dominated the picture at the time of human chorionic gonadotrophin injection. However, the activity was strongest on the day of oocyte retrieval. At that time the percentage of opposing waves increased and fundo-cervical waves disappeared. The highest wave frequency and velocity (4.29+/-0.68 waves/min and 2.73+/-0.54 mm/s respectively) were observed at the time of oocyte retrieval. All patients had some JZ activity on days 2, 3 and 4 after oocyte retrieval but regular wave-like contractility gradually decreased and only single random movements were seen on day 4 after oocyte retrieval. In conclusion, JZ activity throughout the IVF cycle is more exaggerated when compared to the results reported from observations of the natural cycle but follows a similar pattern. This fact can probably be explained by the vastly different hormone levels. Higher JZ activity and correspondingly increased mobility of the endometrium may impair its receptivity and affect implantation.

Adult↗