Biomedical subjects

W T Kable

Publications and source records attributed to W T Kable.

12 recordsLinked to original sources

PubMed1995

Recurrent spontaneous abortion.

The patient with recurrent pregnancy loss is often frustrated and on the verge of despair. Evaluation can sometimes take several visits, allowing the physician the time and opportunity to provide emotional support to the couple. With proper evaluation and therapy, the majority of patients will become pregnant. For those who have exhausted diagnostic and treatment options, the physician should encourage consideration of assisted reproductive technologies or adoption.

Abortion, Habitual↗

PubMed1991

Effect of progestin therapy on cortical and trabecular bone: comparison with estrogen.

PURPOSE: To determine the effect of progestin therapy on bone mineral density in postmenopausal women and to compare its effects to those of estrogen. SUBJECTS AND METHODS: A prospective, randomized clinical trial was performed in 81 postmenopausal women aged 51.7 +/- 4.4 years (mean +/- SD). They were assigned to one of four groups: Provera 20 mg, Premarin 0.6 mg, Premarin 0.3 mg plus Provera 10 mg, and a placebo. In addition, all women received calcium supplementation, if necessary, to a calcium intake of 1,000 mg/day. We used single- and dual-photon absorpiometry, metacarpal radiogrammetry, and computed axial tomography to measure bone mineral density in the total skeleton, spine, radius, and metacarpal. RESULTS: Women receiving placebo lost bone at all sites (p less than 0.01). The Provera-treated group showed no change in total body calcium, but there were decreases in radial density (p less than 0.01), metacarpal cortex (p less than 0.01), and spine density (p less than 0.01). The Premarin-treated group had an increase in spine density and total body density (p less than 0.05), but a decrease in radial density (p less than 0.05). The Premarin-plus-Provera group showed no change in spine density, total body calcium, or radial density but had a decrease in metacarpal cortex (p less than 0.01). CONCLUSIONS: Compared to placebo, Provera reduced the rate of loss in cortical areas of the skeleton, but not in the spine, which contains more trabecular bone. In contrast, Premarin reduced the rate of loss in both cortical and trabecular areas of the skeleton. The low-dose combination of Premarin plus Provera was similar in its effect on bone to that of Premarin alone, suggesting that there may be a synergistic effect of this hormone combination on bone. Serum cholesterol levels decreased with Provera, Premarin, and the combination of both, whereas levels of serum triglycerides increased with Premarin treatment, decreased with the Provera regimen, and were unchanged with the combination therapy. Provera does not adversely affect the lipid profile.

Bone Density↗

PubMed1990

Lipid changes after hormone replacement therapy for menopause.

Three regimens of hormone replacement therapy were administered to 62 postmenopausal women for a period of 12 weeks and evaluated for their effect on blood lipids. Each group was given a continuous dose of 0.625 mg of conjugated estrogens combined with either a continuous dose of 2.5 mg of medroxyprogesterone acetate or 5.0 mg of medroxyprogesterone acetate, or a cyclic dose of 5.0 mg of medroxyprogesterone acetate on days 17-28 of the cycle. After treatment there was a significant decrease in the total cholesterol (P less than .0007) and low density lipoprotein cholesterol (P less than .0001) together with a significant increase in high density lipoprotein cholesterol (P less than .0029). There was no significant difference in the response of the blood lipids to the three hormone groups. Therefore, preference would depend on the combination that caused the least bleeding or amenorrhea.

Alanine Transaminase↗

PubMed1988

Cyclic endometrial changes: US assessment with histologic correlation.

The ultrasonographic (US) appearance of the endometrium was evaluated in 80 patients, and the US diagnosis of endometrial stage was compared with that from same-day endometrial biopsy specimens. The US signs of proliferative endometrium included triple-line sign, hypoechoic function layer, and minimal or absent posterior acoustic enhancement. The signs of secretory endometrium included absent triple-line sign, hyperechoic functional layer, and strong posterior acoustic enhancement. When all of these US signs were clearly depicted in combination, the accuracy of diagnosis was 93% (30 patients). The accuracy of diagnosis for all patients in the study was 76% (73 patients). The relative distributions of each US sign in proliferative and secretory endometrium were compared. Despite complicating extrinsic factors such as uterine leiomyomas and intrinsic factors such as the transition period between endometrial phases, US staging of the endometrium is a useful diagnostic technique that allows serial examinations of the endometrium.

Adult↗

PubMed1988

Endometrial histology and bleeding patterns in menopausal women treated with estrogen and continuous or cyclic progestin.

Thirty-six postmenopausal women were randomized to three groups in a double-blind, prospective study. All were treated for three months with conjugated estrogens (Premarin), 0.625 mg daily, and three different doses of a progestin (Provera), 2.5 mg daily, 5 mg daily or 5 mg during the last 12 days of a 28-day cycle. We found that the endometrium was maintained in an inactive phase in 100% of the women given continuous daily progestin but in only 25% of those given cyclic progestin. Bleeding occurred in 100% of subjects given cyclic progestin and in 50% of those given continuous progestin; however, bleeding episodes diminished with time in those on continuous progestin. A hormonal regimen that leads to reduced or absent bleeding and an inactive endometrium is preferable for postmenopausal women if estrogen therapy is to be used for the long term after menopause.

Antineoplastic Agents↗

PubMed1985

Fertility after conservative treatment of endometriosis.

The charts of 128 infertile patients with laparoscopically confirmed endometriosis for the seven years ending in June 1980 were reviewed. The patients were staged according to the American Fertility Society classification. All couples underwent semen analysis, endometrial biopsy, postcoital testing and hysterosalpingography. Life-table analysis was used to evaluate the different treatment modalities. An unexpected finding was that 9 of 17 patients (52%) who declined therapy after laparoscopy conceived, for a monthly fecundity of 0.03. The most common associated infertility factor was a poor postcoital test (in 23%). Fourteen of the 29 patients with a poor postcoital test (48%) conceived after treatment of their endometriosis, for a monthly fecundity of 0.02.

Adult↗

PubMed1982

Evidence for the involvement of beta-endorphin in the human menstrual cycle.

The possibility that beta-endorphin, an endogenous opiate, is involved in the regulation of the menstrual cycle was examined. Daily serum beta-endorphin levels, in conjunction with luteinizing hormone, progesterone, and 17 beta-estradiol were measured during 26 hormonally normal menstrual cycles. Twenty-one cycles showed a preovulatory peak and postovulatory trough of beta-endorphin, 2 cycles had a postovulatory peak, and 3 had a postovulatory peak with sustained elevation. The raw data were standardized by conversion to "Z-scores," and the composite values were computed for each of the three classes described above. Significance within these three classes was assessed using a one-way analysis of variance with an F-ratio at 95% confidence limits. The composite plot of the 26 cycles showed a statistically significant preovulatory peak occurring 2 days prior to the luteinizing hormone surge and a postovulatory trough of beta-endorphin 5 days later. These results suggest that beta-endorphins play a significant role in the neurochemical mechanisms of gonadotropin release.

Adult↗

PubMed1981