Pap testing intervals. Specialty differences in physicians' recommendations in relation to women's pap testing behavior.

Using data from a survey of internists, family and general practitioners, and obstetricians and gynecologists, and of women in Maryland, this article examines congruence between physicians' recommendations and women's Papanicolaou (Pap) testing behavior. Both the specialty of the physicians and the age of the women are considered. The majority of all three physician specialties recommended annual Pap tests for all their patients.

Cervical cancer screening practices among older women: results from the Maryland Cervical Cancer Case-Control Study.

Considerable evidence shows a large proportion of older women have either never had a Pap test or have significant gaps in their history of cervical cancer screening. Differences in health care utilization patterns by age, cohort differences in use of medical subspecialities, and provider reluctance to perform cancer screening within the general medical care encounter have been suggested as reasons for underscreening. Our study conducted in 1985 documents prior health care utilization patterns of 153 cases of Maryland women with invasive cervical cancer compared with a matched control group.

The role of contraceptive use in cervical cancer: the Maryland Cervical Cancer Case-Control Study.

Recent evidence on the importance of sexual history and sexually transmissible agents in cervical cancer has been reported. Case-control studies have frequently demonstrated increased risk of cervical cancer for women using oral contraceptives, while laboratory results have shown that vaginal spermicides inactivate various sexually transmissible agents. To determine the role of contraceptive use in cervical cancer, 153 cases of Maryland women with invasive cervical cancer and age, race, and residence-matched controls were interviewed in 1985, focusing on sexual history, health care utilization patterns, screening history, contraceptive use, and smoking.

Utilization of obstetrician-gynecologists and prevention of cervical cancer.

In a case-control study, we examined health care utilization histories to determine whether Papanicolaou tests provided by an obstetrician-gynecologist, as opposed to other providers, are more protective of cervical cancer. Women with cervical cancer were less likely than matched controls to have had regular Papanicolaou test screening, to have received a Papanicolaou test within the last five years, or to have obtained a Papanicolaou test from an obstetrician-gynecologist. After controlling for traditional risk factors, we found that receiving any Papanicolaou tests within the last five years from an obstetrician-gynecologist was more protective than receiving Papanicolaou tests from other providers, although the difference did not attain statistical significance.

[The demonstration of proteolytic activity of bovine coronary arteries and the effect of drugs and other substances on it].

Intracellular neutral proteinases activity of bovine coronary arteries was demonstrated, isolated and partially characterized. The enriched crude enzyme preparation can be inhibited by diisopropylphosphofluoridate (DFP) and phenylmethylsulfonylfluoride (PMSF). The inhibitor concentration (pI50 values) by DFP and PMSF in the enzyme preparation and for trypsin are very similar.

Curtailment of well child services by a local health department: impact on rural 2-year-olds.

The impact of changes in the delivery of well child health services by a rural health department on the reported health status, immunization status, and patterns of health care use is evaluated for poor children born in 1981, when well child clinic services were reduced. Using birth certificate records, all 1981 resident births were enumerated for the case county in Maryland and for a demographically similar comparison county that had continued to operate health department well child clinics. Trained local interviewers tracked and interviewed mothers or guardians of the 1981 cohort.

Choriocarcinoma with brain metastases. Successful management of increased intracranial pressure with barbiturates.

Choriocarcinoma is a potentially curable neoplasm. Although the presence of intracranial metastases worsens the ultimate prognosis, several reports have shown successful response to therapy. This clinical report outlines a method by which the appropriate therapy may be initiated in a patient with intracranial metastases, who otherwise may not have survived the interval necessary for the induction of successful therapy.

Retrospective analysis of lifetime changes in women's drinking behavior.

Retrospective data on drinking behavior and related life experiences have been a neglected resource in research on alcohol use in the general population. Data from a 1981 national survey of women's drinking indicate the potential value of retrospective data analysis. The 1981 data provide comparative ages of onset for drinking behavior, drinking consequences, and health problems, and allow comparisons among different cohorts of women.

Women's drinking and drinking problems: patterns from a 1981 national survey.

A 1981 national survey of women's drinking interviewed 917 women in the general population, stratified on the basis of screening interviews to include 500 moderate-to-heavy drinkers. The survey found no evidence of any major recent increase in women's drinking, and no evidence of unusually heavy drinking among working wives. Adverse drinking consequences and episodes of extreme drinking were most common among women aged 21-34; women who were unmarried, divorced or separated, or cohabiting; and women with frequent drinkers as spouses or companions.

Drinking and reproductive dysfunction among women in a 1981 national survey.

This paper presents the first data available on drinking and reproductive dysfunction from a representative national sample of women. In this stratified household sample of 917 women (weighted n = 2552), dysmenorrhea, heavy menstrual flow, and premenstrual discomfort increased with drinking level and were particularly strongly associated with reported consumption of 6 or more drinks a day at least once a week. Women who consumed 6 or more drinks/day at least 5 times a week had elevated rates of gynecologic surgery other than hysterectomy, but hysterectomy was less common among women averaging 2 oz or more of ethanol/day, with age effects controlled.

Mechanisms of recovery from aphasia: evidence from serial xenon 133 cerebral blood flow studies.

In 21 patients who suffered aphasia resulting from left hemisphere ischemic infarction, the xenon 133 inhalation cerebral blood flow technique was used to measure cerebral blood flow within 3 months and 5 to 12 months after stroke. In addition to baseline measurements, cerebral blood flow measurements were also carried out while the patients were performing purposeful listening. In patients with incomplete recovery of comprehension and left posterior temporal-inferior parietal lesions, greater cerebral blood flow occurred with listening in the right inferior frontal region in the late studies than in the early studies.

Regional cerebral blood flow correlates of auditory processing.

To study the regional cerebral blood flow (rCBF) correlates of auditory processing, we performed rCBF measurements in young, normal right-handed volunteers engaged in listening tasks. Using the xenon Xe 133 inhalation technique, rCBF was measured in 11 regions in each hemisphere. Compared with a baseline condition, significant rCBF increases in the left posterior Sylvian regions were associated with both verbal phonologic processing and nonverbal acoustic processing.

Altered cerebral inhibition of respiratory and cardiac responses to hypercapnia in acute stroke.

Ventilatory and heart-rate responses to hypercapnia were evaluated by a CO2 rebreathing technique in 56 patients with acute ischemic stroke and 14 normal controls. Both ventilatory and heart-rate responses were increased in patients with hemispheral lesions, but not in patients with brainstem lesions. In patients with hemispheral infarct, there was a decrease in CO2 sensitivity 1 to 3 weeks later.

Hypercapnic alteration of visual evoked responses in acute cerebral infarction.

To determine the effect of inhaled carbon dioxide on acute ischemic cerebral injury, we have compared occipital visual evoked responses (VER) at baseline and during hypercapnia in 20 patients with acute unilateral cerebral infarction (ten with and ten without homonymous hemianopsia) and in ten normal controls. Visual evoked responses were judged on the basis of interhemispheral symmetry. In eight of ten controls and six of 20 patients, baseline VERs were symmetrical and remained unchanged during hypercapnia.

Superficial temporal to middle cerebral artery anastomosis. Clinical outcome in patients with ischemia of infarction in internal carotid artery distribution.

The clinical outcome of our first 40 patients (six with transient ischemic attacks, 22 with mild ischemic infarctions, and 12 with moderate ischemic infarctions) treated with a superficial temporal artery-middle cerebral artery anastomosis was analyzed. All cerebral ischemias or infarctions occurred in the internal carotid artery distribution. An independent neurologist observer recorded the patients preoperative and postoperative medical and neurological histories and objective neurological findings.

Sympathetic regulation of cephalic blood flow.

Blood flow to bilateral tissues (cranial and extracranial) was studied by means of the particle distribution method in two groups of anesthetized dogs (five using 25-mu radioactive microspheres, six using 15-mu microspheres) and five anesthetized stumptail Macaques monkeys (8-mj spheres) during unilateral sympathetic stimulation. The stimulatory parameters were adjusted to produce maximum pupillary dilatation. In the five dogs hemispheric and regional cerebral blood flow decreased but not significantly.

Respiratory rate and pattern disturbances in acute brain stem infarction.

Respiratory rates and patterns were studied in 23 patients with acute brain stem infarction using impedance pneumography. Autopsy was obtained in six of eight fatal cases. Pontine lesions were present in all patients, with coexistent infarction of midbrain in four and of medulla in nine.

Cerebrospinal fluid in cerebral hemorrhage and infarction.

Cerebrospinal fluid (CSF) abnormalities were correlated with pathological diagnoses in 61 patients with autopsy-verified intracerebral hemorrhage or cerebral infarction. Lumbar punctures were performed within one week of onset of symptoms. The CSF color and red blood cell counts were the most useful CSF parameters in differentiating between intracerebral hemorrhage and cerebral infarction.