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  • 1
    Electronic Resource
    Electronic Resource
    The influence of supraphysiologic estradiol levels on human nidation (1995)
    Springer
    Journal of assisted reproduction and genetics 12 (1995), S. 406-412 
    Details
    ISSN: 1573-7330
    Keywords: in vitro fertilization ; estradiol ; fertilization rates ; pregnancy rates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Exogenous estradiol (E2) has a well-recognized interceptive action when administered shortly after ovulation. The influence of extremely elevated levels of endogenous E2 on human oocyte fertilization and implantation are unclear. The purpose of this study was to evaluate a potential antinidatory role of extremely high endogenous E2 concentrations on implantation and pregnancy duringin vitro fertilization-embryo transfer (IVF-ET). Methods Twenty-five patients receiving human menopausal gonadotropins (hMG) following midluteal GnRHa administration for IVF-ET, in which the maximal E2 concentration was 〉5000 pg/ml (range 5358–16,344 pg/ml) were studied. Cycle parameters including oocyte and embryo characteristics, fertilization, cleavage, and implantation rates as well as pregnancy outcomes were compared to those of 25 patients treated contemporaneously whose treatment cycles had peak E2 values 〈3500 pg/ml. Patients groups were matched for age, infertility diagnoses, duration of infertility and stimulation protocol. Results Cycles characterized by very high endogenous E2 levels resulted in significantly more oocytes per retrieval (21.4± 1.7 versus 8.4± 0.6;P 〈 0.0001), fewer postmature oocytes (1.6%± 1.0% versus 14%± 5.0%;P 〈 0.03), and a decreased fertilization rate (63%±4.0% versus 73%±3.0%;P 〈 0.04) compared to control cycles. There were no differences in the overall mean morphologic grade or cleavage rates between groups. However, high E2 cycles were associated with a significantly increased implantation rate (14%±4.0% versus 8.0%±4.0%;P 〈 0.01) and pregnancy rate per embryo transfer (62%±16% versus 36%±16%;P 〈 0.01) compared to controls. The incidence of spontaneous abortion did not differ between groups. Conclusions Extremely high endogenous E2 levels do not appear to adversely affect implantation or overall cycle pregnancy rates in IVF-ET cycles. However, impaired fertilization rates in such cycles support a potential adverse effect on oocyte quality.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02211139
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A Reasoned Action Approach to Physicians' Utilization of Drug Information Sources (1996)
    Springer
    Pharmaceutical research 13 (1996), S. 1291-1298 
    Details
    ISSN: 1573-904X
    Keywords: drug information sources ; physician ; theory of reasoned action ; health maintenance organization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. The effects of attitude and subjective norm were investigated on physicians' intention to use seven drug information sources: the PDR, medical textbooks, medical journals/newsletters, pharmaceutical manufacturers' literature, pharmaceutical manufacturers' representatives, other physicians, and pharmacists. The effects of past behavior and practice characteristics were also examined. Methods. An eight-page mail questionnaire queried health maintenance organization physicians on their intention to use, attitude (emotional response) and subjective norm (colleagues' approval/ disapproval) toward use of each source when searching for drug information on a fictitious, new H2 antagonist agent. Results. Responses were received from 54% (108) of the 200 physicians surveyed. Positive attitudes toward use had the greatest influence upon intention to use each of the sources (b ≥ .40) (except for pharmacists, for which subjective norm was the most important predictor (b = .31)). Past behavior directly affected intention to use the PDR (b = .27), and pharmaceutical manufacturers' literature (b = .26). The effects of attitude and/or subjective norm on intention to use non-commercial sources of drug information were moderated by the practice characteristics. Conclusions. These findings suggest that physicians' use of drug information sources is strongly influenced by their attitudes toward use. In addition, the importance of situational contingencies should not be overlooked when investigating the use of drug information sources.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1016049311673
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The Determinants of Physician Attitudes and Subjective Norms Toward Drug Information Sources: Modification and Test of the Theory of Reasoned Action (1997)
    Springer
    Pharmaceutical research 14 (1997), S. 1298-1308 
    Details
    ISSN: 1573-904X
    Keywords: physician ; attitudes ; subjective norms ; drug information sources ; appraisals ; attributes ; decision-making ; theory of reasoned action
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. To improve upon the theory of reasoned action and apply it to pharmaceutical research, we investigated the effects of relevant appraisals, attributes, and past behavior of physicians on the use of drug information sources. We also examined the moderating effects of practice characteristics. Methods. A mail questionnaire asked HMO physicians to evaluate seven common sources of drug information on general appraisals (degree of usefulness and ease of use), specific attributes (availability, quality of information on harmful effects and on drug efficacy), and past behavior when searching for information on a new, simulated H2 antagonist agent. Semantic differential scales were used to measure each appraisal, attribute and past behavior. Information was also collected on practice characteristics. Results. Findings from 108/200 respondents indicated that appraisals and attributes were useful determinants of attitudes and subjective norms toward use. Degree of usefulness and quality of information on harmful effects were important predictors of attitudes toward use for several sources of information. Ease of use and degree of usefulness were important predictors of subjective norms toward use. In many cases, moderating effects of practice characteristics were in opposing directions. Past behavior had significant direct effects on attitudes toward the PDR. Conclusions. The findings suggest ways to improve the usefulness of the theory of reasoned action as a model of decision-making. We also propose practical guidelines that can be used to improve the types of drug information sources used by physicians.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1012143915886
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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