Physicians' knowledge and practices regarding natural family planning.

OBJECTIVE: To assess physicians' knowledge and practices of modern methods of natural family planning. METHODS: A questionnaire was mailed to 840 physicians selected randomly from Missouri state licensing records for obstetrics-gynecology, family practice, general practice, and general internal medicine. RESULTS: The response rate was 65%. A total of 375 physicians (69% of respondents) saw women for reproductive issues. About half (46%) of physicians reported that they mentioned natural family planning to at least some women when discussing family planning issues. Observing vaginal discharge of cervical mucus was discussed by 40% of physicians in the context of avoiding pregnancy and by 36% of physicians in the context of helping a couple achieve pregnancy. Twenty-two percent of physicians estimated the best possible effectiveness of natural family planning to avoid pregnancy to be greater than 90%, and 35% estimated the actual effectiveness to avoid pregnancy to be greater than 70%. (The threshold rates of 90% best possible effectiveness and 70% actual effectiveness were chosen to be somewhat less than those reported in medical literature.) Physicians who gave higher estimates of effectiveness of natural family planning and physicians who were aware of an instructor in their community were more likely to provide women with relevant information about natural family planning. CONCLUSION: Most physicians, especially those unaware of availability of instructors in their areas, underestimate the effectiveness of natural family planning and do not give information about modern methods to women.

[Conjunctival epidermoid carcinoma and human immunodeficiency virus]. / Carcinome épidermoïde conjonctival et virus de l'immunodéficience humaine.

We describe the clinical and histopathological findings of a conjunctival squamous cell carcinoma occurring in a patient with acquired immunodeficiency syndrome (AIDS). The excisional biopsy specimen disclosed a papillar, well differentiated and mature squamous cell carcinoma with microinvasion. The biopsy was studied for the presence of Human papilloma virus DNA by using in situ hybridization but no signal was demonstrated in any part of the tumour. Although Kaposi's sarcoma and non-Hodgkin's lymphomas are the most common malignancies reported in AIDS, squamous cell carcinomas may be encountered in the disease. Underlying infection with the human immunodeficiency virus should be considered when conjunctival localization of such malignancies is observed.

Women's interest in natural family planning.

BACKGROUND: In the United States, approximately 4% of women of reproductive age use natural family planning (NFP) to avoid pregnancy. It is unclear whether this low number is related to a lack of available information, women's lack of interest, or other factors. Our study examined women's interest in using NFP either to become pregnant or to avoid it. METHODS: A questionnaire was mailed to 1500 women, aged 18 to 50, who were randomly selected from driver's license renewal records in Missouri for the year beginning July 1991 and ending June 1992. RESULTS: Of the 747 returned questionnaires, 484 were from women who were still potentially fertile. Of these women, 22.5% indicated that they would be likely or very likely to use NFP in the future to avoid pregnancy, and 37.4% indicated that they would be likely or very likely to use NFP in the future to become pregnant. Only 2.8% were currently using a method of NFP. Past use of any method of NFP (including the outdated calendar rhythm method) to avoid pregnancy was associated with interest in future use of modern methods of NFP to avoid pregnancy. Past use of NFP to become pregnant and the possible desire for future pregnancy were associated with interest in future use of NFP to conceive. CONCLUSIONS: Many women who are not currently using NFP indicated that they are interested in doing so in the future, either to avoid pregnancy or to conceive. Interest in future use of NFP is associated with, but not limited to, those who have previously used NFP.

Interest in natural family planning among female family practice patients.

OBJECTIVE: Although modern methods of natural family planning (NFP) are effective both to avoid and to achieve pregnancy, relatively few women use these methods. It is not known whether this is due primarily to lack of interest or to other factors. We therefore explored the level of interest in NFP among female family practice patients. METHODS: We mailed information about NFP to 400 female patients between ages 21 and 42 and conducted follow-up interviews by telephone. We excluded 162 women for whom we could not obtain accurate addresses or phone numbers, 68 women we could not reach by telephone, 67 women who were not currently at risk of pregnancy, and 15 women for other reasons. Twenty-eight women refused to participate in the study. Sixty women completed telephone interviews. RESULTS: Forty-three percent of respondents (n = 60) were interested in learning more about NFP, 24% said they were likely to use NFP to avoid pregnancy, and 32% were likely to use NFP to achieve pregnancy. Younger women and women who were Christian but not Catholic and not of a major Protestant denomination were more interested in NFP. CONCLUSION: Some female family practice patients are interested in learning and using NFP.

PIP: In the summer of 1990 in Columbia, Missouri, a student conducted telephone interviews with 60 women aged 21-42 who had attended an academic family medicine clinic between June 1988 and June 1989 and had received information about natural family planning (NFP) in the mail to determine their level of interest in NFP and what characteristics are associated with interest in NFP. The women were most familiar with the basal body temperature method (43%), the calendar method (39%), and the cervical mucus method (30%). 43% of the women wanted to learn more about NFP. 24% of them were interested in using NFP to prevent pregnancy. 32% of them were interested in using NFP to conceive. Only 35% of the women knew that the body temperature changes after ovulation. Women who were most interested in NFP were those of the nondenominational Christian, Unitarian, Pentecostal, and Charismatic faiths (miscellaneous Christian); young women (age 33 or younger); those who strongly identified with their religion; and those who reported that religion had a strong influence on their choice of family planning method (p 0.05 for all aforementioned characteristics) and those who knew about the change in basal body temperature associated with the postovulatory phase of the cycle (p 0.01). Women most likely to use NFP to prevent pregnancy were miscellaneous Christians and those familiar with the thermal shift in the menstrual cycle (p 0.05). Young women were most likely to use NFP to conceive (p 0.05). Limitations of this study included: a restricted sample (out of 400 letters sent, there were only 60 successful contacts who happened to be well educated and middle class); possible self-reporting bias, especially for questions of a sensitive nature; and self-reported interest does not necessarily mean that they will use NFP. Nevertheless, women in a primary care clinic may be interested in NFP.

[Müllerian adenosarcoma. Apropos of a case]. / L'adénosarcome Müllérien. A propos d'un cas.

Müllerian adenosarcoma is an uncommon disease of the female genital tract with a special place among mixed müllerian tumors because of its slow and more favorable clinical course. This tumor is composed of a benign epithelial contingent and a sarcomatous one. A case of Müllerian adenosarcoma clinically characterized by an atypical outset is described and the literature is reviewed.

Hypertrophic pulmonary osteoarthropathy associated with granulomatous Pneumocystis carinii pneumonia in AIDS.

A case of hypertrophic pulmonary osteoarthropathy (HPOA) in a HIV-infected patient with granulomatous Pneumocystis carinii pneumonia is described. This is the third case of HPOA associated with AIDS reported in the literature. Granulomatous P. carinii pneumonia is an unusual manifestation of P. carinii infection. Surgical treatment of this condition may lead to the dramatic spread of P. carinii causing a fulminant course with fatal outcome.