1.  Peer Reviewed Title: Effects of oral contraception with ethinylestradiol and drospirenone on oxidative stress in women 18-35 years old. Author: De Groote D; d'Hauterive SP; Pintiaux A; Balteau B; Gerday C; Claesen J; Foidart JM Source: Contraception. 2009 Aug;80(2):187-93. Abstract: BACKGROUND: Oral contraceptives (OCs) with estrogens and progestins may affect oxidative stress (OS) status. STUDY DESIGN: A group of 32 women using oral contraceptives (OCU) containing 0.03 mg ethinylestradiol and 3 mg drospirenone have been compared to a matched control group of 30 noncontraception users (NCU). Blood levels of antioxidants, trace elements and markers of lipid peroxidation were assessed by biochemical methods. A microarray analysis of whole blood mRNA levels of 200 genes involved in OS-dependant pathway was also performed. RESULTS: Levels of zinc, vitamin E and antibodies to oxidized low-density lipoproteins (LDLs) were not significantly different between the two groups. On the other hand, significant increases in the mean levels of lipid peroxides (+176%, p<.001), oxidized LDLs (+145%, p<.002), copper (+103%, p<.001), Cu/Zn ratio (+100%, p<.001) and a significant decrease in the mean level of beta-carotene (-41%, p<.01) were observed in the OCU compared to NCU. There was a highly significant positive correlation between the lipid peroxide levels and the copper-to-zinc ratio. From the 200 genes tested by microarray, one coding for HSP70 was significantly up-regulated (log(2) fold change=+ 0.45, p<.02) and one coding for inducible nitric oxide synthase significantly down-regulated (log(2) fold change=-0.24, p<.05) in the OCU compared to the NCU. CONCLUSIONS: The recently introduced combination of ethinylestradiol and drospirenone induced the heightening of lipid peroxidation correlated with high levels of copper, a situation that could be associated with increased cardiovascular risk. Language: English Keywords: BELGIUM | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES, SIDE EFFECTS | METABOLIC EFFECTS | CARDIOVASCULAR EFFECTS | SERUM COPPER LEVEL | Europe, Western | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Hemic System Document Number: 342303 |
| 2. Peer Reviewed Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population. Author: Deboosere P; Gadeyne S; Oyen HV Source: European Journal of Population. 2008 May;25(2):175-196. Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level. Language: English Keywords: BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics Document Number: 340174 |
| 3. Peer Reviewed Title: Differential elevation of matrix metalloproteinase expression in women exposed to levonorgestrel-releasing intrauterine system for a short or prolonged period of time. Author: Labied S; Galant C; Nisolle M; Ravet S; Munaut C; Marbaix E; Foidart JM; Frankenne F Source: Human Reproduction. 2009 Jan;24(1):113-21. Abstract: BACKGROUND: The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective contraceptive and has many non-contraceptive health benefits. However, it is commonly associated with irregular endometrial bleeding. Metalloproteinases contribute to extracellular matrix (ECM) remodelling and regulate bleeding during the menstrual cycle. Enhanced metalloproteinase expression participates in the pathogenesis of breakthrough bleeding. Thus the objective of this study was to compare matrix metalloproteinase (MMP) expression in endometrium during luteal phase and in short-term (1 month) and long-term (> or =6 months) LNG-IUS users. METHODS: MMP expression was analysed by semi-quantitative RT-PCR and immunohistochemistry. Gelatinase activity was determined by gelatin zymography. RESULTS: MMP-1, -2, -3, -7, -9 and -12 mRNAs levels were increased, whereas that of MMP-26 was decreased in the endometrium of LNG-IUS users. MMP-1, -2, -3, -7 and -9 were localized by immunohistochemistry in all biopsies inthe short-term group but in only 0-27% in the control group. The incidence of positive immunostaining for MMP-2 and -3 decreased significantly in the long-term compared with short-term LNG-IUS users. MMP-26 was localized in all biopsies from the control group but in only 14 and 25% from the short- and long-term LNG-IUS groups, respectively. In both LNG groups, the numbers of macrophages (the major source of MMP-12) was increased. CONCLUSIONS: MMP-1, active MMP-2, MMP-3, MMP-7, MMP-9 and MMP-12 are more prevalent in the short-term LNG-IUS group, suggesting their important contribution to ECM breakdown and transient bleeding. The decrease in the percentage of women expressing MMP-2 and -3 might contribute to the decreased occurrence of unwanted spotting and bleeding in long-term LNG-IUS users. Language: English Keywords: BELGIUM | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | CASE CONTROL STUDIES | WOMEN | LEVONORGESTREL | IUD, HORMONE RELEASING | METRORRHAGIA | ENDOMETRIUM | PROTEINS | GENETICS | CYTOCHEMICAL EFFECTS | Developed Countries | Europe, Western | Europe | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Studies | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | IUD | Contraceptive Methods | Bleeding | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cytologic Effects Document Number: 330074 |
| 4. Title: Levonorgestrel-releasing intra-uterine systems (LNG-IUS) and breast cancer [letter] Author: Neven P; Amant F; Poppe W; Van den Broecke R Source: Fertility and Sterility. 2009 Apr;91(4):e5; author reply e6. Abstract: The observational study by Trinh et al. concludes that there is a higher recurrence rate when breast cancers are detected during the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) and when it is not removed after diagnosis. Although the authors mainly generate several hypotheses around their observations, we would like to warn about inappropriate interpretation of their data and premature conclusions, as such a message was released in a couple of Belgian newspapers recently. First, there is a problem with the control group in the authors' study. This control group is matched for "all" LNG-IUS users, including a group with a low risk for relapse, those where the clinician decided to insert an LNG-IUS probably long after breast cancer diagnosis, and a group with a higher risk of relapse, i.e., those diagnosed with breast cancer during the use of the LNG-IUS. Understandably, the high risk of relapse group (more chemotherapy, more ER-negative, more grade 3), also being the LNG-IUS users at breast cancer diagnosis, presented with a poorer outcome than the control subjects. To prove their point, the authors should have matched cases with the LNG-IUS at breast cancer diagnosis for control subjects without LNG-IUS at diagnosis and followed up taking into account demographics such as family history as well as prognostic and predictive factors and adjuvant therapy. Furthermore, the authors hypothesize that breast cancers in LNG users are detected in a much more advanced stage based on differences, e.g., in nodal involvement between the group with the LNG-IUS at diagnosis and those where the LNG-IUS was inserted after diagnosis. They now define a second control group (subgroup B), which is inappropriate. The question of whether breast cancers in LNG users are in a much more advanced stage at diagnosis is therefore not proven by this observation, because the control group is likely biased by selection for the use of an LNG-IUS after breast cancer diagnosis to a lower breast cancer relapse risk population. We believe that a case-control study is more appropriate to prove this point. We also do not know whether breast cancer prognosis is different when the LNG-IUS is removed at diagnosis, an important group which is missing in this study. It is also unclear how long the LNG-IUS was inserted before or after the diagnosis of breast cancers, respectively, in subgroup A and subgroup B. We understand that patients in subgroup A could have had the LNG-IUS for >14 years, whereas those in subgroup B might have had the LNG-IUS inserted several years after their breast cancer diagnosis. This may, again, imply bias through a healthy user effect that may affect relapse of breast cancer. It may also explain local versus distant metastasis between subgroups and control subjects. Finally, both Kaplan-Meier curves suppose a much longer mean followup than the stated 2.8 and 2.9 years for LNG-IUS users and control subjects, respectively. Based on these observations, the hypotheses on neither safety nor prognosis of the LNG-IUS in operable breast cancer have been generated. It remains an open question whether low levels of circulating levonorgestrel affect the natural history of breast cancer at diagnosis and follow-up, or whether it interferes with adjuvant antiestrogen therapy. We continue to agree that there is need for further research and welcome their prospective registration of LNG-IUS. This is an important issue, not only because the LNG-IUS is a very popular method of contraception, and 2% of women in Belgium develop breast cancer during their fertile years, but also because the LNG-IUS is now being used in long-term estrogen and tamoxifen users to protect the uterus from bleeding and proliferative endometrial changes. (full-text) Language: English Keywords: BELGIUM | RESEARCH REPORT | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN | CONTROL GROUPS | MATCHED GROUPS | PREVALENCE | IUD SIDE EFFECTS | IUD, HORMONE RELEASING | LEVONORGESTREL | BIAS | DEMOGRAPHIC FACTORS | TIME FACTORS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Population | Measurement | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Error Sources | Population Dynamics Document Number: 331240 |
| 5. Title: Pelvic actinomycosis: a malignant appearing mass. A case report. Author: Pirenne Y; Bouckaert W; Vangertruyden G Source: Acta Chirurgica Belgica. 2009 Mar-Apr;109(2):250-2. Abstract: Pelvic actinomycosis is a rare complication of a long-term intrauterine contraceptive device. Early diagnosis is important, as clinical and radiological imaging may mimic a malignant pathology and lead to radical and unnecessary surgery. We report a case of pelvic actinomycosis in a woman who had used an intrauterine contraceptive device for the last 13 years. The actinomycosis appeared as a malignant pelvic mass with invasion into the sigmoid and left ureter, with high-grade stenosis of these structures. Because of its rapidly developing obstructive character, an urgent Hartmann procedure with resection of the uterus and both ovaries was performed. Histology revealed actinomycosis. With this case we want to illustrate that for a woman presenting with an intrauterine contraceptive device and a malignant appearing mass in the pelvis, pelvic actinomycosis must be considered in the list of differential diagnosis, so that appropriate diagnostic work out and treatment can be made. Language: English Keywords: BELGIUM | SUMMARY REPORT | CASE STUDIES | CLIENTS | IUD COMPLICATIONS | BACTERIAL AND FUNGAL DISEASES | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | HISTOLOGY | ULTRASONICS | ANTIBIOTICS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Drugs | Treatment Document Number: 342597 |
| 6. Peer Reviewed Title: Effect of steady-state etravirine on the pharmacokinetics and pharmacodynamics of ethinylestradiol and norethindrone. Author: Scholler-Gyure M; Kakuda TN; Woodfall B; Aharchi F; Peeters M; Vandermeulen K; Hoetelmans RM Source: Contraception. 2009 Jul;80(1):44-52. Abstract: BACKGROUND: Etravirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI) active against NNRTI-resistant HIV, is an inducer of CYP3A4 and an inhibitor of CYP2C9/19. STUDY DESIGN: The effect of etravirine on the pharmacokinetics and pharmacodynamics of ethinylestradiol and norethindrone was assessed in 30 HIV-negative females. Following a run-in cycle with ethinylestradiol/norethindrone, the pharmacokinetics of ethinylestradiol and norethindrone was assessed on Day 15 of Cycle 2. Etravirine 200 mg bid was coadministered on Day 1 to Day 15 of Cycle 3, with pharmacokinetic assessments of ethinylestradiol, norethindrone and etravirine on Day 15. RESULTS: When combined with etravirine, the least-squares means (LSM) ratios (90% confidence interval) for ethinylestradiol AUC(24h), C(max) and C(min) were 1.22 (1.13-1.31), 1.33 (1.21-1.46) and 1.09 (1.01-1.18), respectively, compared to administration alone. LSM ratios for norethindrone parameters were 0.95 (0.90-0.99), 1.05 (0.98-1.12) and 0.78 (0.68-0.90), respectively. CONCLUSION: These changes are not considered clinically relevant. No loss in contraceptive efficacy is expected when coadministered with etravirine. Language: English Keywords: BELGIUM | UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | HUMAN VOLUNTEERS | WOMEN | ANTIRETROVIRAL DRUGS | DRUG INTERACTIONS | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | NORETHINDRONE | ENZYMATIC EFFECTS | SIDE EFFECTS | LABORATORY PROCEDURES | Europe, Western | Europe | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Enzymes and Enzyme Inhibitors | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 342790 |
| 7. Title: Ineffective attempt to preserve fertility with a levonorgestrel-releasing intrauterine device in a young woman with endometrioid endometrial carcinoma: a case report and review of the literature. Author: Vandenput I; Van Eygen K; Moerman P; Vergote I; Amant F Source: European Journal of Gynaecological Oncology. 2009;30(3):313-6. Abstract: BACKGROUND: The treatment of endometrial cancer in young women who want to preserve their fertility is challenging. CASE: A 25-year-old woman (A0P0G0) was diagnosed with grade 1 endometrioid endometrial carcinoma (EEC). Imaging studies including transvaginal ultrasound (TVS), computed tomography and magnetic resonance imaging (MRI) could not detect myometrial invasion or metastatic disease. The immunohistochemical expression of the estrogen and progesterone receptor in the tumor was strongly positive, whereas p53 staining was negative. After extensive counseling, we decided to use a levonorgestrel-releasing intrauterine device to preserve her fertility. Follow-up was organized every three months and consisted of serum CA125 levels, TVS, endometrial biopsy and MRI. The tumor regressed after ten months and the intrauterine device was removed. However, nine months later, recurrent EEC was diagnosed and a hysterectomy performed. Pathological examination confirmed Stage Ia EEC. CONCLUSION: Despite the presence of favorable prognostic factors of EEC as determined by grade and immunohistochemistry, the levonorgestrel-releasing intrauterine device was unable to preserve fertility. Language: English Keywords: BELGIUM | SUMMARY REPORT | LITERATURE REVIEW | CASE HISTORIES | CLIENTS | ENDOMETRIAL CANCER | TREATMENT | FECUNDITY | IUD, HORMONE RELEASING | LEVONORGESTREL | ULTRASONICS | HYSTERECTOMY | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Gynecologic Surgery | Urogenital Surgery | Surgery Document Number: 342780 |
| 8. Peer Reviewed Title: Chronic fatigue syndrome: a hormonal origin? A rare case of dysmenorrhea membranacea. Author: Veldman J; Van Houdenhove B; Verguts J Source: Archives of Gynecology and Obstetrics. 2009 May;279(5):717-20. Abstract: BACKGROUND: Membranous dysmenorrhea is a rare entity involving expulsion of fragments of endometrium retaining the shape of the uterus. The condition is often linked to high progesterone levels. An association with a chronic fatigue syndrome was never described. CASE: A 44-year-old woman with a chronic fatigue syndrome (CFS), presented with membranous dysmenorrhea after taking an oral contraceptive pill containing ethinylestradiol 0.02 mg and desogestrel 0.15 mg for 3 months in a continuous regimen as treatment for dysfunctional bleeding. Oral contraception was discontinued and she resumed normal menstruations. Remarkably, she mentioned complete disappearance of the CFS since expulsion of the tissue and started working again. CONCLUSION: The occurrence of membranous dysmenorrhea with a dissolving chronic fatigue syndrome is very rare and was never described before. This case suggests a hormonal dysfunction as a possible cause of chronic fatigue syndrome. A review of the literature on membranous dysmenorrhea is presented. Language: English Keywords: BELGIUM | SUMMARY REPORT | LITERATURE REVIEW | CASE HISTORIES | CLIENTS | FATIGUE | DYSMENORRHEA | HORMONES | EXAMINATIONS AND DIAGNOSES | ORAL CONTRACEPTIVES | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases | Menstruation Disorders | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning Document Number: 341663 |
| 9. Peer Reviewed Title: Contraceptive applications of progesterone receptor modulators. Author: Chabbert-Buffet N; Ouzounian S; Kairis AP; Bouchard P Source: European Journal of Contraception and Reproductive Health Care. 2008 Sep;13(3):222-30. Abstract: Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings. Language: English Keywords: BELGIUM | RESEARCH REPORT | WOMEN | PROGESTERONE | CONTRACEPTION | BLEEDING | UTERINE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | VAGINAL RING | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Methods Document Number: 329698 |
| 10. Title: The association between unwanted early sexual experiences and sexual adjustment among Belgian and South African students. Author: Revell AT; Vansteenwegen A; Nicholas L; Dumont K Source: Sexual and Relationship Therapy. 2008 May;23(2):111-118. Abstract: This study examined the association between unwanted early sexual experiences (UESE) and sexual adjustment among 2,608 Belgian students (men = 1,017; women = 1,587) and 1,081 South African students (men = 335; women = 739) and the severity of the experience in its bothersomeness. Of Belgian women, 14.2% (226) reported UESE compared to 31.3% (231) of South African women; and of Belgian men 12.3% (125) indicated that they had an UESE compared to 56.4% (189) of South African men. Against expectations, those without UESE showed significant poorer sexual adjustment. The severity of UESE was also associated with greater bothersomeness by all respondents except for Belgian men at the time of completing the checklist. However, no association was found between severity and bothersomeness at the time of UESE. (author's) Language: English Keywords: SOUTH AFRICA | BELGIUM | RESEARCH REPORT | ADOLESCENTS | CHILD | CHILD ABUSE | SEXUAL ABUSE | SIGNS AND SYMPTOMS | PSYCHOLOGICAL FACTORS | EXPOSURE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Developed Countries | Europe, Western | Europe | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Diseases | Behavior | Risk Factors | Biology Document Number: 325928 |
| 11. Title: Pharmacokinetic interaction between ethinyl estradiol, norethindrone and darunavir with low-dose ritonavir in healthy women. Author: Sekar VJ; Lefebvre E; Guzman SS; Felicione E; De Pauw M; Vangeneugden T; Hoetelmans RM Source: Antiviral Therapy. 2008;13(4):563-9. Abstract: BACKGROUND: An open-label, randomized, crossover study was performed to investigate the effect of multiple doses of darunavir co-administered with low-dose ritonavir (DRV/r) on the steady-state pharmacokinetics of the oral contraceptives ethinyl estradiol (EE) and norethindrone (NE) (commercial name of the combined drug Ortho-Novum 1/35) in 19 HIV-negative healthy women. METHODS: In session 1, participants received 35 microg EE and 1.0 mg NE from days 1 to 21. In session 2, participants received the same oral contraceptive treatment as in session 1 on days 1 to 21 plus DRV/r (600 mg/100 mg twice daily) on days 1 to 14. Pharmacokinetic assessments were performed on day 14 for each session. RESULTS: Steady-state systemic exposure to EE and NE decreased when DRV/r was co-administered, based on the ratio of least square means of the minimum plasma concentration (Cmin), the maximum plasma concentration (Cmax), and the area under the curve (AUC24h) of EE (which decreased by 62%, 32% and 44%, respectively) and NE (which decreased by 30%, 10% and 14%, respectively) compared with administration of EE and NE alone. Five participants discontinued the study due to grade 2 cutaneous events, as required per protocol, during treatment with EE and NE in combination with DRV/r. There were no clinically relevant findings for laboratory and cardiovascular parameters. CONCLUSIONS: The pharmacokinetic interaction observed here is considered to be clinically relevant as EE concentrations are considerably reduced when DRV/r is co-administered with EE and NE. Alternative or additional contraceptive measures should be used when oestrogen-based contraceptives are co-administered with DRV/r. Language: English Keywords: BELGIUM | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, LOW-DOSE | ADMINISTRATION AND DOSAGE | DRUG INTERACTIONS | CONTRACEPTION TERMINATION | DERMATOLOGICAL EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, COMBINED | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Safety | Public Health Document Number: 328734 |
| 12. Peer Reviewed Title: Use of the levonorgestrel-releasing intrauterine system in breast cancer patients. Author: Trinh XB; Tjalma WA; Makar AP; Buytaert G; Weyler J; van Dam PA Source: Fertility and Sterility. 2008 Jul;90(1):17-22. Abstract: OBJECTIVE: To study the recurrence of breast cancer among patients who were using the levonorgestrel-releasing intrauterine system (LNG IUS). DESIGN: A retrospective, controlled cohort analysis. SETTING: Six Belgian hospitals. PATIENT(S): We identified 79 breast cancer patients who used the LNG IUS, and we selected a control group of 120 patients with no history of LNG IUS use and who were closely matched for age at diagnosis, tumor stage, tumor grade, and treatment modalities. Two subgroups were identified: [1] breast cancer patients who continued using the LNG IUS after diagnosis and [2] breast cancer patients who began using an LNG IUS after treatment for breast cancer. INTERVENTION(S): Patient's data were collected and survival analysis was performed. MAIN OUTCOME MEASURE(S): Breast cancer recurrence rate. RESULT(S): There was a recurrence rate of 21.5% (17/79) among LNG IUS users and of 16.6% (20/120) among the control group (adjusted hazard ratio, 1.86; 95% confidence interval, 0.86-4.00; no statistically significant difference). Subgroup analysis showed that women using the LNG IUS (n = 38) at the time of breast cancer diagnosis (and who continued its use) had a statistically significantly increased risk of recurrence (adjusted hazard ratio, 3.39; 95% confidence interval, 1.01-11.35) compared with patients in the control group. There was 47.4% (18/38) nodal involvement in this subgroup, and all patients who recurred had metastatic disease. CONCLUSION(S): Overall, we did not find an increased risk of breast cancer recurrence associated with use of the LNG-IUS. However, in a subgroup analysis of women who developed breast cancer while using an LNG IUS and who continued to use the LNG IUS, we found a higher risk of recurrence of borderline statistical significance. Additional research is needed to confirm or refute these findings. Language: English Keywords: BELGIUM | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | HOSPITALS | CLIENTS | WOMEN | BREAST CANCER | IUD | CONTRACEPTIVE USAGE | LEVONORGESTREL | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Health Facilities | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 328406 |
| 13. Title: Assisted reproductive technologies are an integrated part of national strategies addressing demographic and reproductive challenges. Author: Ziebe S; Devroey P Source: Human Reproduction Update. 2008 Nov-Dec;14(6):583-92. Abstract: BACKGROUND: The decline in the total fertility rate in the latter half of the 20th century in many European countries is becoming increasingly important in determining the demographic composition of Europe and its individual member states. This review focuses on discussion surrounding how assisted reproductive technology (ART) can impact declining fertility rates. METHODS: This article summarizes key aspects of presentations given at the 'State of the ART 2007-ART and Society' meeting held in Lyon, France, in June 2007. For each topic, searches were conducted in MEDLINE and other databases and the results, alongside unpublished data and personal opinion, were presented to the Workshop Group. Individual subjects were discussed and any disagreements or omissions resolved. RESULTS: Although reduced fertility rates will have an impact on total population number, it is the change in the age structure of the population that is likely to be the most challenging factor faced by the European Union (EU). With evidence suggesting that an ageing population threatens future standards of living and social cohesion, managing demographic change through integrated policy response has become an important component of EU legislation. However, current measures fail to tackle the contribution that ART may play in alleviating falling fertility rates. Indeed, ART can have an important impact on economic and demographic factors, and should be incorporated into a population policy mix. Current barriers to ART include legislative restriction across different EU countries, limited availability to ART and current perception of ART in society. CONCLUSIONS: The inclusion of ART as part of a population policy mix in Europe is justified but must involve better communication among ART professionals, politicians and the general public. Language: English Keywords: BELGIUM | RESEARCH REPORT | LITERATURE REVIEW | DEMOGRAPHICS | FERTILITY | INFERTILITY | REPRODUCTIVE TECHNOLOGIES | Developed Countries | Europe, Western | Europe | Demography | Social Sciences | Science | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Reproduction Document Number: 329625 |
| 14. Peer Reviewed Title: The health of trafficked women: a survey of women entering posttrafficking services in Europe. Author: Zimmerman C; Hossain M; Yun K; Gajdadziev V; Guzun N Source: American Journal of Public Health. 2008 Jan;98(1):55-59. Abstract: Trained counselors interviewed 192 women who had been trafficked and sexually exploited about abuse and evaluated their physical and mental health status within 14 days of entry into posttrafficking services. Most reported physical or sexual violence while trafficked (95%), pretrafficking abuse (59%), and multiple posttrafficking physical and psychological problems. Newly identified trafficked women require immediate attention to address posttrauma symptoms and adequate recovery time before making decisions about participating in prosecutorial or immigration proceedings or returning home. (author's) Language: English Keywords: BELGIUM | BULGARIA | CZECH REPUBLIC | ITALY | MOLDOVA | UKRAINE | UNITED KINGDOM | RESEARCH REPORT | INTERVIEWS | CLINICAL RESEARCH | WOMEN | SEXUAL TRAFFICKING | SEXUAL EXPLOITATION | HEALTH | MENTAL HEALTH | PHYSICAL ABUSE | SIGNS AND SYMPTOMS | Developed Countries | Europe, Western | Europe | Europe, Southeastern | Developing Countries | Europe, Central | Europe, Southern | Europe, Eastern | Data Collection | Research Methodology | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Behavior | Violence | Diseases Document Number: 314039 |
15.  Title: The shape of a fertility transition: an analysis of birth intervals in eastern Belgium. Author: Alter G; Oris M; Tyurin K Source: [Unpublished] 2007. Presented at the Population Association of America 2007 Annual Meeting, New York, New York, March 29-31, 2007. 30 p. Abstract: We propose here a new way to look for evidence of fertility control. Most previous studies have relied on age-specific patterns of marital fertility, which do not provide sensitive measures of the timing of "stopping" behavior and do not consider "spacing" at all. We show that both stopping and spacing can be identified in birth interval survival curves. Analysis of data from nineteenth-century Belgium finds that changes in both stopping and spacing were at work. The fertility transition was characterized by an increase in stopping, but there was also a decrease in spacing, which began earlier and continued while stopping was spreading. We also introduce a statistical technique, known as the "cure model," which allows us to estimate the effects of covariates on stopping and spacing separately. (author's) Language: English Keywords: BELGIUM | SUMMARY REPORT | STATISTICAL STUDIES | DEMOGRAPHIC TRANSITION | BIRTH SPACING | FAMILY PLANNING POLICY | FERTILITY MEASUREMENTS | CHILD SURVIVAL | MARRIAGE DURATION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Population Dynamics | Demographic Factors | Population | Family Planning | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Fertility | Survivorship | Length of Life | Mortality | Marriage | Nuptiality Document Number: 317744 |
| 16. Title: Worldwide coalition against sexual violence. Author: De Decker A Source: Forced Migration Review. 2007 Jan;(27):7. Abstract: Prevention of and response to sexual and gender-based violence (SGBV) will require long-term, multisectoral and coordinated efforts focusing on the economic, health, legal, psychosocial and security concerns of affected populations. In order to achieve tangible results, cooperation at all levels is vital. In light of this, I took the decision to involve Belgium at the field level in the Democratic Republic of Congo. Since 2004 we have been actively involved in an innovative four-year programme in partnership with UNFPA, UNICEF and OHCHR (office of the UN High Commissioner for Human Rights). The programme's holistic approach and success in securing effective cooperation between the various international institutions involved and local NGOs were recognised as outstanding in 2006 by UN Secretary General, Kofi Annan, who made a personal financial contribution as a testimony of his support. I sincerely hope that this programme will encourage similar initiatives in other countries. (excerpt) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | BELGIUM | PROGRESS REPORT | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | RAPE | VIOLENCE | PREVENTION AND CONTROL | WAR | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Europe, Western | Europe | Developed Countries | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Crime | Social Problems | Sociocultural Factors | Behavior | Diseases | Political Factors Document Number: 313165 |
| 17. Peer Reviewed Title: Co-trimoxazole prophylaxis in tropical countries in the era of highly active antiretroviral therapy: Do we know enough? Author: Lynen L; Jacobs J; Colebunders R Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007 Nov;101(11):1059-1060. Abstract: Co-trimoxazole prophylaxis in HIV-infected persons is beyond doubt one of the cheapest and most important interventions, next to antiretroviral therapy (ART), to improve survival. However, many questions, ranging from programme coverage and public health impact to individual tolerance and compliance, remain unanswered. Together with the need for more research to identify optimal ART regimens for resource-poor settings, research regarding optimal chemoprophylaxis against opportunistic infections should also remain high on the agenda. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | HIV | TOXICITY | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | CONTRACEPTIVE METHOD ACCEPTABILITY | USER COMPLIANCE | INFECTIONS | NEEDS | Developed Countries | Europe, Western | Europe | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Usage | Contraception | Family Planning | Behavior | Economic Factors Document Number: 320876 |
| 18. Peer Reviewed Title: Man's involvement in the experience of abortion and the dynamics of the couple's relationship: A clinical study. Author: Naziri D Source: European Journal of Contraception and Reproductive Health Care. 2007 Jun;12(2):168-174. Abstract: The objectives were to investigate the way men experience abortion from a psychodynamic perspective in order to understand better the impact of this experience on their own image as men and on the couple's relationship. In-depth semi-structured interviews with 16 men in Belgium and 14 men in Greece. Intrapsychic factors seem to play for men an important role in their experience of abortion, whatever their cultural context and contraceptive practices. Two-thirds of the men who agreed to participate in the research disagreed with their partner's decision to have an abortion. Such men may feel that it is impossible for them to fulfill themselves, in particular as potential fathers. This impossibility is, according to men, linked to women's attitudes, but may also be related to their own difficult identification with parental images and to socioprofessional concerns. Abortion can create tensions and/or conflicts between partners by revealing their contradictory desires. It is suggested that institutions where men and women are heard can help both partners to outlive this experience as a constructive step in their personal psychosocial evolution and in their relationship. (author's) Language: English Keywords: BELGIUM | GREECE | RESEARCH REPORT | INTERVIEWS | MEN | COUPLES | ABORTION | PARTNER COMMUNICATION | INTERPERSONAL RELATIONS | PSYCHOLOGICAL FACTORS | SELF-PERCEPTION | Developed Countries | Europe, Western | Europe | Europe, Southern | Data Collection | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Behavior | Perception Document Number: 317566 Notification |
| 19. Peer Reviewed Title: How does a Belgian health care provider deal with a request for emergency contraception? Author: Peremans L; Verhoeven V; Philips H; Denekens J; Van Royen P Source: European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):317-325. Abstract: The objective was to evaluate how Belgian health care providers deal with a request for emergency contraception. In 2002-2003 we conducted 12 focus groups with pharmacists, general practitioners and school physicians. A skilled moderator accompanied by an observer conducted the focus groups using a semi-structured screenplay. All these health care providers agree with the free access to emergency contraception (EC), but experience considerable frustration with regard to the practical aspects and the legal framework. General practitioners (GPs) claim to spend a lot of time on requests for EC and they are concerned about the quality of the counselling provided in pharmacies. Pharmacists are creative when giving counselling in the pharmacy, but there is, nevertheless, a problem with a lack of privacy. School physicians are frustrated that there is no legal possibility to respond to a request for EC when they feel they are ideally placed to advise adolescents. The over-the-counter sale of EC offers women better access, but many barriers still interfere with optimal care. Pharmacists experience a lack of skills to communicate with adolescents and a lack of privacy to give counselling. GPs have good intentions, but are confronted with a lack of willingness on the part of the patients and also financial barriers. School physicians want more possibilities to help adolescents. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | QUALITATIVE RESEARCH | FOCUS GROUPS | PHARMACISTS | PHYSICIANS | SCHOOLS | EMERGENCY CONTRACEPTION | COUNSELING | PROGRAM ACCESSIBILITY | Developed Countries | Europe, Western | Europe | Research Methodology | Data Collection | Health Personnel | Delivery of Health Care | Health | Education | Contraception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Program Evaluation Document Number: 322474 |
| 20. Peer Reviewed Title: Effect of different contraceptive methods on the oxidative stress status in women aged 40–48 years from the ELAN study in the province of Liege, Belgium. Author: Pincemail J; Vanbelle S; Gaspard U; Collette G; Haleng J Source: Human Reproduction. 2007 Aug;22(8):2335-2343. Abstract: Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception (OC) in women has been a matter of ongoing discussion. A total of 897 eligible and healthy volunteers were recruited from among the patients of 50 general practitioners participating in the ELAN study (Etude Liegeoise sur les ANtioxydants). A subsample consisting of 209 women aged 40-48 years was studied for a comprehensive oxidative stress status (OSS), including the analysis of antioxidants, trace elements and three markers of oxidative damage to lipids. Among 209 subsample, 49 (23%) were OC users (OCU), 119 (57%) non-contraception users (NCU) and 41 (20%) were intrauterine (hormonal and copper) devices users (IUD). After adjustment for smoking, systolic and diastolic blood pressure and BMI (or waist circumference), a marked and significant increase in lipid peroxides was observed among OCU women when compared with NCU and IUD users. A cut-off value of 660 µM in lipid peroxides allowed the discrimination of OCU from the two other groups. In contrast, no difference was observed in the plasma concentration of both oxidized low-density lipoprotein (LDL) and their related antibodies. The increased level in lipid peroxides was strongly related to higher concentrations of copper (r < 0.84; P < 0.0001, cut-off value 1.2 mg/l). When compared with NCU and IUD users, plasma antioxidant defences were significantly altered in OCU women as shown by lower levels of b-carotene (decrease of 39%; P < 0.01) and gtocopherol (decrease by 22%; P < 0.01). In contrast, higher concentrations of selenium (increased by 11.8%; P < 0.01) were observed in OCU women. Blood concentrations of vitamin C, a-tocopherol and zinc were unaffected by OC use. The intake of OC significantly increases the lipid peroxidation in women aged 40-48 years. This may represent a potential cardiovascular risk factor for these women. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | VOLUNTEERS AND VOLUNTARISM | WOMEN | CONTRACEPTIVE METHODS | ORAL CONTRACEPTIVES | IUD | LIPIDS | VITAMINS AND MINERALS | RISK FACTORS | CARDIOVASCULAR EFFECTS | Europe, Western | Europe | Developed Countries | Organization and Administration | Demographic Factors | Population | Contraception | Family Planning | Physiology | Biology Document Number: 318913 |
| 21. Peer Reviewed Title: New frameless and framed intrauterine devices and systems -- An overview. Author: Wildemeersch D Source: Contraception. 2007 Jun;75(6 Suppl 1):S82-S92. Abstract: There is a need for new, improved birth control methods which are easier to use, with less side effects and which avoid daily action, such as the pill. Perfect use requires consistent daily use or use at every act of intercourse. Long-acting methods eliminate the need for specific action at the time of coitus, or for daily action. Developing a new contraceptive is a major challenge. It is generally estimated that it takes 10-15 years to develop a new method and bring it to the market, at a cost of US$200-300 million, and the industry is reluctant to take the risk of such long-term investment. However, both risk and investment can be reduced by taking small steps. Slight improvements of existing contraceptives could result in a giant step forward. The development of frameless intrauterine systems (IUS) is an attempt to improve the performance and acceptability of intrauterine contraception. Both the frameless GyneFix IUD and the frameless FibroPlant levonorgestrel (LNG)-IUS possess features which may solve the main problems encountered with conventional IUDs (e.g., expulsion, abnormal or excessive bleeding and pain). The performance of frameless devices, however, is dependent on correct anchoring of the device, which requires technical skill. Becoming a proficient GyneFix or FibroPlant provider is easily acquired if the provider follows the procedural instruction strictly. For the less technically skilled provider, the Femilis LNG-IUS, using the new, simplified insertion technique, could be an excellent contraceptive option. It is usually not necessary to provide pain relief for insertion of an IUD/IUS, particularly in parous women. IUD providers should, however, realize that no woman likes to suffer from the insertion of an IUD. Severe discomfort may create a negative attitude towards the method. If the woman is anxious and fears pain (as most nulliparous women do), probably the most convenient, safe and effective method is to use local (intracervical) anesthesia using a dental syringe which can be applied with minimal risk in the office. In some women, the use of misoprostol 400 µg, 3 h prior to fitting of the IUD/IUS, may be useful to dilate the cervical canal. The popularity of the IUD could be much improved if attention is given to this aspect of IUD insertion. (author's) Language: English Keywords: BELGIUM | LITERATURE REVIEW | WOMEN | IUD, COPPER RELEASING | LEVONORGESTREL | SIDE EFFECTS | CONTRACEPTIVE METHODS | RESEARCH AND DEVELOPMENT | PERFORMANCE IMPROVEMENT | PROGRAM ACCEPTABILITY | INSERTION | Europe, Western | Europe | Developed Countries | Demographic Factors | Population | IUD | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Technology | Economic Factors | Management | Organization and Administration | Program Evaluation | Programs Document Number: 316967 |
| 22. Title: Uterine perforation by intrauterine devices and systems [letter] Author: Wildemeersch D Source: European Journal of Contraception and Reproductive Health Care. 2007 Jun;12(2):187-188. Abstract: Intrauterine devices (IUDs) are among the safest birth control methods. Copper-releasing IUDs act locally whereas the systemic absorption of the steroid from hormone-releasing intrauterine systems (IUSs) is so low that serious adverse effects on organs, such as the breast, liver and cardiovascular tissue, are improbable, in contrast with systemic hormonal methods (e.g. the Pill). Whereas the prescription of oral contraceptives is easy and does not require proficiency, IUDs and IUSs, on the contrary, must be correctly inserted and this demands expertise. Inadequate fitting may lead to bleeding and pain, and can result in either expulsion or unintended pregnancy. Improper insertion may also result in immediate or late perforation. With framed conventional IUDs, late perforation can occur even after a correct insertion, this being probably due to incompatibility between the device and the uterine cavity. (excerpt) Language: English Keywords: BELGIUM | CRITIQUE | WOMEN | FAMILY PLANNING ACCEPTORS | PHYSICIANS | IUD COMPLICATIONS | UTERINE PERFORATION | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Family Planning Programs | Family Planning | Health Personnel | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Perforations | Diseases Document Number: 317568 |
| 23. Title: Joining forces to combat sexual violence: the Brussels call to action. Source: UN Chronicle. 2006;:[6] p.. Abstract: For three days in June 2006, more than 250 dedicated women and men from some 30 countries came together at a historic symposium at Palais d'Egmont in Brussels to share experiences, strategies and a renewed commitment to end the scourge of sexual violence in countries torn apart by war. Conflict-related sexual violence is as old as war itself. In many conflicts, the bodies of women and girls become battlegrounds, with rape used as a weapon of war to humiliate, dominate or disrupt social ties in communities under attack. Women and girls, and sometimes men and boys, are also vulnerable to sexual assault and exploitation during flight, in refugee settlements and even in post-conflict situations, where continued sexual violence can perpetuate a cycle of anxiety and fear that may impede recovery and reconstruction. Until recently, its devastating effects on the health and well-being of survivors, communities and nations received little attention. But this is finally changing. The intensified media coverage of sexual atrocities committed in conflict zones-ranging from the former Yugoslavia and Rwanda to Sudan and the Democratic Republic of the Congo (DRC)-coupled with the cumulative impact of decades of research and advocacy by activists, have helped to galvanize a growing movement. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | BELGIUM | CONFERENCES AND CONGRESSES | WOMEN | CHILDREN | VIOLENCE | RAPE | SEXUAL EXPLOITATION | WAR | CARE AND SUPPORT | NATIONAL SECURITY | FOREIGN AID | Europe, Western | Europe | Developed Countries | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Behavior | Crime | Social Problems | Sociocultural Factors | Political Factors | Health Services | Delivery of Health Care | Health | Financial Activities | Economic Factors Document Number: 314980 |
| 24. Title: Personality, identity styles, and religiosity: an integrative study among late and middle adolescents. Author: Duriez B; Soenens B Source: Journal of Adolescence. 2006 Feb;29(1):119-135. Abstract: Past research has shown that the way people deal with religion is related to prejudice. Therefore, it is important to study the determinants of individual differences in adolescent religious attitudes. In the present study, it is proposed that both differences in personality and identity formation might determine these religious attitudes. Recently, Duriez, Soenens, and Beyers tested an integrative model of the Five Factor Model of personality, Berzonsky’s identity styles and the religiosity dimensions of Exclusion vs. Inclusion of Transcendence and Literal vs. Symbolic. In this model, it is assumed that the relationships between adolescent personality and adolescent religious attitudes are mediated by the identity styles. The aim was to replicate this model among late adolescents (Sample 1; N = 332) and to test whether it extends to middle adolescence (Sample 2; N = 323). Whereas most personality factors were weakly and inconsistently related to the religiosity dimensions, Openness to Experience was consistently positively related to Literal vs. Symbolic and negatively to Exclusion vs. Inclusion of Transcendence. Whereas the former relation was mediated by the informational identity style, the latter relation was mediated by the normative identity style in Sample 1 only. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | KAP SURVEYS | THEORETICAL MODELS | ADOLESCENTS | STUDENTS | PERSONALITY DEVELOPMENT | RELIGIOUS ASPECTS | SOCIAL DISCRIMINATION | ATTITUDES | UNIVERSITIES | Europe, Western | Europe | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Personality | Psychological Factors | Behavior | Religion | Sociocultural Factors | Social Problems | Schools Document Number: 300262 |
| 25. Peer Reviewed Title: Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial. Author: Kolibianakis EM; Papanikolaou EG; Camus M; Tournaye H; Van Steirteghem AC Source: Human Reproduction. 2006;21(2):352-357. Abstract: The objective of this randomized controlled trial was to assess the effect of oral contraceptive pill (OCP) pretreatment on the probability of ongoing pregnancy in patients treated with a GnRH antagonist for IVF. A fixed dose of 200 I recombinant FSH (rFSH) was started in 425 patients either on day 2 of the menstrual cycle (non-OCP group: n = 211) or 5 days after discontinuing the OCP (OCP group: n = 214). GnRH-antagonist was initiated on day 6 of stimulation, and triggering of final oocyte maturation was performed with 10,000 I of HCG. Ongoing pregnancy rates per started cycle in the non-OCP and OCP group were 27.5% and 22.9%, respectively [95% confidence interval (CI) of the difference: -3.7 to +12.8]. Pregnancy loss was significantly increased in the OCP (36.4%) compared with the non-OCP group (21.6%) (95% CI of the difference: -28.4 to -2.3). Pretreatment with OCP, as compared with initiation of stimulation on day 2 of the cycle in patients treated with GnRH antagonist and recombinant FSH, appears to be associated with a not significant difference in ongoing pregnancy rates per started cycle and results in a significantly higher early pregnancy loss. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | IN VITRO | FERTILIZATION | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES | ADMINISTRATION AND DOSAGE | PREGNANCY OUTCOMES | Developed Countries | Europe, Western | Europe | Research Methodology | Program Activities | Programs | Organization and Administration | Clinical Research | Reproduction | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Document Number: 297020 |
| 26. Peer Reviewed Title: Management of fever without source in young children presenting to an emergency room. Author: Massin MM; Montesanti J; Lepage P Source: Acta Paediatrica. 2006 Nov;95(11):1446-1450. Abstract: The management of fever without source in young children is controversial. The aim was to analyse the management approach in our paediatric emergency room, and to correlate it to existing practice guidelines. Methods: We indexed 2176 consecutive patients, aged 1 to 36 mo, seen in our emergency department because of fever = 38.5°C. Patients with chronic illness, recent antibiotic use, focal bacterial infection or typical viral illness were excluded, and the management approach of the remaining 376 patients was analysed. The most common final diagnosis was acute febrile illness (n = 228), whereas bacterial and viral infections were demonstrated in 120 and 28 patients, respectively. Most of the time, our residents correctly ordered complete blood count, chest radiograph and urinalysis in children for whom those investigations are recommended. A blood culture was rarely obtained, even in patients under empirical antibiotherapy. Residents often ordered chest radiograph and urinalysis in low-risk patients, and conflicted with guidelines when considering the prescription of empirical antibiotherapy. Their management allowed the early diagnosis and treatment of two pneumococcal bacteraemias, one meningococcal bacteraemia, seven urinary tract infections and 11 pneumonias, which would have been initially missed by strict adherence to the guidelines. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | MANAGEMENT | CHILD | FEVER | EMERGENCY SERVICES | HEALTH SERVICES | LABORATORY PROCEDURES | Developed Countries | Europe, Western | Europe | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Body Temperature | Physiology | Biology | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 306885 |
| 27. Title: [Serological detection of anti HPV 16 / 18 and its association with pap smear in adolescents and young women] Deteccao sorologica de anti-HPV 16 e 18 e sua associacao com os achados do papanicolaou em adolescentes e mulheres jovens. Author: Rama CH; Roteli-Martins CM; Derchain SF; de Oliveira EZ; Aldrighi JM Source: Revista da Associacao Medica Brasileira. 2006 Jan-Feb;52(1):43-47. Abstract: The objective was to verify the relation between HPV 16/18 antibodies and the association with cervical cytology findings in adolescents and young women. A cross sectional study with 541 healthy and sexually active women from 15 to 25 years of age was carried on from September to November 2000. At gynecological examination, a cervical sample on liquid-base for cytology-testing and a blood sample for ELISA identification of HPV 16 and 18 antibodies were collected and sent to a reference laboratory in Belgium. Statistical analysis estimated the prevalence and prevalence ratio with a 95% confidence interval. Of these young women, 150 (27.7%) were seropositive: 79 (14.6%) to HPV 16 antibody; 35 (6.4%) to HPV 18 antibody and 36 (6.6%) to both HPV 16/18 antibodies. Cytological abnormalities were detected in 107 cases (20.5%): 63 presented with atypical squamous cells of undetermined significance (ASCUS), 41 were suggestive of low grade squamous intra-epithelial lesion (LGSIL) and 3 of high grade squamous intraepithelial lesion (HGSIL). Prevalence of abnormal cytology with a positive serology was only 1.75 times that of prevalence of abnormal cytology with a negative serology. Detection of abnormal cytology was not correlated with positive serology. Results of this study indicate a high prevalence of HPV 16 and 18 in young healthy women which showed no relation to the abnormal findings of cytology smears. (author's) Language: Portuguese Keywords: BELGIUM | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | PAP SMEAR | HPV | CERVICAL EFFECTS | SCREENING | Europe, Western | Europe | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 316283 |
| 28. Peer Reviewed Title: The effect of fertility limitation on intergenerational social mobility: the quality-quantity trade-off during the demographic transition. Author: Van Bavel J Source: Journal of Biosocial Science. 2006 Jul;38(4):553-569. Abstract: The hypothesis that family size limitation by parents enhances the upward mobility chances of their children in (post)industrial populations has a long-standing record in many disciplines, including sociology and economics, as well as evolutionary anthropology and social biology. Yet the empirical record supporting or contradicting the theory is surprisingly limited. The aim of this contribution is to develop a test of the effect of family size limitation on children's intergenerational mobility. This test is applied to an urban population in Belgium that was in the process of experiencing its demographic transition, including the decline of fertility, at the end of the 19th century. The results indicate that the effect of family size was strong, even after controlling for parental social status as well as birth order. Surprisingly, the effects of birth order and family size appear to be largely independent. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | INTERGENERATIONAL TRANSFERS | DEMOGRAPHIC TRANSITION | FAMILY SIZE | SOCIAL MOBILITY | IMPACT | SOCIOLOGY | ECONOMICS | Europe, Western | Europe | Developed Countries | Microeconomic Factors | Economic Factors | Population Dynamics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Communication | Social Sciences | Science Document Number: 302362 |
| 29. Peer Reviewed Title: Uterine perforation in women using a levonorgestrel-releasing intrauterine system. Author: Van Houdenhoven K; van Kaam KJ; van Grootheest AC; Salemans TH; Dunselman GA Source: Contraception. 2006 Mar;73(3):257-260. Abstract: The objective was to determine an estimated incidence of uterine perforations related to the insertion of a levonorgestrel-releasing intrauterine system (LNG IUS) and to identify possible risk factors. Design: Retrospective, case report study. Setting: Hospitals in Limburg, the Netherlands. Methods: Gynecologists in hospitals in Limburg were asked about uterine perforations related to the insertion of a LNG IUS between 1999 and 2002. The charts of the reported perforations were studied. Data on the patient, doctor, insertion, diagnosis and removal were collected for every reported uterine perforation. In Limburg, the estimated incidence of uterine perforations related to the insertion of a LNG IUS is 2.6 per 1000 insertions. Insertion in lactating women, even beyond 6 weeks after delivery, was shown to be an important risk factor. Complete registration of complications provides a greater insight into the actual incidence of LNG IUS-related uterine perforations and their possible consequences. This may eventually lead to a decrease in complications. (author's) Language: English Keywords: BELGIUM | NETHERLANDS | RESEARCH REPORT | DATA COLLECTION | RETROSPECTIVE STUDIES | INCIDENCE | RISK ASSESSMENT | HOSPITALS | CLIENTS | WOMEN | UTERINE PERFORATION | IUD, HORMONE RELEASING | LEVONORGESTREL | INSERTION | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Measurement | Evaluation | Health Facilities | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Perforations | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services Document Number: 296217 |
| 30. Peer Reviewed Title: The profile of emergency contraception users in a chlamydia prevalence study in primary care in Belgium. Author: Verhoeven V; Peremans L; Avonts D; Van Royen P Source: European Journal of Contraception and Reproductive Health Care. 2006 Sep;11(3):175-180. Abstract: We describe the use of emergency contraception (EC) and its association with sociodemographic, contraceptive and behavioural characteristics in a sample of family practice attendants in Belgium. The study was part of a large Chlamydia trachomatis (CT) prevalence study in general practice. Sexually active women under 40 who consulted their general practitioner for routine gynaecological care were enrolled in the study. Participants completed a questionnaire on sociodemographic variables, urogenital symptoms, sexual history and sexual behaviour, and delivered a sample for CT testing. Logistic regression analysis was performed to identify determinants of a history of EC use in women in this sample. Of 815 questioned women, 23.5% had ever used EC. EC users were a heterogeneous group with respect to educational level, age and ethnicity. The use of emergency contraception was associated with the level of urbanisation, condom use, not having children yet, young age of first sexual intercourse, having had multiple partners in the past year, a history of unintended pregnancy, and current or previous STI. Information on availability and correct use of EC, and on the need for additional testing for STI, are necessary to help primary care attendees to preserve their future reproductive health. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | STATISTICAL REGRESSION | CLIENTS | EMERGENCY CONTRACEPTION | CHLAMYDIA | PRIMARY HEALTH CARE | CONTRACEPTIVE USAGE DETERMINANTS | EDUCATIONAL STATUS | CONDOM USE | AGE FACTORS | Developed Countries | Europe, Western | Europe | Data Analysis | Research Methodology | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Health Services | Delivery of Health Care | Health | Contraceptive Usage | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Risk Reduction Behavior | Behavior | Population Characteristics | Demographic Factors | Population Document Number: 307163 |
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