1.  Peer Reviewed Title: Safety analysis of the diaphragm in combination with lubricant or acidifying microbicide gels: effects on markers of inflammation and innate immunity in cervicovaginal fluid. Author: Anderson DJ; Williams DL; Ballagh SA; Barnhart K; Creinin MD; Newman DR; Bowman FP; Politch JA; Duerr AC; Jamieson DJ Source: American Journal of Reproductive Immunology. 2009 Feb;61(2):121-9. Abstract: OBJECTIVE: Diaphragms are being considered for use with vaginal microbicide gels to provide enhanced protection against sexually transmitted pathogens. The purpose of this study was to determine whether use of a diaphragm with microbicide or placebo gel causes cervicovaginal inflammation or perturbations in cervicovaginal immune defense. METHOD OF STUDY: Eighty-one non-pregnant women were randomized into three groups and instructed to use Milex (CooperSurgical, Inc., Trumbull, CT, USA)diaphragms overnight for 14 days in combination with one of the two acid-buffering microbicide gels [ACIDFORM (Instead Inc., La Jolla, CA, USA) or BufferGel(trade mark) (BG; ReProtect Inc., Baltimore, Maryland)] or placebo gel (K-Y Jelly); Personal Products Inc., Raritan, NJ, USA). Cervicovaginal lavages (CVLs) were performed prior to study entry and on days 8 and 16. Nine soluble mediators of vaginal inflammation or immune defense were measured in CVLs by Bio-Plex or ELISA. RESULTS: Use of diaphragms with placebo ormicrobicide gel was not associated with increased levels of inflammation markers. Concentrations of secretory leukocyte protease inhibitor (SLPI) were markedly reduced in the BG group. CONCLUSION: Daily use of a diaphragm with placebo or acidifying microbicide gel did not cause cervicovaginal inflammation. However, diaphragm/BG use was associated with markedly reduced levels of SLPI, an important mediator of innate immune defense. Further studies are warranted to establish the safety of diaphragm/microbicide gel combinations. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CASE CONTROL STUDIES | MICROBICIDES | VAGINAL GEL | LUBRICANTS | IMMUNITY, NATURAL | CONTRACEPTIVE SAFETY | VAGINAL DIAPHRAGM | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Studies | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Ingredients and Chemicals | Immunity | Immune System | Physiology | Biology | Safety | Public Health | Vaginal Barrier Methods | Barrier Methods Document Number: 330234 |
| 2. Title: Combined oral contraceptive use and the risk of systemic lupus erythematosus. Author: Bernier MO; Mikaeloff Y; Hudson M; Suissa S Source: Arthritis and Rheumatism. 2009 Mar 30;61(4):476-481. Abstract: OBJECTIVE: To assess whether the risk of incident systemic lupus erythematosus (SLE) is associated with the use of combined oral contraceptives (COCs), because studies of the link between exogenous hormonal exposure and the risk of SLE have produced conflicting results. METHODS: We conducted a population-based nested case-control study among women ages 18-45 years, using the UK's General Practice Research Database. All incident cases of SLE from 1994-2004 (n = 786) were identified in the database and matched with up to 10 controls (n = 7,817) among women without SLE at the time of the case's diagnosis. RESULTS: The adjusted rate ratio (RR) of incident SLE associated with any use of COC was 1.19 (95% confidence interval [95% CI] 0.98-1.45), whereas with current use it was 1.54 (95% CI 1.15-2.07). The rate was particularly increased in current users who had only recently started COC use (RR 2.52, 95% CI 1.14-5.57) compared with longer-term current users (RR 1.45, 95% CI 1.06-1.99). The risk appearedto be particularly elevated with current exposure to first- or second-generation contraceptives (RR 1.65, 95% CI 1.20-2.26), and increasing with the dose of ethinyl estradiol (RR 1.42, 1.63, and 2.92 for Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CASE CONTROL STUDIES | LONGITUDINAL STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | SYSTEMIC LUPUS ERYTHEMATOSUS | PREVALENCE | RISK FACTORS | RISK ASSESSMENT | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Diseases | Measurement | Health | Evaluation Document Number: 330926 |
| 3. Title: Progestogen-only contraceptives and the risk of stroke: a meta-analysis. Author: Chakhtoura Z; Canonico M; Gompel A; Thalabard JC; Scarabin PY; Plu-Bureau G Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1059-62. Abstract: BACKGROUND AND PURPOSE: The association between combined oral contraceptives (OC) use and increased risk of stroke has been reported. While progestogen-only contraceptives (POC) are commonly used worldwide, their impact on cardiovascular disease remains unclear. METHODS: A meta-analysis based on EMBASE and MEDLINE referenced literature corresponding to OCs marketed since 1960 was carried out. Eligible articles assessing the risk of stroke in relation to OC or POC were reviewed, and relevant studies were extracted. All types of POC and routes of administration were taken into account in the meta-analysis. RESULTS: Six case-control studies were identified. The combined odd ratio (OR) showed no increase in the risk of stroke among POC users (OR=0.96; 95% confidence interval: 0.70 to 1.31). This result was similar according to the route of administration (either implant or injectable or oral POC). CONCLUSIONS: Data from observational studies show that POC use is not associated with an increased risk of stroke. However, these results are based on limited data. Further investigations are needed in women with risk factors of stroke. Language: English Keywords: FRANCE | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | RISK ASSESSMENT | CEREBROVASCULAR EFFECTS | CONTRACEPTIVE IMPLANTS | INJECTABLES | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Measurement | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Evaluation | Physiology | Biology | Contraceptive Methods Document Number: 331085 |
| 4. Title: Risk factors for triple-negative breast cancer in women under the age of 45 years. Author: Dolle JM; Daling JR; White E; Brinton LA; Doody DR; Porter PL; Malone KE Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Apr;18(4):1157-66. Abstract: Little is known about the etiologic profile of triple-negative breast cancer (negative for estrogen receptor/progesterone receptor/human epidermal growth factor), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook this study to assess the risk for triple-negative breast cancer among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive use. Study participants were ascertained in two previous population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20 to 45 years in the Seattle-Puget Sound area, diagnosed between January 1983 and December 1992, for whom complete data was obtained for estrogen receptor, progesterone receptor, and human epidermal growth factor status (n = 897; including n = 187 triple-negative breast cancer cases). Controls were age matched and ascertained via random digit dialing. Oral contraceptive use > or =1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (P(heterogeneity) = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (P(heterogeneity) = 0.02 and 0.01, respectively). Among women < or =40 years, the relative risk for triple-negative breast cancer associated with oral contraceptive use > or =1 year was 4.2 (95% confidence interval, 1.9-9.3), whereas there was no significantly increased risk with oral contraceptive use for non-triple-negative breast cancer among women < or =40 years, nor for triple-negative breast cancer or non-triple-negative breast cancer among women 41 to 45 years of age. In conclusion, significant heterogeneity exists for the association of oral contraceptiveuse and breast cancer risk between triple-negative breast cancer and non-triple-negative breast cancer among young women, lending support to a distinct etiology. Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | CASE CONTROL STUDIES | BREAST CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TIME FACTORS | AGE FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 341655 |
| 5. Title: Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy. Author: Epplein M; Reed SD; Voigt LF; Newton KM; Holt VL; Weiss NS Source: Annals of Epidemiology. 2009 Jan;19(1):1-7. Abstract: PURPOSE: We sought to examine the relationship between recent use of oral contraceptives and hormone therapy and endometrial hyperplasia (EH) risk. METHODS: Cases comprised women diagnosed with complex EH (n = 289) or atypical EH (n = 173) between 1985 and 2003. One age-matched control was selected for each case; excluded were women with a prior hysterectomy or diagnosis of EH or endometrial cancer. Hormone use in the 6 months prior to the date of the case's first symptoms was ascertained using a pharmacy database and medical records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Three (1.1%) cases had used oral contraceptives, compared to 16 (6.0%) controls (OR = 0.2, 95% CI: 0.0-0.6). Fifty-one (16.8%) cases had taken estrogen-only hormone therapy, in contrast to two (0.7%) controls (OR = 37.6, 95% CI: 8.8-160.0). The risk of EH among estrogen plus progestin hormone users did not differ from that of non-users (OR = 0.7, 95% CI: 0.4-1.1). CONCLUSIONS: This study suggests that previous findings of the association of estrogen-only hormone therapy with increased risk of EH and the lack of an association between estrogen plus progestin hormone therapy and EH risk are likely to apply to both complex EH and atypical EH. Further examination of the association between oral contraceptives and EH, with greater numbers of OC users, is warranted. Language: English Keywords: WASHINGTON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | ENDOMETRIAL CANCER | HORMONE REPLACEMENT THERAPY | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Measurement | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Population Dynamics | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods Document Number: 330386 |
| 6. Peer Reviewed Title: Mobilizing men as partners: the results of an intervention to increase dual protection among Nigerian men. Author: Exner TM; Mantell JE; Adeokun LA; Udoh IA; Ladipo OA; Delano GE; Faleye J; Akinpelu K Source: Health Education Research. 2009 Apr 9; Abstract: This quasi-experimental, proof-of-concept study evaluated the effects of an intervention designed to help Nigerian men decrease risk for HIV/sexually transmitted infections and unintended pregnancy. The intervention was delivered in groups during two 5-hour workshops, with a monthly 2-hour check-in session. A comparison condition consisted of a group-based half-day didactic workshop. Based on recruitment area, 149 men were assigned to the intervention and 132 to the comparison. Men were evaluated at baseline and 3-month post-intervention. At follow-up, men assigned to the intervention were almost four times more likely than comparison men to report condom use at last intercourse (P < 0.001) and to report fewer unprotected vaginal sex occasions, greater self-efficacy for negotiation, a more egalitarian power dynamic in their primary relationship, more positive expectations for condom use and greater intention for future consistent condom use (all P values < 0.05). Findings suggest that this intervention is both feasible and effective. Language: English Keywords: NIGERIA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | MEN | SEXUAL PARTNERS | MEN'S INVOLVEMENT | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | CONTRACEPTIVE USAGE | WORKSHOPS | PARTNER COMMUNICATION | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Contraception | Family Planning | Education | Interpersonal Relations Document Number: 341487 |
| 7. Peer Reviewed Title: Contraceptive use, birth spacing, and autonomy: an analysis of the Oportunidades program in rural Mexico. Author: Feldman BS; Zaslavsky AM; Ezzati M; Peterson KE; Mitchell M Source: Studies in Family Planning. 2009 Mar;40(1):51-62. Abstract: Oportunidades, a conditional cash-transfer program instituted in Mexico in 1997, provides cash incentives to mothers to invest in the health and education of family members. Drawing from data gathered by Mexico's National Institute of Public Health, this study assesses the effect of the program on contraceptive use and birth spacing among titulares (female household heads) living in rural areas during the experimental period, 1998-2000, and during 2000-03, after incorporation of the control group. In 2000, titulares were more likely to use modern contraceptives than were women in the control group, although by 2003 all beneficiaries had the same probability of use. Change in autonomy was not a mediator, although baseline autonomy modified the program's influence on contraceptive use. Cox proportional hazard models produced estimates that birth spacing was similar between the beneficiaries and controls. Inconsistent findings may be the result of the way contraceptive use was defined in this study. Findings from this study may be useful for helping program planners better understand the role of conditional cash transfers in modifying family planning and fertility among poor rural women in Latin America. Language: English Keywords: MEXICO | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | CASE CONTROL STUDIES | RURAL POPULATION | MOTHERS | WOMEN IN DEVELOPMENT | HEAD OF HOUSEHOLD | BIRTH SPACING | CONTRACEPTIVE USAGE | INCENTIVES | HOME ECONOMICS | North America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Households | Family Planning | Contraception | Policy | Political Factors | Microeconomic Factors Document Number: 331287 |
| 8. Peer Reviewed Title: Effectiveness of contraceptive counselling of women following an abortion: a systematic review and meta-analysis. Author: Ferreira AL; Lemos A; Figueiroa JN; de Souza AI Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):1-9. Abstract: OBJECTIVE: To perform a systematic review of the effectiveness of contraceptive counselling in women undergoing an abortion and its impact on the acceptance and use of contraceptive methods. METHODS: Randomized controlled trials (RCTs) assessing women who had undergone an abortion and received contraceptive counselling at that time met the inclusion criteria. Articles published between 1997 and 2007 were selected from searches of the LILACS, SCIELO, MEDLINE, PubMed and Cochrane Library databases. Two reviewers independently assessed eligibility and the quality of the trial. The internal validity of the RCTs was evaluated by means of the Jadad scale. A meta-analysis of the three retained studies involving 694 women was performed. The Stata 9.2 SE statistical software was used, and a level of significance of 0.05 adopted. RESULTS: There were no differences between intervention and control groups, despite clinical heterogeneity. The results of the meta-analysis were not significant (OR = 1.32; CI: 0.90-1.94). CONCLUSION: There was no evidence indicating that contraceptive counselling is effective in increasing acceptance and use of contraceptive methods after an abortion. This may not apply to developing countries, where the matter still needs to be investigated. Language: English Keywords: BRAZIL | LITERATURE REVIEW | CASE CONTROL STUDIES | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN | COUNSELING | FAMILY PLANNING EDUCATION | POSTABORTAL PROGRAMS | CONTRACEPTIVE USAGE | ACCEPTANCE PROCESS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Family Planning Surveys | Family Planning | Demographic Factors | Population | Clinic Activities | Program Activities | Programs | Organization and Administration | Education | Family Planning Programs | Contraception | Decision Making | Behavior Document Number: 330347 |
| 9. Peer Reviewed Title: Community-based promotional campaign to improve uptake of intermittent preventive antimalarial treatment in pregnancy in Burkina Faso. Author: Gies S; Coulibaly SO; Ky C; Ouattara FT; Brabin BJ; D'Alessandro U Source: American Journal of Tropical Medicine and Hygiene. 2009 Mar;80(3):460-9. Abstract: Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae and secundigravidae and evaluated factors associated with antenatal clinic (ANC) attendance and uptake of IPTp-SP. With promotion, 64.2% completed > or = 3 ANC visits compared with 44.7% without (P = 0.05). Complete uptake of IPTp-SP was 71.8% with and 49.1% without promotion (P = 0.008). The IPTp-SP uptake was lowest in adolescents delivering during high malaria transmission with (29%) or without promotion (30%). Uptake of SP was higher during the low transmission season than in the high transmission season (adjusted odds ratio = 2.17, 95% confidence interval = 1.59-3.03). Community sensitization increased ANC attendance and IPTp-SP uptake. Adolescents were the most difficult to reach, particularly during the high malaria transmission period. The impact of IPTp-SP will be limited unless this high risk group is protected. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | COMMUNITY | ANTIMALARIAL DRUGS | PROMOTION | CAMPAIGNS | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | PREVENTIVE MEDICINE | UTILIZATION OF HEALTH CARE | AGE FACTORS | SEASONAL VARIATION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Residence Characteristics | Population Distribution | Geographic Factors | Malaria | Parasitic Diseases | Diseases | Marketing | Communication Programs | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Medicine | Population Dynamics Document Number: 331127 |
| 10. Peer Reviewed Title: A 15-Minute Interactive, Computerized Condom Use Intervention With Biological Endpoints. Author: Grimley DM; Hook EW 3rd Source: Sexually Transmitted Diseases. 2009 Feb;36(2):73-78. Abstract: BACKGROUND:: Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. METHODS:: Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. RESULTS:: The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). CONCLUSIONS:: These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff. Language: English Keywords: ALABAMA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | STATISTICAL REGRESSION | THEORETICAL MODELS | BLACKS | COMPUTER PROGRAMS AND PROGRAMMING | GONORRHEA | CHLAMYDIA | CONDOM USE | AUDIOVISUAL AIDS | TIME FACTORS | RISK ASSESSMENT | CONTRACEPTIVE PREVALENCE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Educational Methods | Educational Activities | Education | Population Dynamics | Evaluation | Contraceptive Usage | Contraception | Family Planning Document Number: 329674 |
| 11. Peer Reviewed Title: Depot-medroxyprogesterone acetate and combined oral contraceptive use and cervical neoplasia among women with oncogenic human papillomavirus infection. Author: Harris TG; Miller L; Kulasingam SL; Feng Q; Kiviat NB; Schwartz SM; Koutsky LA Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):489.e1-8. Abstract: OBJECTIVE: The objective of the study was to examine the relationship of depot-medroxyprogesterone acetate (DMPA) and combined oral contraceptive (COC) use with cervical intraepithelial neoplasia (CIN). STUDY DESIGN: Two case-control studies of women who presented for gynecologic care and underwent cytologic and human papillomavirus (HPV) testing were performed. The first included oncogenic HPV-positive women grouped based on histology: negative (n = 152), CIN1 (n = 133), and CIN2-3 or greater (n = 173). For the second, 2 groups were identified: negative HPV/negative histology (n = 107) and positive oncogenic HPV/negative histology (n = 152). RESULTS: Among oncogenic HPV-positive women, DMPA use was inversely associated with CIN2-3 or greater (adjusted odds ratio [OR(adj)], 0.4; 95% confidence interval [CI], 0.2-1.1) and CIN1 (OR(adj), 0.1; 95% CI, 0.01-0.6); COC use was not associated with either. Among histologically negative women, DMPA use was associated with oncogenic HPV (OR(adj), 4.7; 95% CI, 1.4-15.8). CONCLUSION: Among women with oncogenic HPV, hormonal contraceptive use was not associated with an increased risk of CIN2-3 or greater. Longer-term DMPA use may attenuate the colposcopic and histologic features of CIN because women reporting such use were more likely than others to have cervical oncogenic HPV without evidence of CIN. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | HPV | CERVICAL CANCER | RISK FACTORS | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | RISK ASSESSMENT | COLPOSCOPY | HISTOLOGY | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Measurement | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Evaluation | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Biology Document Number: 331078 |
| 12. Title: Estrogens, oral contraceptives and hormonal replacement therapy increase the incidence of cutaneous melanoma: a population-based case-control study. Author: Koomen ER; Joosse A; Herings RM; Casparie MK; Guchelaar HJ; Nijsten T Source: Annals of Oncology. 2009 Feb;20(2):358-64. Abstract: BACKGROUND: Multiple studies showed conflicting results on the association between oral contraceptive (OC) use and the development of cutaneous melanoma (CM). We investigated the association between estrogen use and CM incidence. PATIENTS AND METHODS: Data from PHARMO Pharmacy database and PALGA, the pathology database in The Netherlands, were linked. Women, >or=18 years, with a pathology report of a primary CM from 1 January 1991 to 14 December 2004 and >or=3 years of follow-up before CM diagnosis were eligible cases. Controls were matched for age and geographic region. Multivariate logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between CM incidence and estrogen use, OCs and hormonal replacement therapy (HRT), separately. RESULTS: In total, 778 cases and 4072 controls were included. CM risk was significantly associated with estrogen use (>or=0.5 year; adjusted OR = 1.42, 95% CI 1.19-1.69). This effect was cumulative dose dependent (P trend < 0.001). CM risk was also significantly associated with the use of HRT (>or=0.5 year: OR = 2.08; 95% CI 1.37-3.14) and OC (>or=0.5 year: OR = 1.28; 95% CI 1.06-1.54). CONCLUSION: Our study suggests a cumulative dose-dependent increased risk of CM with the use of estrogens. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | MULTIVARIATE ANALYSIS | EPIDEMIOLOGIC METHODS | CASE CONTROL STUDIES | WOMEN | ESTROGENS | CONTRACEPTIVE AGENTS, ESTROGEN | PREVALENCE | DERMATOLOGICAL EFFECTS | CANCER | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | HORMONE REPLACEMENT THERAPY | ADMINISTRATION AND DOSAGE | Europe, Western | Europe | Developed Countries | Research Methodology | Data Analysis | Studies | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Measurement | Neoplasms | Diseases | Safety | Public Health | Health | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Drugs Document Number: 331000 |
| 13. Peer Reviewed Title: Peer-group support intervention improves the psychosocial well-being of AIDS orphans: cluster randomized trial. Author: Kumakech E; Cantor-Graae E; Maling S; Bajunirwe F Source: Social Science and Medicine. 2009 Mar;68(6):1038-43. Abstract: Accumulating evidence suggests that AIDS orphanhood status is accompanied by increased levels of psychological distress such as anxiety, depression, intense guilt, shame, and anger. However, few studies have examined the possible reduction of psychological distress in AIDS orphans through the help of interventions that promote well-being. The objective of the study was to evaluate the effects of a school-based peer-group support intervention combined with periodic somatic health assessments and treatment on the psychosocial well-being of AIDS orphans in the Mbarara District of southwestern Uganda. In a cluster randomized controlled design, 326 AIDS orphans aged 10-15 years were assigned to either peer-group support intervention combined with monthly somatic healthcare (n=159) or control group (n=167) for follow-up assessment. Baseline and 10 week follow-up psychological assessments were conducted in both groups using self-administered Beck Youth Inventories. Complete data were available for 298 orphans. After adjusting for baseline scores, follow-up scores for the intervention group in comparison with controls showed significant improvement in depression, anger, and anxiety but not for self-concept. This study demonstrated that peer-group support intervention decreased psychological distress, particularly symptoms of depression, anxiety and anger. Thus, the use of peer-group support interventions should be incorporated into existing school health programs. Language: English Keywords: UGANDA | EVALUATION REPORT | KAP SURVEYS | CASE CONTROL STUDIES | ORPHANS AND VULNERABLE CHILDREN | PEER GROUPS | SUPPORT GROUPS | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | AIDS | STRESS | DEPRESSION | ANXIETY DISORDERS | SELF ESTEEM | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Knowledge Sources | Communication | Social Networks | Friends and Relatives | HIV Infections | Viral Diseases | Diseases | Behavior | Psychological Factors | Mental Disorders Document Number: 341167 |
| 14. Title: Risk-taking behaviour is more frequent in teenage girls with multiple sexual partners. Author: Kuortti M; Kosunen E Source: Scandinavian Journal of Primary Health Care. 2009;27(1):47-52. Abstract: OBJECTIVE: To investigate associations between sexual behaviour and risk-taking health behaviour among adolescent females in our changing sexual culture. DESIGN: A questionnaire study. Girls who had had multiple sexual partners (at least five in their lifetime or four during the last six months) were compared with those with fewer partners. Logistic regression was applied. SETTING: The Adolescent Clinic, a primary healthcare unit in the city of Tampere, Finland. SUBJECTS: A sample of 247 female clients aged 15-18 years who had experienced sexual intercourse. MAIN OUTCOME MEASURES: Contraceptive practices, substance use, and sexual attitudes. RESULTS: Girls with multiple sexual partners (n = 69) and the reference group (n = 178) did not differ from each other significantly by age, age at menarche, or educational status. In univariate analysis, age at sexual debut, contraceptive practices, and various substance uses were strongly associated with having multiple sexual partners. Ever-use of emergency contraception was marginally associated, while ever-use of conventional hormonal contraception or condoms was not. In multivariate analysis, low age at sexual debut (OR 8.75 for age 11-13), omitting contraception at the most recent intercourse (OR 3.48), ever-use of withdrawal as a contraceptive method (OR 2.34), and repeated use of drugs (OR 4.10) were associated with having multiple sexual partners. CONCLUSION: Different types of risk-taking behaviour are still interlinked. In discussions with adolescents showing one type of risk behaviour health service providers should make an effort to identify other modes of risk-taking. Language: English Keywords: FINLAND | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | CASE CONTROL STUDIES | ADOLESCENTS, FEMALE | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | FIRST INTERCOURSE | ATTITUDES | DRUG USE AND ABUSE | CONTRACEPTIVE USAGE | CONDOM USE | Europe, Northern | Europe | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Psychological Factors | Contraception | Family Planning | Risk Reduction Behavior Document Number: 330352 |
| 15. 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 |
| 16. Peer Reviewed Title: Adrenal glucocorticoid and androgen precursor dissociation in anorexia nervosa. Author: Lawson EA; Misra M; Meenaghan E; Rosenblum L; Donoho DA; Herzog D; Klibanski A; Miller KK Source: Journal of Clinical Endocrinology and Metabolism. 2009 Apr;94(4):1367-71. Abstract: CONTEXT: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs. OBJECTIVE: The aim of the study was to determine whether adrenal steroidogenesis dysregulation contributes to decreased androgen levels in anorexia nervosa. Design and Setting: We conducted a cross-sectional study in a General Clinical Research Center. STUDY PARTICIPANTS: We studied 20 women with anorexia nervosa [10 women with anorexia nervosa receiving OCPs (AN+E) and 10 not receiving OCPs (AN-E)] and 20 healthy controls [10 healthy controls receiving OCPs (HC+E) and 10 not receiving OCPs (HC-E)]. MAIN OUTCOME MEASURES: We measured DHEA and cortisol levels in response to 250-microg cosyntropin stimulation after 1-mg overnight dexamethasone suppression. RESULTS: Mean basal and stimulated, peak stimulated, and area under the curve (AUC) cortisol levels were higher in AN-E than HC-E, but mean basal and stimulated, peak and AUC DHEA were comparable. Mean AUC and peak cortisol were higher and DHEA AUC was lower in AN+E than AN-E. However, after controlling for cortisol binding globulin levels, peak and AUC cortisol were comparable between AN+E and AN-E. After controlling for albumin levels, AUC DHEA was comparable between AN+E and AN-E. CONCLUSIONS: Adrenal glucocorticoid and androgen precursor secretion are dissociated in anorexia nervosa, with relative hypercortisolemia and a preservation of DHEA secretion. Reduced DHEA response to cosyntropin in women receiving OCPs is attributable to decreased albumin levels. In the setting of relative hypercortisolemia, reduced adrenal androgen precursor secretion is not a mechanism underlying low testosterone levels in anorexia nervosa. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN | DEFICIENCY DISEASES | BODY WEIGHT | TESTOSTERONE | ORAL CONTRACEPTIVES, SIDE EFFECTS | DEHYDROEPIANDROSTERONE | ANDROGENS | DEXAMETHASONE ACETATE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | Hormones | Endocrine System | Contraceptive Safety | Safety | Public Health | Health Document Number: 341132 |
| 17. Title: Involution of latent endometrial precancers by hormonal and nonhormonal mechanisms. Author: Lin MC; Burkholder KA; Viswanathan AN; Neuberg D; Mutter GL Source: Cancer. 2009 May 15;115(10):2111-8. Abstract: BACKGROUND: Inactivation of the PTEN suppressor gene has been shown to occur in the majority of endometrial cancer cases. Somatic PTEN inactivation by deletion and/or mutation, the first detectible change of endometrial carcinogenesis, has been reported to occur at a high frequency in the endometrium of normal premenopausal women, although few of these cases progress to cancer. It was hypothesized that the 50% to 60% reduced cancer risk attributed to oral contraceptives (OCPs) and intrauterine devices (IUDs) occurred in part through their activity as negative selection factors for these subclinical mutated glands. METHODS: A total of 71 women with a history of OCP use and 80 with a history of IUD use were age matched with 191 and 119 controls, respectively. Endometrial biopsy specimens were immunostained for PTEN, and each was scored for the presence or absence of PTEN-null glands (latent precancer). RESULTS: The frequency of latent precancers was found to be significantly reduced in OCP-exposed (13%; odds ratio [OR], 0.19 [P < .001]) and IUD-exposed (18%; OR, 0.42 [P = .015]) women compared with respective matched controls (43% and 34%). The presence or absence of endometritis did not appear to be significantly correlated with PTEN status within the IUD-exposed group (P = .24). CONCLUSIONS: Normal-appearing PTEN mutated endometrial glands, which are highly prevalent in the normal population, may be targets of endometrial cancer risk-modulating exposures. Some exposures reported to diminish the incidence of endometrial cancer in epidemiologic outcome studies, including OCP and IUD use, are associated with a proportionate decline in the frequency of latent precancers. Involution of pre-existing endometrial latent precancers, as evaluated by PTEN analysis, may provide an accessible surrogate marker for long-term endometrial cancer risk. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | ENDOMETRIAL CANCER | RISK FACTORS | ENDOMETRITIS | HISTOLOGY | ORAL CONTRACEPTIVES | IUD | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Reproductive Tract Infections | Infections | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 341658 |
| 18. Peer Reviewed Title: Both a combined oral contraceptive and depot medroxyprogesterone acetate impair endothelial function in young women. Author: Lizarelli PM; Martins WP; Vieira CS; Soares GM; Franceschini SA; Ferriani RA; Patta MC Source: Contraception. 2009 Jan;79(1):35-40. Abstract: BACKGROUND: The study was conducted to determine whether the use of a combined oral contraceptive (COC) or depot medroxyprogesterone acetate (DMPA) interferes with endothelial function. STUDY DESIGN: The study was conducted on 100 women between the ages of 18 and 30 years. Fifty women had not used hormonal contraception (control group) for at least 12 months, 25 were current users of a COC (ethinylestradiol 30 mcg+levonorgestrel 150 mcg) and 25 were current users of DMPA (150 mg) for at least a 6-month period. All women were evaluated for brachial flow-mediated dilation (FMD), intima-media thickness, carotid distensibility and stiffness index, arterial pressure, body mass index, waist circumference, heart rate and lipid profile. RESULTS: A significant difference in FMD was observed between the COC and control groups (6.4+/-2.2% vs. 8.7+/-3.4%, p<.01) and between the DMPA and control groups (6.2+/-2.1% vs. 8.7+/-3.4%, p<.01). The DMPA group had lower values of total cholesterol (TC) and low-densitylipoprotein (LDL-C) than COC users and the control group (TC: DMPA=139.9+/-21.5 mg/dL vs. controls=167.1+/-29.2 mg/dL vs. COC=168.2+/-37.5, p=.001; LDL-C: DMPA=85.3+/-20.1 mg/dL vs. controls=102+/-24.5 mg/dL vs. COC=106.7+/-33.3 mg/dL, p=.01). The control group had higher levels of high-density lipoprotein (HDL-C) than the DMPA and COC groups (controls=52.4+/-14.1 mg/dL vs. DMPA=42.2+/-7.2 mg/dL vs. COC=45.4+/-9.1 mg/dL, p=.001). No significant differences were observed regarding the other variables. CONCLUSIONS: FMD was lower among COC and DMPA users, suggesting that these hormonal contraceptives may promote endothelial dysfunction. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EVALUATION INDEXES | WOMEN IN DEVELOPMENT | ORAL CONTRACEPTIVES, COMBINED | DEPO-PROVERA | SIDE EFFECTS | HEALTH STATUS INDEXES | CHOLESTEROL | ADMINISTRATION AND DOSAGE | BLOOD PRESSURE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Economic Development | Economic Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Physiology | Biology | Drugs | Hemic System Document Number: 330537 |
| 19. Peer Reviewed Title: Theory-based strategies for improving contraceptive use: a systematic review. Author: Lopez LM; Tolley EE; Grimes DA; Chen-Mok M Source: Contraception. 2009 Jun;79(6):411-7. Abstract: BACKGROUND: Theories and models help explain how behavior change occurs. We systematically reviewed randomized controlled trials that examined theory-based interventions for improving contraceptive use. STUDY DESIGN: We searched electronic databases for eligible trials. Primary outcomes included pregnancy and contraceptive use. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. RESULTS: Of 14 included trials, 10 showed positive results for a theory-based group: 2 of 10 studies with pregnancy or birth data, 4 of 9 addressing contraceptive use (for contraception) and 5 of 9 with condom use (to prevent HIV/sexually transmitted infections). An experimental group had favorable results for six of seven trials based on Social Cognitive Theory, two based on other social cognition models and two using motivational interviewing. Most interventions focused on adolescents and involved multiple sessions. CONCLUSIONS: Effects were not consistent across outcomes and comparisons. The field could benefit from thorough use of single theories and better reporting on intervention implementation. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | THEORETICAL STUDIES | CASE CONTROL STUDIES | KAP SURVEYS | THEORETICAL MODELS | WOMEN | ADOLESCENTS | CONTRACEPTIVE USAGE | CONDOM USE | CONTRACEPTIVE EFFECTIVENESS | SEXUALLY TRANSMITTED DISEASE PREVENTION | MOTIVATION | TIME FACTORS | PROGRAM DESIGN | Developed Countries | North America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors | Population Dynamics | Programs | Organization and Administration Document Number: 341105 |
| 20. Peer Reviewed Title: Feeding and nutritional characteristics of infants on PMTCT programs. Author: Magezi SR; Kikafunda J; Whitehead R Source: Journal of Tropical Pediatrics. 2009 Feb;55(1):32-5. Abstract: OBJECTIVES: To compare feeding and nutritional characteristics of infants born to mothers on the prevention of mother to child transmission (PMTCT) programs with infants not in the program. DESIGN: A hospital-based case-control study was used. SETTING: The study was conducted in Nsambya hospital, Kampala, Uganda. SUBJECTS: A total of 176 mother/baby pairs were included in the study with 88 from each group. Infants were aged from 3 to 12 months. RESULTS: The percentage of mothers exclusively breastfeeding was lower in PMTCT mothers (65%) compared to the 98% in non-PMTCT mothers (p < 0.01). The mean duration of breastfeeding was 2.5 months among PMTCT mothers compared to 4.1 months in non-PMTCT mothers (p < 0.01). Dietary diversity score (DDS) was higher among PMTCT babies (4.3) compared to 3.7 among non-PMTCT babies (p < 0.05). The percentage of babies reported ill in the previous month was much higher among the PMTCT infants (79%) compared to the non-PMTCT infants (69%) and the incidence of diarrhoea was almost twice as high among the PMTCT infants (18.1%) compared to the 9.3% in non-PMTCT infants [risk ratio (RR) = 1.94]. In addition, the incidence of respiratory infections was higher among the PMTCT infants (47.7%) compared to 39.5% in the non-PMTCT infants (RR = 1.2). The mean z-scores: [Weight for age z-score (WAZ)] [height for age z-score (HAZ)] and [weight for height z-score (WHZ)] were significantly lower (p < 0.01) for PMTCT infants. The incidence of stunting among PMTCT infants (11.8%) was twice that of the non-PMTCT ones (5.2%) and incidence of underweight was 8.4% in the PMTCT infants compared to 1.2% in the non-PMTCT ones. CONCLUSIONS: The feeding patterns of the PMTCT infants were significantly different from the non-PMTCT ones both in terms of breastfeeding and DDS. Although DDS was higher among the PMTCT infants it did not translate into better nutritional status. The higher incidence of morbidity combined with the lower incidence of breastfeeding among the PMTCT infants are some of the contributing factors to significantly higher levels of malnutrition. Language: English Keywords: UGANDA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EPIDEMIOLOGIC METHODS | INFANT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | INFANT NUTRITION | BREASTFEEDING, EXCLUSIVE | PREVALENCE | DIARRHEA | BODY WEIGHT | MALNUTRITION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Nutrition | Health | Breastfeeding | Measurement | Physiology | Biology | Nutrition Disorders Document Number: 330403 |
| 21. Title: Voice onset time in women as a function of oral contraceptive use. Author: Morris RJ; Gorham-Rowan MM; Herring KD Source: Journal of Voice. 2009 Jan;23(1):114-8. Abstract: Previous studies of the effect of hormonal changes across phases of the menstrual cycle on voice onset time (VOT) have not considered the variable of oral contraceptive use. The purpose of this study was to examine both the effects of menstrual cycle phase and that of oral contraceptive use on VOT. It was hypothesized that women taking oral contraceptives would exhibit smaller VOT differences across the phases of their menstrual cycles. The study was a prospective matched-group experimental design. Participants were 10 women who were on oral contraceptives and 10 who were not. The participants were recorded over two menstrual cycles, on the 10th and 20th day to evaluate their speech during the preovulation and premenstrual phases of their menstrual cycle. Participants produced 10 repetitions of the phrase "Speak ___ to me" containing the target syllables /bae/ and /pae/. Repeated measure ANOVAs revealed no significant differences in VOT between the two groups. Statistical results showed significant interactions between the menstrual cycle phase and the 2 recording months. It is possible that month-to-month differences in hormonal levels and other factors that can affect speech may have a greater effect on VOT than either the taking of oral contraceptives or the phase differences within a menstrual cycle. Language: English Keywords: FLORIDA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | MATCHED GROUPS | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | MENSTRUAL CYCLE | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Control Groups | Demographic Factors | Population | Contraceptive Safety | Safety | Public Health | Health | Menstruation | Reproduction Document Number: 331291 |
| 22. Peer Reviewed Title: The effects of acute malaria on Epstein-Barr Virus (EBV) load and EBV-specific T cell immunity in Gambian children. Author: Njie R; Bell AI; Jia H; Croom-Carter D; Chaganti S; Hislop AD; Whittle H; Rickinson AB Source: Journal of Infectious Diseases. 2009 Jan 1;199(1):31-8. Abstract: Background. To investigate how intense Plasmodium falciparum infection predisposes to Epstein-Barr virus (EBV)-positive Burkitt lymphoma (BL), we analyzed the effect of acute malaria on existing EBV-host balance. Methods. EBV genome loads in peripheral blood mononuclear cells were assayed by quantitative polymerase chain reaction, and EBV-specific CD8_ T cell responses were assayed by interferon-y enzyme-linked immunospot assay. Results. Gambian children, from whom samples were obtained during an acute malaria attack and again up to 6 weeks later, had extremely high viral loads, reaching levels that in the United Kingdom are seen only in patients with infectious mononucleosis. Gambian control subjects (children and adults with no recent history of malaria) had lower median viral loads, although they were still >10-fold above the median for healthy UK adults. Limited experiments with EBV epitope peptides (restricted through the HLA-B*3501 and HLA-B*5301 alleles) also suggested an impairment of virus-specific CD8+ T cell function in children with malaria, but only during acute disease. Conclusions. Acute malaria is associated with sustained increase in EBV load and, possibly, a transient decrease in EBV-specific T cell surveillance. We infer that the unusually high set point of virus carriage in P. falciparum-challenged populations, allied with the parasite's capacity to act as a chronic B cell stimulus, probably contributes to the pathogenesis of endemic BL. Language: English Keywords: GAMBIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | CHILDREN | VIRAL DISEASES | IMMUNITY, CELLULAR | MALARIA | COMPLICATIONS | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Immunity | Immune System | Physiology | Biology | Parasitic Diseases Document Number: 328587 |
| 23. Title: Side effects of oral misoprostol for the prevention of postpartum hemorrhage: results of a community-based randomised controlled trial in rural India. Author: Patted SS; Goudar SS; Naik VA; Bellad MB; Edlavitch SA; Kodkany BS; Patel A; Chakraborty H; Derman RJ; Geller SE Source: Journal of Maternal-Fetal and Neonatal Medicine. 2009 Jan;22(1):24-8. Abstract: OBJECTIVE: To investigate the side effects of 600 microg oral misoprostol given for the mother and the newborn to prevent postpartum hemorrhage (PPH). METHODS: One thousand six hundred twenty women delivering at home or subcentres in rural India were randomised to receive misoprostol or placebo in the third stage of labour. Women were evaluated for shivering, fever, nausea, vomiting and diarrhea at 2 and 24 h postpartum. Newborns were evaluated within 24 h for diarrhea, vomiting and fever. Symptoms were graded as absent, mild-to-moderate or severe. RESULTS: Women who received misoprostol had a significantly greater incidence of shivering (52%vs. 17%, p < 0.001) and fever (4.2%vs. 1.1%, p < 0.001) at 2 h postpartum compared with women who received placebo. At 24 h, women in the misoprostol group experienced significantly more shivering (4.6%vs. 1.4%, p < 0.001) and fever (1.4%vs. 0.4%, p < 0.03). There were no differences in nausea, vomiting or diarrhea between the two groups. There were no differences in the incidence of vomiting, diarrhea or fever for newborns. CONCLUSIONS: Misoprostol is associated with a significant increase in postpartum maternal shivering and fever with no side effects for the newborn. Given its proven efficacy for the prevention of PPH, the benefits of misoprostol are greater than the associated risks. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | POSTPARTUM WOMEN | WOMEN IN DEVELOPMENT | RURAL POPULATION | COMMUNITY HEALTH SERVICES | SIDE EFFECTS | MISOPROSTOL | BLEEDING | PREVENTION AND CONTROL | PREGNANCY COMPLICATIONS | ORAL CONTRACEPTIVES, SIDE EFFECTS | SIGNS AND SYMPTOMS | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Puerperium | Reproduction | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Treatment | Medical Procedures | Medicine | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Diseases | Contraceptive Safety | Safety | Public Health Document Number: 330717 |
| 24. Title: Breast feeding, but not use of oral contraceptives, is associated with a reduced risk of rheumatoid arthritis. Author: Pikwer M; Bergstrom U; Nilsson JA; Jacobsson L; Berglund G; Turesson C Source: Annals of the Rheumatic Diseases. 2009 Apr;68(4):526-30. Abstract: OBJECTIVE: To determine whether breast feeding or the use of oral contraceptives (OCs) affects the future risk of rheumatoid arthritis (RA) in a community-based prospective cohort. METHODS: A community-based health survey (18 326 women) was linked to regional and national registers, and incident cases of RA were identified. All women with a diagnosis of RA after inclusion in the health survey (n = 136) and four female controls for every case, who were alive and free from RA when the index person was given a diagnosis of RA, were included in a case-control study. Data on lifestyle factors at baseline were derived from a self-administered questionnaire. Potential predictors were examined in logistic regression models. RESULTS: 136 women with incident RA were compared with 544 age-matched controls. A longer history of breast feeding was associated with a reduced risk of RA (OR 0.46 (95% CI 0.24 to 0.91) for women who had breast fed for >/=13 months and OR 0.74 (95% CI 0.45 to 1.20) for those who had breast fed for 1-12 months, compared with those who had never breast fed). The protective effect of longer breast feeding remained significant after adjustment for smoking and level of education in multivariate models, and point estimates were protective also when the analyses were restricted to parous women. Neither parity nor OC use had any significant effect on the risk of RA. CONCLUSION: In this study, long-term breast feeding, but not OC use, was associated with a significant reduction in the risk of RA. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COHORT ANALYSIS | STATISTICAL REGRESSION | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | PREVALENCE | BREASTFEEDING | ORAL CONTRACEPTIVES | RHEUMATOID FACTOR | SKELETAL EFFECTS | TIME FACTORS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Data Analysis | Economic Development | Economic Factors | Measurement | Infant Nutrition | Nutrition | Health | Contraceptive Methods | Contraception | Family Planning | Autoantibodies | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Population Dynamics | Demographic Factors | Population Document Number: 331290 |
| 25. Peer Reviewed Title: Follicular development in a 7-day versus 4-day hormone-free interval with an oral contraceptive containing 20 mcg ethinyl estradiol and 1 mg norethindrone acetate. Author: Rible RD; Taylor D; Wilson ML; Stanczyk FZ; Mishell DR Jr Source: Contraception. 2009 Mar;79(3):182-8. Abstract: BACKGROUND: Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate. STUDY DESIGN: Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7. RESULTS: Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mmdiameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups. CONCLUSION: In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE | ADMINISTRATION AND DOSAGE | MENSTRUATION | TIME FACTORS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Population Dynamics Document Number: 330059 |
| 26. Peer Reviewed Title: A case-control study of oral contraceptive use and incident breast cancer. Author: Rosenberg L; Zhang Y; Coogan PF; Strom BL; Palmer JR Source: American Journal of Epidemiology. 2009 Feb 15;169(4):473-9. Abstract: Oral contraceptive (OC) use has been linked to increased risk of breast cancer, largely on the basis of studies conducted before 1990. In the Case-Control Surveillance Study, a US hospital-based case-control study of medication use and cancer, the authors assessed the relation of OC use to breast cancer risk among 907 case women with incident invasive breast cancer (731 white, 176 black) and 1,711 controls (1,152 white, 559 black) interviewed from 1993 to 2007. They evaluated whether the association differed by ethnicity or tumor hormone receptor status. After control for breast cancer risk factors, the multivariable odds ratio for 1 year or more of OC use, relative to less than 1 year of use, was 1.5 (95% confidence interval: 1.2, 1.8). The estimates were similar within age strata (<50 years and >or= 50 years). The odds ratios were larger for use within the previous 10 years, long-duration use, and black ethnicity, but these differences were not statistically significant. The association of OC use with breast cancer risk did not differ according to the estrogen or progestogen receptor status of the tumor. These results suggest that OC use is associated with an increased risk of breast cancer diagnosed in recent years. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | MULTIVARIATE ANALYSIS | CASE CONTROL STUDIES | ETHNIC GROUPS | WOMEN | PREVALENCE | BREAST CANCER | ORAL CONTRACEPTIVES, SIDE EFFECTS | HORMONE RECEPTORS | RISK ASSESSMENT | CONTRACEPTIVE SAFETY | TIME FACTORS | Developed Countries | North America | Americas | Research Methodology | Data Analysis | Studies | Cultural Background | Population Characteristics | Demographic Factors | Population | Measurement | Cancer | Neoplasms | Diseases | Safety | Public Health | Health | Membrane Proteins | Physiology | Biology | Evaluation | Population Dynamics Document Number: 330380 |
| 27. Peer Reviewed Title: Re: Estrogen-progestin contraceptive use during adolescence prevents bone mass acquisition: a 4-year follow-up study [letter] Author: Schilling LH Source: Contraception. 2009 Mar;79(3):241; author reply 241-2. Abstract: Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH PROPOSAL | LONGITUDINAL STUDIES | FOLLOW-UP STUDIES | CASE CONTROL STUDIES | WOMEN | SKELETAL EFFECTS | OSTEOPOROSIS | CONTRACEPTIVE AGENTS, ESTROGEN | SIDE EFFECTS | PROGESTATIONAL HORMONES | PREGNANCY COMPLICATIONS | POSTPARTUM AMENORRHEA | LONGTERM EFFECTS | |