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1.
Title: Intrauterine devices: an effective alternative to oral hormonal contraception.
Source: Prescrire International. 2009 Jun;18(101):125-30.
Abstract: (1) Intrauterine devices (IUDs) are placed in the uterine cavity with the objective of providing long-term contraception, mainly by preventing fertilisation. The best-known IUDs contain copper, but there is also an IUD delivering levonorgestrel, a progestin; (2) How effective are these devices, and what are their adverse effects? To answer these questions, we analysed the literature using the standard Prescrire methodology; (3) T-shaped copper IUDs, with a copper surface area of 380 mm2 on 3 arms, and the levonorgestrel-releasing device, have similar contraceptive efficacy as combined oral contraceptives that are used correctly. In contrast, IUDs are more effective than oral contraception used incorrectly; (4) Among IUD users, there are on average about 6 pregnancies per 1000 woman-years. There is less experience with the levonorgestrel IUD which seems to be at least as effective as copper IUDs; (5) The rare intrauterine pregnancies that occur in women using an IUD generally end in miscarriage. About 25% of these pregnancies end in a live birth if the device is left in place, compared to about 90% if the device is removed; (6) Ectopic pregnancies are rarer in IUD users than in women who do not use contraception. However, about one in 20 pregnancies that occur in women using an IUD is ectopic; (7) The IUD is expelled in about 5% to 10% of cases within 5 years, and expulsion recurs in about 30% of these women; (8) Problems such as difficult insertion, pain, bleeding and syncope are reported in less than 1.5% of cases overall; (9) Uterine perforation during insertion is rare, occurring in 0.6 to 16 cases per 1000 insertions, regardless of the type of IUD. The risk of perforation is higher when the IUD is inserted less than 4 to 6 weeks after delivery or elective abortion; (10) During the first 3 months after insertion, the risk of pelvic infection is slightly higher than in the general population, especially in women with pre-existing asymptomatic Chlamydia trachomatis infection. There are about 6 pelvic infections per 1000 woman-years of IUD use. Routine antibiotic prophylaxis is unnecessary. The interview and physical examination may lead to diagnosis of C. trachomatis infection or other sexually transmitted infections. In these cases, treatment may be needed before IUD insertion. Women must be warned that IUDs do not protect them from sexually transmitted diseases; (11) Menstrual bleeding is often heavier in women with cooper IUDs than in women who do not use IUDs, and may be associated with menstrual pain; (12) The levonorgestrel IUD is associated with a marked reduction in menstrual blood loss and irregular bleeding; amenorrhoea occurs in 35% of women after 2 years of use. The levonorgestrel IUD also has hormonal adverse effects such as headache, acne, breast tension and functional ovarian cysts; (13) IUDs can safely be used in breastfeeding women, immediately after a pregnancy, in cases of diabetes or HIV infection, during nonsteroidal antiinflammatory drug therapy, and after an ectopic pregnancy. The only problems occurring in women who have never had children are pain during insertion and more frequent expulsions; (14) A copper IUD is a first-line contraceptive method for women with a history of deep venous thrombosis, pulmonary embolism, or coronary events; (15) It is better to postpone IUD insertion when the woman has a genital tract infection or unexplained vaginal bleeding; (16) IUD insertion is an effective alternative to "morning-after" hormonal contraception.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | IUD | CONTRACEPTIVE MODE OF ACTION | IUD COMPLICATIONS | IUD EXPULSION | INSERTION | IUD SIDE EFFECTS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | PREGNANCY, ECTOPIC | UTERINE PERFORATION | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Pregnancy Complications | Diseases | Perforations
Document Number: 342301  

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Peer Reviewed

Title: Oral contraceptives for functional ovarian cysts.
Source: Obstetrics and Gynecology. 2009 Sep;114(3):679-80.
Abstract: BACKGROUND:: Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s. OBJECTIVES:: This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. SEARCH STRATEGY:: We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed. SELECTION CRITERIA:: We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials. DATA COLLECTION AND ANALYSIS:: Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we used Peto odds ratios with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences with 95% CI. MAIN RESULTS:: We identified seven randomized controlled trials from four countries; the studies included a total of 500 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological. AUTHORS' CONCLUSION:: Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub2. Copyright the Cochrane Collaboration, reproduced with permission.
Language: English

Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | EXAMINATIONS AND DIAGNOSES | Measurement | Research Methodology | Diseases | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342569  

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Title: Implanon: a review of the literature with recommendations for clinical management.
Author: Adams K; Beal MW
Source: Journal of Midwifery and Women's Health. 2009 Mar-Apr;54(2):142-9.
Abstract: Implanon is a new implantable, progestin-only contraceptive which was approved in the United States in July 2006. Implanon is comprised of a single ethylene vinylacetate copolymer rod that is 4 cm long and 2 mm in diameter. It is inserted subdermally in the groove between the biceps and triceps of the nondominant arm. A literature review was conducted and side effects are discussed. Implanon offers promise as a high-efficacy, long-term contraceptive and can enhance the contraceptive options offered by the women's health care providers. Clinical trial data indicate that the device is both safe and effective.
Language: English

Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | CONTRACEPTIVE AGENTS, PROGESTIN | CONTRACEPTION | CONTRACEPTIVE EFFECTIVENESS | MANAGEMENT | Developed Countries | North America | Americas | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Organization and Administration
Document Number: 341634  

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Title: Prevention of low birthweight.
Author: Alam DS
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68.
Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW.
Language: English

Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341347  

5.
Title: [Of office hysteroscopy for the removal of intrauterine device. Literature review] Histeroscopia de consultorio para la extraccion de dispositivo intrauterino.
Author: Alanis Fuentes J; Amoroso Hernandez MA
Source: Ginecologia Y Obstetricia De Mexico. 2009 Apr;77(4):197-201.
Abstract: OBJECTIVE: To review the literature related to the hysteroscopic techniques such as outpatient diagnostic and therapeutic tools for the extraction of foreign bodies in patients with intrauterine device. METHOD: We searched the main electronic databases were searched for those words: hysteroscopy and intrauterine device in articles related to the removal of intrauterine devices by hysteroscopy. RESULTS: The loss or translocation of IUD is a common problem resulting from the large number of women who have applied. The importance of early diagnosis is to avoid, such as the inappropriate position of the device promotes an unwanted pregnancy, genital bleeding and injury to adjacent organs such as bowel and bladder. The assessment by ultrasound or X-rays, or both, allowing the device to locate and determine the desirability or otherwise of outpatient hysteroscopy (in practice) without anesthesia and with low morbidity for the patient or, well, resorting to other methods, and laparoscopy in the operating room. CONCLUSIONS: Hysteroscopy is an effective procedure for recovering intrauterine foreign bodies or hidden in properly selected patients.
Language: Spanish

Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | HYSTEROSCOPY | IUD | CONTRACEPTIVE REMOVAL | CONTRACEPTIVE USE-EFFECTIVENESS | PROGRAM EFFECTIVENESS | Demographic Factors | Population | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Treatment | Contraceptive Effectiveness | Program Evaluation | Programs | Organization and Administration
Document Number: 342313  

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Title: Headache induced by the use of combined oral contraceptives.
Author: Allais G; Gabellari IC; Airola G; Borgogno P; Schiapparelli P; Benedetto C
Source: Neurological Sciences. 2009 May;30 Suppl 1:S15-7.
Abstract: Although combined oral contraceptives (COCs) are a safe and highly effective method of birth control, they may also give rise to problems of clinical tolerability in migraine patients. Indeed, headache is among the most common side effects reported with the use of COCs, frequently leading to their being discontinued. The latest International Classification of Headache Disorders identified at least two entities evidently related to the use of COCs, i.e., exogenous hormone-induced headache and estrogen-withdrawal headache. As to the former, the newest formulations of COCs are generally well tolerated by migraine without aura patients, but can worsen headache in migraine with aura patients. Headache associated with COCs, generally, tends to improve as their use continues. However, although it is not yet clear if there is an association between headache and the composition of COCs (both in the type and amount of hormones), it has been observed that the incidence of headache during COC use seems greater if migraine is associated with menstrual trigger. The estrogen-withdrawal headache is a headache that generally appears within the first 5 days after cessation of estrogen use and resolves within 3 days, even if in some cases it may appear on the sixth or seventh day after pill suspension and lasts more than 3 days.
Language: English

Keywords:
ITALY | LITERATURE REVIEW | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | HEADACHE | MIGRAINE | INCIDENCE | HORMONES | ESTROGENS | Developed Countries | Europe, Southern | Europe | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Signs and Symptoms | Diseases | Vascular Diseases | Measurement | Research Methodology | Endocrine System | Physiology | Biology
Document Number: 342617  

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Title: Interventions for pain with intrauterine device insertion.
Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P
Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373.
Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation.
Language: English

Keywords:
UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology
Document Number: 342475  

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Title: Oral contraceptives and the risk of multiple sclerosis: A review of the epidemiologic evidence.
Author: Alonso A; Clark CJ
Source: Journal of the Neurological Sciences. 2009 May 7;
Abstract: Multiple sclerosis (MS) is more frequent in women than in men, suggesting that sex hormones could play a role in the development of MS. For this reason, several studies have assessed whether use of oral contraceptives modifies the risk of MS. In this article, we review the methodology and results of published epidemiologic studies addressing this issue. On the whole, the existing epidemiologic evidence does not support an important effect of oral contraceptive use on the risk of MS, though it does suggest that oral contraceptives might delay the onset of the disease.
Language: English

Keywords:
UNITED KINGDOM | UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CENTRAL NERVOUS SYSTEM EFFECTS | RISK ASSESSMENT | EPIDEMIOLOGY | Developed Countries | Europe, Western | Europe | North America | Americas | Research Methodology | Demographic Factors | Population | Safety | Public Health | Health | Central Nervous System | Physiology | Biology | Evaluation
Document Number: 341145  

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Title: Combined oral contraceptive pills for treatment of acne.
Author: Arowojolu AO; Gallo MF; Lopez LM; Grimes DA; Garner SE
Source: Cochrane Database of Systematic Reviews. 2009;(3):CD004425.
Abstract: BACKGROUND: Acne is a common skin disorder among women. Although no uniform approach to the management of acne exists, combination oral contraceptives (COCs), which contain an estrogen and a progestin, often are prescribed for women. OBJECTIVES: To determine the effectiveness of combined oral contraceptives (COCs) for the treatment of facial acne compared to placebo or other active therapies. SEARCH STRATEGY: We searched for randomized controlled trials of COCs and acne in the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, POPLINE, and LILACS. We also searched for clinical trials in ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We wrote to authors of identified trials to seek any unpublished or published trials that we might have missed. SELECTION CRITERIA: All randomized controlled trials reported in any language that compared the effectiveness of a COC containing an estrogen and a progestin to placeboor another active therapy for acne in women were eligible. DATA COLLECTION AND ANALYSIS: We extracted data on total and specific (i.e., open or closed comedones, papules, pustules and nodules) facial lesion counts; acne severity grades; global assessments by the clinician or the participant and discontinuation due to adverse events. Data were entered and analyzed in RevMan. MAIN RESULTS: The search yielded 25 trials: 7 placebo-controlled trials made 4 different comparisons, 17 trials made 13 comparisons between 2 different COC regimens, and 1 additional trial compared a COC to an antibiotic. COCs reduced acne lesion counts, severity grades and self-assessed acne compared to placebo. Differences in the comparative effectiveness of COCs containing varying progestin types and dosages, though, were less clear. COCs that contained chlormadinone acetate or cyproterone acetate improved acne better than levonorgestrel, although this apparent advantage was based on limited data. A COC with cyproterone acetate might result in better acne outcomes than one with desogestrel; however, the three studies comparing these COCs produced conflicting results. Likewise, levonorgestrel showed a slight improvement over desogestrel in acne outcomes in one trial, but a second trial found the COC groups were similar. AUTHORS' CONCLUSIONS: The four COCs evaluated in placebo-controlled trials are effective in reducing inflammatory and non-inflammatory facial acne lesions. Few important differences were found between COC types in their effectiveness for treating acne. How COCs compare to alternative acne treatments is unknown since limited data were available regarding this question.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | COMPARATIVE STUDIES | WOMEN | ACNE | TREATMENT | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | ANTIBIOTICS | HORMONES | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Endocrine System | Physiology | Biology
Document Number: 341912  

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Peer Reviewed

Title: Bleeding patterns associated with non-oral hormonal contraceptives: a review of the literature.
Author: Bachmann G; Korner P
Source: Contraception. 2009 Apr;79(4):247-58.
Abstract: It is generally accepted that poor tolerance to changes in vaginal bleeding associated with hormonal contraceptive use may influence compliance and continuation with the chosen method. However, disparities in the collation and reporting of bleeding data hamper comparison among studies and products. In this review, we systematically assessed MEDLINE and EMBASE for articles assessing parenteral hormonal contraceptives that reported bleeding data based on reference periods as recommended by the World Health Organization (WHO). Overall, 31 studies published between 1986 and October 2007 were included in this review. The use of parenteral hormonal contraception was in general associated with a decrease in bleeding with continued use from Reference Period 1 to 4. However, this decrease was less marked with the combined hormonal depots and both progestin-only and combined hormonal vaginal rings than with progestin-only implants, depots and the levonorgestrel intrauterine system. Overall, reporting vaginal bleeding by 90-day reference periods as recommended by the WHO allows straightforward comparison of bleeding patterns between studies.
Language: English

Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | BLEEDING | CONTRACEPTIVE IMPLANTS | VAGINAL RING | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330560  

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Peer Reviewed

Title: Systematic review of HIV and HCV infection among drug users in China.
Author: Bao YP; Liu ZM
Source: International Journal of STD and AIDS. 2009 Jun;20(6):399-405.
Abstract: To determine the HIV and hepatitis C virus (HCV) geographical distribution among drug users in China, a systematic literature review of 40 peer-reviewed publications (comprising 15,565 drug users) was conducted. Of the total drug users, 10,724 were found to be injection drug users (IDUs) and 4841 were non-injection drug users (non-IDUs). Various studies identified that among IDUs and non-IDUs, the overall HIV prevalence rates were 12.55% and 1.05%, and the HCV prevalence rates were 66.97% and 18.30%, respectively. The HIV prevalence rate ranged from 0% (Anhui and Inner Mongolia) to 52.51% (Yunnan) among IDUs, and from 0% to 19.80% among non-IDUs correspondingly. The HCV prevalence rate ranged from 11.43% (Shannxi) to 90.77% (Hubei) among IDUs, and from 0% (Anhui) to 40.00% (Fujian) among non-IDUs. Based on the high prevalence of HIV and HCV among drug users, scaling-up harm reduction was required from 'heroin trafficking areas' to other areas in China.
Language: English

Keywords:
CHINA | RESEARCH REPORT | LITERATURE REVIEW | PREVALENCE | IV DRUG USERS | HIV INFECTIONS | HEPATITIS | POPULATION DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Measurement | Research Methodology | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Geographic Factors | Population
Document Number: 342442  

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Peer Reviewed

Title: Questioning gender norms with men to improve health outcomes: Evidence of impact.
Author: Barker G; Ricardo C; Nascimento M; Olukoya A; Santos C
Source: Global Public Health. 2009;:1-15.
Abstract: This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and child health; their interaction with their children; their use of violence against women; their questioning of violence with other men; and their health-seeking behaviour. The evidence indicates that programmes that incorporate a gender-transformative approach and promote gender-equitable relationships between men and women are more effective in producing behaviour change than narrowly focused interventions, as are programmes which reach beyond the individual level to the social context. (author's)
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | SOCIAL BEHAVIOR | REPRODUCTIVE HEALTH | MEN'S INVOLVEMENT | PROGRAM EFFECTIVENESS | ATTITUDES | SEX BEHAVIOR | HIV PREVENTION | MALE ROLE | VIOLENCE | BEHAVIOR CHANGE | Behavior | Health | Programs | Organization and Administration | Program Evaluation | Psychological Factors | HIV Infections | Viral Diseases | Diseases
Document Number: 342230  

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Peer Reviewed

Title: Return to fertility following discontinuation of oral contraceptives.
Author: Barnhart KT; Schreiber CA
Source: Fertility and Sterility. 2009 Mar;91(3):659-63.
Abstract: OBJECTIVES: To provide an overview of the studies that have evaluated the return to fertility following cessation of oral contraceptives (OCs), including recent evidence in women discontinuing extended-cycle and continuous-use regimens. DESIGN: Comprehensive review. PATIENT(S): None. INTERVENTION(S): Relevant articles were identified through a PubMed literature search (1960-2007) and a cross-reference of published data. MAIN OUTCOME MEASURE(S): Time to fertility following contraceptive use. RESULT(S): Numerous studies have demonstrated some delay in the time to conception in previous users of OCs who discontinued use in order to conceive, but this impairment appears to be temporary and typically limited to the early months following cessation of OC use. Reported 12-month conception rates in former cyclic OC users range from 72%-94% and are similar to those observed in women discontinuing intrauterine devices (71%-92%), progestin-only contraceptives (70%-95%), condoms (91%), and natural family planning (92%). There is a limited amount of data on the time to conception in women stopping extended-cycle and continuous-use OCs, but the data suggest that subsequent return to fertility is generally comparable to that of cyclic OCs. CONCLUSION(S): A comprehensive survey of reported data indicates that the return of fertility in former OC users (both cyclic and extended/continuous regimens) in women who stop use in order to conceive is comparable to that observed with other contraceptive methods.
Language: English

Keywords:
UNITED STATES OF AMERICA | PENNSYLVANIA | LITERATURE REVIEW | FERTILITY | ORAL CONTRACEPTIVES | CONTRACEPTIVE USAGE | REVERSIBILITY | Developed Countries | North America | Americas | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning
Document Number: 330562  

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Title: On what diseases and health conditions should new economic research on health and development focus?
Author: Behrman JR; Behrman JA; Perez NM
Source: Health Economics. 2009 Apr;18 Suppl 1:S109-28.
Abstract: Given the public goods nature of research, economic research on health in developing countries is likely to have the highest returns by focusing, inter alia, on diseases and health conditions that are relatively widespread and costly and that are relatively rapidly growing. This article first summarizes the time patterns in economic research on diseases and health in developing countries for 1990-2005. It then compares those time patterns with the distribution of disability-adjusted life years (DALYs) for diseases and health conditions in developing countries estimated for 2005 and for 2030. These comparisons suggest relatively overemphasis on HIV/AIDS and underemphasis on noncommunicable diseases (NCDs). This opens the possibility for individuals or organizations initiating, re-evaluating, or increasing their economic research on health and development to make a significant contribution by focusing particularly on the analysis of behaviour and policy choices related to NCDs. Careful consideration must, of course, be given to other demands, but on the basis of these two criteria, potential contributions are likely to be greatest from research with such a focus.
Language: English

Keywords:
GLOBAL | CRITIQUE | LITERATURE REVIEW | RESEARCH ACTIVITIES | ECONOMICS | ECONOMIC DEVELOPMENT | HEALTH | HIV INFECTIONS | DISEASES | INTERVENTIONS | COST BENEFIT ANALYSIS | LENGTH OF LIFE | Research Methodology | Social Sciences | Science | Sociocultural Factors | Economic Factors | Viral Diseases | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 341823  

15.
Title: [Particularities of epileptic women's care] Particularites de la prise en charge des femmes epileptiques.
Author: Ben Hamouda I; Mrabet A
Source: La Tunisie Medicale. 2009 Mar;87(3):169-72.
Abstract: AIM: Development on the epileptic women's care. METHOD: A research in the medical literature on PubMed and an exhaustive review of the published summaries and reports of Epileptology International Meetings, in the last five years. We included cohort studies, reviews and randomized double blinded therapeutic trials. Case reports and fundamental research studies have been excluded. RESULTS: sensitizing of the epileptic women starts with adolescence with an education and a preparation to sexual life and available contraceptive methods, in order to avoid undesired pregnancies and the serious consequences which they are likely to generate. Approximately 1/3 of the epileptic women have variations of their disease related to the menstrual cycle, probably because of a neurotoxic effect of estrogens (not counterbalanced by progestational hormones). Antiepileptic teratogenicity issue is not, yet, solved, in spite of new molecules commercialisation. The upkeep of a register concerning the use of AED during pregnancy makes it possible to better identify the problems and to establish an optimal therapeutic control for the mother and the child. CONCLUSION: Epilepsy impact on women's life is very different compared to men, because it interferes with the fields of sexuality, reproduction, menstrual cycle and contraception, in addition of AED teratogenicity. A close cooperation between obstetricians and neurologist and a sensitizing of health professionals are essential for the global care of the epileptic pregnant women or in age of procreation.
Language: French

Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | COHORT ANALYSIS | WOMEN | NEUROLOGIC EFFECTS | CONTRACEPTION | SEX BEHAVIOR | PREGNANCY, UNWANTED | IMPACT | Research Methodology | Demographic Factors | Population | Physiology | Biology | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Communication
Document Number: 342404  

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Title: Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review.
Author: Berghella V; Airoldi J; O'Neill AM; Einhorn K; Hoffman M
Source: BJOG. 2009 Aug;116(9):1151-7.
Abstract: BACKGROUND: Second trimester pregnancy induction with misoprostol in women with prior caesarean delivery is not well studied. OBJECTIVE: To estimate the risk of uterine rupture using misoprostol as an induction agent for pregnancy termination in the second trimester of pregnancy in women with prior caesarean delivery. SEARCH STRATEGY: Cases of women with a history of prior caesarean delivery and subsequent misoprostol induction for pregnancy termination in the second trimester (16-28 weeks) were obtained from two main data sources. First, a retrospective chart analysis was performed at Thomas Jefferson University Hospital and Christiana Hospital between 1998 and 2004. Second, multiple Medline, Scopus and POPLINE literature searches were performed. SELECTION CRITERIA: Case series and cohort studies of women with one or more prior caesarean delivery (of any type), and with a subsequent pregnancy with induction of labour for pregnancy termination at 16-28 weeks using misoprostol as the initial primary agent were included. Case reports were analysed separately. DATA COLLECTION AND ANALYSIS: Total cases were analysed by type and number of prior caesarean delivery, for the primary outcome of uterine rupture. MAIN RESULTS: The incidence of uterine rupture associated with second trimester misoprostol termination was 0.4% (2/461) in women with one prior low transverse, 0% (0/46) in those with two prior low transverse and 50% (1/2) in those with a prior classical caesarean delivery. One of the cases of uterine rupture in a woman with a prior low transverse caesarean required transfusion. None of the total eight cases (including case reports) of uterine rupture was associated with hysterectomy. CONCLUSIONS: Second trimester misoprostol termination appears safe among women with one prior low transverse caesarean birth, as it is associated with incidences of uterine rupture of 0.4% (95% confidence interval 0.08-1.67%), of hysterectomy of 0% and of transfusion of 0.2%. There are insufficient data on risk with more than one prior caesarean birth or with prior classical caesarean birth.
Language: English

Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | ABORTION | CESAREAN SECTION | UTERINE EFFECTS | RISK FACTORS | INCIDENCE | Developed Countries | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Measurement
Document Number: 342794   Notification

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Peer Reviewed

Title: Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature.
Author: Bollini P; Pampallona S; Wanner P; Kupelnick B
Source: Social Science and Medicine. 2009 Feb;68(3):452-61.
Abstract: Immigrant mothers in developed countries often experience worse pregnancy outcomes than native women. Several epidemiological studies have described the pregnancy outcome of immigrant women in European receiving countries, with conflicting results. The present systematic review makes a quantitative synthesis of available evidence on the association between pregnancy outcomes and integration policies. We reviewed all epidemiological studies comparing the pregnancy outcome of native versus immigrant women in European countries from 1966 to 2004 and retained 65 for analysis, from 12 host countries. Overall, as compared to native women, immigrant women showed a clear disadvantage for all the outcomes considered: 43% higher risk of low birth weight, 24% of pre-term delivery, 50% of perinatal mortality, and 61% of congenital malformations. The risks were clearly and significantly reduced in countries with a strong integration policy. This trend was maintained even after adjustment for age at delivery and parity. On the basis of an analysis of naturalisation rates, five countries in our sample could be categorised as having a strong policies promoting the integration of immigrant communities. The mechanisms through which integration policies may be protective include the increased participation of immigrant communities in the life of the receiving society, and the decreased stress and discrimination they may face. The results of this study highlight a serious problem of equity in perinatal health across European countries. Immigrant women clearly need targeted attention to improve the health of their newborn, but a deep societal change is also necessary to integrate and respect immigrant communities in receiving societies.
Language: English

Keywords:
EUROPE | RESEARCH REPORT | LITERATURE REVIEW | PREGNANT WOMEN | FETUS | PREGNANCY | MIGRATION | ANTENATAL CARE | HEALTH POLICY | PREGNANCY OUTCOMES | Developed Countries | Population Characteristics | Demographic Factors | Population | Reproduction | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors
Document Number: 331051  

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Peer Reviewed

Title: Putting mental health on the agenda for HIV+ women: a review of evidence from sub-Saharan Africa.
Author: Brandt R
Source: Women and Health. 2009 Mar-May;49(2-3):215-28.
Abstract: This article reviews the scientific literature regarding mental health services for poor HIV-infected women in sub-Saharan Africa and argues that they should constitute part of the healthcare agenda for these women. Key evidence points to the growing feminization of the HIV epidemic, as well as the differential social and economic impact of HIV on women. Further, HIV and poverty, both disproportionately affecting women, contribute independently and cumulatively to the risk for poor mental health. The limited empirical evidence regarding the mental health of this population is discussed. Multi-level psychosocial services, integrated within general health provision, are required to ensure long-term psychological benefits for HIV-infected women in the region.
Language: English

Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | MENTAL HEALTH | HEALTH SERVICES | POVERTY | PROGRAM ACCESSIBILITY | Africa | Developing Countries | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | Health | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 342427  

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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  

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Title: Blockade of alpha(1A)-adrenoceptor: A novel possible strategy for male contraception.
Author: Chen Y; Li H; Dong Q; Wang KJ
Source: Medical Hypotheses. 2009;73:140-141.
Abstract: Worldwide almost one quarter of all couples practicing contraception rely on male methods. However, currently available options for male contraception are limited. Thus, it is urgent to develop safe, effective, and reversible male contraceptives. To date, alpha(1)-blockers are the most widely used agents for the treatment of benign prostatic hyperplasia. Several studies reveal that in elderly patients the alpha(1A)-selective antagonist tamsulosin can induce a notably high incidence of ejaculation dysfunction characterized by low ejaculate volume. Recent clinical trials suggest that tamsulosin may effectively inhibit sperm ejaculation in young volunteers. Since alpha(1A)-adrenoceptor subtype plays a dominant role in mediating the contractions of accessory sex organs contributing to ejaculation, we hypothesize that blockade of alpha(1A)-adrenoceptor may suppress the motility of these organs, thereby inhibiting sperm transport and achieving contraception, and the alpha(1A)-selective antagonists can act as a male contraceptive. If our hypotheses can be further supported with clinical trials it will shift the paradigm for male-based contraception and provide a wider range of choice for all.
Language: English

Keywords:
CHINA | RESEARCH PROPOSAL | LITERATURE REVIEW | CLINICAL RESEARCH | MEN | MALE CONTRACEPTION | HORMONE ANTAGONISTS | SPERM TRANSPORT INHIBITION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Hormones | Endocrine System | Physiology | Biology | Inhibition of Fertilization | Contraceptive Mode of Action
Document Number: 341144  

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Title: Women's health and gender-based clinical trials on etoricoxib: methodological gender bias.
Author: Chilet-Rosell E; Ruiz-Cantero MT; Horga JF
Source: Journal of Public Health. 2009 Sep;31(3):434-45.
Abstract: BACKGROUND: The aim of this study was to determine compliance with published good practice guidelines for gender and clinical trials using etoricoxib. The rationale for choosing etoricoxib was that it is widely used by women and there is evidence of potential interaction with contraceptives and hormone replacement therapy as highlighted in the product characteristics. METHODS: The study reviewed 58 etoricoxib published trials (54 papers) to determine if they met the gender recommendations of the Guidelines of Food and Drug Administration (1993) and the Sex, Gender and Pain Special Interest Group Consensus Working Group Report (2007). RESULTS: Women formed 70% of a total of 49 835 subjects included in the etoricoxib trials, but only 31% of the subjects were in Phase I. About 85.7% of trials did not show sex-stratified data. About 90.6 and 93.3% did not provide efficacy and adverse effects data by sex, respectively. There is scarce information about the influence of issues that specifically affect women. Discussion Women are under-represented in the published etoricoxib trials, specifically, in Phase I. Sex-stratified data on efficacy and adverse effects are scarce in etoricoxib trials. Together with the lack of data on women-specific issues, this suggests that etoricoxib may pose the same potential problems for women as other cyclooxygenase-2 inhibitors.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | DRUGS | ADMINISTRATION AND DOSAGE | DRUG INTERACTIONS | CONTRACEPTIVE AGENTS, FEMALE | HORMONE REPLACEMENT THERAPY | SIDE EFFECTS | THROMBOSIS | SEX FACTORS | PREGNANCY | VALIDITY | Clinical Research | Research Methodology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Thromboembolism | Embolism | Vascular Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Reproduction | Measurement
Document Number: 342950  

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Peer Reviewed

Title: Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature.
Author: Church K; Mayhew SH
Source: Studies in Family Planning. 2009 Sep;40(3):171-186.
Abstract: The last comprehensive literature review to examine the effectiveness of family planning (FP) services in delivering STI and HIV prevention and care was published in 2000. This review updates that report by examining evidence of the impact of integrating any components of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. Forty-four reports were identified from a comprehensive search of published databases and ‘grey literature.’ The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Evidence of FP services reaching men and adolescents and of their impact on health outcomes is inconclusive. Several studies found that providers frequently miss opportunities to integrate care and that the capacity to maintain the quality of care is also influenced by many programmatic challenges. The range of experiences indicates that managers need to determine appropriate health-care service-delivery models based on a consideration of epidemiological, structural, and health-systems factors.
Language: English

Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | EPIDEMIOLOGY | FAMILY PLANNING | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | PROGRAM EFFECTIVENESS | Public Health | Health | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 339700  

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Title: HIV in adolescents in sub-Saharan Africa.
Author: Cowan F; Pettifor A
Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):288-93.
Abstract: The authors summarize existing evidence on the effectiveness of different intervention approaches to HIV prevention in adolescents. They focus on studies that are either from or are relevant to sub-Saharan Africa. In addition, they include a brief review of other issues relevant to HIV prevention research in adolescents. Although numerous adolescent behavioral HIV prevention interventions have been evaluated, few have assessed their impact on HIV endpoints or been undertaken in Africa. In the three trials from Africa, which had HIV endpoints, none of the interventions had an impact on HIV, although all affected some knowledge and attitudes and reported behaviors. In one of these trials, there was a borderline effect on herpes simplex virus-2 incidence. Adolescents have typically been excluded from trials of biological interventions, although they are likely to benefit from these interventions if found to be effective. Despite the regulatory difficulties, they must be considered for inclusion in these trials as an important target population.
Language: English

Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | ADOLESCENTS | HIV PREVENTION | INTERVENTIONS | PROGRAM EFFECTIVENESS | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | BEHAVIOR CHANGE | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Program Evaluation | Sociocultural Factors | Psychological Factors | Behavior
Document Number: 342339  

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Peer Reviewed

Title: Safety of Contraceptive Method Use Among Women With Systemic Lupus Erythematosus: A Systematic Review.
Author: Culwell KR; Curtis KM; Del Carmen Cravioto M
Source: Obstetrics and Gynecology. 2009 Aug;114(2, Part 1):341-353.
Abstract: OBJECTIVE:: To evaluate the evidence on the safety of contraceptive method use among women with systemic lupus erythematosus (SLE). DATA SOURCES:: We searched the PubMed, MEDLINE, and LILACS databases for peer-reviewed articles published from database inception through January 2009, concerning the safety of contraceptive use among women with SLE. METHODS OF STUDY SELECTION:: We included studies that examined health outcomes among women using a contraceptive method after the diagnosis of SLE. The quality of each individual piece of evidence was assessed using the U.S. Preventive Services Task Force grading system. TABULATION, INTEGRATION, AND RESULTS:: Our search yielded 275 articles. A total of 14 articles that reported on 13 studies met our inclusion criteria. Available evidence, including two good-quality randomized controlled trials, indicates that use of combined oral contraceptives does not lead to increased flares of disease or worsening disease activity in women with inactive or stable active SLE. No increase in disease activity with use of progestogen-only contraceptives was noted in four studies. Limited evidence indicates a possible increased risk of thrombosis in women with positive antiphospholipid antibodies and history of oral contraceptive use. Limited evidence indicates that the use of the copper intrauterine device is not associated with worsening disease activity or infection in women with SLE. CONCLUSION:: Available evidence indicates that many women with SLE can be considered good candidates for most contraceptive methods, including hormonal contraceptives. The benefits of contraception for many women with SLE likely outweigh the risks of unintended pregnancy in this population. Women with positive antiphospholipid antibodies are not good candidates for combined hormonal contraception given their elevated baseline risk of thrombosis.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | CLIENTS | WOMEN | SYSTEMIC LUPUS ERYTHEMATOSUS | CONTRACEPTIVE METHODS | CONTRACEPTIVE SAFETY | RISK FACTORS | ANTIBODIES | CARDIOVASCULAR EFFECTS | THROMBOSIS | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Diseases | Contraception | Family Planning | Safety | Public Health | Health | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases
Document Number: 342215  

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Peer Reviewed

Title: Use of contraceptive methods by women with current venous thrombosis on anticoagulant therapy: a systematic review.
Author: Culwell KR; Curtis KM
Source: Contraception. 2009 Oct;80(4):337-45.
Abstract: BACKGROUND: As nearly all women with venous thromboembolism (VTE) will be treated with anticoagulant therapy, it is important to consider how anticoagulation affects the safety of contraceptive use. STUDY DESIGN: We conducted a systematic review of the literature regarding use of contraceptive methods in women with current VTE on anticoagulant therapy. Due to the limited direct evidence that was identified, we expanded our search to include women on anticoagulant therapy for indications other than VTE and women with bleeding disorders. RESULTS: Six articles met our inclusion criteria. Three observational studies found the levonorgestrel-releasing IUD (LNG-IUD) was an effective treatment for menorrhagia for women on anticoagulation therapy or with bleeding disorders. Prevention of recurrent hemorrhagic ovarian cysts was seen in women on chronic anticoagulation treated with depot-medroxyprogesterone acetate (DMPA) in one small observational study. Among women with bleeding disorders, no complications were seen in 16 women with placement of the LNG-IUD. One pharmacokinetic study found no statistically significant interaction between combined oral contraceptives and warfarin. Other than one case report, no evidence was found regarding the risk of recurrent thrombosis in women on anticoagulation therapy using a contraceptive method. CONCLUSION: The majority of studies in this review examined treatment effects of the LNG-IUD or DMPA on complications of anticoagulation and found overall beneficial effects of their use in these circumstances. Minimal evidence in women with inherited bleeding disorders suggests that insertion of the LNG-IUD does not pose major bleeding risks in these women with appropriate management.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | THROMBOSIS | COMPLICATIONS | DRUGS | IUD, HORMONE RELEASING | IUD SIDE EFFECTS | INSERTION | DEPO-PROVERA | BLOOD COAGULATION EFFECTS | HEREDITARY DISEASES | MENSTRUATION DISORDERS | CONTRACEPTIVE SAFETY | Thromboembolism | Embolism | Vascular Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hematological Effects | Hemic System | Physiology | Biology | Safety | Public Health
Document Number: 342773  

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Peer Reviewed

Title: Progestogen-only contraceptive use in obese women.
Author: Curtis KM; Ravi A; Gaffield ML
Source: Contraception. 2009 Oct;80(4):346-54.
Abstract: BACKGROUND: The objective of this systematic review is to determine whether obese women who use progestogen-only contraceptives are more likely to experience weight gain or serious adverse events as compared to nonobese users. STUDY DESIGN: We searched PubMed for all articles (in all languages) published in peer-reviewed journals from database inception through October 2008, for evidence relevant to obesity and progestogen-only contraceptives. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. RESULTS: From 579 articles, we identified nine studies fitting our selection criteria. Evidence from five studies suggests that among adult women, baseline weight or body mass index is not associated with weight gain among depot medroxyprogesterone acetate (DMPA) users (Level II-2, Fair). Evidence from three studies suggests that among adolescent women, overweight or obese DMPA users may gain more weight than normal weight DMPA users or overweight/obese nonusers (Level II-2, Fair). Evidence from one small study of Norplant users showed no differences in weight gain by baseline weight (Level II-3, Poor). We did not identify studies of other progestogen-only contraceptive methods that examined weight change by baseline weight, nor did we identify studies that reported on any serious adverse events by baseline weight. CONCLUSIONS: Adolescent DMPA users who are obese may gain more weight than normal weight users. This observation was not seen in adult DMPA users or adolescent Norplant users.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | ADULTS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | DEPO-PROVERA | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OBESITY | BODY WEIGHT | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medroxyprogesterone Acetate | Contraceptive Methods
Document Number: 342772  

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Peer Reviewed

Title: Intensified case finding for tuberculosis in prevention of mother-to-child transmission programs: a simple and potentially vital addition for maternal and child health.
Author: Deluca A; Chaisson RE; Martinson NA
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):196-9.
Abstract: The intersection of HIV and tuberculosis (TB) poses a serious threat to HIV-infected women and their children. The majority of patients with TB in sub-Saharan Africa are infected with HIV, and together the overlapping epidemics synergistically accelerate illness and death. Escalating case rates, increased mortality, and the recent emergence of extensively drug-resistant TB highlights how catastrophic a once preventable and curable disease has become among people with HIV/AIDS. The HIV epidemic requires new strategies to control TB in high-burden areas especially as women of reproductive age are disproportionately affected by the epidemic. Intensified case finding for TB has the potential to reduce morbidity and mortality for people living with HIV, especially pregnant women, their families, and infants. (excerpt)
Language: English

Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | RECOMMENDATIONS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | COMPLICATIONS | INTEGRATED PROGRAMS | PREVALENCE | INCIDENCE | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Measurement
Document Number: 330367  

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Peer Reviewed

Title: HIV vaccine preparedness studies in the non-organization for economic co-operation and development (non-OECD) countries.
Author: Dhalla S; Nelson KE; Singer J; Poole G
Source: AIDS Care. 2009 Mar;21(3):335-48.
Abstract: HIV vaccine development remains an urgent priority. Vaccine preparedness studies to assess feasibility are an important precursor to HIV vaccine trials. Studies such as these have taken place in many non-Organization for Economic Co-operation and Development (non-OECD) countries using diverse cohorts. This article is a systematic review of retention rates and willingness to participate (WTP) in HIV vaccine trials. Studies took place in Brazil, the Democratic Republic of Congo, Haiti, India, Russia, Thailand, and several sub-Saharan African countries. Studies generally reported recruitment of high-risk individuals. Of 33 studies we identified, retention was assessed in 16 studies, and the 12-month retention ranged from 77 to 85%. Willingness to participate was assessed in 21 studies. Willingness to participate ranged from 23 to 100%, and increased knowledge was associated with an increased WTP. Vaccine preparedness studies have taken place using diverse cohorts in the non-OECD countries. In general, retention rates and WTP have been adequate to conduct HIV vaccine trials. Educational programs to improve knowledge about HIV vaccines may contribute to better follow-up and an increased WTP in these countries.
Language: English

Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL TRIALS | RESEARCH ACTIVITIES | HIV PREVENTION | VACCINES | EPIDEMIOLOGY | PARTICIPATION | MOTIVATION | OBSTACLES | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Behavior | Behavior | Psychological Factors | Organization and Administration
Document Number: 341856  

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Peer Reviewed

Title: Estimating the burden of malaria in pregnancy: a case study from rural Madhya Pradesh, India.
Author: Diamond-Smith N; Singh N; Gupta RK; Dash A; Thimasarn K; Campbell OM; Chandramohan D
Source: Malaria Journal. 2009;8:24.
Abstract: BACKGROUND: Malaria in pregnancy (MiP) is inadequately researched in India, and the burden is probably much higher than current estimates suggest. This paper models the burden of MiP and associated foetal losses and maternal deaths, in rural Madhya Pradesh, India. METHODS: Number of pregnancies per year was estimated from the number of births and an estimate of pregnancies that end in foetal loss. The prevalence of MiP, risk of foetal loss attributable to MiP and case fatality rate of MiP were obtained from the literature. The estimated total number of pregnancies was multiplied by the appropriate parameter to estimate the number of MiP cases, and foetal loss and maternal deaths attributable to MiP per year. A Monte Carlo simulation sensitivity analysis was done to assess plausibility of various estimates obtained from the literature. The burden of MiP in tribal women was explored by incorporating the variable prevalence of malaria in tribal and non-tribal populations and in forested and non-forested regions within Madhya Pradesh. RESULTS: Estimates of MiP cases in rural Madhya Pradesh based on the model parameter values found in the literature ranged from 183,000-1.5 million per year, with 73,000-629,000 lost foetuses and 1,500-12,600 maternal deaths attributable to MiP. The Monte Carlo simulation gave a more plausible estimate of 220,000 MiP cases per year (inter-quartile range (IQR): 136,000-305,000), 95,800 lost foetuses (IQR: 56,800-147,600) and 1,000 maternal deaths (IQR: 650-1,600). Tribal women living in forested areas bore 30% of the burden of MiP in Madhya Pradesh, while constituting 18% of the population. CONCLUSION: Although the estimates are uncertain, they suggest MiP is a significant public health problem in rural Madhya Pradesh, affecting many thousands of women and that reducing the MiP burden should be a priority.
Language: English

Keywords:
INDIA | LITERATURE REVIEW | CASE STUDIES | PREVALENCE | RURAL AREAS | PREGNANT WOMEN | MALARIA | MATERNAL MORTALITY | CAUSES OF DEATH | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Measurement | Geographic Factors | Population | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Mortality | Population Dynamics
Document Number: 330550  

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Title: Advances and future directions in HIV surveillance in low- and middle-income countries.
Author: Diaz T; Garcia-Calleja JM; Ghys PD; Sabin K
Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):253-9.
Abstract: PURPOSE OF REVIEW: To present recent advances in HIV/AIDS surveillance methods in low- and middle-income countries. RECENT FINDINGS: From 2001 to 2008, 30 low- and middle-income countries implemented national population-based surveys with HIV testing. Antenatal clinic HIV sentinel surveillance sites in sub-Saharan Africa increased from just over 1000 in 2003-2004 to almost 2500 in 2005-2006, becoming more representative of rural areas. Between 2003 and 2007, at least 122 behavioral surveys in low- and middle-income countries used respondent-driven sampling for surveillance among high-risk populations, although many countries with concentrated epidemics continue to have major sentinel surveillance gaps. Improvements have been made in modeling estimates of number of persons HIV infected, and systems are now in place to measure HIV drug resistance. However, the reliable monitoring of trends and the measuring of HIV incidence, morbidity, and mortality is still a challenge. SUMMARY: In the past 5 years, there have been substantial improvements in the quantity and quality of HIV surveillance studies, especially in the countries with high prevalence. Further efforts should be made in countries that lack fully implemented surveillance systems to improve HIV incidence, morbidity, and mortality surveillance and to use data more effectively.
Language: English

Keywords:
GLOBAL | LITERATURE REVIEW | RECOMMENDATIONS | HIV INFECTIONS | AIDS | EPIDEMICS | MONITORING | MORTALITY | PREVALENCE | HIV TESTING | DRUG RESISTANCE | INCIDENCE | Viral Diseases | Diseases | Evaluation | Population Dynamics | Demographic Factors | Population | Measurement | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment
Document Number: 342342  
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