1.  Title: Kangaroo mother care for low birth weight babies: a prospective observational study. Source: Journal of Nepal Paediatric Society. 2009 Jan-Jun;29(1):6-9. Abstract: Introduction: Kangaroo Mother Care is the low cost, humane technique for caring low birth weight babies by direct skin to contact with the mother. Objective: The Prospective observational study was done to see the effect of KMC especially on weight gain on low birth weight babies weighing 2000 grams or less at Special Care Baby Unit of Paropakar Maternity and Women's hospital, Kathmandu. Method: The study was conducted in Special Care Baby Unit (SCBU) of Paropakar Maternity and Women's Hospital over 7 months period May 2007 to Nov. 2008 (from Baishakh 2064 to Kartik 2065). The method of care consisted of skin to skin contact between the mother and the infant. Result: It was observed that babies had good weight gain of average 30gms/day and had short duration of hospital stay of average 9 days. Babies had less morbidities like hypothermia, apnea, skin infections and oral thrush.100% babies had exclusive breast feeding and KMC was acceptable to mothers. Conclusion: Kangaroo Mother Care shows early and good weight gain in low birth weight babies. It is simple, low cost technique and well acceptable by mother and family and can be continued at home. Language: English Keywords: NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | LOW BIRTH WEIGHT | TREATMENT | INFANT HEALTH | GESTATIONAL AGE | BREASTFEEDING, EXCLUSIVE | COST EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Health | Fetus | Pregnancy | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 341512 |
2.  Peer Reviewed Title: ACOG Committee Opinion No. 434: induced abortion and breast cancer risk. Author: Committee on Gynecologic Practice Source: Obstetrics and Gynecology. 2009 Jun;113(6):1417-8. Abstract: The Relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk. Language: English Keywords: GLOBAL | CRITIQUE | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | BIAS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Error Sources | Measurement Document Number: 341807 Notification |
| 3. Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. Author: Ahmad A; Khan AU Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71. Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures. Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities Document Number: 342002 |
| 4. Peer Reviewed Title: Menstrual blood loss in women using the frameless FibroPlant LNG-IUS. Author: Andrade A; Wildemeersch D Source: Contraception. 2009 Feb;79(2):134-8. Abstract: BACKGROUND: This study was conducted to report on a menstrual blood loss (MBL) study and iron stores in women with and without heavy menstrual bleeding using the frameless FibroPlant levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception. STUDY DESIGN: An open, prospective, noncomparative MBL study, using FibroPlant releasing 14 mcg of LNG/day for contraception. MBL was assessed by the quantitative alkaline hematin (QAH) technique. RESULTS: The MBL study was conducted in 40 heavy and normally menstruating Brazilian women seeking contraception. MBL was reduced from a mean baseline menstrual volume of 29.7 mL to a mean volume of 1.5 mL after 24 months, while ferritin values increased from a mean value of 31.1 ng/mL (at baseline) to a mean level of 72.5 ng/mL (after 24 months of use). Differences were highly significant (p<.0005). There were no significant differences between those who had normal menstrual bleeding and the heavy bleeders. The heavy bleeders had comparable MBL to thenormal bleeders 3 months after insertion, and by 24 months post-insertion, their ferritin levels were comparable to those of the normal bleeders. Amenorrhea occurred in 80% of women out of 40 after 24 months of use. No pregnancies were recorded. CONCLUSION: The LNG-IUS is effective in reducing MBL in normally menstruating women as well as in women with heavy menstrual bleeding. The authors agree with the recommendations by the UK National Institute for Clinical Effectiveness and the new Finnish guidelines for heavy menstrual bleeding that the LNG-IUS should be positioned as first-line treatment prior to endometrial ablation or hysterectomy. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MENSTRUATION | SERUM IRON LEVEL | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | TIME FACTORS | AMENORRHEA | PREVALENCE | CONTRACEPTIVE EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Hemic System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Measurement Document Number: 331016 |
| 5. Title: Adherence and treatment response among HIV-1 infected adults receiving antiretroviral therapy in a rural government hospital in southwestern Uganda. Author: Bajunirwe F; Arts EJ; Tisch DJ; King CH; Debanne SM Source: Journal of the International Association of Physicians in AIDS Care. 2009 Mar-Apr;8(2):139-147. Abstract: Background. Large-scale, government-based antiretroviral therapy (ART) programs in rural areas of resource-poor countries remain largely unevaluated. Methods. We conducted a retrospective review of all patients receiving (n = 399) to assess survival and retention in care and a prospective evaluation of patients on ART for at least 6 months (n = 175). We used 3-day self-report to measure adherence. Results. The probability (95% confidence interval [CI]) of surviving and remaining in care was 0.76 (0.72, 0.81) at 1 year. Men and patients with advanced disease were more likely to die or be lost to follow-up. At baseline, 149 (85%) reported 100% adherence. Nonadherence was associated with lack of suppression of viral replication (odds ratio [OR] = 4.5; 95% CI: 1.8, 11.5). Missing a scheduled clinic visit and lack of disclosure of HIV status were associated with nonadherence. Conclusion. Viral suppression was high, but counseling to include HIV disclosure to family and keeping scheduled clinic appointments may improve long-term adherence and treatment outcomes. Language: English Keywords: UGANDA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | RURAL POPULATION | HIV INFECTIONS | USER COMPLIANCE | ANTIRETROVIRAL THERAPY | GOVERNMENT PROGRAMS | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | HIV | Programs | Organization and Administration Document Number: 331336 |
| 6. Title: Evaluation of commercial HIV test kits used in Nigeria. Author: Banwat EB; Peter JY; Egah DZ Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4. Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries. Language: English Keywords: NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342689 |
| 7. Peer Reviewed Title: Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study. Author: Battaglia C; Mancini F; Fabbri R; Persico N; Busacchi P; Facchinetti F; Venturoli S Source: Fertility and Sterility. 2009 Jul 8; Abstract: OBJECTIVE: To compare the effects of a pill containing drospirenone with those of a combined contraceptive vaginal ring on the lipid and carbohydrate metabolism and on the surrogate markers of arterial function. SETTING: Bologna University School of Medicine. PATIENT(S): Thirty-seven women with polycystic ovary syndrome (PCOS) were randomly submitted to drospirenone + ethinylestradiol (group I; n = 19) or combined contraceptive vaginal ring (group II; n = 18) therapy. The duration of the study was 6 months. INTERVENTION(S): The effect of treatments was assessed after 6 months of therapy. MAIN OUTCOME MEASURE(S): Utero-ovarian ultrasound analysis and color Doppler evaluation of uterine and stromal ovarian arteries. In addition, analysis of brachial artery flow-mediated vasodilatation and 24-hour ambulatory blood pressure monitoring were performed. Fasting blood samples were drawn for testing biochemical and hormonal parameters and nitrites/nitrates. RESULT(S): Both treatments improved hirsutism, hyperandrogenemia, and ultrasound and color Doppler ovarian parameters. Both drospirenone + ethinylestradiol or contraceptive vaginal ring induced a slight but significant increase of diurnal and 24-hour blood pressure. Although both therapies worsened the lipid profile, the oral pill administration was associated with a more evident increase of circulating triglycerides. The 6-month treatment with the vaginal ring significantly improved the area under the curve for glucose, insulin, and C-peptide, whereas the drospirenone + ethinylestradiol pill induced an increase in the insulinogenic index and homeostatic model assessment estimate for insulin resistance values. CONCLUSION(S): Vaginal hormonal contraception appears to be preferable to oral ethinylestradiol + drospirenone administration in hyperinsulinemic patients with PCOS. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | CLIENTS | OVARIAN CYSTS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | VAGINAL RING | CARDIOVASCULAR EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | BLOOD PRESSURE | ULTRASONICS | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Physiology | Biology | Metabolic Effects | Lipids | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342128 |
| 8. Title: Added benefits and user satisfaction with a low-dose oral contraceptive containing drospirenone : results of three multicentre trials. Author: Bitzer J; Paoletti AM Source: Clinical Drug Investigation. 2009;29(2):73-8. Abstract: The ethinylestradiol 20 mug/drospirenone 3 mg combined oral contraceptive (COC), administered in cycles of 21 days continuous use followed by a 7-day hormone-free interval (21/7) [Yasminelle((R))], has been proven to be an effective and well tolerated contraceptive with an acceptable bleeding pattern and good safety profile. In addition, the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC prevents water-retention-related weight gain, and improves physical and emotional well-being, consistent with other drospirenone-containing COCs. In clinical studies, >85% of those who received the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC were satisfied or very satisfied with this contraceptive. The positive attributes of the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC beyond contraceptive protection may have important implications for improving treatment compliance and reducing treatment discontinuation. Physical well-being stayed the same or improved during use of this COC in 56% and 34% of women, respectively. Emotional well-being stayed the same or improved in 71% and 20% of women, respectively. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE EFFECTIVENESS | SATISFACTION | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Psychological Factors | Behavior Document Number: 329809 |
| 9. Title: Adolescents' cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study. Author: Bouma EM; Riese H; Ormel J; Verhulst FC; Oldehinkel AJ Source: Psychoneuroendocrinology. 2009 Jul;34(6):884-93. Abstract: Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS | GENDER ISSUES | MENSTRUATION | ORAL CONTRACEPTIVES | STRESS | HORMONES | TRANSCORTIN BOUND CORTISOL ALTERATIONS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Reproduction | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System Document Number: 342582 |
| 10. Peer Reviewed Title: Impact of Plasmodium falciparum infection on the frequency of moderate to severe anaemia in children below 10 years of age in Gabon. Author: Bouyou-Akotet MK; Dzeing-Ella A; Kendjo E; Etoughe D; Ngoungou EB; Planche T; Koko J; Kombila M Source: Malaria Journal. 2009 Jul 20;8(1):166. Abstract: ABSTRACT: BACKGROUND: Improving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies. METHODS: A prospective observational study was conducted over a two-year period to assess the burden of anaemia and its relationship to Plasmodium falciparum infection and age in 8,195 febrile Gabonese children. RESULTS: The proportion of children with anaemia was 83.6% (n=6830), higher in children between the ages of six and 23 months. Those under three years old were more likely to develop moderate to severe anaemia (68%). The prevalence of malaria was 42.7% and P. falciparum infection was more frequent in children aged 36-47 months (54.5%). The proportion of anaemic children increased with parasite density (p<0.01). Most of infected children were moderately to severely anaemic (69.5%, p<0.01). Infants aged from one to 11 months had a higher risk of developing severe malarial anaemia. In children over six years of age, anaemia occurrence was high (>60%), but was unrelated to P. falciparum parasitaemia. CONCLUSION: Malaria is one of the main risk factors for childhood anaemia which represents a public health problem in Gabon. The risk of severe malarial anaemia increases up the age of three years. Efforts to improve strategies for controlling anaemia and malaria are needed. Language: English Keywords: GABON | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILDREN | MALARIA | ANEMIA | PREVALENCE | FEVER | RISK FACTORS | AGE FACTORS | HEMOGLOBIN LEVEL | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Measurement | Body Temperature | Physiology | Biology | Health | Hemic System Document Number: 342284 |
| 11. Peer Reviewed Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study. Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA Source: BMC Women's Health. 2009 Mar 26;9(1):7. Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330849 |
| 12. Peer Reviewed Title: Route of administration of contraceptives containing desogestrel/etonorgestrel and insulin sensitivity: a prospective randomized study. Author: Cagnacci A; Ferrari S; Tirelli A; Zanin R; Volpe A Source: Contraception. 2009 Jul;80(1):34-9. Abstract: BACKGROUND: The study was conducted to investigate whether hormonal contraceptives administered via the oral and vaginal route exert a similar effect on insulin sensitivity (SI). STUDY DESIGN: This is a prospective, randomized study performed in the University Hospital. Subjects were healthy lean young women, needing a hormonal contraceptive, randomly allocated to receive for 6 months (a) an oral contraceptive (OC) containing 30 mcg ethinylestradiol (EE)/150 mcg desogestrel (DSG) (high-estrogen group; n=12), (b) an OC containing 20 mcg EE/150 mcg DSG (low-estrogen group; n=12) and (c) a vaginal ring contraceptive releasing, per day, 15 mcg EE/120 mcg etonorgestrel, the active DSG metabolite (n=12). SI and glucose utilization independent of insulin (Sg) were evaluated by the minimal model method. Modifications of total, high-density lipoprotein (HDL) and low-density lipoprotein cholesterol and triglycerides were also evaluated. RESULTS: Sg did not vary with any treatment. SI decreased during OCs (5.74+/-0.49 vs. 3.86+/-0.44; p=.0005), independently of the high/low-estrogen dose. SI did not decrease during vaginal ring use (4.64+/-1.03 vs. 5.25+/-1.36; p=.57; p=.019 vs. oral). Total cholesterol and HDL cholesterol increased (p=.02) during OCs, independently of the dose. Triglycerides increased during both oral (p=.01) and vaginal (p=.032) contraceptive use. CONCLUSIONS: The present data indicate that in contrast to OC use, vaginal contraception with the ring does not deteriorate SI. The vaginal ring may represent an appropriate choice for long-term contraception in women at risk for developing diabetes mellitus or metabolic syndrome. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | VAGINAL RING | CONTRACEPTION | ADMINISTRATION AND DOSAGE | DESOGESTREL | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 341584 |
| 13. Title: Causes of death in HIV-infected persons who have tuberculosis, Thailand. Author: Cain KP; Anekthananon T; Burapat C; Akksilp S; Mankhatitham W; Srinak C; Nateniyom S; Sattayawuthipong W; Tasaneeyapan T; Varma JK Source: Emerging Infectious Diseases. 2009 Feb;15(2):258-64. Abstract: Up to 50% of persons with HIV and a diagnosis of tuberculosis (TB) in Thailand die during TB treatment. In a prospective observational study, a team of physicians ascribed the cause of death after reviewing verbal autopsies (interviews of family members about events preceding death), laboratory data, and medical records. Of 849 HIV-infected TB patients enrolled, 142 (17%) died. The cause of death was TB for 38 (27%), including 6 with multidrug-resistant TB and 20 with disseminated TB; an HIV-associated condition other than TB for 50 (35%); and a condition unrelated to TB or HIV for 22 (15%). Twenty-three patients (16%) were judged not to have had TB at all. Death from all causes except those unrelated to TB or HIV was less common in persons receiving antiretroviral therapy (ART). In addition to increasing the use of ART, death rates may be reduced through expanded use of modern TB diagnostic techniques. Language: English Keywords: THAILAND | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | CAUSES OF DEATH | AUTOPSY | ANTIRETROVIRAL THERAPY | DRUGS | PNEUMONIA | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Infections | Mortality | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Treatment | Pulmonary Effects | Physiology | Biology Document Number: 341840 |
| 14. Title: Gonadotropin-releasing hormone analog combined with a low-dose oral contraceptive to treat heavy menstrual bleeding. Author: Cetin NN; Karabacak O; Korucuoglu U; Karabacak N Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):236-9. Abstract: OBJECTIVE: To compare the effects of low-dose oral contraceptives used alone and in combination with a gonadotropin-releasing hormone (GnRH) analog to treat heavy menstrual bleeding. METHODS: Fifty-eight patients with heavy menstrual bleeding were prospectively randomized into two treatment groups to receive either a low-dose oral contraceptive alone (group 1), or combined with a GnRH analog (group 2) for 6 months. The patients' hormonal profiles, and hemoglobin and hematocrit levels were measured at the beginning and at the end of the treatment period. RESULTS: Hemoglobin and hematocrit levels significantly improved in both groups after 6 months of treatment (P<0.05 and P<0.01, respectively). Even in the first month of the study, the number of pads used and the duration of menstruation were significantly decreased in both groups and markedly lower in group 2 (P<0.01). CONCLUSION: The addition of a GnRH analog to low-dose oral contraceptive treatment for heavy menstrual bleeding resulted in bettercontrol of vaginal bleeding, even in the first month of therapy. Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | MENORRHAGIA | TREATMENT | ORAL CONTRACEPTIVES, LOW-DOSE | GONADOTROPINS | ENDOMETRIAL EFFECTS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Menstruation Disorders | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Hormones | Endocrine System | Physiology | Biology | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 341388 |
| 15. Title: Frequency of Mycobacterium bovis as an etiologic agent in extrapulmonary tuberculosis in HIV-positive and -negative Mexican patients. Author: Cicero R; Olivera H; Hernandez-Solis A; Ramirez-Casanova E; Escobar-Gutierrez A Source: European Journal of Clinical Microbiology and Infectious Diseases. 2009 May;28(5):455-60. Abstract: Mycobacterium bovis can be an important etiological agent for extrapulmonary (EP) manifestations of tuberculosis, especially in HIV-infected persons. From January 2000 to December 2003, M. bovis as a cause of EP tuberculosis was investigated at the Pneumonology Service, Hospital General de Mexico, Mexico City. Eighty HIV-positive (HIV+) patients and 83 HIV-negative (HIV-) with EP involvement (ganglionar, genitourinary, meningeal, cutaneous, peritoneal, and pericardial) were analyzed using clinical, immunological, bacteriological, histopathological, and molecular biology methods. Mycobacterium species were identified by hsp65-RFLP analysis and species of M. tuberculosis complex isolates by spoligotyping. M. bovis was present in 6 HIV- cases (7.2%; 3 with lymphadenitis and 3 genitourinary) vs 11 in HIV+ cases (13.75%; 7 with lymphadenitis, 3 genitourinary, and 1 meningeal). Favorable response to retroviral and specific M. bovis chemotherapy was observed. Spoligotyping showed a unique profile in each isolate, 16 belonging to BOV1 lineage and 1 to BOV2 lineage. M. bovis is an significant re-emerging cause of EPTB in Mexico. Consumption of unpasteurized dairy products is the most likely source of transmission. Successful treatment depends on the adequate and opportune identification of the agent responsible. Language: English Keywords: MEXICO | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | ADULTS | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | BACTERIAL AND FUNGAL DISEASES | ANTIBIOTICS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | North America | Americas | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341794 |
| 16. Title: Cerebral venous and sinus thrombosis in women. Author: Coutinho JM; Ferro JM; Canhao P; Barinagarrementeria F; Cantu C; Bousser MG; Stam J Source: Stroke. 2009 Jul;40(7):2356-61. Abstract: BACKGROUND AND PURPOSE: Little is known about the gender-specific manifestations of cerebral venous and sinus thrombosis, a disease that is much more common in women than men. METHODS: We used data of the International Study on Cerebral Vein and Dural sinus Thrombosis (ISCVT), a multicenter prospective observational study, to analyze gender-specific differences in clinical presentation, etiology, and outcome of cerebral venous thrombosis. RESULTS: Four hundred sixty-five of a total of 624 patients were women (75%). Women were significantly younger, had less often a chronic onset of symptoms, and had more often headache at presentation. There were no gender differences in ancillary investigations or treatment. A gender-specific risk factor (oral contraceptives, pregnancy, puerperium, and hormonal replacement therapy) was present in 65% of women. Women had a better prognosis than men (complete recovery 81% versus 71%l P=0.01), which was entirely due to a better outcome in female patients with gender-specific risk factors. Women without gender-specific risk factors are similar to men in clinical presentation, risk factor profile, and outcome. Logistic regression analysis confirmed that the absence of gender-specific risk factors is a strong and independent predictor of poor outcome in women with sinus thrombosis (OR, 3.7; CI, 1.9 to 7.4). CONCLUSIONS: Our study identified important differences between women and men in presentation, course, and risk factors of cerebral venous and sinus thrombosis and showed that women with a gender-specific risk factor have a much better prognosis than other patients. Language: English Keywords: GLOBAL | RESEARCH REPORT | PROSPECTIVE STUDIES | STATISTICAL REGRESSION | CLIENTS | WOMEN | CEREBROVASCULAR EFFECTS | THROMBOSIS | RISK FACTORS | SEX FACTORS | SIGNS AND SYMPTOMS | Studies | Research Methodology | Data Analysis | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Population Characteristics Document Number: 342314 |
| 17. Peer Reviewed Title: Impact of obesity on oral contraceptive pharmacokinetics and hypothalamic-pituitary-ovarian activity. Author: Edelman AB; Carlson NE; Cherala G; Munar MY; Stouffer RL; Cameron JL; Stanczyk FZ; Jensen JT Source: Contraception. 2009 Aug;80(2):119-27. Abstract: BACKGROUND: This study was conducted to determine whether increased body mass index (BMI) affects oral contraceptive (OC) pharmacokinetics and suppression of hypothalamic-pituitary-ovarian (HPO) axis activity. STUDY DESIGN: Ovulatory reproductive-age women with normal weight (BMI <25 kg/m(2); n=10) and with obesity (BMI >30 kg/m(2); n=10) received OCs for two cycles (prospective cohort). Subjects were admitted for two 48-h inpatient stays at the beginning and end of the hormone-free interval. Ethinyl estradiol and levonorgestrel (LNG) levels were evaluated during both inpatient stays. Gonadotropin pulsatility (follicle-stimulating hormone and luteinizing hormone) was measured during the second inpatient stay. Estradiol (E(2)) and progesterone (P) were measured daily during inpatient stays and twice per week in Cycle 2. RESULTS: BMI was greater in the obese compared to the normal-BMI group [37.3 kg/m(2) (SD, 6.0) vs. 21.9 kg/m(2) (SD, 1.6); p<.05]. The LNG half-life was significantly longer in the obese group (52.1+/-29.4 vs. 25.6+/-9.3 h, p<.05), which correlated with a lower maximum LNG concentration on Cycle 2, Day 1 [1.9 ng/mL (SD, 0.5) vs. 2.5 ng/mL (SD, 0.7)] and a longer time to reach steady state (10 vs. 5 days) in obese women. There were no significant differences in volume of distribution between groups. LH pulse parameters did not differ statistically between groups but trended toward greater HPO activity in the obese group. Additionally, more obese (6/10 vs. 3/10 normal BMI, p>.05) women exhibited E(2) levels consistent with development of a dominant follicle and P levels consistent with ovulation (2/10 vs. 1/10) during Cycle 2. CONCLUSIONS: Compared to women with normal BMI, obese women exhibit differences in OC pharmacokinetics that are associated with greater HPO activity. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | OBESITY | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTION FAILURE | ETHINYL ESTRADIOL | LEVONORGESTREL | GONADOTROPINS, PITUITARY | LABORATORY PROCEDURES | TIME FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Body Weight | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Gonadotropins | Hormones | Endocrine System | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics Document Number: 342308 |
| 18. Title: Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. Author: Einarson A; Choi J; Einarson TR; Koren G Source: Journal of Obstetrics and Gynaecology Canada. 2009 May;31(5):452-6. Abstract: OBJECTIVE: The use of antidepressants during pregnancy remains a controversial issue, and there is little information on the risk of spontaneous abortions following antidepressant exposure in early pregnancy. We sought to examine whether use of antidepressants increases the rates of spontaneous abortion (SA) and therapeutic abortion (TA) in women exposed in early pregnancy. METHODS: In a cohort of women who contacted the Motherisk program during pregnancy, we compared two groups of women, one exposed and the other not exposed to antidepressants during pregnancy, and calculated the associated rates of SA and TA. RESULTS: Among 937 women exposed to antidepressants prior to and during early pregnancy, there were 122 SAs (13.0%) including three ectopic pregnancies, and in the comparison group there were 75 SAs (8.0%) and no ectopic pregnancies. The relative risk was 1.63 (95% CI 1.24-2.14). Three-fold more women reported a TA in the exposed group, 26 (2.4%) compared to 8 (0.7%) in the non-exposed group (RR 3.25; 95% CI 1.48-7.14). A sub-analysis revealed that in both groups, of 338 women with a prior SA, 58 (17.2%) reported having a SA in the current pregnancy, compared with 61/652 (9.4%) with no prior SA (chi square = 12.09, P lt; 0.001). In the antidepressant group, the incidence was 20.7%, and in the non-exposed group, it was 13.3%. Logistic regression confirmed that only antidepressant exposure and prior SA were significantly associated with current SA. CONCLUSION: Exposure to antidepressants in the first trimester of pregnancy appears to be associated with a small but statistically significant increased risk of SA and decision to terminate a pregnancy. The risk for SA is further elevated with a history of previous SA. However, any underlying depression must be taken into consideration when evaluating these results. Language: English Keywords: CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | ABORTION, SPONTANEOUS | ABORTION | RISK FACTORS | DEPRESSION | DRUGS | PREGNANCY, FIRST TRIMESTER | INCIDENCE | INTERVIEWS | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Health | Mental Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Measurement | Data Collection Document Number: 342785 Notification |
| 19. Title: Evaluation of postpartum blood loss after misoprostol-induced labour. Author: Elsedeek MS; Awad EE; Elsebaey SM Source: International Journal of Obstetrics and Gynaecology. 2009;116:431-435. Abstract: Objective: To objectively evaluate postpartum blood loss after successful misoprostol induction and compare it with blood loss after oxytocin induction of labour. Design Prospective randomised study. Setting: Labour ward in university maternity hospital. Population A total of 150 women up to third parity with completed 40 weeks of singleton normal pregnancy, average size cephalic fetus. Methods: Cases were randomised between oxytocin induction and misoprostol induction. Blood was collected in suction set and measured in the delivery room starting after delivery of the fetus and was evaluated by pad weighing in the following 6 hours. Pre- and postdelivery haematocrit were measured and difference between the two values was assessed and analysed. Main outcome measures Success of induction, induction delivery interval, postpartum blood loss, and difference between pre- and postdelivery haematocrit. Results: Induced labour was significantly faster with misoprostol induction (P < 0.001). Blood loss and haematocrit difference was significantly greater in the misoprostol group than in oxytocin group (P < 0.02 and 0.001, respectively). Blood loss in both groups was significantly correlated with higher initial Bishop score (P < 0.001 and 0.024, respectively) and short labour duration (P < 0.0002 and 0.0001, respectively). Conclusions Misoprostol induction is associated with increased blood loss especially when used in women with high Bishop score; therefore, it is better reserved for cases requiring cervical ripening. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | MISOPROSTOL | POSTPARTUM | BLEEDING | EVALUATION | Developed Countries | North America | Americas | Studies | Research Methodology | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Puerperium | Reproduction | Signs and Symptoms | Diseases Document Number: 340207 |
| 20. Title: A Canadian, Multicentre Study Comparing the Efficacy of a Levonorgestrel-releasing Intrauterine System to an Oral Contraceptive in Women With Idiopathic Menorrhagia. Author: Endrikat J; Shapiro H; Lukkari-Lax E; Kunz M; Schmidt W; Fortier M Source: Journal of Obstetrics and Gynaecology Canada. 2009 Apr;31(4):340-347. Abstract: Objectives: To evaluate the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) compared with a combined oral contraceptive containing 1 mg norethindrone acetate and 20 mg ethinyl estradiol (OC1/20) in reducing menstrual blood loss (MBL) in women with idiopathic menorrhagia. Methods: A prospective, randomized, open-label study was conducted in nine centres in Canada. Healthy women over 30 years of age suffering from idiopathic menorrhagia were treated either with LNG-IUS (n = 20) or with OC1/20 (n = 19) over 12 months. The primary endpoint was the change in MBL from baseline to 12 months. Secondary endpoints included treatment success (defined as a MBL score < 100 after 12 months), hemoglobin levels, and the menorrhagia severity score. Results: In both treatment groups, MBL decreased significantly from baseline to 12 months (P < 0.001). For the primary endpoint, the MBL score decreased significantly more in the LNG-IUS group (median from 228 to 13, mean percent change-83%) compared to the OC1/20 group (median from 290 to 72; mean percent change-68%) (P = 0.002) after 12 months. In the LNG-IUS group, 80% of subjects had treatment success compared with 36.8 % in the OC1/20 group (P < 0.009). Both treatments increased hemoglobin concentrations significantly between baseline and 12 months. The menorrhagia severity score was consistently lower in the LNG-IUS group at all study time points and was significantly lower (P = 0.045) at six months. Both treatments were well tolerated. Conclusion: Both the LNG-IUS and the combined oral contraceptive effectively decreased menstrual blood loss in women with idiopathic menorrhagia. The overall clinical benefit was more pronounced with LNG-IUS than with OC1/20. Language: English Keywords: CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | BLEEDING | MENORRHAGIA | TREATMENT | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Menstruation Disorders | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341573 |
| 21. Peer Reviewed Title: Bleeding pattern, tolerance and patient satisfaction with a drospirenone-containing oral contraceptive evaluated in 3488 women in Europe, the Middle East and Canada. Author: Endrikat JS; Milchev NP; Kapamadzija A; Georgievska J; Gerlinger C; Schmidt W; Feroze S Source: Contraception. 2009 Jun;79(6):428-32. Abstract: BACKGROUND: This study was conducted to assess the bleeding pattern, tolerance and patient satisfaction associated with an oral contraceptive (OC) containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol under real-life conditions. STUDY DESIGN: A multicenter, prospective and observational six-cycle study was conducted in 12 countries in Europe, the Middle East and Canada. The efficacy variables included an assessment of bleeding patterns, premenstrual symptoms of water retention and patient satisfaction as determined by a visual analog scale. RESULTS: A total of 3488 women was enrolled in the study. The percentage of women with intermenstrual bleeding decreased from 27.9% at baseline to 5.4% at the end of Cycle 6, while dysmenorrhea decreased from 67% to 17.7%. Also, amenorrhea decreased from 21.3% to 7.5%. The decreases in all three parameters were statistically significant (p<.0001). Approximately 70% of the women reported abdominal bloating and/or breast tenderness at baseline and less than 38% did so at the end of Cycle 6 (p<.0001). Patient satisfaction increased for all investigated items. Upon completion of the study, 86.2% of the women answered "yes" to continuing treatment with this OC. CONCLUSION: The OC containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol has beneficial effects on bleeding pattern, symptoms of water retention and patient satisfaction. Language: English Keywords: EUROPE | MIDDLE EAST | CANADA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | KAP SURVEYS | WOMEN | BLEEDING | SATISFACTION | ORAL CONTRACEPTIVES, COMBINED | ESTRADIOL | CONTRACEPTIVE SAFETY | AMENORRHEA | METRORRHAGIA | Developed Countries | North America, Northern | Americas | Research Methodology | Studies | Surveys | Sampling Studies | Demographic Factors | Population | Signs and Symptoms | Diseases | Psychological Factors | Behavior | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Estrogens | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health | Health | Menstruation Disorders Document Number: 341103 |
| 22. Title: HIV and HCV progression in parenterally coinfected children. Author: England K; Thorne C; Castelli-Gattinara G; Vigano A; El Mehabresh MI; Newell ML Source: Current HIV Research. 2009 May;7(3):346-53. Abstract: Shared transmission routes of HCV and HIV mean parenteral HIV/HCV coinfection still occurs, often in resource-limited settings. The extent to which coinfection and treatment impact on morbidity and mortality in HIV/HCV coinfected children remains unknown thus optimal management and treatment is difficult to achieve. Using data from a unique, large, prospective cohort of parenterally HIV/HCV coinfected children in Libya we determine the immunological, virological and clinical profiles of HIV/HCV coinfected children documenting the natural and treated history of parenterally acquired coinfection for the first time in such a large group. 160 parenterally HIV/HCV coinfected children were analysed. Thirty-three (21%) received antiretroviral treatment (ART) for HIV disease during follow-up. In children receiving ART, HIV RNA viral load decreased in two-thirds 6-12 months after initiation. 85% (17/20) experienced a positive immunological response to ART with a median increase in CD4 cell count z-score of 131%. Half had progressed to moderate or severe immunosuppression and/or moderate or severe clinical symptoms three years after infection. In those who progressed during follow-up, 85% had done so within three years of infection. Children progressing to moderate or severe immunosuppression and/or clinical symptoms were significantly more likely to be receiving ART. This novel investigation of the natural and treated history of parenterally HIV/HCV coinfected children in a large prospectively followed group demonstrates minimal clinical symptoms and immunosuppression to date, despite low prevalence of treatment, and a response to ART similar to vertically HIV-only infected children. Language: English Keywords: LIBYA | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILDREN | HIV INFECTIONS | HEPATITIS | INFECTION TRANSMISSION | NEEDLE PIERCING | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | TIME FACTORS | Africa, North | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Infections | Risk Behavior | Behavior | HIV | Immunity | Immune System | Physiology | Biology | Population Dynamics Document Number: 341771 |
| 23. Peer Reviewed Title: Anthropometric indices of infants born to HIV-1-infected mothers: a prospective cohort study in Lagos, Nigeria. Author: Ezeaka VC; Iroha EO; Akinsulie AO; Temiye EO; Adetifa IM Source: International Journal of STD and AIDS. 2009 Aug;20(8):545-8. Abstract: Numerous studies have reported that HIV-infected pregnant women are at increased risk of delivery of low birth weight (LBW) infants, of preterm deliveries and of intrauterine growth restriction. The objective of the study was to determine the effect of maternal HIV infection on the anthropometric characteristics of the babies at birth. A prospective study was carried out at the Lagos University Teaching Hospital, Nigeria. There were three times more LBW babies in the HIV-positive group than in the uninfected mothers (odds ratio = 3.47, 95% confidence interval = 1.69, 7.27; chi(2) = 12.99, P = 0.0003).The maternal weight (t = 15.85; P = 0.0001), maternal body mass index (BMI) (t = 15.07; P = 0.0003), birth weight of infants (t = 27.17; P = 0.0001) and birth length (t = 31.20; P = 0.001) were significantly less in HIV-positive mothers than in controls. In conclusion, poor maternal bodyweight and low BMI are significant contributors to LBW in HIV-infected women. Nutritional counselling, dietary intake and weight monitoring during pregnancy should be emphasized to improve pregnancy outcome in HIV-infected women. Language: English Keywords: NIGERIA | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | MOTHERS | INFANT | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | ANTHROPOMETRY | BIRTH WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Nutrition | Health | Measurement | Body Weight | Physiology | Biology Document Number: 342221 |
| 24. Title: Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition. Author: Fergusson P; Chinkhumba J; Grijalva-Eternod C; Banda T; Mkangama C; Tomkins A Source: Archives of Disease in Childhood. 2009 Jul;94(7):512-6. Abstract: OBJECTIVE: Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV. This study explores nutritional recovery in HIV-infected and HIV-uninfected children during inpatient nutrition rehabilitation and 4 months of follow-up. DESIGN: Prospective cohort study. SETTING: Lilongwe district, Malawi. MAIN OUTCOME MEASURES: Weight gain, anthropometrics. RESULTS: In our sample of 454 children with severe acute malnutrition (SAM), 17.4% (n = 79) of children were HIV infected. None of the children were on antiretroviral therapy upon admission. Among the HIV-infected children, 35.4% (28/79) died, compared with 10.4% (39/375) in HIV-uninfected children (p<0.001). All children who survived achieved nutritional recovery (>85% weight for height and no oedema), regardless of HIV status. HIV-infected children had similar weight gain to HIV-uninfected children (8.9 vs 8.0 g/kg/d, not significant (NS)). Mean increases in z-scores for both subscapular (2.72 vs 2.69, NS) and triceps (1.26 vs 1.48, NS) skinfolds were similar between HIV-infected and HIV-uninfected children, respectively, during nutrition rehabilitation. 362 children were followed for 4 months, at which time mean weight for height z-score was similar in HIV-infected and HIV-uninfected children (-0.85 vs -0.64, NS). CONCLUSIONS: HIV-infected children with SAM have higher mortality rates than HIV-uninfected children. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children. Language: English Keywords: MALAWI | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILDREN | HIV INFECTIONS | MALNUTRITION | CASE FATALITY RATE | GROWTH | ANTHROPOMETRY | BODY WEIGHT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Nutrition Disorders | Death Rate | Mortality | Population Dynamics | Child Development | Biology | Measurement | Physiology Document Number: 342645 |
| 25. Title: Reduced rate of adverse reactions to the BCG vaccine in children exposed to the vertical transmission of HIV infection and in HIV-infected children from an endemic setting in Brazil. Author: Fernandes RC; de Araujo LC; Medina-Acosta E Source: European Journal of Pediatrics. 2009 Jun;168(6):691-6. Abstract: We report on the adverse reactions to the Bacillus Calmette-Guerin (BCG) vaccine in BCG-vaccinated children. We examined children exposed to the vertical transmission of human immunodeficiency virus (HIV) (n = 141), who participated in a prevention program of vertical transmission, and HIV-infected children (n = 66) in a setting endemic for HIV and tuberculosis (TB) in Brazil from August 2000 to February 2008. No cases of disseminated BCG disease occurred in either group of children. While no cases of regional BCG disease were noted in exposed/uninfected children, the rate of regional BCG disease in HIV-infected children was 4.5% (3/66); the three events occurred in <1-year-old children (3/17; 17.6%). One case was associated with severe immunodepression before highly active antiretroviral therapy (HAART). Two cases were manifestations of immune reconstitution inflammatory syndrome (IRIS). Among the HIV-infected children, the accrued benefits of potentially preventing severe TB outweighed the risks associated with the use of the BCG vaccine. Language: English Keywords: BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | VACCINES | SIDE EFFECTS | MOTHER-TO-CHILD TRANSMISSION | IMMUNOLOGICAL EFFECTS | ANTIRETROVIRAL THERAPY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Transmission | Immunity | Immune System | Physiology | Biology | HIV Document Number: 342835 |
| 26. Peer Reviewed Title: Successful integration of tuberculosis and HIV treatment in rural South Africa: the Sizonq'oba study. Author: Gandhi NR; Moll AP; Lalloo U; Pawinski R; Zeller K; Moodley P; Meyer E; Friedland G Author: Tugela Ferry Care and Research (TFCaRes) Collaboration Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Jan 1;50(1):37-43. Abstract: BACKGROUND: Tuberculosis (TB) is the leading cause of death among HIV-infected patients worldwide. In KwaZulu-Natal, South Africa, 80% of TB patients are HIV coinfected, with high treatment default and mortality rates. Integrating TB and HIV care may be an effective strategy for improving outcomes for both diseases. METHODS: Prospective operational research study treating TB/HIV-coinfected patients in rural KwaZulu-Natal with once-daily antiretroviral (ARV) therapy concurrently with TB therapy by home-based, modified directly observed therapy. Patients were followed for 12 months after ARV initiation. RESULTS: Of 119 TB/HIV-coinfected patients enrolled, 67 (56%) were female, mean age was 34.0 years, and median CD4 count was 78.5 cells per cubic millimeter. After 12 months on ARVs, mean CD4 count increase was 211 cells per cubic millimeter, and 88% had an undetectable viral load; 84% completed TB treatment. Thirteen patients (11%) died; 10 (77%) with multidrug-resistant or extensively drug-resistant TB. There were few severe adverse events or immune reconstitution events. Adherence was high with 93% of study visits attended and 99% of ARV doses taken. CONCLUSIONS: Integration of TB and HIV treatment in a rural setting using concurrent home-based therapy resulted in excellent adherence and TB and HIV outcomes. This model may result in successful management of both diseases in other rural resource-poor settings. Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | PROSPECTIVE STUDIES | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | AIDS PREVENTION | TREATMENT | RURAL HEALTH SERVICES | COMPLICATIONS | ANTIRETROVIRAL THERAPY | HOME VISITS | DRUG RESISTANCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Communication Document Number: 330981 |
| 27. Peer Reviewed Title: Predicting preparatory behaviours for condom use in female undergraduate students: a one-year follow-up study. Author: Gebhardt WA; van Empelen P; van Beurden D Source: International Journal of STD and AIDS. 2009 Mar;20(3):161-4. Abstract: The objective of this study is to investigate whether the Theory of Planned Behaviour (i.e. attitude, subjective norm, perceived behavioural control and intention), fluctuations in motivation over time, and variables from the Prototype-Willingness Model (i.e. behavioural expectation and behavioural willingness to have unprotected sex) predict preparatory behaviours for condom use. Sixty-two female undergraduates completed baseline and one-year follow-up questionnaires. Having condoms at home and carrying condoms were predicted by behavioural willingness to have unsafe sex at baseline. Having bought condoms was predicted by the behavioural expectation to use condoms with new partners at baseline. Intention and fluctuations in motivation did not emerge as significant predictors of preparatory actions. Female undergraduates, who are more willing to have unprotected sex under risk-conducive circumstances, are also less likely to prepare adequately for condom use, and thereby increase their chances of encountering such situations. Overall, the findings are in support of the Prototype-Willingness Model. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | YOUTH | WOMEN | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX EDUCATION | MOTIVATION | SEX BEHAVIOR | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Psychological Factors Document Number: 330465 |
| 28. Title: A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India. Author: George C; Yesoda A; Jayakumar B; Lal L Source: Journal of Clinical Pharmacy and therapeutics. 2009 Feb;34(1):33-40. Abstract: OBJECTIVE: This prospective, observational, study evaluates the clinical outcomes, drug utilization patterns, and adherence to treatment of patients on highly active anti retroviral therapy (HAART) at a government institution in Kerala, India. METHODS: Patients who met criteria for treatment of HIV/AIDS were enrolled into the study, given free NNRTI-based combination therapy, and were followed for a period of 6 months. Data regarding demographics, clinical outcome, laboratory results, drug utilization, adherence and adverse effects were collected. Analysis was conducted utilizing descriptive statistics, anova, Fisher-exact, andt-test. RESULTS: One hundred and forty-two patients with HIV-1 were enrolled in the study into three treatment groups. The mean age was 37.88 years, 64% of the patients were male, and 92% were married. Group 1 was given zidovudine, lamivudine, and nevirapine [n = 52 (37%)], group 2 was given lamivudine, stavudine, and nevirapine [n = 51 (36%)], and group 3 was given lamivudine, stavudine, and efavirenz [n = 39 (27%)]. The increase in CD4 was 107.46 (SD: 106.25). Mean medication adherence for the 104 patients who completed the study, was 90.7%; for group 1: 92.06%, group 2: 93.37%1, and group 3: 85.71% (P > 0.05). Forty (38%) patients have at least one adverse event to HARRT, with headache being the most common side effect (11.5%). Mortality rate was 3.5% during the course of the study. CONCLUSION: Provision of free NNRTI-based combination therapy to patients in Kerala, India, resulted in greater than 90% adherence leading to better clinical outcomes in terms of increasing CD4 counts and low mortality, for patients consistently attending a treatment clinic. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COST BENEFIT ANALYSIS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | COST EFFECTIVENESS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HEADACHE | SIDE EFFECTS | DEATH RATE | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Evaluation Indexes | HIV | Behavior | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 330372 |
| 29. Peer Reviewed Title: Sexual behaviour, condom use and rates of sexually transmitted infections in HIV clinic attendees in South East London. Author: Hamlyn E; Welz T; Rebaudengo S; Simms H; Poulton M Source: International Journal of STD and AIDS. 2009 Sep 16; Abstract: The aim of this study was to examine sexual behaviour, condom use and rates of sexually transmitted infections (STIs) among attendees at a dedicated on-site STI clinic at a South London HIV centre. Data were prospectively collected by using a nurse-completed questionnaire. Ninety-eight percent of women reported one or no sexual partners in the preceding three months, whereas 57% of men who have sex with men (MSM) reported two or more partners. Only 28% of women, 53% of heterosexual men and 29% of MSM always used a condom for vaginal or anal intercourse. Positive STI diagnoses were found in 17.5% of women, 20% of heterosexual men and 49% of MSM. Twenty percent of patients who reported always using a condom and 38% of MSM reporting no sexual activity in the preceding three months had an STI. These results highlight the need for safe sex promotion and STI screening in HIV-infected patients regardless of self-reported sexual activity. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | QUESTIONNAIRES | CLINIC ACTIVITIES | SCREENING | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342841 |
| 30. Title: Metabolic and endocrine effects of metformin and metformin plus cyclic medroxyprogesterone acetate in women with polycystic ovary syndrome. Author: Haydardedeoglu B; Simsek E; Kilicdag EB; Bagis T Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):32-5. Abstract: OBJECTIVE: To evaluate the metabolic and endocrine effects of treatment with cyclic medroxyprogesterone acetate (MPA) plus metformin compared with metformin alone in women with PCOS. METHODS: In this prospective randomized study of women with PCOS, 20 women received 850 mg of metformin twice a day, and 20 women received 850 mg of metformin plus 5 mg of MPA twice a day. Body mass index, hormonal and lipid blood profiles, homocysteine blood level, and insulin sensitivities assessed by homeostasis model assessment (HOMA) were recorded at baseline and at 3 months. RESULTS: Total cholesterol levels decreased in the metformin plus MPA group (P=0.002) but did not change significantly in the metformin group (P=0.159). While homocysteine levels remained unchanged in the metformin plus MPA group, they increased significantly in the metformin group (P=0.002). CONCLUSION: There were no adverse effects of short-term cyclic MPA plus metformin treatment on metabolic parameters or insulin resistance in patients with PCOS over a 3-month treatment period. Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | MEDROXYPROGESTERONE ACETATE | OVARIAN CYSTS | TREATMENT | ENDOCRINE EFFECTS | METABOLIC EFFECTS | CHOLESTEROL | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Program Activities | Programs | |