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1.          Title: Migration of an intrauterine contraceptive device during the course of pregnancy: a case report. Author: Glass T; Baker T; Kauffman RP Source: Journal of Minimally Invasive Gynecology. 2009 Jan-Feb;16(1):81-3. Abstract: Uterine perforation by a contraceptive intrauterine device (IUD) is a relatively rare event. These events may result secondary to mechanical force applied during placement (primary perforation) or migration by uterine contractions or surgical manipulation after placement (secondary perforation). A 33-year-old woman with an IUD placed 9 years before admission visited the emergency department with an early pregnancy and a 3-day history of vaginal bleeding. Vaginal examination revealed IUD strings visible at the cervical os, and transvaginal ultrasound confirmed the presence of an IUD in the lower uterine segment and upper cervix. The IUD migrated spontaneously to the fundal myometrium at 15 weeks' gestation. Premature rupture of membranes ensued at 20 weeks' gestation, and, at delivery, the IUD could not be retrieved. Subsequent computed tomography confirmed that the IUD was incompletely embedded in the fundal myometrium and partially extending into the peritoneal cavity. At laparoscopic sterilization 6 weeks later, the IUD had perforated the small bowel, and the device was removed with concomitant bowel repair. This case documents spontaneous migration of a copper IUD from the lower uterine segment through the fundus during early pregnancy and supports removal of asymptomatic ectopic IUDs whenever possible. Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | CASE STUDIES | WOMEN | PREGNANCY | IUD | CONTRACEPTION FAILURE | UTERINE PERFORATION | LAPAROSCOPY | IUD MIGRATION | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Perforations | Diseases | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330821

2.          Title: Editorial fair play and emergency contraception [letter] Author: Kauffman RP Source: Southern Medical Journal. 2009 May;102(5):551. Abstract: With pleasure and a sense of academic responsibility, I accepted an invitation to submit an editorial addressing a paper by Galvin and Fagan in the January 2009 issue of Southern Medical Journal. Subsequently, I read with interest a thoughtful second editorial which addressed not only the investigation by Galvin and Fagan but also commented on my editorial. A second perspective is fair enough, of course, given that emergency contraception (EC) is viewed with controversy by some. In the spirit of robust debate, I offer the following comments that I would have included in my original editorial had the opportunity been granted. Jones and Stammers ventured that I "bravely risk tautology" by stating that EC does not act at the postimplantation level. In response, I would ask that they be able to offer reasonable evidence-based data that it does. Instead, they provided only speculation. Considerable evidence supports inhibition of ovulation as EC's mechanism of action,while implantation prevention remains unsubstantiated. Nonhuman primate and murine models have failed to demonstrate a postfertilization effect by levonorgestrel-containing EC. While I agree that human data would be welcomed, this task will prove methodologically and statistically daunting given that most fertilized ova do not implant in vivo under normal conditions. The American College of Obstetricians and Gynecologists (ACOG) Practice Guideline (on which my statement concerning EC's mechanism of action was plainly referenced) is based on best available medical evidence. ACOG recommendations are regularly updated when better evidence arises. One could only wish for the same equanimity from governmental regulatory agencies cued by ideological communities. Jones and Stammers quibble with the meaning of "efficacy," but their contention that EC is ineffective is little more than cherry-picking the literature. The recent Cochrane Database Systematic Review of the 81 randomized, controlled trials concluded that EC does work although mifepristone is more effective than levonorgestrel (Plan BŪ) or the Yuzpe method. In fact, the Cochrane Plain Language Summary concludes, "Mifepristone and levonorgestrel are very effective with few adverse effects . . .." Confounders, some known and others more obscure, may explain the relative lack of benefit of EC in some published trials. Scientific debate is healthy and necessary, and it is imperative that medical journals assure that the discussion is sound and bidirectional. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | CRITIQUE | EMERGENCY CONTRACEPTION | LEVONORGESTREL | RU-486 | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | North America | Americas | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Effectiveness Document Number: 341207

3.          Peer Reviewed Title: Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users. Author: Le YC; Rahman M; Berenson AB Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 1):279-84. Abstract: OBJECTIVE:: To examine if early weight gain in depot medroxyprogesterone acetate (DMPA) users predicts continued excessive weight gain and to identify risk factors of early weight gain in DMPA users. METHODS:: Depot medroxyprogesterone acetate users (N=240) were assessed before initiating contraception and every 3 months for 36 months. Early weight gain was defined as more than 5% baseline weight gain within 6 months of DMPA use. Mean weight gain at 6-month intervals was estimated based on early weight gain status (at or below 5% gain compared with above 5% gain). Multiple logistic and mixed-model regression analyses were used. RESULTS:: About one-fourth of DMPA users had early weight gain. The mean weight gain of the at or below 5% group and above 5% group was 0.63 kg and 8.04 kg, 1.48 kg and 10.86 kg, and 2.49 kg and 11.08 kg after 12, 24, and 36 months (P<.001 at all observations), respectively. Early weight gainers also had a much steeper slope of weight gain over time than the regular weight gainers (0.35 kg/month compared with 0.08 kg/month, P<.001). Risk factors for early weight gain were body mass index less than 30 (odds ratio [OR] 4.00, 95% confidence interval [CI] 1.513-10.455), parity (OR 2.23, 95% CI:1.040-4.761), and self-reported increased appetite after 6 months of DMPA use (OR 3.06, 95% CI 1.505-6.214). CONCLUSION:: Most DMPA users who gain excessive weight experience more than a 5% weight increase within 6 months. These data help physicians predict who is at risk of excessive gain and counsel them appropriately. LEVEL OF EVIDENCE:: II. Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | WOMEN | MEDROXYPROGESTERONE ACETATE | ORAL CONTRACEPTIVES, SIDE EFFECTS | BODY WEIGHT | RISK FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology Document Number: 342271

4.          Title: Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner Syndrome. Author: Murphy EH; Davis CM; Journeycake JM; Demuth RP; Arko FR Source: Journal of Vascular Surgery. 2009 Mar;49:697-703. Abstract: OBJECTIVE: May-Thurner syndrome is characterized by left common iliac obstruction secondary to compression of the left iliac vein by the right common iliac artery against the fifth-lumbar vertebra. This anatomic variant results in an increased incidence of left-sided deep venous thrombosis (DVT). Furthermore, while a preponderance of left-sided DVT has been demonstrated in women during pregnancy and oral contraceptive use, patients are not typically screened for this condition after developing a left-sided DVT. As anticoagulation alone is ineffective for DVT treatment in the setting of May-Thurner anatomy, more aggressive treatment is warranted. Failure to diagnosis this condition predisposes these women to the unnecessary risks of recurrent DVT and post-thrombotic syndrome. METHODS: We present the occurrence of 7 adolescent patients with previously undiagnosed May-Thurner syndrome who presented with DVT after the initiation of oral contraceptive steroids (OCP) use. All 7 patients elected to proceed with mechanical thrombolysis/catheter based thrombolysis followed by endovascular stenting and were postoperatively treated with 6 months of warfarin. RESULTS: Mean patient age was 18.3 +/- 3.3 years (range, 16-24 years). Mean time to presentation after initiation of OCP was 5 weeks (range, 2-10 weeks). Mean time to intervention was 16.8 days (range, 10-24 days). All patients were treated with mechanical thrombectomy. Our rate of intraoperative clot resolution was 100%. All 7 patients were treated with self expanding nitinol stents after angioplasty of the iliac vein stenosis with resolution of the stenotic segment. Primary stent patency is 100% (7/7). Mean follow-up time is 13 +/- 13.84 months (range, 6-42 months). There have been no long-term complications related to surgical treatment or anticoagulation. All 7 patients have experienced resolution of left leg swelling and pain and have no evidence of post-thrombotic syndrome or DVT recurrence to date. CONCLUSIONS: Women on OCPs presenting with left-sidediliofemoral DVT should be screened for hypercoagulable disorders and underlying May-Thurner anatomy. Treatment of May-Thurner syndrome should include thrombolysis/thrombectomy and anticoagulation for current DVT in addition to angioplasty and stenting of the underlying obstruction. Language: English Keywords: TEXAS | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | VASCULAR DISEASES | ORAL CONTRACEPTIVES, SIDE EFFECTS | THROMBOSIS | TIME FACTORS | TREATMENT | SURGERY | BLOOD COAGULATION EFFECTS | EDEMA | PAIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Contraceptive Safety | Safety | Public Health | Health | Thromboembolism | Embolism | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Hematological Effects | Hemic System | Physiology | Biology | Signs and Symptoms Document Number: 329670

5.          Title: Confronting the legal risks of prescribing the contraceptive patch with ongoing litigation [letter] Author: Patsner B Source: Obstetrics and Gynecology. 2009 Jun;113(6):1367. Abstract: The valuable commentary by Drs. Phelps and Kelver on potential liability issues for physicians prescribing the Ortho-Evra (norelgestromin/ethinyl estradiol [E2]), Ortho Women's Health & Urology, Raritan, NJ) contraceptive patch1 provides a much-needed start, but only one perspective, on this important and ongoing clinical practice issue. As a food and drug law attorney as well as a former Senior Medical Officer in the Division at the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration (FDA), which handled the original approval of the contraceptive patch as well the ensuing controversy, I would like to provide additional information and a different perspective. None of the major verdicts on the contraceptive patch litigation are in yet. There is likely to be more information, some potentially negative, forthcoming on both FDA and sponsor conduct. There was a great deal of controversy within the FDA itself over whether the controversy was handled correctly, whether the original new drug application should have been approved, how the original data and the data corrections on pharmacokinetics and adverse events were reviewed and rereviewed, whether there was an attempt at "information control" of either FDA errors or unfavorable information about the product, and significant internal disagreements over the general lack of timely cooperation by the FDA with organizations such as the American College of Obstetricians and Gynecologists when the latter urgently requested guidance for its member physicians. The two studies quoted by the authors clearly do not provide a sufficient basis for their claim that "the transdermal patch may be the best choice for many patients who prefer the convenience of a weekly patch." Citing the higher incidence of venous thromboembolism in pregnancy as a possible defense to claims concerning the incidence for the contraceptive patch is largely irrelevant because the comparison in any malpractice action will be with oral contraceptives, not pregnancy.Physicians should be aware that even the best informed consent likely will provide little or no shield if they are sued in a medical malpractice action for prescribing the patch and that significant safety concerns remain for this product, particularly because it has been difficult to predict which women are at greatest risk for early embolic events. Absent an overwhelming reason for prescribing the contraceptive patch, I personally think ob-gyns should steer clear of the product. More importantly, it would have been more instructive for the authors to go to the original new drug application itself (readily accessed although the Center for Drug Evaluation and Research Web site at www.cder.fda.gov) to discuss the original safety data as well as why the approval decision was made, rather than just citing the labeling update or an FDA "Talk Paper." Even a cursory perusal of the original new drug application2 reveals many pages discussing concerns about the potentially higher risk of venous thromboembolism for this product. Because there are no firm FDA "rules" for determining the outcome of the risk-benefit calculus for any new prescription drug product, and because the patch not only did not work "better" than existing oral contraceptives but also had a potentially greater risk, the justification for approving the product was largely because it was a novel delivery system. The fact is that the FDA can and does approve new drug products that are less effective or more dangerous than existing drug products already on the market. All practicing physicians should be aware of this. When drug safety is less of an FDA priority than getting new products to market (as was the case under the Bush administration), the risks to patients will be greater. When the FDA does its job poorly, regulation of big pharma depressingly comes down to the plaintiffs' bar. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | CRITIQUE | USFDA | PRESCRIPTIONS | ETHINYL ESTRADIOL | DRUGS | CONTRACEPTION | PRODUCT APPROVAL | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Legislation Document Number: 341194

6.          Peer Reviewed Title: Confronting the legal risks of prescribing the contraceptive patch with ongoing litigation. Author: Phelps JY; Kelver ME Source: Obstetrics and Gynecology. 2009 Jun;113(6):1367-8. Abstract: As former Senior Medical Officer in the Division at the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration (FDA), which handled the original approval for Ortho Evra (norelgestromin/ethinyl estradiol [E2], Ortho Women's Health & Urology, Raritan, NJ), Dr. Patsner's insider perspective is informative and a worthwhile contribution. However, we respectfully disagree with his comments that "physicians should be aware that even the best informed consent likely will provide little or no shield if they are sued in a medical malpractice action for prescribing the patch . . ." and that ". . . ob-gyns should steer clear of the product." We stand firm that providing proper informed consent is critical not only to providing quality patient care but also to deterring potential lawsuits against physicians prescribing the contraceptive patch. Additionally, despite litigation, we believe that the contraceptive patch should remain an option for many patients. The two primary causes of action that plaintiff attorneys may pursue against physicians prescribing the contraceptive patch are 1) medical negligence for breaching the standard of care by prescribing the contraceptive patch and 2) failure to provide informed consent by not warning patients of the risks of the contraceptive patch. As long as the contraceptive patch remains U.S. Food and Drug Administration-approved, it will be difficult for plaintiff attorneys to prevail in arguing that a physician breached the standard of care by prescribing the contraceptive patch, unless it was prescribed to a patient with a known contraindication to the contraceptive patch. The vast majority of patients seeking birth control do not have known medical contraindications to the contraceptive patch. The best way to negate the other potential cause of action-failure to provide informed consent-is to provide and document informed consent in the medical records. Once informed consent is documented in the medical records, there is the legal presumption in favor of the physician that the medical records are accurate and that the patient was provided proper informed consent. However, this is a rebuttable presumption, and an injured patient will be given the opportunity to dispute that she was not properly informed of the risks and that she would not have chosen the contraceptive patch as a means of contraception if she had been properly informed of the risks. Nevertheless, the legal presumption remains that the information documented in the medical records is accurate. By documenting proper informed consent in the medical records, physicians should be more comfortable in prescribing the contraceptive method they believe best fits the needs of their patients, regardless of ongoing litigation and controversies surrounding a contraceptive product. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | CRITIQUE | USFDA | PHYSICIANS | PRESCRIPTIONS | CONTRACEPTION | PRODUCT APPROVAL | INFORMED CONSENT | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Distributional Activities | Program Activities | Programs | Organization and Administration | Family Planning | Legislation | Health Services Document Number: 341195

7.          Peer Reviewed Title: An event-level analysis of condom use as a function of mood, alcohol use, and safer sex negotiations. Author: Schroder KE; Johnson CJ; Wiebe JS Source: Archives of Sexual Behavior. 2009 Apr;38(2):283-9. Abstract: Daily self-reports of condom-protected intercourse were analyzed as a function of emotional states, alcohol consumption, and safer sex negotiations in a sample of single, low-income Hispanic students. The sample included 15 women and 17 men who reported a minimum of four sexual episodes as well as inconsistent condom use over a 3-month self-reporting period. The analyses focused on 829 days out of 2,586 daily self-reports on which sexual intercourse was reported. Hierarchical linear modeling was used to predict condom-protected intercourse as a function of mood states, substance use, and safer sex negotiations. Safer sex negotiation was the strongest positive predictor of condom use. Contrary to expectation, unprotected intercourse was less likely to occur in episodes characterized by greater negative affect and more likely in episodes in which greater positive mood was reported. No main effect of alcohol consumption on safer sex was observed; however, an interaction between alcohol consumption and positive mood emerged, indicating that unprotected intercourse was most likely to occur when positive mood was combined with alcohol consumption. The results contradict the assumption that emotional distress predicts engagement in more risky sexual behavior and indicate that safer sex negotiations are likely to outweigh any effects of mood or alcohol consumption on subsequent condom use. Language: English Keywords: TEXAS | RESEARCH REPORT | KAP SURVEYS | EVENT HISTORY ANALYSIS | LINEAR REGRESSION | HISPANICS | STUDENTS | CONDOM USE | PARTNER COMMUNICATION | ALCOHOL USE AND ABUSE | SAFER SEX | EMOTIONS | STRESS | RISK BEHAVIOR | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Analysis | Statistical Regression | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Education | Risk Reduction Behavior | Behavior | Interpersonal Relations | Psychological Factors Document Number: 330970

8.          Peer Reviewed Title: Correlates of consistent condom use with main-new and main-old sexual partners. Author: Wiemann CM; Chacko MR; Kozinetz CA; DiClemente R; Smith PB; Velasquez MM; von Sternberg K Source: Journal of Adolescent Health. 2009 Sep;45(3):296-9. Abstract: An exploratory study identified correlates of consistent condom use for young women reporting Main-new or Main-old partners in the past 3 months: frequency of vaginal sex (across partner types); perceived likelihood of getting a STI (Main-new); age and STI history (Main-old). To enhance programmatic efficacy in community clinics, these key correlates of condom use for main partner types should be incorporated in STI risk reduction counseling. Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | ADOLESCENTS | SEXUAL PARTNERS | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 342571

9.    Title: Lessons learned from a binational survey to examine women's health status in the US-Mexico border region [editorial] Author: Delgado E; Castrucci BC; Fonseca V; Dutton RJ; Berrahou F Source: Preventing Chronic Disease. 2008 Oct;5(4):A107. Also available in Spanish: http://www.cdc.gov/pcd/issues/2008/oct/pdf/08_0073_es.pdf Abstract: This editorial discusses lessons learned from the reproductive health surveillance in the US- Mexico border region. It explains that the Brownsville-Matamoros Sister City Project for Women’s Health (BMSCP) overcame many challenges but there is more to be done with expanding the surveillance and making it more consistent and timely. Language: English Keywords: UNITED STATES OF AMERICA | MEXICO | TEXAS | RESEARCH REPORT | HEALTH SURVEYS | WOMEN | WOMEN IN DEVELOPMENT | BORDER CROSSING | INTERNATIONAL COOPERATION | WOMEN'S HEALTH | WOMEN'S STATUS | FAMILY PLANNING | HIV TESTING | PREVALENCE | HIV INFECTIONS | Developed Countries | North America | Americas | Developing Countries | Health | Demographic Factors | Population | Economic Development | Economic Factors | International Migration | Migration | Population Dynamics | Political Factors | Sociocultural Factors | Socioeconomic Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Measurement | Research Methodology | Viral Diseases | Diseases Document Number: 329181

10.          Title: Child health promotion and protection among Mexican mothers. Author: Gallagher MR; Gill S; Reifsnider E Source: Western Journal of Nursing Research. 2008 Aug;30(5):588-605. Abstract: For numerous reasons, children of Mexican descent experience many health disparities. One strategy for addressing these disparities is to increase health promotion and protection behaviors that mothers use with their preschool children. Limited literature is available on such practices used by mothers of Mexican descent with their healthy preschool children. This study explored child health promotion and protection practices used by mothers of Mexican descent. A naturalistic design, guided by Spradley's ethnographic interview techniques, was selected for this study. The sample included 9 Mexican-descent mothers from an urban U.S. community with healthy preschool children. Despite significant challenges, participants promoted and protected the health of their preschool children by al cuidado (taking care) and by being al pendiente (being mindful) of balancing the health of their children's bodies, minds, and souls. Understanding these mothers' approaches allows the creation of culturally sensitive health programs that can build on existing maternal strengths. Language: English Keywords: MEXICO | TEXAS | RESEARCH REPORT | KAP SURVEYS | MOTHERS | CHILDREN | WOMEN IN DEVELOPMENT | IMMIGRANTS | URBAN POPULATION | CHILD HEALTH | PROMOTION | CULTURE | INEQUALITIES | ANTHROPOLOGY, CULTURAL | CHILD CARE | North America | Americas | Developing Countries | United States of America | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Migrants | Migration | Population Dynamics | Health | Marketing | Socioeconomic Factors | Anthropology | Social Sciences | Science | Child Rearing | Behavior Document Number: 328831

11. Title: Characteristics of young women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health. Author: Galvan Gonzalez FG; Mirchandani GG; McDonald JA; Ruiz M; Echegollen Guzman A; Castrucci BC; Gossman GL; Lewis KL Source: Preventing Chronic Disease. 2008 Oct;5(4):A120. Abstract: INTRODUCTION: Childbearing during adolescence and young adulthood is associated with adverse effects on health and quality of life. Lowering birth rates among young women is a binational priority in the US-Mexico border region, yet baseline information about birth rates and pregnancy risk is lacking. Increased understanding of the characteristics of young women who give birth in the region will help target high-risk groups for sexual and reproductive health services. METHODS: We examined data on reproductive health characteristics collected in hospitals from 456 women aged 24 years or younger who gave birth from August 21 through November 9, 2005, in Matamoros, Tamaulipas, Mexico, and Cameron County, Texas. We calculated weighted percentages and 95% confidence intervals (CIs) for each characteristic and adjusted odds ratios (AORs) for Matamoros and Cameron County women by using multiple logistic regression techniques. RESULTS: Numbers of births per 1,000 women aged 15 to 19 years and 20 to 24 years were similar in the 2 communities (110.6 and 190.2 in Matamoros and 97.5 and 213.1 in Cameron County, respectively). Overall, 38.5% of women experienced cesarean birth. Matamoros women reported fewer prior pregnancies than did Cameron County women and were less likely to receive early prenatal care but more likely to initiate breastfeeding. Few women smoked before pregnancy, but the prevalence of alcohol use in Cameron County was more than double that of Matamoros. In both communities combined, 34.0% of women used contraception at first sexual intercourse. CONCLUSION: Despite geographic proximity, similar ethnic origin, and comparable birth outcomes, young Mexican and US women showed different health behavior patterns. Findings suggest possible pregnancy prevention and health promotion interventions. Language: English Keywords: MEXICO | TEXAS | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | WOMEN'S HEALTH | REPRODUCTIVE HEALTH | BIRTH RATE | CESAREAN SECTION | ANTENATAL CARE | BREASTFEEDING | TOBACCO USE | ALCOHOL USE AND ABUSE | North America | Americas | Developing Countries | United States of America | Developed Countries | Comparative Studies | Studies | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health | Fertility Measurements | Fertility | Population Dynamics | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Infant Nutrition | Nutrition | Behavior Document Number: 329177

12. Title: Prenatal HIV testing in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health. Author: Gossman GL; Carillo Garza CA; Johnson CH; Nichols JJ; Castrucci BC; McDonald JA; Lewis KL; Mirchandani GG Source: Preventing Chronic Disease. 2008 Oct;5(4):A121. Abstract: INTRODUCTION: Routine prenatal human immunodeficiency virus (HIV) screening provides a critical opportunity to diagnose HIV infection, begin chronic care, and prevent mother-to-child transmission. However, little is known about the prevalence of prenatal HIV testing in the US-Mexico border region. We explored the correlation between prenatal HIV testing and sociodemographic, health behavior, and health exposure characteristics. METHODS: The study sample consisted of women who delivered live infants in 2005 in hospitals with more than 100 deliveries per year and resided in Matamoros, Tamaulipas, Mexico (n = 489), or Cameron County, Texas (n = 458). We examined univariate and bivariate distributions of HIV testing in Matamoros and Cameron County and quantified the difference in odds of HIV testing by using logistic regression. RESULTS: The prevalence of prenatal HIV testing varied by place of residence--57.6% in Matamoros and 94.8% in Cameron County. Women in Cameron County were significantly more likely than those in Matamoros to be tested. Marital status, education, knowledge of methods to prevent HIV transmission (adult-to-adult), discussion of HIV screening with a health care professional during prenatal care, and previous HIV testing were significantly associated with prenatal HIV testing in Matamoros, although only the latter 2 variables were significant in Cameron County. CONCLUSION: Although national policies in both the United States and Mexico recommend prenatal testing for HIV, a greater proportion of women in Cameron County were tested, compared with women in Matamoros. Efforts between Matamoros and Cameron County to improve HIV testing during pregnancy in the border region should consider correlates for testing in each community. Language: English Keywords: MEXICO | TEXAS | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | STATISTICAL REGRESSION | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HIV TESTING | ANTENATAL CARE | SCREENING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MARITAL STATUS | EDUCATIONAL STATUS | KNOWLEDGE | North America | Americas | Developing Countries | United States of America | Developed Countries | Comparative Studies | Studies | Research Methodology | Data Analysis | Surveys | Sampling Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Disease Transmission Control | Prevention and Control | Diseases | Nuptiality | Socioeconomic Status | Socioeconomic Factors | Sociocultural Factors Document Number: 329176

13.          Peer Reviewed Title: Accuracy of self-screening for contraindications to combined oral contraceptive use. Author: Grossman D; Fernandez L; Hopkins K; Amastae J; Garcia SG Source: Obstetrics and Gynecology. 2008 Sep;112(3):572-8. Abstract: OBJECTIVE: To estimate how well a convenience sample of women from the general population could self-screen for contraindications to combined oral contraceptives using a medical checklist. METHODS: Women 18-49 years old (N=1,271) were recruited at two shopping malls and a flea market in El Paso, Texas, and asked first whether they thought birth control pills were medically safe for them. They then used a checklist to determine the presence of level 3 or 4 contraindications to combined oral contraceptives according to the World Health Organization Medical Eligibility Criteria. The women then were interviewed by a blinded nurse practitioner, who also measured blood pressure. RESULTS: The sensitivity of the unaided self-screen to detect true contraindications was 56.2% (95% confidence interval [CI] 51.7-60.6%), and specificity was 57.6% (95% CI 54.0-61.1%). The sensitivity of the checklist to detect true contraindications was 83.2% (95% CI 79.5-86.3%), and specificity was 88.8% (95% CI 86.3-90.9%). Using the checklist, 6.6% (95% CI 5.2-8.0%) of women incorrectly thought they were eligible for use when, in fact, they were contraindicated, largely because of unrecognized hypertension. Seven percent (95% CI 5.4-8.2%) of women incorrectly thought they were contraindicated when they truly were not, primarily because of misclassification of migraine headaches. In regression analysis, younger women, more educated women, and Spanish speakers were significantly more likely to correctly self-screen (P<.05). CONCLUSION: Self-screening for contraindications to oral contraceptives using a medical checklist is relatively accurate. Unaided screening is inaccurate and reflects common misperceptions about the safety of oral contraceptives. Over-the-counter provision of this method likely would be safe, especially for younger women and if independent blood pressure screening were encouraged. Language: English Keywords: TEXAS | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | KNOWLEDGE | WHO | BLOOD PRESSURE | SELF CARE | SCREENING | HYPERTENSION | MIGRAINE | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Sociocultural Factors | UN | International Agencies | Organizations | Political Factors | Hemic System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Examinations and Diagnoses | Vascular Diseases | Diseases Document Number: 329053

14.          Peer Reviewed Title: Prior pill experiences and current continuation among pill restarters. Author: Kalmuss D; Koenemann S; Westhoff C; Heartwell S; Edwards S; Zieman M; Cushman L; Robilotto C; Stuart G Source: Perspectives on Sexual and Reproductive Health. 2008 Sep;40(3):138-43. Abstract: CONTEXT: Discontinuation of oral contraceptives often puts women at risk for unintended pregnancies. Understanding why a woman discontinued pill use can provide insight into her risk of discontinuation if she restarts use. METHODS: Women younger than 25 obtaining oral contraceptives at three university health centers in 2003-2005 were recruited to participate in a randomized trial; 628 former users were interviewed about their previous experience with the method, and were followed up three months after restarting use. Bivariate and multinomial logistic regression analyses were used to assess the relationship between prior reasons for stopping pill use and method continuation. RESULTS: Women who had discontinued using oral contraceptives because of side effects were less likely to be very sure about restarting the pill at baseline (73%) than were those who had stopped for logistical or fertility-related reasons (88-94%). They also were less likely to have been satisfied with the pill in the last use interval (49% vs. 95-98%) and less likely to be satisfied with it in the three months after restarting (76% vs. 89-93%). These women were more likely to report a short duration of use than an intermediate duration or continuous use during follow-up (odds ratios, 2.5 and 4.5). CONCLUSIONS: When counseling women who are restarting pill use, providers should ask about their experiences with the method and reasons for discontinuation; counseling for women who discontinued because of side effects should address their risk factors for early discontinuation and informing them about other contraceptive choices. Language: English Keywords: TEXAS | NEW YORK | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTION TERMINATION | CONTRACEPTION CONTINUATION | MOTIVATION | ORAL CONTRACEPTIVES, SIDE EFFECTS | FERTILITY | LOGISTICS | SATISFACTION | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Safety | Safety | Public Health | Health | Population Dynamics | Management | Organization and Administration Document Number: 329168

15.          Title: Parent-Adolescent Relationship Education (PARE): Program delivery to reduce risks for adolescent pregnancy and STDs. Author: Lederman RP; Chan W; Roberts-Gray C Source: Behavioral Medicine. 2008 Winter;33(4):137-144. Abstract: The first author recruited parent-adolescent dyads (N = 192) into after-school prevention education groups at middle schools in southeast Texas. This author placed participants in either (1) an Interactive Program (IP) in which they role-played, practiced resistance skills, and held parent-child discussions or (2) an Attention Control Program (ACP) that used the same curriculum but was delivered in a traditional, didactic format. Questionnaires administered at the beginning and end of the 4-session program and again after booster sessions in 3 subsequent semesters provided measures of social controls (eg, communication with parents) and self controls (eg, protection against risk) on the youths' sexual health behaviors. Linear mixed models adjusted for gender, age, and ethnicity showed that the IP, in comparison with the ACP, achieved significant gains in social control by increasing parental rules about having sex and other risky behaviors and also enhanced students' self-control by increasing their knowledge about prevention and enhancing resistance responses when pressured to have sex. (author's) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | ADOLESCENTS | ADOLESCENT PREGNANCY | PARENTAL INVOLVEMENT | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREVENTION AND CONTROL | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Child Rearing | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration Document Number: 326928

16.          Peer Reviewed Title: Condom use among high-risk heterosexual women with concurrent sexual partnerships, Houston, Texas, USA. Author: Richards JE; Risser JM; Padgett PM; Rehman HU; Wolverton ML; Arafat RR Source: International Journal of STD and AIDS. 2008 Nov;19(11):768-71. Abstract: Concurrent sexual partnerships allow for enhanced transmission of sexually transmitted infections (STIs). Condom use dynamics in this context may be an important factor for transmission of HIV. We conducted a cross-sectional study to describe the frequency of concurrency among high-risk heterosexual women in Houston, Texas and determine the factors associated with condom use. A total of 553 participants were recruited using respondent-driven sampling and completed an anonymous questionnaire; 256 (49%) were identified as having a concurrent partnership. The prevalence of condom use at last sexual encounter was 26%. Women were significantly more likely to use condoms if their sexual encounter was with a casual partner and if alcohol and/or drugs were not used. The high prevalence of concurrent partnerships suggests the presence of a dense sexual network which may enable the rapid spread of STIs and HIV. The risk of transmission may be additionally increased due to the low prevalence of condom use. Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SEXUAL PARTNERS | WOMEN | HETEROSEXUALS | CONDOM USE | HIV TRANSMISSION | RISK BEHAVIOR | RISK FACTORS | RISK ASSESSMENT | Developed Countries | North America | Americas | Research Methodology | Sex Behavior | Behavior | Demographic Factors | Population | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Biology | Evaluation Document Number: 330482

17. Title: Prior contraceptive use among women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health. Author: Robles JL; Lewis KL; Folger SG; Ruiz M; Gossman G; McDonald JA; Castrucci BC; Perez M; Zapata L; Garcia I; Marchbanks PA Source: Preventing Chronic Disease. 2008 Oct;5(4):A128. Abstract: INTRODUCTION: Dramatic population growth in the US-Mexico border region suggests more effective family planning services are needed, yet binational data are scarce. The Brownsville-Matamoros Sister City Project for Women's Health collected binational, standardized data from 947 postpartum women in Cameron County (Texas) and Matamoros (Tamaulipas, Mexico) hospitals from August through November 2005. METHODS: We analyzed these data to estimate the proportion of women with unintended pregnancy and the proportion of these women who reported contraceptive use, and to identify associated factors. RESULTS: The current pregnancy was unintended for 48% of women overall. Almost half of these women reportedly used birth control at conception, but many used low-efficacy methods. Among women with unintended pregnancy who did not use contraception, 34.1% of Mexico residents believed they could not become pregnant and 28.4% of US residents reported no reason for nonuse. Overall, contraceptive use to prevent pregnancy was less common among younger than older women and among women who had not graduated high school compared with those who had. Among Mexico residents, those who had a source of routine health care were more likely than those who did not to have used contraception. CONCLUSION: More effective contraceptive practices are needed in this population, especially among younger and less-educated women. A cooperative binational approach that integrates reproductive and family planning services may be most effective. Language: English Keywords: MEXICO | TEXAS | RESEARCH REPORT | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | CROSS-CULTURAL COMPARISONS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | CONTRACEPTIVE PREVALENCE | PREGNANCY, UNWANTED | CONTRACEPTIVE EFFECTIVENESS | MOTIVATION | AGE FACTORS | EDUCATIONAL STATUS | North America | Americas | Developing Countries | United States of America | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Comparative Studies | Economic Development | Economic Factors | Puerperium | Reproduction | Contraceptive Usage | Contraception | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Psychological Factors | Behavior | Population Characteristics | Socioeconomic Status | Socioeconomic Factors Document Number: 329175

18.          Title: The potential impact of a prophylactic herpes simplex vaccine. Author: Rupp R; Bernstein DI Source: Expert Opinion on Emerging Drugs. 2008 Mar;13(1):41-52. Abstract: Herpes Simplex virus (HSV) infections had a significant impact on health causing a wide range of diseases. Oral-facial and genital sites are the most common locations of infection and may lead to recurrent painful lesions. HSV infection acquired perinatally may result in severe sequelae or even death despite appropriate therapy. Furthermore, it is becoming increasingly clear that genital HSV infections significantly raise the risk of HIV transmission. The objective was to describe the strategies, impediments, and advancements in the development of vaccines to prevent HSV disease. A review of the literature was performed, limited to prophylactic HSV vaccines and their potential effect on genital herpes, oral-facial disease, and perinatal herpes. There are several vaccine strategies under development that show promise for the treatment these diseases. (author's) Language: English Keywords: TEXAS | LITERATURE REVIEW | CLINICAL RESEARCH | TARGET POPULATION | VACCINES | HERPES GENITALIS | MOTHER-TO-CHILD TRANSMISSION | NEONATAL DISEASES AND ABNORMALITIES | HIV TRANSMISSION | RISK FACTORS | SEXUALLY TRANSMITTED DISEASE PREVENTION | RESEARCH AND DEVELOPMENT | NEEDS ASSESSMENT | United States of America | North America | Americas | Developed Countries | Research Methodology | Program Design | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Transmission | HIV Infections | Viral Diseases | Biology | Technology | Economic Factors | Evaluation Document Number: 325254

19.          Peer Reviewed Title: Frequency and management of breakthrough bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial. Author: Sulak PJ; Smith V; Coffee A; Witt I; Kuehl AL Source: Obstetrics and Gynecology. 2008 Sep;112(3):563-71. Abstract: OBJECTIVE: To assess bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage breakthrough bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process, but if breakthrough bleeding/spotting occurred for 5 days or more, they were to remove the ring for 4 days, store it, and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal bleeding during continuous use, with group 2 experiencing a statistically greater percentage of days without breakthrough bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving breakthrough bleeding/spotting than continuing ring use. CONCLUSION: A reduction in bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable bleeding profile in most patients, reduction in flow, reduction in pelvic pain, and a high continuation rate. Language: English Keywords: TEXAS | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | WOMEN | VAGINAL RING | BLEEDING | MENSTRUATION DISORDERS | COMPLICATIONS | TREATMENT | PAIN | PELVIS | United States of America | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Anatomy | Biology Document Number: 329054

20.          Peer Reviewed Title: Fetal and early postnatal environmental exposures and reproductive health effects in the female. Author: Woodruff TK; Walker CL Source: Fertility and Sterility. 2008 Feb;89(2 Suppl 1):e47-e51. Abstract: The environment influences not only the development of the reproductive system, but also impacts adult reproductive function. Environmental cues such as the light:dark cycle, caloric signals, and pheromones are integrated at the central nervous system and, in combination with endogenous endocrine and paracrine signals, create a permissive or nonpermissive environment for the initiation and maintenance of the normal reproductive cycle. On the other hand, exposure to environmental agents can have profound negative effects on the development and function of the reproductive tract. The developmental programming hypothesis proposes that at critical times during development, exposure of developing tissues to an adverse stimulus or insult can permanently reprogram normal physiologic responses, and so give rise to metabolic and hormonal disorders later in life. The female reproductive tract has been shown to be a target for developmental programming as a result of environmental hormone exposure. This short review presents current research into the role of the environment in normal female reproductive function and pathogenesis, specifically focusing on the ovary and uterus. (excerpt) Language: English Keywords: TEXAS | LITERATURE REVIEW | CLINICAL RESEARCH | FETUS | PREGNANT WOMEN | WOMEN | ENVIRONMENT | TOXICITY | OVARIAN EFFECTS | FOLLICLE STIMULATING HORMONE | ESTROGENS | UTERUS | DIETHYLSTILBESTROL | REPRODUCTIVE HEALTH | POSTPARTUM | United States of America | North America | Americas | Developed Countries | Research Methodology | Pregnancy | Reproduction | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Health | Puerperium Document Number: 325258

21.    Title: Infant abandonment. State policies in brief as of January 1, 2007. Author: Guttmacher Institute Source: New York, New York, Guttmacher Institute, 2007 Jan 1. [2] p. Abstract: In response to apparently rare but highly publicized instances in which infants have been abandoned and sometimes left to die, almost every state, beginning with Texas in 1999, has enacted a provision intended to provide a safe and confidential means of relinquishing an unwanted infant. These infant abandonment measures--also referred to as "safe haven" or "safe surrender" provisions--typically follow the Texas model and allow a parent or other specified party to relinquish an infant under certain circumstances without threat of prosecution for child abandonment. Variations include limits on an infant's age (ranging from 72 hours to one year) and the places or personnel authorized to accept an infant (e.g., hospital emergency room staff or emergency services personnel [ESP], such as emergency medical technicians, firefighters or law enforcement officers). Some states explicitly guarantee parental anonymity; others require personnel accepting an infant to inquire into the infant's medical history. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | PREGNANCY, UNWANTED | INFANT | ORPHANS AND VULNERABLE CHILDREN | CHILD REARING | North America | Americas | Developed Countries | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Behavior | Family and Household Document Number: 310878

22.          Peer Reviewed Title: Adolescent human immunodeficiency virus and sexually transmitted disease prevention programmes: Are gender-blind approaches justified? Author: Ateka GK; Selwyn BJ Source: Public Health. 2007 Sep;121(9):682-689. Abstract: The objective was to present findings that gender might be more predictive of human immunodeficiency virus (HIV) and sexually transmitted disease (STD) knowledge, and sexual behaviour, compared with participation in knowledge-based HIV prevention programmes. A cross-sectional study comparing students attending public high schools running an HIV and STD prevention programme. It is based on a study that evaluated the City of Houston HIV and STD prevention programme in public high schools. Comparison was initially between groups (intervention vs comparison) and subsequently between gender. The main variables for comparison were level of interest and knowledge of the subject of HIV and STD, and a range of sexual behaviour variables. Self-administered questionnaires were used for eliciting both knowledge and behavioural data. A specific question required participants to rate their level of interest in the subject of HIV and STD on a scale of 1-4 (lowest to highest). The knowledge component was marked and scores awarded in percentage form. Descriptive statistical analysis was followed by stratified analysis. Finally, a select number of variables were used in a logistic regression model. STATA version 8 was the main statistical software. A significantly large proportion of girls reported the highest level of interest in the subject of HIV and STD (a score of 4); had higher HIV and STD knowledge scores; and reported less risk-taking sexual behaviour compared with boys. The only variable in which boys faired better was condom use, reporting higher rates of condom use than girls. Gender-blind HIV and STD prevention programmes seem to have a minimal effect on boys. Although a myriad of other factors influence male response to such programmes, the relatively low level of interest in the subject of HIV and STD among boys might be contributory. HIV and STD prevention programmes need to be re-designed using approaches that are more appealing to boys. Boys will otherwise remain the weak link and therefore the rate-limiting step in the quest for sexual behaviour change among adolescents. (author's) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, MALE | SEXUALITY | SEX FACTORS | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | KNOWLEDGE | BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors Document Number: 319098

23.          Peer Reviewed Title: Long-term assessment of symptomatology and satisfaction of an extended oral contraceptive regimen. Author: Coffee AL; Sulak PJ; Kuehl TJ Source: Contraception. 2007 Jun;75(6):444-449. Abstract: The study was conducted to assess hormone withdrawal symptoms, patient acceptance and occurrence and management of bleeding with an extended oral contraceptive (OC) regimen. Subjects were placed on an OC containing 3 mg drosperinone (DRSP) and 30 micrograms ethinyl estradiol (EE), in the standard 21/7 fashion for two cycles, before converting to an extended pattern of OC for women who indicated they had menstrually related symptoms such as headaches, cramping and mood swings (52 weeks with phone-call follow-up 6 months later). Daily assessments of bleeding, headache, pelvic pain, mood and number of pain pills were recorded. Results are reported as means with S.E., and values were compared using analysis of variance with Dunnett's post hoc test for comparison with 21/7 cycle, Duncan's post hoc test for comparison of changes during the course of the extended regimen and Pearson's chi-square for comparison of proportions. Of the 111 women who began the extended OC regimen, 80 completed 1 year of use.Mood scores, headache scores and pelvic pain were all improved in the extended OC intervals, compared to the 21/7 cycle (p less than .001 for all comparisons). Improvement in symptoms persisted throughout the 1 year extended regimen. The findings indicated that 53.7% of subjects had no breakthrough bleeding or breakthrough spotting (BTB/BTS) during any given 28-day interval of the extended regimen. BTB/BTS decreased in the second half compared to the first half of the extended regimen. To manage BTB/BTS, instituting a 3-day hormone-free interval (HFI) was significantly more effective than continuing OCs (p less than .001). At the 6-month follow-up, most subjects had continued the extended regimen on their own with a high level of satisfaction. An extended OC regimen containing DRSP/EE significantly improved mood, headaches and pelvic pain scores throughout the 1 year of use, compared to a 21/7 cycle. Sustained BTB/BTS episodes occurred in 45 subjects (56%), decreasing in the second half of the study and effectively managed with a 3-day HFI. (author's) Language: English Keywords: TEXAS | RESEARCH REPORT | KAP SURVEYS | PROSPECTIVE STUDIES | WOMEN | SIGNS AND SYMPTOMS | SATISFACTION | ORAL CONTRACEPTIVES, COMBINED | WITHDRAWAL | MENSTRUAL REGULATION | ETHINYL ESTRADIOL | HEADACHE | PELVIS | PAIN | ANALGESIA | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Diseases | Psychological Factors | Behavior | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Family Planning, Behavioral Methods | Fertility Control, Postcoital | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Anatomy | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 313555

24.          Title: Diabetes and tuberculosis: An unhealthy partnership. Author: Dixon B Source: Lancet Infectious Diseases. 2007 Jul;7(7):444. Abstract: WHO's reports, website, and press releases are conspicuous for their comprehensive coverage of global tuberculosis. In March this year, for example, WHO issued a considerable amount of material marking a levelling off in the worldwide epidemic since it was first declared an emergency in 1993. One document in particular seemed to encapsulate the entire story-the improving epidemiological picture together with the impediments to more rapid progress - multi and extensively drug-resistant Mycobacterium tuberculosis, co-infection with HIV, and in some countries, inadequate access to diagnosis and treatment. But not a word about diabetes mellitus. This is odd, since several recent papers have reflected increasing concern among tuberculosis field workers that type 2 diabetes may be a major force in converting latent infection into overt disease. Indeed, a book published as early as 1694, Richard Morton's Phthisiologia: or a treatise on consumption stated that an association between the two conditions was suggested even in Roman times. The mid-20th century saw a few reports documenting such a link and speculating on its significance. However, improved treatment for diabetes combined with a pronounced decline in tuberculosis in developed countries meant that physicians tended to overlook the possible practical importance of this comorbidity. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | MEXICO | CRITIQUE | POPULATION AT RISK | TUBERCULOSIS | DIABETES | PREVENTION AND CONTROL | POVERTY | MALNUTRITION | IMMUNE SYSTEM | Developed Countries | North America | Americas | Developing Countries | Research Methodology | Infections | Diseases | Socioeconomic Factors | Economic Factors | Nutrition Disorders | Physiology | Biology Document Number: 318071

25.          Peer Reviewed Title: Safety and acceptability with the use of a contraceptive vaginal ring after surgical or medical abortion. Author: Fine PM; Tryggestad J; Meyers NJ; Sangi-Haghpeykar H Source: Contraception. 2007 May;75(5):367-371. Abstract: The study was conducted to determine if a contraceptive vaginal ring (CVR) is a safe and acceptable method of contraception when used in the proximate postabortion period following first-trimester surgical or medical abortion. A CVR was inserted within 1 week following a medical or surgical abortion. Participants were followed up for 3 months to determine safety and acceptability. Safety was measured by the absence of signs of infection or serious adverse events. Acceptability was assessed by the CVR satisfaction survey, completed at the 3-month follow-up visit. Of 81 participants enrolled in the study, 69 (85%) completed the first-month follow-up visit, and 54 (67%) completed the final 3-month follow-up visit. There were no serious adverse events and no signs of infection on physical exam. Most adverse events were mild and not specifically related to the CVR. Related adverse events were those commonly associated with hormonal contraception use. Eighty-nine percent of participants chose to continue the CVR as their birth control method. The CVR is potentially safe and has high acceptability when used in the proximate postabortion period following a firsttrimester abortion. (author's) Language: English Keywords: TEXAS | RESEARCH REPORT | FOLLOW-UP STUDIES | KAP SURVEYS | WOMEN | CONTRACEPTIVE SAFETY | SATISFACTION | VAGINAL RING | ABORTION | POSTABORTION | PREGNANCY, FIRST TRIMESTER | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Demographic Factors | Population | Safety | Public Health | Health | Psychological Factors | Behavior | Contraceptive Methods | Contraception | Family Planning | Fertility Control, Postconception | Reproduction | Pregnancy Document Number: 315385   Notification

26.          Peer Reviewed Title: Menarchal status and calf circumference predict calcaneal ultrasound measurements in girls. Author: Hergenroeder AC; Hoelscher DM; Day RS; Kelder SH; Ward JL Source: Journal of Adolescent Health. 2007 Apr;40(4):318-324. Abstract: The purpose of this study was to predict calcaneal QUS measurements in healthy adolescent females as a function of anthropometric measures, pubertal stage and menarchal status. This was a secondary data analysis from a 2-year intervention designed to increase bone accretion. Simple Pearson correlation and Spearman's rank correlation analyses, followed by linear stepwise regression analyses were conducted. Setting: 12 middle schools. Participants: 672 female students, baseline; 587 students at 18 months. Main outcome measure: Calcaneal stiffness index (SI) by quantitative ultrasound. Eighty percent of the subjects were premenarchal at baseline; 33% at 18 months. Although SI correlated with self-assessed pubic hair (rho = .21) and menarchal status (rho = .23, p < .01 for both) at baseline, the model for predicting SI included menarchal status, not pubic hair, and calf circumference, controlling for BMI (R/2 = .22, p < .01). At 18 months, SI correlated with self-assessed pubic hair (rho = .21) and menarchal status (rho = .25, p < .01 for both). The best model to predict SI included calf circumference and pubic hair stage (R/2 = .14, p < .01), and not menarchal status as 67% of the subjects at 18 months were postmenarchal. In research assessing calcaneal SI in groups of adolescents, assessment of pubertal stage could be replaced with menarchal status and calf circumference when the majority of subjects are premenarchal. When the majority is postmenarchal, pubic hair stage and calf circumference together may be used to assess for pubertal maturation without menstrual status. (author's) Language: English Keywords: TEXAS | RESEARCH REPORT | STATISTICAL REGRESSION | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | ULTRASONICS | ANTHROPOMETRY | MENARCHE | PUBERTY | SKELETAL EFFECTS | CALCIUM | Developed Countries | United States of America | North America | Americas | Data Analysis | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Menstruation | Reproduction | Physiology | Biology | Metals | Vitamins and Minerals Document Number: 308480

27.    Title: The role of medical and social history in addressing relative contraindications to antiretroviral medications. Author: Kabue MM; Risser JM; Grimes RM Source: Malawi Medical Journal. 2007 Jun;19(2):89. Abstract: A cross-sectional, descriptive study that utilized selfadministered questionnaire responses from 100 systematically selected patients at a public HIV clinic (Northwest Clinic; facility serving low-income patients in Houston, United States), was done in 2004. The aim was to determine how often potential contraindications are encountered to ARVs recommended to initiate ART, based on medical and social/ lifestyle history. Six ART regimens recommended by the US Department of Health and Human Services in 2005, were examined. The regimens are: 1) Efavirenz, Lamivudine & Zidovudine, 2) Efavirenz, Lamivudine & Tenofovir DF, 3) Efavirenz, Emtricitabine & Zidovudine, 4) Efavirenz, Emtricitabine & Tenofovir DF, 5) Kaletra (Lopinavir/ Ritonavir), Lamivudine & Zidovudine, and 6) Kaletra (Lopinavir/Ritonavir), Emtricitabine & Zidovudine. Data were first were analyzed on each antiretroviral drug and then in regimens. Package inserts and treatment guidelines were reviewed for possible medical/medications history and lifestyle contraindications. (excerpt) Language: English Keywords: TEXAS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | LOW INCOME POPULATION | URBAN POPULATION | ANTIRETROVIRAL THERAPY | CONTRAINDICATIONS | AIDS PREVENTION | LIFE STYLE | SOCIAL BEHAVIOR | United States of America | North America | Americas | Developed Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | AIDS | Behavior Document Number: 321979

28. Title: Pregnant teenagers and teenage mothers: how much they really know about the risks to children's health associated with smoking during and after pregnancy? [letter] Author: Leiner M; Villa H; Singh N; Medina I; Shirsat P Source: Journal of School Health. 2007 Mar;77(3):101-102. Abstract: In the children of teenage mothers, prenatal and postnatal tobacco exposure has been associated with reduced birth weight, miscarriages, sudden infant death syndrome, asthma, and other respiratory problems. Despite all the information available, some teenage mothers continue smoking during pregnancy; some expose babies to secondhand smoke. Little is known about how much pregnant teenagers and teenage mothers understand about the risks associated with smoking during and after pregnancy. During a school district citywide event for teenage mothers and pregnant teenagers (75% Hispanics) held in El Paso, TX, we asked teenage mothers (n = 98) and pregnant teenagers (n = 81) to respond to a brief questionnaire (n = 179) about their knowledge of the risks to their baby associated with smoking during and after pregnancy. The study's goals were to (1) determine whether respondents felt they were informed about risks, (2) identify the sources of information on smoking, and (3) determine how knowledgeable respondents were about risks of smoking during pregnancy and after pregnancy. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | KAP SURVEYS | PREGNANT WOMEN | ADOLESCENTS, FEMALE | MOTHERS | FETUS | CHILDREN | TOBACCO USE | KNOWLEDGE | CHILD HEALTH | INFORMATION SOURCES | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Age Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Pregnancy | Reproduction | Behavior | Health | Information Document Number: 312215

29.          Title: Fighting stigma: An adolescent mother takes action. Author: Lewis CM; Scarborough M; Rose C; Quirin KB Source: Journal of Women and Social Work. 2007 Fall;22(3):302-306. Abstract: Like many recent high school graduates, 18-year-old Charlie Rose eagerly anticipated the start of her freshman year in college. One of a select few accepted to Plan II, the nationally ranked honors program at the University of Texas (UT) at Austin, Charlie declared a premed-math double major. She dreams of a career working with the uninsured as an obstetrician-gynecologist. Similar to her Plan II peers, she has a record of high academic achievement during high school (she was a Hispanic-National Merit Scholar, high school salutatorian, and recipient of more than $100,000 in scholarships), which is complemented by an impressive list of extracurricular activities (working for two nonprofit organizations and clocking more than 300 hours of volunteer work annually for various causes). Unlike most of her peers, though, Charlie's most important "extracurricular activity" is mothering Cae, her toddler son. Charlie caught the attention of researchers at the UT Center for Social Work Research when she participated in a focus group that evaluated support services for pregnant and parenting teenagers in the Austin area. Struck by her intelligence, resourcefulness, energy, and independence, they were inspired by her passion for social justice and commitment to dispelling the stigmas that are associated with teenage mothers. Charlie, who moved out of her parents' home at age 14, represented living proof that, with ample social support, teenage mothers can be successful parents, students, employees, and members of the community. (excerpt) Language: English Keywords: