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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

Title: Combined oral contraceptive pills for treatment of acne.
Author: Arowojolu AO; Gallo MF; Lopez LM; Grimes DA; Garner SE
Source: Cochrane Database of Systematic Reviews. 2009;(3):CD004425.
Abstract: BACKGROUND: Acne is a common skin disorder among women. Although no uniform approach to the management of acne exists, combination oral contraceptives (COCs), which contain an estrogen and a progestin, often are prescribed for women. OBJECTIVES: To determine the effectiveness of combined oral contraceptives (COCs) for the treatment of facial acne compared to placebo or other active therapies. SEARCH STRATEGY: We searched for randomized controlled trials of COCs and acne in the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, POPLINE, and LILACS. We also searched for clinical trials in ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We wrote to authors of identified trials to seek any unpublished or published trials that we might have missed. SELECTION CRITERIA: All randomized controlled trials reported in any language that compared the effectiveness of a COC containing an estrogen and a progestin to placeboor another active therapy for acne in women were eligible. DATA COLLECTION AND ANALYSIS: We extracted data on total and specific (i.e., open or closed comedones, papules, pustules and nodules) facial lesion counts; acne severity grades; global assessments by the clinician or the participant and discontinuation due to adverse events. Data were entered and analyzed in RevMan. MAIN RESULTS: The search yielded 25 trials: 7 placebo-controlled trials made 4 different comparisons, 17 trials made 13 comparisons between 2 different COC regimens, and 1 additional trial compared a COC to an antibiotic. COCs reduced acne lesion counts, severity grades and self-assessed acne compared to placebo. Differences in the comparative effectiveness of COCs containing varying progestin types and dosages, though, were less clear. COCs that contained chlormadinone acetate or cyproterone acetate improved acne better than levonorgestrel, although this apparent advantage was based on limited data. A COC with cyproterone acetate might result in better acne outcomes than one with desogestrel; however, the three studies comparing these COCs produced conflicting results. Likewise, levonorgestrel showed a slight improvement over desogestrel in acne outcomes in one trial, but a second trial found the COC groups were similar. AUTHORS' CONCLUSIONS: The four COCs evaluated in placebo-controlled trials are effective in reducing inflammatory and non-inflammatory facial acne lesions. Few important differences were found between COC types in their effectiveness for treating acne. How COCs compare to alternative acne treatments is unknown since limited data were available regarding this question.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | COMPARATIVE STUDIES | WOMEN | ACNE | TREATMENT | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | ANTIBIOTICS | HORMONES | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Endocrine System | Physiology | Biology
Document Number: 341912

4.
Title: A randomized controlled trial of a low-dose combined oral contraceptive containing 3 mg drospirenone plus 20 microg ethinylestradiol in the treatment of acne vulgaris: lesion counts, investigator ratings and subject self-assessment.
Author: Maloney JM; Dietze P Jr; Watson D; Niknian M; Lee-Rugh S; Sampson-Landers C; Korner P
Source: Journal of Drugs In Dermatology. 2009 Sep;8(9):837-44.
Abstract: OBJECTIVE: To assess the efficacy of a combined oral contraceptive (COC) containing 3 mg drospirenone (drsp) plus 20 microg ethinylestradiol (EE) administered in 24 days of active treatment followed by a four-day hormone-free interval (24/4 regimen) compared with placebo for the treatment of moderate acne vulgaris. METHODS: Healthy females (14-45 years old) with moderate facial acne were randomized to 3 mg drsp/20 microg EE 24/4 (n = 270) or placebo (n = 268) for six cycles. The secondary efficacy variables measured included change from baseline to endpoint (cycle 6) in individual lesion count for nodules, papules, pustules, open and closed comedones. RESULTS: There were significantly greater reductions in individual lesion counts from baseline to endpoint in the 3 mg drsp/20 microg EE group than in the placebo group (P < 0.05 from parametric model). CONCLUSION: The 3 mg drsp/20 microg EE COC administered in a 24/4 regimen significantly reduced acne lesions.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | LOW-DOSE PROGESTINS | ETHINYL ESTRADIOL | ACNE | TREATMENT | DERMATOLOGICAL EFFECTS | Developed Countries | North America | Americas | Research Methodology | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology
Document Number: 342779

Peer Reviewed

Title: Efficacy of a combined oral contraceptive containing 0.030 mg ethinylestradiol/2 mg dienogest for the treatment of papulopustular acne in comparison with placebo and 0.035 mg ethinylestradiol/2 mg cyproterone acetate.
Author: Palombo-Kinne E; Schellschmidt I; Schumacher U; Graser T
Source: Contraception. 2009 Apr;79(4):282-9.
Abstract: BACKGROUND: Acne is a multifactorial disease characterized by androgenic stimulation of sebaceous glands. Therefore, combined oral contraceptives (COCs) containing anti-androgenic progestogens are suitable candidates for acne treatment. This study aimed to show that a COC containing the anti-androgen dienogest (DNG) is superior to placebo and not inferior to a COC containing the potent anti-androgen cyproterone acetate (CPA) in improving mild to moderate acne. STUDY DESIGN: Healthy women between 16 and 45 years old with mild to moderate facial acne were randomly assigned to receive ethinylestradiol (EE)/DNG (n=525), EE/CPA (n=537) or placebo (n=264) for six cycles in a multinational, multicenter, three-arm, double-blind and randomized trial. The primary efficacy variables were the percentages of change (from baseline to cycle 6) in inflammatory and total lesion count and the percentage of patients with acne improvement according to the Investigator Global Assessment. RESULTS: All primary analyses proved that EE/DNG was superior to placebo and non-inferior to EE/CPA (p<.05). For inflammatory lesions, the reduction (+/-SD) rates were -65.6+/-29.9% for EE/DNG, -64.6+/-31.2% for EE/CPA and -49.4+/-41.0% for placebo. For total lesions, the reduction rates were -54.7+/-26.3% for EE/DNG, -53.6+/-27.5% for EE/CPA and -39.4+/-33.6% for placebo. The percentages of patients with improvement of facial acne were 91.9% for EE/DNG, 90.2% for EE/CPA and 76.2% for placebo. CONCLUSION: EE/DNG was superior to placebo, in spite of the prominent placebo effects, and as effective as EE/CPA in the treatment of mild to moderate acne, thus proving a valid option for the treatment of acne in women seeking oral contraception.
Language: English
Keywords:
GERMANY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | ACNE | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | TREATMENT | Europe, Central | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Dermatitis | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330559

Peer Reviewed

Title: Efficacy of an oral contraceptive containing EE 0.03 mg and CMA 2 mg (Belara) in moderate acne resolution: a randomized, double-blind, placebo-controlled Phase III trial.
Author: Plewig G; Cunliffe WJ; Binder N; Hoschen K
Source: Contraception. 2009 Jul;80(1):25-33.
Abstract: BACKGROUND: The study was conducted to assess the effects of the monophasic combined oral contraceptive containing ethinyl estradiol (EE) 0.03 mg and chlormadinone acetate (CMA) 2 mg (EE/CMA) on papulopustular acne of the face, decollete (low neck) and back; on moderate comedonal acne of the face; and on seborrhea, alopecia and hirsutism. STUDY DESIGN: Three hundred seventy-seven women were randomized (2:1) to receive EE/CMA (n=251) or placebo (n=126) for six medication cycles. Due to the placebo-controlled, double-blind design of the trial, condoms were supplied for contraception. The primary efficacy end point was defined as a reduction of at least 50% in the number of papules and/or pustules of the face from admission to Medication Cycle 6. RESULTS: In total, 64.1% (161/251) of subjects treated with EE/CMA responded compared with 43.7% (55/126) of those taking placebo (p=.0001). The median reduction in papules/pustules on the face at Cycle 6 compared with admission was 63.6% (EE/CMA) compared with 45.3% (placebo group). For comedonal lesions of the face, the reduction in lesion numbers was 54.8% (EE/CMA) compared with 32.4% (placebo). Moderate papulopustular acne of the decollete decreased by 92.9% (EE/CMA) vs. 50% (placebo group) and of the back by 86.0% and 58.3%, respectively. For these skin conditions, the p values for the relative difference between groups vs. baseline were <.05 at Cycles 3 and 6, in favor of EE/CMA. As part of a self-assessment rating, at least 70.5% (EE/CMA) vs. 41.3% (placebo) reported an at least satisfactory improvement of their moderate acne. Even 39.8% of women taking EE/CMA reported an "excellent improvement" or "complete resolution" of moderate acne compared with 12.7% taking placebo. CONCLUSION: In addition to its contraceptive efficacy described elsewhere, EE/CMA is an effective treatment for moderate papulopustular acne and other androgen-related skin disorders.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | RANDOMIZED RESPONSE TECHNIC | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | ACNE | HIRSUTISM | TREATMENT | PROGRAM EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Questionnaire Design | Survey Methodology | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Dermatitis | Diseases | Signs and Symptoms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 341585

Title: [Oral contraception - dosis and way of administration] Hormonale Kontrazeption - Dosierung und Verabreichungsformen.
Author: Thaler C; Kuhl H; Mueck A; Birkhauser M; Braendle W; Neulen J; Keller PJ; Kiesel L
Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):93-9.
Abstract: Since the correlation between the amount of Ethinylestradiol (EE) and the thromboembolic risk has been recognized, the development of new oral contraceptives (OC) has been characterized by a constant lowering of the EE dosage. The consecutive decrease of ovulation inhibition has been compensated by the introduction of potent progestagens. Therefore, the contraceptive safety has been maintained in presence of less side-effects. The effect of ultra-low-dose OC on acne and seborrhea remains beneficial. The effect of ultra-low-dose OC on bone is contradictory. Because there are fundamental differences between Estradiol and EE, the thromboembolic risk is not decreased by the parenteral administration of EE. In users of the contraceptive patch, it is even increased. EE is not bound at SHBG. Because of its Ethinyl group, the inactivation of EE occurs slowly. Therefore, EE reaches the liver in a low but constant concentration where it modifies many estrogen-dependent hepatic parameters significantly. One of these is hemostasis. It is generally accepted that such changes are responsable for the increased thromboembolic risk of the contraceptive patch and vaginalring. A reduction of the homone-free interval of the pill to 5 or 4 days results in a complete suppression of the ovarian function, a reliable ovulation inhibition and an increase of the contraceptive efficacy in spite of a reduction of the EE dosage to 20 mug or 15 mug.
Language: German
Keywords:
RESEARCH REPORT | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, LOW-DOSE | ACNE | ADMINISTRATION AND DOSAGE | Safety | Public Health | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Dermatitis | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 329573

Title: Duration of breast-feeding and the risk of childhood allergic diseases in a developing country.
Author: Ehlayel MS; Bener A
Source: Allergy and Asthma Proceedings. 2008 Jul-Aug;29(4):386-91.
Abstract: Exclusive breast-feeding (EBF) seems to reduce risk of allergies in the western countries, but there are few reports from developing countries. The purpose of this study was to assess the effect of EBF on the development of allergic diseases and eczema in a developing country. This is a cross-sectional survey done at the well-baby clinics of 11 primary health centers, Hamad Medical Corporation, Qatar. A multistage sampling design was used and a representative sample of 1500 children (0-5 years old) and mothers (18-47 years old) were surveyed between October 2006 and September 2007. Of them, 1278 mothers (85.2%) participated in the study. A confidential, anonymous questionnaire assessing breast-feeding and allergic diseases was completed by mothers bringing children for immunization. Questionnaire included allergic rhinitis, wheezing, eczema, type and duration of breast-feeding, parental smoking habits, number of siblings, family income, maternal education, and parental allergies. Univariate and multivariate statistical methods were performed for statistical analysis. More than one-half of the infants (59.3%) were on EBF. Length of breast-feeding was associated with maternal age. Prevalence of eczema (19.4%), allergic rhinitis (22.6%), and wheezing (12.7%) were significantly less frequent in those with prolonged (>6 months) compared with short-term fed infants. The association between EBF and eczema tended to be similar in children with a positive family history of atopy (p < 0.001) and eczema (p < 0.001) compared with those without. In children of developing countries, prolonged breast-feeding reduces the risk of developing allergic diseases and eczema even in the presence of maternal allergy, where it might be a practical, effective preventive measure.
Language: English
Keywords:
QATAR | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | HEALTH SURVEYS | MULTIVARIATE ANALYSIS | CHILDREN | PREVALENCE | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | ALLERGIC REACTION | ECZEMA | TOBACCO USE | RESPIRATORY INSUFFICIENCY | MATERNAL AGE | Developed Countries | Middle East | Research Methodology | Health | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Breastfeeding | Infant Nutrition | Nutrition | Population Dynamics | Signs and Symptoms | Diseases | Dermatitis | Behavior | Pulmonary Effects | Physiology | Biology | Parental Age
Document Number: 329232

10.

Title: Hormonal therapy for acne.
Author: George R; Clarke S; Thiboutot D
Source: Seminars In Cutaneous Medicine and Surgery. 2008 Sep;27(3):188-96.
Abstract: Acne affects more than 40 million people, of which more than half are women older than 25 years of age. These women frequently fail traditional therapy and have high relapse rates even after isotretinoin. Recent advances in research have helped to delineate the important role hormones play in the pathogenesis of acne. Androgens such as dihydrotestosterone and testosterone, the adrenal precursor dehydroepiandrosterone sulfate, estrogens, growth hormone, and insulin-like growth factors may all contribute to the development of acne. Hormonal therapy remains an important part of the arsenal of acne treatments available to the clinician. Women dealing with acne, even those without increased serum androgens, may benefit from hormonal treatments. The mainstays of hormonal therapy include oral contraceptives and antiandrogens such as spironolactone, cyproterone acetate, or flutamide. In this article, we discuss the effects of hormones on the pathogenesis of acne, evaluation of women with suspected endocrine abnormalities, and the myriad of treatment options available.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ACNE | TREATMENT | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Demographic Factors | Population | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning
Document Number: 329648

11.

Title: Non-contraceptive benefits of oral contraceptives.
Author: Huber JC; Bentz EK; Ott J; Tempfer CB
Source: Expert Opinion On Pharmacotherapy. 2008 Sep;9(13):2317-25.
Abstract: BACKGROUND: There is increasing awareness of the opportunity that many contraceptive interventions may provide for additional health benefits. However, treatment of medical problems with oral contraceptives (OCs) is often an 'off-label' practice. OBJECTIVE: The aim of this review is to summarize available data on non-contraceptive benefits of OCs. METHODS: Review of the literature. RESULTS: OCs have been shown to reduce the risk of ovarian, endometrial, and colorectal cancer. It has been suggested that OCs may be used in treatment of endometriosis, menorrhagia, and uterine leiomyomas. Pelvic inflammatory disease, dysmenorrhea, premenstrual syndrome, and acne have been shown to improve under OCs. CONCLUSION: OCs are important for global and female health. Besides contraception, non-contraceptive effects of OCs are evidence based, well established, and commonly used in clinical practice.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | ENDOMETRIOSIS | ACNE | ENDOMETRIAL CANCER | MENSTRUATION DISORDERS | OVARIAN CANCER | PELVIC INFECTIONS | PREMENSTRUAL TENSION | ORAL CONTRACEPTIVES | Diseases | Dermatitis | Cancer | Neoplasms | Infections | Contraceptive Methods | Contraception | Family Planning
Document Number: 328808

12.
Title: Effects of an oral contraceptive containing chlormadinone and ethinylestradiol on acne-prone skin of women of different age groups: an open-label, single-centre, phase IV study.
Author: Kerscher M; Reuther T; Bayrhammer J; Schramm G
Source: Clinical Drug Investigation. 2008;28(11):703-11.
Abstract: BACKGROUND AND OBJECTIVE: Acne-prone skin, a common skin condition not only in adolescents but also in adults, can significantly influence the affected individual's quality of life. The aim of this open-label, prospective, single-centre, phase IV study was to investigate the effects of an oral contraceptive containing chlormadinone 2 mg and ethinylestradiol 0.03 mg (Belara) on the physiology of acne-prone facial skin in healthy women aged 18-37 years. METHODS: Forty-four Caucasian women requesting hormonal contraception divided into two age groups (group A: 18-27 years; group B: 28-37 years) were treated with chlormadinone/ethinylestradiol for six menstrual cycles. During each treatment phase, each subject took one tablet per day for 21 consecutive days, followed by a 7-day pill-free interval. Medication was commenced on the first day of menses. Changes in skin parameters were evaluated in terms of the clinical sum score (the primary outcome variable, calculated from the number of comedones, the number of papules/papulopustules, and the sebum secretion state), the evaluation of the pore size using standardized photography, and a range of biophysical in vivo measurements, assessed at baseline, after 12 weeks and after 24 weeks. RESULTS: In both age groups, facial skin condition as quantified by the clinical sum score improved significantly after three and six treatment cycles, with reduced numbers of acne lesions (comedones and papules/papulopustules) and a reduction in seborrhoea. Moreover, there was a statistically significant decrease in pore size. Biophysical evaluations confirmed favourable effects of the medication on diverse skin parameters. Skin surface pH remained within the normal physiological range and there was an improvement in epidermal barrier function (as manifested by decreased transepidermal water loss from the skin of the forehead). Stratum corneum hydration increased in both age groups and the lipid content of the skin surface on the forehead decreased significantly after three treatment cycles in subjects aged 28-37 years. Ultrasound measurements verified that there was no retention of water within the dermis. There was no difference between the two age groups. CONCLUSION: For the first time, improvements in several facial skin parameters during treatment with a combined oral contraceptive (chlormadinone/ethinyl-estradiol) were quantified by biophysical methods and a clinical sum score. The highly statistically significant improvements in clinical findings and various biophysical skin parameters observed in this study suggest that the antiandrogenic oral contraceptive chlormadinone/ethinylestradiol may be a major therapy option in women with acne-prone skin who request hormonal contraception.
Language: English
Keywords:
GERMANY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | WHITES | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | ACNE | DERMATOLOGICAL EFFECTS | TREATMENT | AGE FACTORS | Europe, Central | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Dermatitis | Diseases | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329816

13.
Title: [Summary of the practice guideline 'Acne' (second revision) from the Dutch College of General Practitioners] Samenvatting van de standaard 'Acne' (tweede herziening) van her Nederlands
Author: Kertzman MG; Smeets JG; Boukes FS; Goudswaard AN
Source: Nederlands Tijdschrift Voor Geneeskunde. 2008 May 31;152(22):1271-5.
Abstract: The 1999 practice guideline 'Acne vulgaris' from the Dutch College of General Practitioners has been revised. Benzoyl peroxide and local retinoids are first choice in local treatment of acne. When treatment with oral antibiotics is indicated, doxycycline is first choice. Use of minocycline is not recommended in general practice. It is recommended that both local and oral antibiotics are always combined with local benzoyl peroxide or a local retinoid. Oral contraceptives are only recommended in women with acne who also desire contraception. Use of oral contraceptives containing cyproterone acetate is no longer recommended in women with acne, because they are not more effective than other oral contraceptives. Treatment with oral isotretinoin may be given by the general practitioner, as long as the treatment guidelines are carefully followed.
Language: Dutch
Keywords:
NETHERLANDS | RESEARCH REPORT | STANDARDS | ACNE | TREATMENT | SAFETY | ANTIBIOTICS | ORAL CONTRACEPTIVES | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Research Methodology | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Drugs | Contraceptive Methods | Contraception | Family Planning | Contraceptive Effectiveness
Document Number: 328922

14.
Peer Reviewed

Title: Advances in the treatment of acne.
Author: Kimball AB
Source: Journal of Reproductive Medicine. 2008 Sep;53(9 Suppl):742-52.
Abstract: Acne vulgaris affects most people at some time in their life. This common condition can have devastating effects on a person's quality of life and may leave permanent scars. Treatment options, which are designed to disrupt one or more of the pathogenic features that characterize acne, include topical therapies (e.g., antibiotics, retinoids, benzoyl peroxide and combination products), systemic treatments (e.g., oral antibiotics, hormonal therapies and oral retinoids, which are indicated for severe recalcitrant nodulocystic acne), and, to a lesser extent, light-based and physical treatments. Combination oral contraceptives (COCs) represent one type of hormonal treatment. Their mode of action is to reduce the availability of free testosterone, which stimulates the sebaceous glands to produce sebum. Most COCs used in the United States contain progestins derived from 19-nortestosterone, giving them at least some degree of androgenic activity. Of the 3 COCs with an FDA indication for the treatment of moderate acne, only YAZ contains drospirenone, a progestin that combines no androgenic activity with antiandrogenic activity. This drospirenone-containing COC has been shown to be effective in reducing both inflammatory and noninflammatory acne lesions.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | ACNE | DIET | NUTRITION | PREVALENCE | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, COMBINED | TREATMENT | Developed Countries | North America | Americas | Dermatitis | Diseases | Health | Measurement | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 329797

15.

Title: Efficacy and tolerance of acne treatment using both spironolactone and a combined contraceptive containing drospirenone.
Author: Krunic A; Ciurea A; Scheman A
Source: Journal of the American Academy of Dermatology. 2008 Jan;58(1):60-62.
Abstract: The use of either oral contraceptives or antiandrogens has been shown to be helpful in the treatment of women with acne. We investigated the safety and efficacy of acne treatment using both spironolactone and a combined contraceptive containing drospirenone. Twenty-seven women with either severe papular or nodulocystic facial acne were treated with a combined oral contraceptive containing 30 microg ethinyl estradiol and 3 mg drospirenone (EE/DRSP; Yasmin) and spironolactone (SL) 100 mg taken daily. A serum potassium level was obtained before initiation of therapy. Between 4 and 6 weeks after the start of both medications, a second serum potassium level was obtained. Side effects were recorded. Results: No significant elevation of serum potassium was found in any of the subjects nor were there any reported additional side effects significant enough to discontinue treatment. At follow up, 85% of subjects were entirely clear of acne lesions or had excellent improvement, 7.4% were mildly improved, and7.4% were not improved. This was a small prospective study. The combination of EE/DRSP and SL 100 mg daily appears to have efficacy and is well tolerated in the treatment of severe papular and nodulocystic acne in women. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ACNE | TREATMENT | DRUGS | ORAL CONTRACEPTIVES | CONTRACEPTIVE USE-EFFECTIVENESS | CONTRACEPTIVE SAFETY | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Effectiveness | Safety | Public Health
Document Number: 323636

16.
Title: A combined oral contraceptive containing 3-mg drospirenone/ 20-microg ethinyl estradiol in the treatment of acne vulgaris: a randomized, double-blind, placebo-controlled study evaluating lesion counts and participant self-assessment.
Author: Lucky AW; Koltun W; Thiboutot D; Niknian M; Sampson-Landers C; Korner P
Source: Cutis; Cutaneous Medicine For the Practitioner. 2008 Aug;82(2):143-50.
Abstract: This study compared the efficacy of a low-dose combined oral contraceptive (COC) containing 3-mg drospirenone and 20-microg ethinyl estradiol (3-mg DRSP/20-microg EE) administered in a 24-day active pill/4-day inert pill (24/4) regimen and placebo in women with moderate acne vulgaris during 6 treatment cycles. A total of 534 participants were randomized and dispensed study medication (n = 266 [3-mg DRSP/20-microg EE 24/4 regimen COC group]; n = 268 [placebo group]). Women of reproductive age were eligible for inclusion in the study. Treatment with the 3-mg DRSP/20-microg EE 24/4 regimen COC was associated with a greater reduction from baseline to end point in individual lesion counts (papules, pustules, open and closed comedones) compared with placebo. The mean nodule count remained essentially constant throughout the study and was low in both treatment groups. There was a significantly higher probability that a participant had an improved assessment on the investigator's overall improvement rating scale (odds ratio [OR], 4.02; 95% CI [confidence interval], 2.29-7.31; P < .0001) and participant's overall self-assessment rating scale (OR, 2.82; 95% CI, 1.60-5.13; P = .0005) in the 3-mg DRSP/20-microg EE 24/4 regimen COC group than in the placebo group. The COC 3-mg DRSP/20-microg EE 24/4 regimen is a suitable option for women with moderate acne vulgaris who require contraception.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | WOMEN | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | ACNE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | SELF-PERCEPTION | ADMINISTRATION AND DOSAGE | TREATMENT | USFDA | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Dermatitis | Diseases | Perception | Psychological Factors | Behavior | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 328895

17.

Peer Reviewed

Title: Non-contraceptive health benefits of oral contraceptives.
Author: Maia H Jr; Casoy J
Source: European Journal of Contraception and Reproductive Health Care. 2008 Mar;13(1):17-24.
Abstract: The use of combined oral contraceptives (COCs) is associated with a reduced risk of developing endometriosis, myomas, and endometrial and ovarian carcinoma. The mechanisms involved are multiple; next to ovulation suppression, a reduction in inflammation in the genital tract is involved. This is accomplished through inhibition of the endometrial expression of enzymes related to the biosynthesis of prostaglandin and oestrogen, particularly cyclooxygenase type II (Cox-2) and aromatase. The blockade of these enzymatic systems by COCs explains the beneficial effects of these compounds in treating the symptoms, and halting the progression of myomas, endometriosis and adenomyosis, all of which are characterized by increased inflammation. Inhibition of aromatase and Cox-2 expression in the endometrium by COCs may explain their efficacy in controlling the pain and excessive uterine bleeding caused by these pathologies. The reduction of inflammation in the endometrium may also be the mechanism behind the lower incidence of endometrial carcinoma in COC users. The blockade of ovulation and ovarian steroidogenesis, on the other hand, may explain the lesser incidence of ovarian cancer and the improvement of acne in users. In conclusion, inflammation appears to play a pivotal role in the development of various benign and malignant gynecological diseases. COCs reduce inflammation in the female genital tract by blocking enzymes such as Cox-2 and aromatase. (author's)
Language: English
Keywords:
BRAZIL | LITERATURE REVIEW | WOMEN | ORAL CONTRACEPTIVES | ENDOMETRIOSIS | MENORRHAGIA | ENDOMETRIAL CANCER | OVARIAN CANCER | ACNE | MENOPAUSE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Menstruation Disorders | Cancer | Neoplasms | Dermatitis | Reproduction
Document Number: 324655

18.

Peer Reviewed

Title: Treatment of acne using a 3-milligram drospirenone/20-microgram ethinyl estradiol oral contraceptive administered in a 24/4 regimen: a randomized controlled trial.
Author: Maloney JM; Dietze P Jr; Watson D; Niknian M; Lee-Rugh S
Source: Obstetrics and Gynecology. 2008 Oct;112(4):773-81.
Abstract: OBJECTIVE: To assess the efficacy of the combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol (3-mg drospirenone/20-microgram ethinyl estradiol) administered as 24 consecutive days of active treatment after a 4-day hormone-free interval (24/4 regimen) compared with placebo for the treatment of moderate acne vulgaris. METHODS: Healthy females aged 14-45 years with moderate acne were randomized in this double-blind study to 3-mg drospirenone/20-microgram ethinyl estradiol (n=270) or placebo (n=268) for six cycles of 28 days. The primary outcome measures of acne lesion counts and Investigator Static Global Assessment scale ratings were assessed at baseline and during cycles 1, 3, and 6. RESULTS: The percentage reduction from baseline to endpoint for total lesions is 46.3% for 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 combination oral contraceptive group and 30.6% for placebo group (P<.001). The likelihood of participants in the 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen group having "clear" or "almost clear" skin as rated by the investigators at endpoint was about threefold (odds ratio 3.13, 95% confidence interval 1.69-5.81; P=.001) greater than in the placebo group. The 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen was well tolerated. CONCLUSION: The low-dose combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol administered in a 24/4 regimen significantly reduced acne lesion counts more effectively than placebo and demonstrated greater improvement in the Investigator Static Global Assessment rating of acne. The safety profile was consistent with low-dose combined oral contraceptive use.
Language: English
Keywords:
CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | DOUBLE-BLIND STUDIES | EVALUATION INDEXES | WOMEN | ACNE | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | HEALTH STATUS INDEXES | ORAL CONTRACEPTIVES, SIDE EFFECTS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Dermatitis | Diseases | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Safety | Safety | Public Health
Document Number: 329095

19.
Peer Reviewed

Title: An oral contraceptive with 3 approved indications.
Author: Mishell DR Jr
Source: Journal of Reproductive Medicine. 2008 Sep;53(9 Suppl):717-9.
Abstract: This introductory article provides a historical overview of COCs in addition to describing the contents of the journal issue which is to inform clinician about YAZ, a COC that is unique in several ways. YAZ is a low-dose COC that combines 3 mg of drospirenone with 20 microg of EE; its regimen consists of 24 days of active pills in a 28-day cycle.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | ORAL CONTRACEPTIVES, COMBINED | ACNE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | TREATMENT | Developed Countries | North America | Americas | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Dermatitis | Diseases | Safety | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 329800

20.
Peer Reviewed

Title: YAZ and the novel progestin drospirenone.
Author: Mishell DR Jr
Source: Journal of Reproductive Medicine. 2008 Sep;53(9 Suppl):721-8.
Abstract: Drospirenone is a novel progestin that is structurally related to 17 alpha-spirolactone and has antimineralocorticoid and antiandrogenic activity. A 3-mg dose of drospirenone was first used in combination with ethinyl estradiol (EE) 30 microg in a combination oral contraceptive (COC) that is administered for 21 days, followed by a 7-day hormone-free interval (HFI) (drospirenone/30EE, or Yasmin). The 21/7 regimen is considered to be the standard regimen for COC delivery. A formulation with the metabolic benefit of COCs containing a lower estrogen dose has been developed combining drospirenone 3 mg with EE 20 microg and using a regimen of 24 days of active pills, followed by a 4-day HFI (drospirenone/20EE-24/4), or YAZ (Bayer HealthCare Pharmaceuticals Inc., Wayne, New Jersey). Since drospirenone has a half-life of > 30 hours, its activity extends for a prolonged time into the shortened HFI. This new COC has been shown to provide effective contraception and to have a good safety profile. Two large noninterventional studies have recently evaluated the safety of drospirenone/30EE in 2 areas of special interest: hyperkalemia and thromboembolic events. Use of a drospirenone-containing COC was not associated with an increased risk of either type of disorder in comparison with COCs containing other progestins. Drospirenone/20EE-24/4 provides a low dose of EE in combination with drospirenone in an effective and safe COC that is administered using a regimen with a shortened HFI. Drospirenone/20EE-24/4 is the only COC with 3 indications: contraception and the treatment of premenstrual dysphoric disorder in women who wish to use a COC for birth control, and the treatment of moderate acne in women who are at least 14-years-old, have achieved menarche and wish to use a COC for birth control.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | ACNE | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | METABOLIC EFFECTS | CONTRACEPTIVE MODE OF ACTION | PREMENSTRUAL TENSION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Dermatitis | Diseases | Safety | Public Health | Health | Population Dynamics | Physiology | Biology | Menstruation Disorders
Document Number: 329799

21.

Title: Adolescent female acne: etiology and management.
Author: Olutunmbi Y; Paley K; English JC 3rd
Source: Journal of Pediatric and Adolescent Gynecology. 2008 Aug;21(4):171-6.
Abstract: Acne vulgaris, a multifactorial condition often conferring significant psychosocial morbidity, affects an estimated 40 million people in the United States. The majority of these individuals are adolescents and young adults. The pathophysiology of the condition is still not fully known, but it is believed to be related in part to excess sebum production, follicular hyperkeratinization, microbial colonization by P acnes, and inflammation. Prior to initiating treatment in a female patient, a hyperandrogenic state must be considered and ruled out through history, physical exam, and laboratory evaluation if necessary. Treatment options are vast and include hormonal therapy among others. Hormonal therapies have long been noted to reduce acne lesions and offer a valuable adjuvant to standard therapy. Hormonal agents are thought to improve acne by blocking the androgen receptor and/or decreasing circulating androgens which leads to decreased sebum production. Hormonal treatment options include spironolactone, other antiandrogens, and oral contraceptives. The use of these agents to effectively treat acne has been demonstrated in several randomized, placebo-controlled clinical trials. Optimal results are often achieved with combination therapy with the goal of targeting multiple pathogenic pathways in acne development.
Language: English
Keywords:
UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | ACNE | MANAGEMENT | TREATMENT | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Dermatitis | Diseases | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning
Document Number: 328622

22.

Peer Reviewed

Title: The relationship between skin manifestations and CD4 counts among HIV positive patients.
Author: Rad F; Ghaderi E; Moradi G; Mafakheri L
Source: Pakistan Journal of Medical Sciences. 2008 Jan-Mar;24(1):114-117.
Abstract: Skin manifestations are common clinical features among HIV positive patients. The aim of this study was to document skin manifestations and their relationships with CD4 cell counts among HIV positive patients in Sanandaj. This was a descriptive study. The patients were examined for skin disorders by a dermatologist and CD4 counts were obtained from the patient's medical records. Independent samples T test were used for data analysis. In this study 66 (94.3%) patients had at least one skin problem. Fungal infections were the most common cause. The eight most common types of mucocutaneous problems were gingivitis, pallor, itching, photosensitivity, seborrheic dermatitis, candidiasis, folliculitis and tinea versicolor. The most common manifestation was gingivitis. Mean CD4 cell counts were lower in individuals with viral and bacterial skin diseases (P less than 0.05). The results of this study indicated that skin problems were common among HIV positive patients. Patients with advanced stages of skin disorders had relatively lower CD4 counts. Therefore examination of skin is recommended for all HIV positive patients for early detection of skin disorders, as early diagnosis and management of dermatologic problems will improve the quality of life in HIV positive patients. (author's)
Language: English
Keywords:
IRAN | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | DERMATOLOGICAL EFFECTS | PREVALENCE | IMMUNOLOGICAL EFFECTS | EXAMINATIONS AND DIAGNOSES | BACTERIAL AND FUNGAL DISEASES | ECZEMA | Developing Countries | Middle East | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Physiology | Biology | Measurement | Research Methodology | Immunity | Immune System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Dermatitis
Document Number: 325110

23.
Peer Reviewed

Title: YAZ in the treatment of premenstrual dysphoric disorder.
Author: Rapkin AJ
Source: Journal of Reproductive Medicine. 2008 Sep;53(9 Suppl):729-41.
Abstract: Premenstrual disorders negatively affect millions of U.S. women. The premenstrual disorder at the most severe end of the spectrum is premenstrual dysphoric disorder (PMDD). The specific diagnostic criteria developed for PMDD and the availability of validated symptom diaries have allowed a more organized study of severe premenstrual disorders. The U.S Food and Drug Administration has now approved 4 agents for the treatment of PMDD: 3 antidepressants (i.e., selective serotonin reuptake inhibitors) and 1 low-dose combination oral contraceptive (COC) that contains the progestin drospirenone and is administered using a regimen of 24 days of active pills in a 28-day cycle (drospirenone/20EE-24/4). Drospirenone is unique among progestins used in COCs in that it has both antimineralocorticoid and antiandrogenic activities. Two pivotal studies have shown drospirenone/20EE-24/4 to be effective in treating the mood, physical and behavioral symptoms of PMDD and symptoms specifically associated with food, water retention and negative interpersonal relationships.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | ACNE | ORAL CONTRACEPTIVES, COMBINED | PREMENSTRUAL TENSION | SIGNS AND SYMPTOMS | TREATMENT | Developed Countries | North America | Americas | Dermatitis | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Menstruation Disorders | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329798

25.
Title: Sexual dysfunction in patients with chronic hand eczema in the Turkish population.
Author: Ergun M; Ermertcan AT; Ozturkcan S; Temeltas G; Deveci A
Source: Journal of Sexual Medicine. 2007 Nov;4(6):1684-1690.
Abstract: Hand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction. The aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients. Sexual functions were evaluated in hand eczema patients. Ninety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression. Among 43 female subjectswith hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 +or- 9.19 vs. 24.04 +or- 3.40, P < 0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 +or- 9.19 vs. 22.23 +or- 5.82, P < 0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 +or- 14.83 vs. 59.88 +or- 5.65 vs. 62.03 +or- 11.04, P < 0.05). The results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CASE CONTROL STUDIES | EVALUATION INDEXES | ADULTS | ECZEMA | PSYCHOSOCIAL FACTORS | MENTAL DISORDERS | DEPRESSION | SEX BEHAVIOR | SEXUALITY | HEALTH STATUS INDEXES | IMPOTENCE | HUMAN REPRODUCTIVE INDEXES | SEX FACTORS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Age Factors | Population Characteristics | Demographic Factors | Population | Dermatitis | Diseases | Behavior | Personality | Psychological Factors | Health | Genital Effects, Male | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Reproductive Behavior | Fertility | Population Dynamics
Document Number: 321835

26.

Peer Reviewed

Title: Contraceptive efficacy and side effects of Implanon.
Author: Gezginc K; Balci O; Karatayli R; Colakoglu MC
Source: European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):362-365.
Abstract: The objective was to determine the efficacy and side effects of Implanon used for long-term contraception. Prospective study of 80 patients who used Implanon for longterm contraception between January 2004 and January 2006; side effects, efficacy and removals were recorded. Amenorrhoea, infrequent bleeding and frequent bleeding were reported by 33 (41.25%), 19 (23.75%) and 14 patients (17.5%), respectively. Non-menstrual side effects comprised breast tenderness in 15 patients (18.75%), acne in eight (10%), headache and dizziness in three (3.75%); depressive mood disorders, pelvic pain and loss of libido were mentioned each by two of the women (2.5%). During the study period, Implanon was removed from 20 participants. No problem was encountered during its placement or removal. Patients considering use of Implanon must be carefully selected and informed about its expected side effects before placement. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | DIZZINESS | MENSTRUATION DISORDERS | ACNE | PREVALENCE | HEADACHE | DEPRESSION | PELVIS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Signs and Symptoms | Diseases | Dermatitis | Measurement | Mental Disorders | Anatomy | Biology
Document Number: 313978

27.

Title: Sexual dysfunction in patients with chronic hand eczema in the Turkish population.
Author: Mahizer E; Ermertcan AT; Serap O; Gokhan T; Artuner D
Source: Journal of Sexual Medicine. :7 p.
Abstract: Hand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction. The aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients. Main Outcome Measures: Sexual functions were evaluated in hand eczema patients. Ninety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression. Among 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 � 9.19 vs. 24.04 � 3.40, P < 0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 � 9.19 vs. 22.23 � 5.82, P < 0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 � 14.83 vs. 59.88 � 5.65 vs. 62.03 � 11.04, P < 0.05). The results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLIENTS | GENITAL EFFECTS, MALE | GENITAL EFFECTS, FEMALE | ECZEMA | QUALITY OF LIFE | IMPOTENCE | Developing Countries | Europe, Southeastern | Europe | Program Activities | Programs | Organization and Administration | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Genitalia, Female | Dermatitis | Diseases | Social Welfare | Economic Factors
Document Number: 313342

28.

Title: Implanon: A new implantable contraceptive.
Author: Newberry YG
Source: Nursing for Women's Health. 2007 Dec;11(6):607-611.
Abstract: In July 2006, six years after Norplant was removed from the U.S. market, a new contraceptive implant, Implanon, was approved by the Food and Drug Administration (FDA). Implanon is a single-rod progestin implant that is placed subdermally in the upper arm and is effective for up to three years. Its use has been studied in 17 countries, including the United States. Organon USA, the company marketing Implanon, has reported extensive experience with the drug in more than 30 countries, with approximately 2.5 million implants inserted since 1998. Implanon releases 68 mg of etonogesterel, a third-generation progestin desogestrel metabolite with less androgenic activity than levonorgesterel. The single matchstick-size (4 cm x 2 mm) rod comes preloaded in a disposable sterile applicator. The system uses a carrier polymer, ethylene vinyl acetate, which provides controlled release over three years. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | GLOBAL | SUMMARY REPORT | ADOLESCENTS, FEMALE | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE MODE OF ACTION | CONTRACEPTIVE EFFECTIVENESS | DRUG INTERACTIONS | CONTRAINDICATIONS | BLEEDING | ACNE | SIDE EFFECTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | COUNSELING | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Dermatitis | Contraceptive Agents | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 324047

29.

Title: Hypersensitivity to aeroallergens in patients with recurrent vulvovaginitis of undetermined etiology.
Author: Ozturk S; Caliskaner Z; Karaayvaz M; Dede M; Gulec M
Source: Journal of Obstetrics and Gynaecology Research. 2007 Aug;33(4):496-500.
Abstract: Recent findings show that the vaginal mucosa can develop an allergic response to environmental allergens and there is a strong association between atopy and some recurrent vulvovaginal infections. In this study, we investigated prospectively the rate of atopy in patients with recurrent vulvovaginitis of undetermined etiology (RVV). After being investigated by a gynecologist, 35 patients with RVV who were considered as undetermined etiology formed the study group. The control group consisted of 150 healthy females. Study and control groups were investigated for atopy by means of skin prick test for common aeroallergens. Associated allergic disease and familial atopy history of the subjects were recorded. The rate of atopy (11/35; 31.4% vs 9/150; 6%) was significantly higher (P < 0.001) in the study group than in the controls. Familial history of atopy was significantly more frequent in the study group than in the controls (10/35; 28.6% vs 8/150; 5.3%, P < 0.05). RVV in atopics is more associated with seasonal rhinitis than in nonatopics (5/11; 45.4% vs 2/24; 8.3%, P < 0.05). We concluded that a significant number of RVV is associated with atopy. Although the exact mechanism(s) of this relationship remains to be investigated atopy might be a causative and/or contributing factor in the pathogenesis of RVV. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | SIGNS AND SYMPTOMS | VAGINITIS | ALLERGIC REACTION | SEASONAL VARIATION | PRURITUS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Diseases | Vaginal Abnormalities | Population Dynamics | Dermatitis
Document Number: 319417

30.

Peer Reviewed

Title: Noncontraceptive benefits of two combined oral contraceptives with antiandrogenic properties among adolescents.
Author: Sabatini R; Orsini G; Cagiano R; Loverro G
Source: Contraception. 2007 Nov;76(5):342-347.
Abstract: The aim of this study was to assess the noncontraceptive benefits of two combined oral contraceptives, containing progestins with well-known antiandrogenic properties, in adolescent girls. In this prospective observational study, the effects of two formulations containing 30 mcg of ethinyl estradiol combined with 2 mg chlormadinone acetate or 3 mg drospirenone were compared. Six-month data were obtained from 156 sexually active adolescents requiring contraception. We investigated the advantages of these regimens on intermenstrual bleeding, dysmenorrhea, acne and hair and skin disorders. Furthermore, their effects on sexual interest, intercourse frequency and sexual satisfaction were evaluated. Both preparations provided effective contraception, good cycle control and beneficial effects on preexisting hair and skin disorders without effects on body weight. However, the best results were obtained with the formulation containing chlormadinone acetate, with the difference being statistically significant. Furthermore, the contraceptive adherence to teenager expectations and the counseling effectiveness enhancing compliance contribute to a high rate of continuation. (author's)
Language: English
Keywords:
ITALY | GLOBAL | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | TREATMENT | MENSTRUATION DISORDERS | DYSMENORRHEA | DERMATOLOGICAL EFFECTS | ACNE | Europe, Southern | Europe | Developed Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Physiology | Biology | Dermatitis
Document Number: 321662


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