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Title: Risk factors for deep vein thrombosis in women aged 18 to 50: a retrospective analysis.
Author: Binder B; Lackner HK; Salmhofer W; Hofmann-Wellenhof R
Source: Dermatologic Surgery. 2009 Mar;35(3):451-6.
Abstract: BACKGROUND: Deep vein thrombosis (DVT) occurs in one of every 1,000 individuals per year. Various inherited and acquired risk factors are known. We investigated the importance of oral contraceptives (OCs) as a risk factor in women of child-bearing age. OBJECTIVES: To evaluate the risk factors for DVT in a female patient collective. METHODS: We analyzed the records of 99 women aged 18 to 50 with DVT. We documented age, identifiable risk factor of DVT, location of the thrombus, use of OCs, and thrombophilia. RESULTS: 52.5% of patients suffering from DVT were aged between 40-50 years. Forty-six patients had an unprovoked DVT; the most common risk factor was immobilization in 41. Thrombophilia was found in 18 cases. Twenty-nine patients used OCs; no influence of OCs on any of the other risk factors was found. CONCLUSIONS: In our patient group, the most important risk factors were older age and immobilization. DVT is typically idiopathic and may be caused by subtle nondetectable thrombophilic disorders. The use of OCs was distributed in DVT patients just as in the general Austrian community and seems not to be a severe additional risk factor. Examining the whole lower extremity during ultrasonography is important so as not to overlook a DVT of the lower leg.
Language: English
Keywords:
AUSTRIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | PREGNANT WOMEN | THROMBOSIS | AGE FACTORS | RISK FACTORS | Developed Countries | Europe, Central | Europe | Studies | Research Methodology | Demographic Factors | Population | Population Characteristics | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health
Document Number: 331221

Peer Reviewed

Title: Twenty or thirty microgram ethinyloestradiol in an oral contraceptive: Does it make a difference in the mind and the daily practice of gynaecologists and general practitioners?
Author: Bitzer J; Frey B; von Schonau M; Sabler N; Tschudin S
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun 5;:1-10.
Abstract: Objectives Currently, evidence-based guidelines concerning the use of oral contraceptives (OCs) containing either 20 or 30 mug ethinyloestradiol (EE) and the same progestogen, are lacking. We wanted to identify whether Swiss gynaecologists and general practitioners (GPs) have specific criteria on which they base their prescribing habit. Methods Two questionnaires were submitted to 158 physicians. The first one contained a list of possible criteria relevant for decision making and a description of specific clinical situations. The second one concerned actual patients who received either a 20 mug (Yasminelle(R)) or a 30 mug (Yasmin(R)) OC containing the same progestogen drospirenone. Results The most relevant criteria for decision making (in hierarchical order) were family history of venous thromboembolic disease (VTE), headache, smoking, age beyond 35, stability of the menstrual cycle, breast tenderness, body mass index, irregular bleeding and acne. The 20 mug dosage was preferred for women older than 35, those smoking more than 15 cigarettes per day, those with a family history of VTE, and those complaining of breast tenderness or headache. The 30 mug dosage was preferred for patients with a history of irregular bleeding, a family history of osteoporosis, expected poor compliance and acne. Conclusion Swiss gynaecologists and GPs do not preferentially prescribe the lowest possible dosage of EE. They use indirect markers they consider relevant for differential prescribing. For some markers, there is inconsistency, indicating that preferences for 20 mug and 30 mug preparations may be influenced by other factors.
Language: English
Keywords:
SWITZERLAND | RESEARCH REPORT | PHYSICIANS | WOMEN | CLIENTS | DECISION MAKING | TOBACCO USE | HEADACHE | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | CONTRACEPTIVE AGENTS, SIDE EFFECTS | THROMBOEMBOLISM | AGE FACTORS | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Central | Europe | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Behavior | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Embolism | Vascular Diseases | Population Characteristics | Drugs | Treatment | Medical Procedures | Medicine | Health Services
Document Number: 341601

5.
Title: [The statement of Polish Gynecological Society experts on oral use of contraceptive 75 microg desogestrel minipill in different clinical cases--state of art in 2008] Stanowisko Zespolu Ekspertow Polskiego Towarzystwa Ginekologicznego dotyczace
Author: Debski R; Kotarski J; Paszkowski T; Pawelczyk L; Skrzypulec V; Tomaszewski J
Source: Ginekologia Polska. 2009 Jan;80(1):63-75.
Abstract: Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland.
Language: Polish
Keywords:
POLAND | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGY | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE SAFETY | Developing Countries | Europe, Central | Europe | Research Methodology | Public Health | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Safety
Document Number: 330922

6.
Title: Consequences of thrombophilia screening for life quality in women before prescription of oral contraceptives and family members of VTE patients.
Author: Eichinger S
Source: Hamostaseologie. 2009 Feb;29(1):110-1.
Abstract: A large number of hereditary and acquired alterations in the coagulation system that are associated with an increased risk of venous thrombosis have been described. Screening for these thrombophilic defects has become particularly popular in women before the prescription of oral contraceptives. The relevance of the results with regard to the management of the patients remains, however, to be questioned. In a recent review of six articles that were aimed to determine the nature and extent of psychological impact of thrombophilia screening, no valid conclusions could be drawn about the psychological impact due to heterogeneity of the data and lack of methodological accuracy. We performed a questionnaire-based study in 247 women with and in 132 women without factor V Leiden who were referred for factor V Leiden testing before oral contraceptive intake. A large proportion (76%) of the women reported being emotionally disturbed by genetic testing. 16% of women with wildtype factor V were discouraged from OC use, while 3% of women with factor V Leiden were encouraged to take OC. This indicates that recommendations after testing are not consistently driven by the test result, which compromises the quality of patient care. Given the large number of women who are taking oral contraceptives unequivocal guidelines for counseling prior to their prescription are urgently needed. These guidelines should integrate the risks and benefits of oral contraceptives but also the impact of screening on quality of life and aspects of counselling.
Language: English
Keywords:
AUSTRIA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | COUNSELING | THROMBOSIS | RISK FACTORS | SCREENING | GENETIC TECHNIQUES | EMOTIONS | QUALITY OF LIFE | Developed Countries | Europe, Central | Europe | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Psychological Factors | Behavior | Social Welfare | Economic Factors
Document Number: 329794

Peer Reviewed

Title: Traces of the second demographic transition in four selected countries in Central and Eastern Europe: union formation as a demographic manifestation.
Author: Hoem JM; Kostova D; Jasilioniene A; Muresan C
Source: European Journal of Population. 2009 Aug;25(3):239-255.
Abstract: Using data from the first round of the national Gender and Generations Surveys of Russia, Romania, and Bulgaria, and from a similar survey of Hungary, which were all collected in recent years, we study rates of entry into marital and non-marital unions. We have used elements from the narrative of the Second Demographic Transition (SDT) as a vehicle to give our analysis of the data from the four countries some coherence, and find what can be traces of the SDT in these countries. The details vary by country; in particular, latter-day developments in union formation patterns did not start at the same time in all countries, but in our assessment it began everywhere before communism fell, that is, before the societal transition to a market economy got underway in 1990.
Language: English
Keywords:
RUSSIA | EUROPE | ROMANIA | HUNGARY | BULGARIA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | DATA ANALYSIS | MARRIAGE | LIVING ARRANGEMENTS | MARRIAGE AGE | Developing Countries | Asia, Northern | Asia | Developed Countries | Europe, Southeastern | Europe, Central | Population Dynamics | Demographic Factors | Population | Research Methodology | Nuptiality | Residence Characteristics | Population Distribution | Geographic Factors | Marriage Patterns
Document Number: 339896

8.
Title: [Attitudes of Czech women toward induced abortions] Interrupcni chovani a postoje k umelemu preruseni tehotenstvi u ceskych zen:
Author: Holla K; Weiss P; Unzeitig V; Cibula D
Source: Ceska Gynekologie. 2009 Apr;74(2):92-6.
Abstract: OBJECTIVE: Survey of attitudes of Czech women toward abortions. DESIGN: Representative survey. METHODS: Anonymous questionnare survey of the sample of 1011 Czech women aged 15 to 50. RESULTS: Number of induced abortions significantly increases with age; women with one or more children frequently undergo induced abortion; women using hormonal contraception have significantly less incidence of induced abortion in their case history; independently of age or place of residence Czech women have liberal attitudes towards the possibility for induced abortion, whereas the religious beliefs significantly increase the restrictive attitudes towards induced abortion. CONCLUSION: In spite of the very liberal attitudes of Czech women toward induced abortions their number is constantly decreasing--probably as a result of the increasing number of hormonal contraception users.
Language: Czech
Keywords:
CZECHOSLOVAKIA | RESEARCH REPORT | WOMEN | ABORTION | ATTITUDES | AGE FACTORS | CONTRACEPTIVE USAGE | Europe, Central | Europe | Developing Countries | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Psychological Factors | Behavior | Population Characteristics | Contraception
Document Number: 342406 Notification

Peer Reviewed

Title: Birth records from Swiss married couples analyzed over the past 35 years reveal an aging of first-time mothers by 5.1 years while the interpregnancy interval has shortened.
Author: Kalberer U; Baud D; Fontanet A; Hohlfeld P; de Ziegler D
Source: Fertility and Sterility. 2009 Jul 14;
Abstract: Although the general trend for delaying childbearing is generally viewed as causing infertility, its consequences on the interpregnancy interval have been unknown. A study of birth records for Swiss married women from 1969 to 2006 revealed that the woman's age at first birth has increased from 25.0 to 30.1 years, whereas calculated theoretical interpregnancy intervals after the first and second child decreased from 23.2 to 13 and from 22.4 to 7.9 months, respectively.
Language: English
Keywords:
SWITZERLAND | SUMMARY REPORT | COUPLES | CURRENTLY MARRIED | DELAYED CHILDBEARING | DEMOGRAPHIC AGING | FERTILITY | BIOLOGICAL AGING | BIRTH RECORDS | FIRST BIRTH | AGE FACTORS | FIRST BIRTH INTERVALS | Developed Countries | Europe, Central | Europe | Family Characteristics | Family and Household | Sociocultural Factors | Marital Status | Nuptiality | Demographic Factors | Population | Reproductive Behavior | Population Dynamics | Physiology | Biology | Vital Statistics | Population Statistics | Research Methodology | Pregnancy History | Fertility Measurements | Population Characteristics | Birth Intervals
Document Number: 342041

10.

Peer Reviewed

Title: Psychological and behavioural factors associated with sexual risk behaviour among Slovak students.
Author: Kalina O; Geckova AM; Jarcuska P; Orosova O; van Dijk JP; Reijneveld A
Source: BMC Public Health. 2009 Jan 13;9(15):[10] p.
Abstract: Knowledge about the prevalence of sexual risk behaviour (SRB) in adolescence is needed to prevent unwanted health consequences. Studies on SRB among adolescents in Central Europe are rare and mostly rely on a single indicator for SRB. This study aims to assess the association of behavioural and psychological factors with three types of SRB in adolescents in Central Europe. We obtained data on behavioural factors (having been drunk during previous month, smoking during previous week, early sexual initiation), psychological factors (self-esteem, wellbeing, extroversion, neuroticism, religiousness), and SRB (intercourse under risky conditions, multiple sexual partners, and inconsistent condom use) in 832 Slovak university students (response 94.3%). Among those with sexual experience (62%), inconsistent condom use was the most prevalent risk behaviour (81% in females, 72% in males). With the exception of having been drunk in males, no factor was associated with inconsistent condom use. Regarding the other types of SRB, early sexual initiation was most strongly associated. In addition, other, mostly behavioural, factors were associated, in particular having been drunk. Results suggest that behavioural factors are more closely related to SRB than psychological factors. Associations differ by type of SRB and gender but offer few clues to target risk groups for inconsistent condom use. Results show a high need for health-promotion programmes in early adolescence that target SRB in conjunction with other health risk behaviours such as alcohol abuse.
Language: English
Keywords:
SLOVAKIA | RESEARCH REPORT | PREVALENCE | SEXUAL PARTNERS | ADOLESCENTS | ADOLESCENT PREGNANCY | PREGNANCY, UNWANTED | KNOWLEDGE | RISK BEHAVIOR | SEX BEHAVIOR | PSYCHOLOGICAL FACTORS | ALCOHOL USE AND ABUSE | SELF ESTEEM | RELIGION | Europe, Central | Europe | Developing Countries | Measurement | Research Methodology | Behavior | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Sociocultural Factors
Document Number: 329530

11.

Peer Reviewed

Title: Change and stability in parent-child contact in five western countries.
Author: Kalmijn M; de Vries J
Source: European Journal of Population. 2009 Aug;25(3):257-276.
Abstract: Although much is known about changes in the conjugal family, little is known about trends in contact between parents and adult (independently living) children. Using unique survey data, we study changes in contact with the mother and the father in five western countries over a 15-year period (Austria, West Germany, Great Britain, the United States, and Italy). We describe changes and we examine the role of compositional changes in the trend. We find no evidence for a decline in intergenerational contact, in contrast to notions of individualism. In two countries, there has been an increase in contact with the mother and in three countries no net trend is observed. Contact with the father has not changed. Other forms of contact (e.g., telephone contact) have increased. Some compositional changes have had a downward pressure on the trend, leading to a decline in contact (i.e., rising education, declining church attendance), but these pressures have been compensated by counteracing compositional changes (declining sibsize) and by behavioral changes.
Language: English
Keywords:
UNITED KINGDOM | UNITED STATES OF AMERICA | GERMANY | AUSTRIA | ITALY | RESEARCH REPORT | PARENTS | CHILDREN | FAMILY LIFE | BONDING | CHANGES | BEHAVIOR CHANGE | Developed Countries | Europe, Western | Europe | North America | Americas | Europe, Central | Europe, Southern | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Interpersonal Relations | Behavior | Social Change
Document Number: 339897

12.

Peer Reviewed

Title: Sexual behaviour and HIV/sexually transmitted infection risk behaviours in the general population of Slovenia, a low HIV prevalence country in central Europe.
Author: Klavs I; Rodrigues LC; Wellings K; Weiss HA; Hayes R
Source: Sexually Transmitted Infections. 2009 Apr;85(2):132-8.
Abstract: OBJECTIVES: To describe sexual and HIV/sexually transmitted infection (STI) risk behaviours in Slovenia. METHODS: A nationally representative cross-sectional survey of the general population aged 18-49 years in 1999-2001 was conducted. The data were collected by face-to-face interviews and anonymous self-administered questionnaires. Statistical methods for complex survey data were used. RESULTS: 849 men and 903 women were interviewed. In the past 5 years, both men and women reported a median of one heterosexual partner (means 3.2, 1.5, respectively), concurrent heterosexual partnerships were reported by 24.4% of men and 8.2% of women, heterosexual sex with non-Slovenian partners by 12.6% of men and 12.2% of women, forced sex by 4.8% of women, paid heterosexual sex by 2.6% of men, sex with another man by 0.6% of men and heterosexual sex with an injecting drug user by 1.2% of men and 1.3% of women. In the past year, 22.7% of men and 9.5% of women reported forming at least one new heterosexual partnership. The mean numbers of episodes of heterosexual sex in the previous 4 weeks were 6.1 for men and 6.0 for women. Consistent and inconsistent condom use was reported more frequently among men reporting multiple female partners and those not married or cohabiting. CONCLUSIONS: Recent patterns of reported sexual behaviour are consistent with a low risk of HIV and STI transmission in Slovenia. The results will inform Slovenian sexual health policies including HIV/STI prevention, and are particularly valuable because population-based data on HIV/STI risk behaviour have not previously been available in low HIV prevalence countries of central Europe.
Language: English
Keywords:
SLOVENIA | RESEARCH REPORT | SURVEYS | SEX BEHAVIOR | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | INTERVIEWS | QUESTIONNAIRES | RISK BEHAVIOR | CONDOM USE | Developing Countries | Europe, Central | Europe | Sampling Studies | Studies | Research Methodology | Behavior | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Measurement | Data Collection | Risk Reduction Behavior
Document Number: 341850

13.
Title: Induced abortions: still important reproduction loss in the Czech Republic?
Author: Kocourkova J; Fait T
Source: Neuro Endocrinology Letters. 2009 Mar;30(1):111-8.
Abstract: OBJECTIVES: The aim of study was to evaluate the importance of induced abortions for reproduction medicine in Czech Republic. DESIGN: Demographic analysis of data published by EUROSTAT and Czech statistical office. SETTING: Department of Demography and Geodemography Faculty of Science, Charles University Prague. RESULTS: Widespread use of the liberal abortion law in socialist countries contributed to the decline of fertility rates only to the replacement level. In the Czech Republic total fertility rate dropped below 1.3 in 1995 and it did not increase above 1.5 children per woman till 2007. The increased use of modern contraceptive methods that results in a sharp decline in fertility and in a significant decrease of induced abortions can be documented. The total abortion rate fell from 1.54 abortions per a woman in 1990 to 0.34 in 2007. The proportion of women aged 15-49 years who were prescribed oral contraception increased from 4 percent in 1990 to 48 percent in 2007. An induced abortion is still used largely as a way to avoid birth of additional children by women who already have the number of children they want. This is in sharp contrast with the situation in the majority of Western European countries in which abortion is used mainly by teen-age girls whose attempts to avoid pregnancy have failed. CONCLUSION: In contrast to other demographic characteristics which classify the Czech Republic to Eastern Europe, the level of induced abortion rate is comparable with the levels observed in some Western European countries.
Language: English
Keywords:
CZECH REPUBLIC | RESEARCH REPORT | MEDICINE | ABORTION | FERTILITY RATE | RESEARCH AND DEVELOPMENT | Developing Countries | Europe, Central | Europe | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Technology | Economic Factors
Document Number: 341822 Notification

14.
Title: Metabolic profile and sex hormone binding globulin (SHBG) in different reproductive phases of Czech women and their relations to weight, body composition and fat distribution.
Author: KOSKOVA I; PETRASEK R; VONDRA K; DUSKOVA M; STARKA L
Source: Physiological Research / Academia Scientiarum Bohemoslovaca. 2009;58(3):393-402.
Abstract: In our study, 213 healthy Czech women aged 20 to 65 years were examined and divided into fully reproductive, premenopausal, menopausal and postmenopausal groups. In all subjects body composition was determined by classical anthropometry and metabolic profile was assessed. A total of 146 subjects completed 3-year longitudinal study. Total and LDL cholesterol increased and ratio HDL/total cholesterol decreased with age (p<0.001), most significantly in menopause. Triacylglycerols increased only up to menopause. HDL had a very slight trend to decrease in menopause and postmenopause. Fasting blood glucose level increased progressively (p<0.001), in postmenopause frequently exceeded normal range. Higher BMI, total fat mass and central fat indices were associated with higher total and LDL cholesterol, triacylglycerols, C-peptide, insulin and fasting blood glucose level (p<0.001; fasting blood glucose level to waist-to-hip ratio: p<0.01) and lower HDL cholesterol (p<0.001). Higher C-peptide and insulin were associated with lower HDL cholesterol and higher triacylglycerols (p<0.001). Fasting glucose correlated with LDL cholesterol (p<0.01). Higher SHBG was associated with higher HDL and lower LDL cholesterol (p<0.001). Hormone replacement treatment was related to lower fasting blood glucose level in postmenopausal women (p<0.01). Oral contraception is suggestive of a positive influence on lipid spectrum by increasing the ratio HDL/total cholesterol. Markers of lipid and carbohydrate metabolism are not only age-related, but they are also related to BMI, total fat mass and central fat indices. Therefore, preventive programs should be focused above all on menopausal women.
Language: English
Keywords:
CZECHOSLOVAKIA | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | CHOLESTEROL | BODY WEIGHT | ANTHROPOMETRY | AGE FACTORS | MENOPAUSE | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | Europe, Central | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342621

15.

Title: Persistence of nevirapine in breast milk and plasma of mothers and their children after single-dose administration.
Author: Kunz A; Frank M; Mugenyi K; Kabasinguzi R; Weidenhammer A; Kurowski M; Kloft C; Harms G
Source: Journal of Antimicrobial Chemotherapy. 2009 Jan;63(1):170-7.
Abstract: OBJECTIVES: Nevirapine is widely used in the developing world for the prevention of mother-to-child transmission (PMTCT) of HIV. A single mutation in the HIV genome is sufficient to lead to significant nevirapine resistance. Persistence of low-level drug concentrations in body compartments can foster resistance formation. In this study, concentration-time courses of nevirapine after single-dose administration were analysed over an extended post-partum period. PATIENTS AND METHODS: Breast milk and plasma samples of 62 HIV-positive Ugandan mother-child pairs who had received single-dose nevirapine were collected at delivery and 1, 2 and 6 weeks post-partum. Nevirapine concentrations were quantified by LC/tandem-mass-spectrometry using a quantification limit of 15 ng/mL, and a population pharmacokinetic (PK) analysis was performed. RESULTS: Concentration-time profiles in breast milk, maternal plasma and child plasma showed similar shapes. At week 1, median nevirapine concentrations were 164 ng/mL in maternal plasma, 114 ng/mL in breast milk and 183 ng/mL in child plasma. The population PK model predicted nevirapine concentrations>10 ng/mL (IC50 for nevirapine) for 13 days in breast milk, 14 days in maternal plasma and 18 days in child plasma in 80% of the samples. CONCLUSIONS: Nevirapine concentrations were present for 2-3 weeks in the three compartments. The concentrations are probably sufficiently high to protect most breastfed children from HIV transmission during the first 2 weeks. The long presence of slowly decreasing levels of nevirapine is likely to induce resistance formation. Post-natal addition of antiretrovirals for 1 week only, as recommended in the current PMTCT guidelines, will not suffice to avoid nevirapine resistance formation.
Language: English
Keywords:
GERMANY | RESEARCH REPORT | MOTHERS | INFANT | POSTPARTUM | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | DRUGS | BREASTFEEDING | HUMAN MILK | ADMINISTRATION AND DOSAGE | TREATMENT | Europe, Central | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Nutrition | Nutrition | Lactation | Maternal Physiology | Physiology | Biology
Document Number: 329752

16.

Peer Reviewed

Title: Oral contraception usage in relation to bone mineral density and bone turnover in adolescent girls.
Author: Lattakova M; Borovsky M; Payer J; Killinger Z
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):207-14.
Abstract: OBJECTIVES: To compare the effect of a low-dose oral contraceptive (OC) containing 30 microg ethinyloestradiol (EE) with that of an ultra-low-dose OC containing 15 microg EE on bone turnover and BMD in healthy adolescent women and, in addition, to ascertain the influence of body mass index (BMI) and exercise on these indices of bone metabolism. METHODS: We recruited to the study 92 healthy girls aged between 16 and 19. They were divided into three groups. Participants in the first two groups used an OC with either 15 or 30 microg ethinyloestradiol (EE), whereas those in the third group used no hormonal contraception. Bone mineral density (BMD) and bone turnover markers were measured before and after 12 months of treatment. RESULTS: The BMD values of the total hip in females using the OC containing 30 microg EE was 0.912 g/cm(2) at baseline and 0.918 g/cm(2) after one year; in females using the OC containing 15 microg EE the corresponding values were 0.888 g/cm(2) and 0.895 g/cm(2) whereas in females who used no contraception BMD values were 0.942 g/cm(2) and 0.949 g/cm(2), respectively. The changes were statistically insignificant. Levels of osteocalcin and CTX had decreased after one year in all groups, but not statistically significantly so. CONCLUSION: Low dose and ultra-low dose oral contraceptives did not significantly differ in their effects on bone mineral density or bone turnover markers in adolescent girls aged 16-19.
Language: English
Keywords:
SLOVAKIA | RESEARCH REPORT | CONTROL GROUPS | ADOLESCENTS, FEMALE | ORAL CONTRACEPTIVES, LOW-DOSE | ADMINISTRATION AND DOSAGE | SKELETAL EFFECTS | ETHINYL ESTRADIOL | BODY WEIGHT | FITNESS | Developing Countries | Europe, Central | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 341800

17.

Title: Intrinsic clotting factors in dependency of age, sex, body mass index, and oral contraceptives: definition and risk of elevated clotting factor levels.
Author: Luxembourg B; Schmitt J; Humpich M; Glowatzki M; Seifried E; Lindhoff-Last E
Source: Blood Coagulation and Fibrinolysis. 2009 Jul 17;
Abstract: Elevated clotting factors have been demonstrated to be a risk factor for venous thromboembolism (VTE). The aim of our study was to investigate the impact of age, sex, body mass index, and oral contraceptives on the clotting factor activities of factors VIII, IX, XI, and XII and their impact on the cutoff definition and risk of VTE associated with elevated clotting factors. Factor VIII, IX, XI, and XII activities were measured in 499 blood donors and 286 patients with VTE. Age and body mass index predicted significantly and independently the clotting factor activities of factors VIII, IX, and XI, whereas use of oral contraceptives predicted factor IX, XI, and XII levels. Percentiles of clotting factor activities, which are often used for the cutoff definition of elevated clotting factors, varied due to the effect of age, body mass index, and oral contraceptives. The adjusted odds ratios for VTE were 10.3 [95% confidence interval (CI) 5.1-20.7], 6.1 (95% CI 3.1-12.0), and 3.3 (95% CI 1.9-5.8) for elevated factors VIII, IX, and XI, respectively. Furthermore, our study demonstrates for the first time that elevated factor XII is associated with an increased risk of VTE (adjusted odds ratio 2.9, 95% CI 1.6-5.3).
Language: English
Keywords:
GERMANY | RESEARCH REPORT | CLIENTS | BLOOD DONORS | AGE FACTORS | BODY WEIGHT | ORAL CONTRACEPTIVES | THROMBOEMBOLISM | RISK FACTORS | Europe, Central | Europe | Developed Countries | Program Activities | Programs | Organization and Administration | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Embolism | Vascular Diseases | Diseases
Document Number: 342216

18.

Title: Why use of dienogest for the first contraceptive pill with estradiol?
Author: Mueck AO; Seeger H; Buhling KJ
Source: Gynecological Endocrinology. 2009 Aug 11;:1-5.
Abstract: Dienogest (DNG) has the essential properties of an effective progestogen for use in a new contraceptive pill using estradiol valerate as estrogenic component - it inhibits ovulation and protects against endometrial proliferation. DNG is a derivative of norethisterone (NET), but has a cyanomethyl- instead of an ethinyl-group in C17 position which may offer a variety of benefits regarding hepatic effects. The similarity to NET is reflected in the high endometriotropy and in similar pharmacokinetics like short plasma half-live and high bioavailability. However, DNG also elicits properties of progesterone derivatives like neutrality in metabolic and cardiovascular system and considerable antiandrogenic activity, the latter increased by lack of binding to SHBG as specific property of DNG. It has no glucocorticoid and antimineralocorticoid activity and has no antiestrogenic activity with the consequence that possible beneficial estradiol effects should not be antagonized. This may be of special importance for the tolerability and safety of the first pill with estradiol valerate instead of ethinylestradiol, although well-designed postmarketing studies are still ongoing to demonstrate what can be expected on the basis of pharmacology.
Language: English
Keywords:
GERMANY | CRITIQUE | ORAL CONTRACEPTIVES, PHASIC | LOW-DOSE PROGESTINS | ESTRADIOL | CONTRACEPTIVE SAFETY | ENDOMETRIAL EFFECTS | HEPATIC EFFECTS | CENTRAL NERVOUS SYSTEM EFFECTS | MENSTRUAL CYCLE | HORMONE REPLACEMENT THERAPY | Europe, Central | Europe | Developed Countries | Oral Contraceptives, Combined | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Estrogens | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health | Health | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Central Nervous System | Menstruation | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 342487

19.

20.

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

21.

Peer Reviewed

Title: Sexual activity and contraceptive use among secondary-school students in Slovenia.
Author: Pinter B; Verdenik I; Grebenc M; Ceh F
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):127-33.
Abstract: OBJECTIVES: To evaluate sexual activity and contraceptive use among secondary-school students in Slovenia. METHODS: A representative sample of 1095 third grade secondary-school students in Slovenia in 2004 was assessed by means of a self-administered questionnaire. RESULTS: The average age of the students was 17.4 +/- 0.7 years. Most students had experienced being in love (92%), dating (82%), kissing (87%), caressing (78%) and petting (61%). One half (53%) of them had already had coitus. Homosexual contacts had occurred among 2% of the boys and 11% of the girls. The main reason for the first sexual intercourse was love (44%) but it occurred by chance in 27% of the cases. Contraceptive methods used foremost at first intercourse were the condom (75%) and the pill (7%). Contraceptive methods resorted to on the occasion of the last intercourse were the condom (50%), the pill (32%), a double method whereby a condom is used in addition to the pill (4%), withdrawal (4%), periodic abstinence (1%), emergency contraception (1%), and other methods (1%); no contraceptive measures at all were applied in 7% of the encounters. CONCLUSIONS: At the age of 17 about one half of secondary-school students in Slovenia have already had sexual intercourse. Most students resort to effective contraception, but the double method is underused.
Language: English
Keywords:
SLOVENIA | RESEARCH REPORT | KAP SURVEYS | STUDENTS | HOMOSEXUALS | SECONDARY SCHOOLS | CONTRACEPTIVE PREVALENCE | SEX BEHAVIOR | RISK BEHAVIOR | LOVE | INTERPERSONAL RELATIONS | SEXUAL INTERCOURSE | SEX FACTORS | FIRST INTERCOURSE | CONDOM USE | Developing Countries | Europe, Central | Europe | Surveys | Sampling Studies | Studies | Research Methodology | Education | Behavior | Schools | Contraceptive Usage | Contraception | Family Planning | Emotions | Psychological Factors | Reproduction | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior
Document Number: 330934

23.
Title: Contraception and thrombophilia.
Author: Rott H; Krumpel A; Kappert G; Nowak-Gottl U; Halimeh S
Source: Hamostaseologie. 2009 May;29(2):193-6.
Abstract: The risk of thromboembolic events (TE) is increased by acquired or inherited thrombophilias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contraception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values . Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.
Language: English
Keywords:
FEDERAL REPUBLIC OF GERMANY | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | ADOLESCENTS, FEMALE | THROMBOEMBOLISM | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRAINDICATIONS | CONTRACEPTIVE AGENTS, PROGESTIN | PREGNANCY COMPLICATIONS | Developed Countries | Europe, Central | Europe | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Embolism | Vascular Diseases | Diseases | Safety | Public Health | Health | Contraceptive Agents | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Contraceptive Agents, Female
Document Number: 331280

24.

Title: Are oral contraceptive use and menstrual cycle phase related to anterior cruciate ligament injury risk in female recreational skiers?
Author: Ruedl G; Ploner P; Linortner I; Schranz A; Fink C; Sommersacher R; Pocecco E; Nachbauer W; Burtscher M
Source: Knee Surgery, Sports Traumatology, Arthroscopy. 2009 Mar 31;
Abstract: Oral contraceptive use and menstrual cycle phase are suggested to influence the risk of anterior cruciate ligament (ACL) injuries in female athletes. However, only few data are available for recreational sports. Therefore, female recreational skiers with a non-contact ACL injury and age-matched controls completed a self-reported questionnaire relating to menstrual history, oral contraceptive use and previous knee injuries. Menstrual history data were used to group subjects into either preovulatory or postovulatory phases of menstrual cycle. Our findings suggest that oral contraceptive use did not show any protective effect against ACL injuries nor did self-reported previous knee injuries show any association with ACL injury rate in recreational alpine skiing. Analysis of menstrual history data revealed that recreational skiers in the preovulatory phase were significantly more likely to sustain an ACL injury than were skiers in the postovulatory phase.
Language: English
Keywords:
AUSTRIA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN | ATHLETES | SPORTS | LEISURE | ORAL CONTRACEPTIVES | MENSTRUAL CYCLE | ACCIDENTS AND INJURIES | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | PREVALENCE | Developed Countries | Europe, Central | Europe | Research Methodology | Demographic Factors | Population | Population Characteristics | Social Behavior | Behavior | Contraceptive Methods | Contraception | Family Planning | Menstruation | Reproduction | Health | Contraceptive Safety | Safety | Public Health | Measurement
Document Number: 330925

25.

Title: Rising U.S. teen fertility.
Author: Saenz R; Conde E
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Feb. [3] p.
Abstract: The United States has higher fertility rates among teenage girls compared with other developed countries of the world. For example, girls ages 15 to 19 have fertility rates more than five times higher than their counterparts in developed countries such as France, Italy, Japan, Slovenia, and Switzerland. Nonetheless, the fertility rate of girls ages 15 to 19 declined consecutively over the period from 1991 to 2005. During this time, the fertility rate of the age group dropped by one-third, from 61.8 births per 1,000 girls ages 15 to 19 in 1991 to 40.5 in 2005. However, the latest data for 2006 may point to a reversal of this trend, with the fertility rate inching upward to 41.9. This trend is of great concern because adolescent pregnancy has been associated with unemployment, poverty, repeated pregnancy, sexually transmitted diseases, infant mortality, high risk pregnancy, and lower educational achievement. Furthermore, teenage pregnancy is a primary indicator of adult poverty among women.
Language: English
Keywords:
FRANCE | ITALY | JAPAN | SLOVENIA | SWITZERLAND | SUMMARY REPORT | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | UNEMPLOYMENT | POVERTY | SEXUALLY TRANSMITTED DISEASES | INFANT MORTALITY | PREGNANCY, HIGH RISK | FERTILITY RATE | Developed Countries | Europe, Western | Europe | Europe, Southern | Asia, Eastern | Asia | Developing Countries | Europe, Central | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Employment | Macroeconomic Factors | Economic Factors | Socioeconomic Factors | Reproductive Tract Infections | Infections | Diseases | Mortality | Pregnancy | Reproduction | Birth Rate | Fertility Measurements
Document Number: 331480

26.

Peer Reviewed

Title: Suppression of ovarian function by a combined oral contraceptive containing 0.02 mg ethinyl estradiol and 2 mg chlormadinone acetate given in a 24/4-day intake regimen over three cycles.
Author: Spona J; Binder N; Hoschen K; Feichtinger W
Source: Fertility and Sterility. 2009 Aug 24;
Abstract: OBJECTIVE: To describe the suppression of ovarian function with 0.02 mg ethinyl E(2)-2 mg chlormadinone acetate administered in a 24/4-day intake regimen in healthy women. DESIGN: Open, uncontrolled, multiple dosing, phase II trial. SETTING: Single clinic. PATIENT(S): Forty women treated. INTERVENTION(S): Treatment for up to three cycles with 0.02 mg ethinyl E(2)-2 mg chlormadinone acetate given in a 24/4-day regimen. MAIN OUTCOME MEASURE(S): Assessments of ovarian function classified by the Hoogland and Skouby score, thickness of endometrium, cervical reaction, and sex hormone levels, as well as overall tolerability. RESULT(S): No ovulation was observed in the per protocol set (N = 36), and one in the full analysis set (N = 38) after vomiting and diarrhea. Absence of ovarian activity, residual ovarian activity, and formation of a luteinized unruptured follicle were observed in 75.0%, 15.9%, and 1.1% of medication cycles, respectively. Endometrial thickness was suppressed to 4 to 5 mm compared with 10 to 12 mm without medication. Cervical reaction was negative. Hormone levels were lower with medication than without, and the medication was well tolerated. Treatment-related adverse events were typical of those associated with hormonal contraceptive use. CONCLUSION(S): Follicular development, cervical reaction, and endometrial thickness were suppressed profoundly after 0.02 mg ethinyl E(2)-2 mg chlormadinone acetate administration in a 24/4-day regimen, resulting in inhibition of ovulation and unfavorable conditions for fertilization, implantation, and thus pregnancy.
Language: English
Keywords:
AUSTRIA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | OVARIAN EFFECTS | Developed Countries | Europe, Central | Europe | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342590

27.
Title: [Pharmacotherapy for pelvic endometriosis in women] Farmakoterapia endometriozy narzaadow miednicy u kobiet.
Author: Starczewski A; Brodowska A; Brodowski J
Source: Polski Merkuriusz Lekarski. 2009 Mar;26(153):231-3.
Abstract: Pelvic endometriosis in women is a very common disease. The incidence of this condition in Poland in reproductive age women is about 7-15%, and as much as 50% of cases is diagnosed in patients with co-existing infertility and/or pain and adhesion of a true pelvis. The choice of a therapeutic method depends on the patient's age, stage of the disease, desire for pregnancy, the presence of adhesion, focus localization and a reaction to previous treatment. Currently, the most popular is surgical treatment sometimes followed by pharmacotherapy. Pharmacological treatment includes hormone therapy and symptomatic treatment, also the use of painkillers. Hormonal agents are administered to suppress ovarian activity and cause atrophy of ectopic foci of endometrium. At present, post-surgical pharmacotherapy for endometriosis uses mainly such hormones as: the Combined Oral Contraceptive Pill (COCP), progestagens, danazol, GnRh (gonadotropin-releasing hormone) analogues, aromatase inhibitors and other less common drugs. Also other therapeutic procedures are recommended in endometriosis treatment, procedures which support and in certain clinical situations even replace classical pharmacological methods. Some of them are immunotherapy and a diet rich in isoflavones, organic compounds which modulate estrogen receptor activity. Numerous clinical trials proved that preoperative pharmacotherapy does not improve treatment results and is not applicable to endometriomas in women. On the other hand, postoperative pharmacotherapy still ignites controversy. As maintained by the most recent literature, in the case of mild endometriosis (clinical Stage I and II according to the American Society for Reproductive Medicine) endometrial ablation has better effects than observation only, however postoperative pharmacotherapy does not improve the results of treatment. In more severe cases (clinical Stage III and IV), the best results are achieved by the combined treatment. Nevertheless, no randomized research has been carried out on awide scale in this group of patients.
Language: Polish
Keywords:
POLAND | RESEARCH REPORT | INCIDENCE | WOMEN | PELVIC INFLAMMATORY DISEASE | ENDOMETRIOSIS | GYNECOLOGIC SURGERY | PAIN | TREATMENT | EVALUATION | Developing Countries | Europe, Central | Europe | Measurement | Research Methodology | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Urogenital Surgery | Surgery | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms
Document Number: 341113

28.

Title: Is induced abortion a risk factor in subsequent pregnancy?
Author: Voigt M; Henrich W; Zygmunt M; Friese K; Straube S; Briese V
Source: Journal of Perinatal Medicine. 2009;37(2):144-9.
Abstract: OBJECTIVE: To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. PATIENTS AND METHODS: Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. The control group consisted of primiparous women without previous induced abortions. Maternal age was adjusted for. RESULTS: There was an overall trend towards an increased rate of preterm delivery at or=2 previous induced abortions were 7.8% and 8.5%, respectively, compared to 6.5% in the control population (P=0.015). Preceding terminations of pregnancy did not alter the rate of small-for-gestational-age newborns. Psychosocial stress and symptoms associated with prematurity such as cervical incompetence and vaginal bleeding before and after 28 weeks of gestation occurred more frequently in women with previous induced abortion compared to the control group (P<0.0001). CONCLUSION: The rate of preterm births increases with the number of preceding abortions. Similarly, symptoms associated with prematurity are more common. The rate of small-for-gestational-age newborns was not affected by preceding terminations of pregnancy.
Language: English
Keywords:
GERMANY | RESEARCH REPORT | WOMEN | PARITY | ABORTION | PREMATURE BIRTH | PREGNANCY COMPLICATIONS | RISK FACTORS | LOW BIRTH WEIGHT | Europe, Central | Europe | Developed Countries | Demographic Factors | Population | Fertility Measurements | Fertility | Population Dynamics | Fertility Control, Postconception | Family Planning | Pregnancy Outcomes | Pregnancy | Reproduction | Diseases | Health | Birth Weight | Body Weight | Physiology | Biology
Document Number: 331182 Notification

29.

Peer Reviewed

Title: Implanon versus medroxyprogesterone acetate: effects on pain scores in patients with symptomatic endometriosis--a pilot study.
Author: Walch K; Unfried G; Huber J; Kurz C; van Trotsenburg M; Pernicka E; Wenzl R
Source: Contraception. 2009 Jan;79(1):29-34.
Abstract: BACKGROUND: Implanon has been reported to be effective in the treatment of dysmenorrhea. We compared the therapeutic efficacies of depot medroxyprogesterone acetate (DMPA) and Implanon with regard to pain relief in women with endometriosis. STUDY DESIGN: In a clinical research center at a university hospital, 41 patients with dysmenorrhea, nonmenstrual pelvic pain and dyspareunia associated with histologically proven endometriosis were included in an open, prospective, randomized, controlled clinical trial. Twenty-one women were assigned by computer-generated randomization to receive Implanon, and 20 women to receive DMPA. As main outcome measures of this pilot study, we evaluated pain improvement quantified according to visual analog scale score, side effects, vaginal bleeding patterns, withdrawal rate and overall degree of satisfaction. RESULTS: During a follow-up period of 1 year, we ascertained a clear improvement in pain intensity for both treatment options. After 6 months, the average decrease in pain was 68% in the Implanon group and 53% in the DMPA group. The side-effects profile and the overall degree of satisfaction after study termination were comparable for both treatment options. CONCLUSION: Concerning pain relief, the therapeutic efficacy of the contraceptive implant Implanon is not inferior to that of DMPA in symptomatic endometriosis.
Language: English
Keywords:
AUSTRIA | NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ENDOMETRIOSIS | PAIN | PELVIC INFECTIONS | CONTRACEPTIVE AGENTS, PROGESTIN | MEDROXYPROGESTERONE ACETATE | TREATMENT | Developed Countries | Europe, Central | Europe | Europe, Western | Research Methodology | Demographic Factors | Population | Diseases | Signs and Symptoms | Infections | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330538

30.

Title: St John's wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive.
Author: Will-Shahab L; Bauer S; Kunter U; Roots I; Brattstrom A
Source: European Journal of Clinical Pharmacology. 2009 Mar;65(3):287-94.
Abstract: PURPOSE: St John's wort (Hypericum perforatum) is an herbal remedy that is widely used in the treatment of depression. Recent clinical data have demonstrated that St John's wort extracts interfere with the action of various drugs and possibly also with combined oral contraceptives. Therefore, we investigated the effects of a St John's wort extract (Ze 117) with low hyperforin content on the pharmacokinetics of ethinylestradiol and 3-ketodesogestrel. METHOD: Sixteen healthy female volunteers, who had taken a low-dose oral contraceptive (Lovelle contains 0.02 mg ethinylestradiol + 0.15 mg desogestrel) for at least 3 months, participated in the study. Pharmacokinetic data (AUC, C(max), t(max)) were determined the day before (reference) and after (test) a 14-day period of Ze 117 intake (250 mg twice daily). RESULTS: Before the co-administration of Ze 117 on day 7, the geometric mean (geometric coefficient of variation) for the AUC(0-24) of ethinylestradiol was 152.53 pg.h/ml (87.39%) and after co-administration on day 21 it was 196.57 pg.h/ml (78.14%). The respective values for ketodesogestrel were 36.37 pg.h/ml (34.18%) and 41.12 pg.h/ml (34.36%). The mean of individual ratios (reference-to-test) of log-transformed AUC values (90% confidence interval) were 0.951 (0.915-0.986) for ethinylestradiol and 0.968 (0.944-0.992) for ketodesogestrel indicating a small loss in bioavilability, but bioequivalence nevertheless. CONCLUSION: These results indicate that the recommended dose of the hypericum extract Ze117, which has a low hyperforin content, does not interact with the pharmacokinetics of the hormonal components of the low-dose oral contraceptive.
Language: English
Keywords:
FEDERAL REPUBLIC OF GERMANY | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | ETHINYL ESTRADIOL | DESOGESTREL | DRUG INTERACTIONS | Developed Countries | Europe, Central | Europe | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Drugs | Treatment | Medical Procedures | Medicine | Health Services |