| 1. Peer Reviewed Title: Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal. Author: De Beaudrap P; Etard JF; Diouf A; Ndiaye I; Gueye NF; Gueye PM; Sow PS; Mboup S; Ndoye I; Ecochard R; Eric D Author: ANRS 1215/90 Study Group Source: American Journal of Tropical Medicine and Hygiene. 2009 Jun;80(6):1047-53. Abstract: To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm3 (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was approximately 421 cells/mm3 (95% CI = 390; 454) in patients with < 200 cells/mm3 at baseline and approximately 500 cells/mm3 in patients with > 200 cells/mm3. The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm3 at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment. Language: English Keywords: SENEGAL | RESEARCH REPORT | STATISTICAL STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | TIME FACTORS | HEMATOLOGIC TESTS | USER COMPLIANCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Immunity | Immune System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 341762 |
2.   Title: [Descriptive study on contraceptive requirements for clinical trials in Spain. Do we need a debate?] Estudio descriptivo de las recomendaciones anticonceptivas en los ensayos Author: Gastaminza Lasarte G; Algorta Pineda J Source: Medicina Clinica. 2009 Jan 24;132(2):70-4. Abstract: Among the measures that seek to avoid the toxic effects on reproduction (teratogenic, embryotoxic, fetotoxic or otherwise) include the obligation to conduct preclinical tests to investigate this aspect in different animal species before marketing a new drug, although its application in time differs Europe-European Medicines Agency (EMEA) and US-Food and Drug Administration (FDA). In Europe requires that prior to including women in phase I of clinical trials have been completed preclinical studies on embryo-fetal development, without any mention of contraception. In contrast, U.S. can include women in the fertile clinical trials have not completed initial pre-clinical tests on the safety play, if they practice a pregnancy test before participation in contraception and take some action "highly effective". Are considered "highly effective" (by both the FDA and the EMEA, to be included in a document of the International Conference on Harmonization) methods with low failure rate (<1% per year) when used properly, such as implants, injectables, combined oral, some intrauterine devices (IUDs), sexual abstinence or a vasectomy for the partner. (excerpt) Language: Spanish Keywords: SPAIN | RESEARCH REPORT | CLINICAL TRIALS | PREGNANCY TESTS | ORAL CONTRACEPTIVES, COMBINED | IUD | INJECTABLES | CONTRACEPTIVE IMPLANTS | VASECTOMY | Europe, Southwestern | Europe | Developed Countries | Clinical Research | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Male Sterilization | Sterilization, Sexual Document Number: 329576 |
| 3. Peer Reviewed Title: Serum levonorgestrel levels and endometrial thickness during extended use of the levonorgestrel-releasing intrauterine system. Author: Hidalgo MM; Hidalgo-Regina C; Bahamondes MV; Monteiro I; Petta CA; Bahamondes L Source: Contraception. 2009 Jul;80(1):84-9. Abstract: BACKGROUND: The levonorgestrel-releasing intrauterine system (LNG-IUS) is a contraceptive method approved for five years of use. However, there is some evidence that its life span may be longer. The aim of the study was to evaluate serum levonorgestrel (LNG) and estradiol (E(2)) levels and endometrial thickness every 6 months from 7 to 8 1/2 years after insertion. STUDY DESIGN: At the end of the approved 5-year life span, no replacement devices were available; therefore, 86 women were allowed to retain the same device for a further 2 years. At the 7-year follow-up visit, the women who consented were again allowed to retain the same device for a further 18 months and were followed-up at six-monthly intervals. At each visit, vaginal sonography was performed to measure endometrial thickness, and a blood sample was taken to measure LNG and E(2). RESULTS: Eighty-four months after insertion, 67 women aged 34.3+/-0.8 years (mean+/-SEM) (range, 25-49 years) returned for follow-up. Mean+/-SEM LNG levels decreased from an initial 253+/-27 pg/mL (range, 86-760) during the first 2 months following insertion to 137+/-12 (range, 23-393) at 84 months and 119+/-9 pg/mL (range, 110-129) at 102 months of use (+/-SEM). At 84 months of use, mean+/-SEM endometrial thickness was 2.8+/-0.1 mm, increasing to 3.8+/-0.5 mm at 102 months of use. The incidence of amenorrhea decreased from 41.8% at 84 months to 31.5% at 102 months of use. No correlation was found between LNG levels and bleeding patterns; however, a weak correlation was found between high body mass index (kg/m(2)), high weight, and low serum LNG levels. E(2) levels were similar to those of the follicular phase of the menstrual cycle of regularly menstruating women. CONCLUSIONS: During extended use of the LNG-IUS, serum LNG levels were nearly half those found in the first 2 months of use (Wilcoxon signed rank test); serum E(2) levels were normal. Despite the very thin endometrium, menstrual bleeding was reinstated in many cases. At the end of its 5-year life span, there is a window for changing the LNG-IUS, and physicians and users should not be concerned about delaying replacement of the device for a short time beyond the approved life span; however, maintaining the same device long after its approved life span cannot be recommended. Language: English Keywords: BRAZIL | RESEARCH REPORT | FAMILY PLANNING ACCEPTORS | IUD, HORMONE RELEASING | LEVONORGESTREL | ESTRADIOL | ENDOMETRIUM | TIME FACTORS | ULTRASONICS | HEMATOLOGIC TESTS | AMENORRHEA | INCIDENCE | MENSTRUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Family Planning Programs | Family Planning | IUD | Contraceptive Methods | Contraception | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Estrogens | Hormones | Endocrine System | Physiology | Biology | Uterus | Genitalia, Female | Genitalia | Urogenital System | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Menstruation Disorders | Diseases | Measurement | Research Methodology | Reproduction Document Number: 342787 |
| 4. Title: The role of nursing in the management of unintended pregnancy. Author: Levi AJ; Simmonds KE; Taylor D Source: Nursing Clinics of North America. 2009 Sep;44(3):301-14. Abstract: This article explores the role of nurses in the prevention, management, and treatment of unintended pregnancy. All nurses have a responsibility to understand the importance of reproductive health care in the primary care of women and their families, and to be prepared to respond to patients' needs for the prevention and management of unintended pregnancy. A public health framework provides an opportunity to identify the role of the nurse in primary, secondary, and tertiary prevention strategies that can contribute to the management of unintended pregnancy for the health of women and their families. Nursing education and the role of nurses in advocacy for reproductive health concerns are also addressed. Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | NURSES AND NURSING | PREGNANCY, UNPLANNED | REPRODUCTIVE HEALTH | PRIMARY HEALTH CARE | FAMILY PLANNING PROGRAMS | ABORTION | COUNSELING | PREGNANCY TESTS | HEALTH EDUCATION | ADVOCACY | Developed Countries | North America | Americas | Health Personnel | Delivery of Health Care | Health | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Health Services | Family Planning | Fertility Control, Postconception | Clinic Activities | Program Activities | Programs | Organization and Administration | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Education | Communication Document Number: 342606 Notification |
| 5. Peer Reviewed Title: Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking. Author: Luque-Ramirez M; Mendieta-Azcona C; Del Rey J; Maties M; Escobar-Morreale H Source: European Journal of Endocrinology. 2009;160:469-480. Abstract: Objective: To study the blood clotting tests and endothelial function of PCOS patients and non-hyperandrogenic women, and their changes during PCOS treatment, as a function of the presence of obesity and smoking. Design: Case-control study followed by a randomized clinical trial. Methods: Blood clotting and endothelial function were analyzed in 40 PCOS patients and 20 non-hyperandrogenic women. 34 PCOS women were randomized to Diane35Diario or metformin (850 mg twice daily), monitoring the changes on these parameters during 24 weeks of treatment. The influence of obesity and smoking was also analyzed. Results: Blood clotting and endothelial function tests were similar among PCOS patients and controls with the exception of a higher platelet count in the former. Obesity increased circulating fibrinogen levels, prothrombin activity and platelet counts, and reduced prothrombin and activated partial thromboplastin times. Smoking increased fibrinogen levels, platelet counts and prothrombin activity, andreduced prothrombin time, in relation to the larger waist circumference of smokers. Irrespective of the treatment received, PCOS patients showed a decrease in prothrombin time and an increase in prothrombin activity, with a parallel increase in homocysteine levels with metformin. The activated partial thromboplastin time decreased markedly with Diane35Diario. Finally, flow-mediated dilation improved in non-smokers irrespective of the drug, but worsened in smokers. Conclusions: Oral contraceptives and metformin may exert deleterious effects on blood clotting tests of PCOS women, yet the effects of metformin appear to be milder. Because smoking potentiates some of these effects and deteriorates endothelial function, smoking cessation should be promoted in PCOS patients. Language: English Keywords: SPAIN | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | CLIENTS | BLOOD | HEMATOLOGIC TESTS | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | OBESITY | BODY WEIGHT | TOBACCO USE | Europe, Southwestern | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Hemic System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Behavior Document Number: 329669 |
| 7. Peer Reviewed Title: A little bit pregnant: modeling how the accurate detection of pregnancy can improve HIV prevention trials. Author: Schreiber CA; Sammel M; Hillier SL; Barnhart KT Source: American Journal of Epidemiology. 2009 Feb 15;169(4):515-21. Abstract: The prevalence of unplanned pregnancies contributes to the methodological challenges of human immunodeficiency virus (HIV) prevention trials. In this paper, the authors discuss the incidence of pregnancy, including chemical pregnancy, and how the different methods of pregnancy diagnosis could affect the statistical power and calculated outcomes of HIV prevention trials. Study sample size inflation factors are estimated to aid in the design of clinical trials.The authors used published data of women attempting pregnancy as well as data from HPTN 055 (www.HPTN.org/research_studies/hptn055.asp) to estimate the percentage of early study discontinuation that would be associated with 3 diagnostic methods for pregnancy in a hypothetical clinical trial. They classified chemical pregnancies as false-positive pregnancy tests and showed the sample size adjustment that would be necessary in clinical trial design because of the early discontinuations associated with pregnancy. There is a greater than 3-fold difference in the number of falsely positive pregnancy tests that will be detected, depending upon the diagnostic method used. The number of incident pregnancies may render HIV prevention trial sample sizes inadequate by as much as 50%. Pregnancy prevention and precise pregnancy diagnosis are critical to the statistical power and integrity of HIV prevention trials. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL TRIALS | COMPARATIVE STUDIES | SAMPLING STUDIES | MATHEMATICAL MODEL | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | PREGNANCY TESTS | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | FALSE POSITIVE REACTIONS | GONADOTROPINS, CHORIONIC | Developed Countries | North America | Americas | Research Methodology | Clinical Research | Studies | Theoretical Models | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Measurement | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Error Sources | Gonadotropins | Hormones | Endocrine System | Physiology | Biology Document Number: 330376 |
| 8. Peer Reviewed Title: Interest in Intrauterine Contraception Among Seekers of Emergency Contraception and Pregnancy Testing. Author: Schwarz EB; Kavanaugh M; Douglas E; Dubowitz T; Creinin MD Source: Obstetrics and Gynecology. 2009 Apr;113(4):833-839. Abstract: OBJECTIVE:: To estimate the interest in using intrauterine contraception among women and adolescent girls seeking emergency contraception or walk-in pregnancy testing. METHODS:: We surveyed 412 women and adolescent girls who requested emergency contraception or pregnancy testing at four family planning clinics in Pittsburgh, Pennsylvania. The 41-item survey assessed knowledge of, attitudes toward, and interest in using an intrauterine device (IUD). Data were analyzed using chi and Fisher exact tests and multivariable logistic regression methods. RESULTS:: The response rate was 85%. Twelve percent (95% confidence interval [CI] 9-15) of women and adolescent girls surveyed expressed interest in same-day insertion of an IUD, and 22% (95% CI 18-26) wanted more information about IUDs. Interest in same-day IUD insertion increased with higher education level, prior unwanted pregnancy, and experience with barriers to use of contraception. CONCLUSION:: Same-day IUD insertion may be a reasonable way to increase the use of highly-effective contraception among women and adolescent girls seeking emergency contraception or walk-in pregnancy testing. LEVEL OF EVIDENCE:: II. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | PREGNANCY TESTS | IUD | CONTRACEPTIVE USAGE | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods Document Number: 330855 |
| 9. Title: Checklist for screening clients who want to initiate use of the copper IUD. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2008. [3] p. Abstract: Research findings over the past 25 years have established that intrauterine devices (IUDs) are safe and effective for use by most women, including those who have not given birth, who wish to space births, and those living with or at risk of HIV infection. For some women, IUD insertion is not recommended due to the presence of certain medical conditions, such as genital cancer and current cervical infection. Women who desire to use an IUD should therefore be screened for such medical conditions in order to determine if they are appropriate candidates for the IUD. Based on the recently revised recommendations of the Medical Eligibility Criteria for Contraceptive Use (WHO, 2004; updated 2008), Family Health International (FHI) has developed a simple checklist to help health care providers screen clients who have made an informed decision to use an IUD. The IUD Checklist consists of 21 questions designed to identify medical conditions and high-risk behaviors that would prevent safe IUD use or requirefurther screening. It also provides further guidance and directions based on clients' responses. Language: English Keywords: GLOBAL | MANUAL | STANDARDS | SCREENING | CLIENTS | WOMEN | IUD, COPPER RELEASING | PREGNANCY TESTS | SEX BEHAVIOR | PELVIC EXAM | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Laboratory Procedures | Laboratory Examinations and Diagnoses | Behavior | Physical Examinations and Diagnoses | Reproductive Tract Infections | Infections | Diseases Document Number: 331509 |
| 10. Title: How to be reasonably sure a client is not pregnant. [Checklist]. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p. Abstract: In order to help nonmenstruating clients safely initiate their method of choice, Family Health International (FHI) developed a simple checklist for use by family planning providers. Although originally the Pregnancy Checklist was developed for use by family planning providers, it can also be used by other health care providers who need to determine whether a client is not pregnant. For example, pharmacists may use this checklist when prescribing certain medications that should be avoided during pregnancy (e.g., certain antibiotics or anti-seizure drugs). The checklist is endorsed by the World Health Organization (WHO) and is based on criteria established by WHO for determining with reasonable certainty that a woman is not pregnant. Evaluation of the checklist in family planning clinics has demonstrated that the tool is very effective in correctly identifying women who are not pregnant. Furthermore, recent studies in Guatemala, Mali, and Senegal have shown that use of the checklist by family planning providers significantly reduced the proportion of clients being turned away due to menstrual status and improved women's access to contraceptive services. Language: English Keywords: GUATEMALA | MALI | SENEGAL | SUMMARY REPORT | PREGNANT WOMEN | PREGNANCY TESTS | RELIABILITY | MEDICINE | DRUGS | SIDE EFFECTS | TREATMENT | FAMILY PLANNING | WHO | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration Document Number: 331506 |
| 11. Title: Improving provision of hormonal contraceptives. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p. (FHI Briefs: Menu of PracticesUSAID Cooperative Agreement No. GPO-A-00-05-00022-0) Abstract: Hormonal contraceptives are a significant proportion of the contraceptive method mix in most countries. In sub-Saharan Africa, over half of all women using reversible contraceptives choose hormonal methods. Combined oral contraceptive pills (COCs) are the most frequently used hormonal method, with over 100 million women using them worldwide. However, medical barriers such as menstrual requirements and unnecessary exams often restrict or deny access to hormonal methods for eligible women who desire these methods. In order to ensure efficient, accessible, and high-quality family planning services, programs should implement the most up-to-date and evidence-based practices related to the provision of hormonal contraceptive methods.. Language: English Keywords: AFRICA, SUB SAHARAN | RECOMMENDATIONS | WOMEN | PREGNANCY TESTS | ORAL CONTRACEPTIVES | MEDROXYPROGESTERONE ACETATE | COUNSELING | Africa | Developing Countries | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331523 |
| 12. Title: Declining semen quality among south Indian infertile men: A retrospective study. Author: Adiga SK; Jayaraman V; Kalthur G; Upadhya D; Kumar P Source: Journal of Human Reproductive Sciences. 2008 Jan-Jun;1(1):15-18. Abstract: Male reproductive function has recently attracted increasing attention due to reports on time-related decline in semen quality. Furthermore, regional differences in the semen quality have also been reported. The aim was to investigate the semen quality among large cohort of infertile individuals at a regional level, in terms of the sperm concentration, total sperm motility, sperm morphology and incidence of azoospermia over a period of 13 years. The setting for the study was the University infertility clinic at Kasturba Hospital, Manipal which is a tertiary healthcare center serving the general population. The design used was a retrospective analysis. This includes a total of 7770 subjects who presented for semen analysis from 1993-2005. The data regarding ejaculate volume, sperm density, motility, morphology and the incidence of azoospermia were collected. The statistical analysis used was a one way analysis of variance (ANOVA), regression analysis and Chi square analysis. The average sperm density among infertile men during 2004-2005 was 26.61 plus or minus 0.71 millions/ml which was significantly lower than the average sperm density observed in 1993-1994 (38.18 plus or minus 1.46 millions/ml). Similar trend was also observed for sperm motility (47.41% motile sperms vs 61.16%) and normal sperm morphology (19.75% vs 40.51%). Interestingly, the incidence of severe oligospermia (mean sperm density less than 10 millions/ml) observed in 2002-2005 and 1993-1997 demonstrated a significant inverse relationship (p less than 0.001). Our study provides the first evidence that the quality of human semen evaluated for infertility is deteriorating in the southern part of the India over the years, probably due to environmental, nutritional, life style or socioeconomic causes. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | COHORT ANALYSIS | LONGITUDINAL STUDIES | MEN | INFERTILITY | TIME FACTORS | HUMAN GEOGRAPHY | SEMEN | SPERM COUNT | SPERMATOZOA | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Demographic Factors | Population | Reproduction | Population Dynamics | Geography | Social Sciences | Science | Sociocultural Factors | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Germ Cells Document Number: 325575 |
| 13. Peer Reviewed Title: Clinical malaria in African pregnant women. Author: Bardaji A; Sigauque B; Romagosa C; Bruni L; Sanz S Source: Malaria Journal. 2008 Jan 30;7(27):[23] p. Abstract: There is a widespread notion, based on limited information, that in areas of stable malaria transmission most pregnant women with Plasmodium falciparum infection are asymptomatic. This study aim to characterize the clinical presentation of malaria in African pregnant women and to evaluate the adequacy of case management based on clinical complaints. A hospital-based descriptive study between August 2003 and November 2005 was conducted at the maternity clinic of a rural hospital in Mozambique. All women attending the maternity clinic were invited to participate. A total of 2,330 women made 3,437 eligible visits, 3129 were analysed, the remainder were excluded because diagnostic results were unavailable or they were repeat visits. Women gave a standardized clinical history and had a medical exam. Malaria parasitaemia and haematocrit in capillary blood was determined for all women with signs or symptoms compatible with malaria including: presence and history of fever, arthromyalgias, headache, history of convulsions and pallor. Outcome measure was association of malaria symptoms or signs with positive blood slide for malaria parasitaemia. In 77.4% of visits pregnant women had symptoms suggestive of malaria; 23% (708/3129) were in the first trimester. Malaria parasitaemia was confirmed in 26.9% (842/3129) of visits. Headache, arthromyalgias and history of fever were the most common symptoms (86.5%, 74.8% and 65.4%) presented, but their positive predictive values for malaria parasitaemia were low [28% (27-30), 29% (28-31), and 33% (31-35), respectively]. Symptoms suggestive of malaria were very frequent among pregnant women attending a rural maternity clinic in an area of stable malaria transmission. However, less than a third of them were parasitaemic. In the absence of microscopy or rapid diagnostic tests, a large proportion of women, including those in the first trimester of gestation, would be unnecessarily receiving antimalarial drugs, often those with unknown safety profiles for pregnancy. Accessibility to malaria diagnostic tools needs to be improved for pregnant women and drugs with a safety profile in all gestational ages are urgently needed. (author's) Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | MALARIA | HEMATOCRIT | SIGNS AND SYMPTOMS | FEVER | HEADACHE | CENTRAL NERVOUS SYSTEM EFFECTS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Parasitic Diseases | Diseases | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Body Temperature | Physiology | Biology | Central Nervous System | Measurement Document Number: 324321 |
| 14. Peer Reviewed Title: Laboratory diagnosis of dual HIV-1/HIV-2 infection in Ghanaian patients. Author: Bonney EY; Sackey ST; Brandful JA Source: East African Medical Journal. 2008 Nov;85(11):537-43. Abstract: OBJECTIVE: To determine the true prevalence of HIV dual infections in a previously characterised HIV seropositive patient group due to inconsistencies between different diagnostic methods. DESIGN: A cross-sectional study of an HIV seropositive group with different diagnostic methods. SETTING: Three hospitals in the Northern, Ashanti and Greater Accra Regions of Ghana. SUBJECTS: One hundred and forty five HIV infected patients/individuals sampled from June to September 2002. MAIN OUTCOME MEASURES: Using serological and molecular methods, the seropositive status of HIV-infected patients, previously determined by a preliminary screening process, was confirmed and discrepancies noted. The data was used to propose a more accurate laboratory diagnosis of HIV dual infections involving HIV-1 and HIV-2. RESULTA: HIV-1 infections were mostly accurately detected, but difficulties were encountered in diagnosing HIV-2 infections. To achieve a positive detection on confirmatory immunoblots, antibody concentration in some samples tested was enhanced by using larger volumes. In other cases, diagnosis of HIV infections by PCR, especially HIV-2, was possible only after increasing the DNA template or MgCl2 concentrations. Such samples would otherwise have been inaccurately scored for HIV infections. CONCLUSION: Based on the results of this study, we propose that the accurate diagnosis of HIV dual infections, especially HIV-2 component, must use an algorithm that involves PCR. Our results however underscore conclusions of a previous study that most dually seroreactive samples are predominantly HIV-1 infections with crossreactivity to HIV-2 antigens. Language: English Keywords: GHANA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | LABORATORY EXAMINATIONS AND DIAGNOSES | HIV INFECTIONS | PREVALENCE | HEMATOLOGIC TESTS | HIV TESTING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Laboratory Procedures Document Number: 341329 |
| 15. Peer Reviewed Title: [Male fertility control--where are we?] Preface. [editorial] Author: Colvard D; Habenicht UF; Harper MJ Source: Contraception. 2008 Oct;78(4 Suppl):S1-2. Abstract: The Application of Molecular Pharmacology for Posttesticular Activity (AMPPA) project was conceived by a group of founding fathers, which included Gunter Stock, Egon Diczfalusy and Mahmoud Fathalla (who was at that time associated with the Rockefeller Foundation) as a novel cooperation between the public and the private sectors- Ernst Schering Research Foundation and the Rockefeller Foundation. AMPPA started in 1997 and ran for a 5-year period. The aim was to conduct basic research on the epididymis to identify novel targets for male contraception that would act posttesticularly. This was to be achieved by a network of investigators who met every 6 months to review progress and plan for the future [1]. Results from the initial AMPPA collaboration have been reported, along with others, in a special issue of the Molecular and Cellular Endocrinology [2]. Toward the end of AMPPA, it was decided that additional effort was needed to develop new leads for nonhormonal male contraception and that the research scope should be enlarged to encompass postmeiotic testicular targets. A new partnership was therefore formed between Schering AG and CONRAD to support a program to last for at least three years. This project began in 2003 and was named Application of Molecular Pharmacology for Post-meiotic Activity-II (AMPPA-II). Both parties contributed equally to funding the network of investigators. Direction for the program was shared equally between Schering (Ulrich Gottwald and Ursula-F. Habenicht) and CONRAD (Doug Colvard and Michael Harper). AMPPA-II investigators focused on biological validation of targets for male contraception, in particular, on regulators of epididymal initial segment function, antioxidant enzymes, sperm volume-regulating channels, calcium regulation, tyrosine kinases and epididymal genes regulated by androgens. Selection of targets for further evaluation was based on several criteria, including target validation potential (e.g., by gene "knockout" mice), target organ specificity, existence of functional human homolog, drugability, appropriate tools (e.g., assays, biomarkers) and patentability. Completion of AMPPA-II was constrained by available resources and corporate reprioritization that occurred when Bayer AG took over Schering AG in early 2006. At the final meeting of AMPPA-II in May 2007, the participants in this unique endeavor unanimously concluded that it had been successful, and certain promising targets for male contraception had been identified that should continue to be pursued. The final AMPPA-II meeting was immediately followed by a meeting on June 1, 2007, to review and discuss important aspects of the present and future of male contraceptives entitled, "Male Fertility Control-Where are we?" The attendees sought to address questions such as "Where do we stand?," "What progress was made?" and "Is there a social and medical need?" and to illuminate bridging approaches between female and male fertility control, to share some thoughts on the putative consumer and to discuss the role of public-private partnership to accelerate the long way from research to the product. The chapters that follow represent presentations and comments from this last meeting. (full-text) Language: English Keywords: RESEARCH REPORT | CLINICAL RESEARCH | CRITIQUE | MEN | MALE CONTRACEPTION | TESTIS | SPERM COUNT | SPERMATOGENESIS BLOCKING AGENTS | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Male | Contraceptive Agents Document Number: 329141 |
| 16. Peer Reviewed Title: Self pregnancy testing in an urban family planning clinic: promising results for a new approach to contraceptive follow-up. Author: Estes CM; Ramierez J; Tiezzi L; Westhoff C Source: Contraception. 2008 Jan;77(1):40-43. Abstract: Immediate initiation of depo-medroxyprogesterone acetate (DMPA) increases continuation and decreases pregnancies compared to conventional (next menstrual period) initiation. A drawback is the need to return in 4 weeks for a repeat pregnancy test to identify any pregnancy that was too early to diagnose on the day of injection. If women can performhome pregnancy tests (HPTs) to detect human chorionic gonadotropin (hCG) in urine, the need for this follow-up visit may be eliminated. This study assesses whether women can perform their own HPT. This is a single-visit observational trial of an HPT kit. Subjects recruited from a waiting room in an urban family planning clinic received an HPT kit with standard instructions to use immediately. Subjects and a research assistant each interpreted the test. Their results were then compared to a standard cassette type test for detection of hCG performed by clinic staff. k was calculated to assess the level of agreement. Three hundred ten subjects enrolled. They were young (mean age, 25.2 years), mostly Hispanic (91%) women. A change in the font and explicitness of the instructions decreased the incidence of invalid tests from 12.7% to 4.8%. The subject and research assistant's interpretation of the test had a high level of agreement, k = 0.95 [95% confidence interval (CI), 0.92-0.99]. There was also a high level of agreement between the subjects' results and the standard test, k = 0.88 (95% CI, 0.82-0.95). Women presenting for pregnancy testing at an urban clinic are able to perform HPTs with a high level of accuracy. The appearance of the instructions influenced the incidence of false-negative and invalid tests. Home pregnancy tests may be useful in follow-up protocols when immediate initiation of DMPA is employed. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | URBAN AREAS | FOLLOW-UP STUDIES | PREGNANCY TESTS | CONTRACEPTION | DEPO-PROVERA | FAMILY PLANNING CENTERS | HOME CARE | Developed Countries | North America | Americas | Geographic Factors | Population | Studies | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Health Facilities | Care and Support Document Number: 323057 |
| 17. Peer Reviewed Title: Comparative study of interactions between chloroquine and chlorpheniramine or promethazine in healthy volunteers: A potential combination-therapy phenomenon for resuscitating chloroquine for malaria treatment in Africa. Author: Gbotosho GO; Happi CT; Sijuade A; Ogundahunsi OA; Sowunmi A Source: Annals of Tropical Medicine and Parasitology. 2008;102(1):3-9. Abstract: Although, in in-vitro and limited in-vivo studies, chlorpheniramine (CP) and promethazine (PR) have each been shown to reverse chloroquine (CQ) resistance, the pharmacokinetic basis of this reversal has not been fully elucidated. In the present study, 15 healthy volunteers were randomly allotted to receive standard doses of CQ alone or in combination with CP or PR. Blood samples were collected from each volunteer at 21 time-points, from immediately before to 168 h after the initial dose. These samples were used to follow the changes in the plasma and erythrocytic concentrations of CQ. The ratio between the mean maximum CQ concentration in the erythrocytes and that in the plasma was 4.2 for the volunteers given CQ alone, 7.3 in those given CQ-CP, and 3.2 in those given CQ-PR. CP significantly enhanced the erythrocytic accumulation of CQ, increasing the maximum CQ concentration observed in the erythrocytes by 24% (P = 0.02). The bio-availability of CQ was also significantly increased in the presenceof CP, with the mean value for the area under the curve, of erythrocytic concentration v. time, increasing from 99,921 to 214,516 ng/ml.h (P = 0.001). The mean half-life of CQ in the erythrocytes also increased when CP was used, from 51 to 100 h, but this change was not statistically significant (P = 0.83). In contrast to CP, PR had no statistically significant effect on the disposition of CQ. As CP clearly enhances disposition of CQ, a combination of CQ with CP may be useful in the management of CQ-resistant infections. Detailed toxicological studies are required to understand the full clinical implications of CP's elevation of erythrocytic CQ concentrations. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | COMPARATIVE STUDIES | CLINICAL RESEARCH | MEN | MALARIA | PARASITE CONTROL | DRUG INTERACTIONS | ERYTHROCYTE SEDIMENTATION RATE | TIME FACTORS | ADMINISTRATION AND DOSAGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Parasitic Diseases | Diseases | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Population Dynamics Document Number: 325617 |
| 18. Title: Retinol-binding protein 4 and insulin resistance in polycystic ovary syndrome. Author: Hutchison SK; Harrison C; Stepto N; Meyer C; Teede HJ Source: Diabetes Care. 2008 Jul;31(7):1427-32. Abstract: OBJECTIVE: Polycystic ovary syndrome (PCOS) is an insulin-resistant state with insulin resistance being an established therapeutic target; however, measurement of insulin resistance remains challenging. We aimed to 1) determine serum retinol-binding protein 4 (RBP4) levels (purported to reflect insulin resistance) in women with PCOS and control subjects, 2) examine the relationship of RBP4 to conventional markers of insulin resistance, and 3) examine RBP4 changes with interventions modulating insulin resistance in overweight women with PCOS. RESEARCH DESIGN AND METHODS: At baseline, 38 overweight women (BMI >27 kg/m(2)) with PCOS and 17 weight-matched control subjects were compared. Women with PCOS were then randomly assigned to 6 months of a higher-dose oral contraceptive pill (OCP) (35 microg ethinyl estradiol/2 mg cyproterone acetate) or metformin (1 g b.i.d.). Outcome measures were insulin resistance (total insulin area under the curve) on an oral glucose tolerance test, RBP4, and metabolic/inflammatory markers. RESULTS: Overweight women with PCOS were more insulin resistant than control subjects, yet RBP4 levels were not different in women with PCOS versus those in control subjects (35.4 +/- 4.3 vs. 28.9 +/- 3.1 microg/ml, P = 0.36). RBP4 correlated with cholesterol and triglycerides but not with insulin resistance. Metformin improved insulin resistance by 35%, whereas the OCP worsened insulin resistance by 33%. However, RBP4 increased nonsignificantly in both groups (43.7 +/- 6.3 vs. 42.6 +/- 5.5 microg/ml, P = 0.92). CONCLUSIONS: Overweight women with PCOS were more insulin resistant than control subjects, but this finding was not reflected by RBP4 levels. RBP4 correlated with lipid levels but not with insulin resistance markers. RBP4 levels did not change when insulin resistance was reduced by metformin or increased by the OCP. These data suggest that RBP4 is not a useful marker of insulin resistance in PCOS but may reflect other metabolic features of this condition. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | BASELINE SURVEYS | GLUCOSE TOLERANCE TEST | WOMEN | OBESITY | BODY WEIGHT | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | VITAMIN A | METABOLIC EFFECTS | INTERVENTIONS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Physiology | Biology | Diseases | Contraceptive Methods | Contraception | Family Planning | Vitamins and Minerals | Programs | Organization and Administration Document Number: 328383 |
| 19. Peer Reviewed Title: Effect of folic acid in women with and without insulin resistance who have hyperhomocysteinemic polycystic ovary syndrome. Author: Kazerooni T; Asadi N; Dehbashi S; Zolghadri J Source: International Journal of Gynecology and Obstetrics. 2008 May;101(2):156-160. Abstract: The objective was to study the effect of folic acid on homocysteine (Hcy) levels in women with insulin resistance and polycystic ovary syndrome (PCOS) in a prospective clinical trial. Of 210 women with PCOS, 70 were hyperhomocysteinemic; and of these, 32 were insulin resistant and 38 were not. The 70 women were treated with folic acid for 3 months. Baseline and serum levels of Hcy and insulin were measured in both groups. In both groups Hcy concentrations were significantly decreased following folic acid supplementation. The mean plus or minus SD levels before and after treatment were 14.03 plus or minus 1.5 micromol/L and 12.53 plus or minus 1.72 micromol/L in group 1 (P less than 0.001), and they were 12.07 plus or minus 0.87 micromol/L and 8.83 plus or minus 0.78 micromol/L in group 2 (P less than 0.001). The Hcy levels of hyperhomocysteinemic women with PCOS were reduced after 3 months of folic acid supplementation, and the rate of reduction was higher among women without insulin resistance. No change was found in fasting insulin levels. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL TRIALS | CLIENTS | OVARIAN CYSTS | DIABETES | FOLIC ACID | FOOD SUPPLEMENTATION | GLUCOSE TOLERANCE TEST | ENDOCRINE EFFECTS | Developing Countries | Middle East | Clinical Research | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Endocrine System Document Number: 325979 |
| 20. Title: Predictors for partial suppression of spermatogenesis of hormonal male contraception. Author: Li JW; Gu YQ Source: Asian Journal of Andrology. 2008 Sep;10(5):723-30. Abstract: AIM: To analyze factors influencing the efficacy of hormonal suppression of spermatogenesis for male contraception. METHODS: A nested case-control study was conducted, involving 43 subjects, who did not achieve azoospermia or severe oligozoospermia when given monthly injections of 500 mg testosterone undecanoate (TU), defined as partial suppressors compared with 855 subjects who had suppressed spermatogenesis (complete suppressors). Sperm density, serum testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations at the baseline and the suppression phase were compared between partial and complete suppressors. Polymorphisms of androgen receptor (AR) and three single nucleotide variants and their haplotypes of FSH receptor (FSHR) genes determined by polymerase chain reaction (PCR) and DNA sequencing technique were compared between 29 partial and 34 complete suppressors. RESULTS: Baseline serum LH level was higher and serum LH as well as FSH level during the suppression phase was less suppressed in partial suppressors. Additionally, in a logistic regression analysis larger testis volume, higher serum FSH concentrations alone, or interaction of serum LH, FSH, testosterone and sperm concentrations were associated with degree of suppression. The distribution of polymorphisms of AR or FSH receptor genes did not differ between partial and complete suppressors. In cases with incomplete FSH suppression (FSH 0.2 IU/L), the chances of reaching azoospermia were 1.5 times higher in the subjects with more than 22 CAG triplet repeats. CONCLUSION: Partial suppression of spermatogenesis induced by 500 mg TU monthly injections is weakly influenced by hormonal and clinical features but not polymorphism in AR and FSHR genes. Language: English Keywords: CHINA | RESEARCH REPORT | CASE STUDIES | MALE CONTRACEPTION | ANDROGENS | FOLLICLE STIMULATING HORMONE | SPERM COUNT | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Contraception | Family Planning | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328849 |
| 21. Peer Reviewed Title: Determinants of the rate and extent of spermatogenic suppression during hormonal male contraception: an integrated analysis. Author: Liu PY; Swerdloff RS; Anawalt BD; Anderson RA; Bremner WJ Source: Journal of Clinical Endocrinology and Metabolism. 2008 May;93(5):1774-1783. Abstract: Context: Male hormonal contraceptive methods require effective suppression of sperm output. Objective: The objective of the study was to define the covariables that influence the rate and extent of suppression of spermatogenesis to a level shown in previous World Health Organizationsponsored studies to be sufficient for contraceptive purposes (< or = 1 million/ml). Design: This was an integrated analysis of all published male hormonal contraceptive studies of at least 3 months' treatment duration. Setting: Deidentified individual subject datawereprovided by investigators of 30 studies published between 1990 and 2006. Participants: A total of 1756 healthy men (by physical, blood, and semen exam) aged 18-51 yr of predominantly Caucasian (two thirds) or Asian (one third) descent were studied. This represents about 85% of all the published data. Intervention(s): Men were treated with different preparations of testosterone, with or without various progestins. Main Outcome Measure: Semen analysis was the main measure. Results: Progestin coadministration increased both the rate and extent of suppression. Caucasian men suppressed sperm output faster initially but ultimately to a less complete extent than did non-Caucasians. Younger age and lower initial blood testosterone or sperm concentration were also associated with faster suppression, but the independent effect sizes for age and baseline testicular function were relatively small. Conclusion: Male hormonal contraceptives can be practically applied to a wide range of men but require coadministration of an androgen with a second agent (i.e. progestin) for earlier and more complete suppression of sperm output. Whereas considerable progress has been made toward defining clinically effective combinations, further optimization of androgen-progestin treatment regimens is still required. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | CLINICAL RESEARCH | MEN | ETHNIC GROUPS | SPERMATOGENESIS BLOCKING AGENTS | CONTRACEPTIVE AGENTS, MALE | SPERM COUNT | SEMEN | TIME FACTORS | TESTOSTERONE ANALYSIS | ADMINISTRATION AND DOSAGE | ANDROGENS | Research Methodology | Demographic Factors | Population | Cultural Background | Population Characteristics | Contraceptive Agents | Contraception | Family Planning | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Population Dynamics | Testosterone | Hormones | Endocrine System | Drugs | Treatment Document Number: 327774 |
| 22. Title: Screening of "y" chromosome microdeletions in Iranian infertile males. Author: Malekasgar AM; Mombaini H Source: Journal of Human Reproductive Sciences. 2008 Jan-Jun;1(1):2-9. Abstract: It has been hypothesized that microdeletions of Yq may account for a significant proportion of men with infertility. Three nonoverlapping regions, referred to as "azoospermia factors" (AZFa, b, c from proximal to distal Yq) have been defined as spermatogenesis loci and deletions in these regions have been shown to be pathogenically involved in male fertility associated with azoospermia or severe oligospermia. The aim was the evaluation the frequency of Y chromosome microdeletions in Iranian population. Fifty infertile men were selected. Semen analysis was done and on the basis of the mean sperm count, all patients were categorized into azoospermia and oligozoospermia, groups. Blood samples were obtained for DNA extraction and chromosomal analysis. Genomic DNA was extracted from blood lymphocytes and amplified by sequence tagged sites-polymerase chain reaction (STS-PCR) method to determine the presence of microdeletions in AZF locus. A total of 34 STS primers including two controls were selected toidentify microdeletions of Y chromosome on each subject. 26/50 cases (52%) showed deletion of at least one of the STS Marker. Totally 41 microdeletions was observed. A total of 17 cases (34%) had deletion in one STS. Four Oligospermia cases (8%) had deletion in 2 STS site. Three azoospermia cases (6%) had again deletion in 2 STS site, but in different STS. One case had three deletions in three STS site and finally one individual had seven deletions in AZF locus. The overall frequency of Y chromosome microdeletions observed in the present study was found to be 26/50 (52%). Comparison of our data with the result of other investigators world wide shows that the incidence of Yq microdeletions in Iranian population is much higher than international frequency. Our data agree with other studies regarding microdeletions of AZFc, but for microdeletions of AZFa (14.6%) our results is much higher and differ significantly with many studies. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | MEN | INFERTILITY | CHROMOSOME ABNORMALITIES | SPERMATOGENESIS | SPERM COUNT | SPERMATOZOA | Developing Countries | Middle East | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Laboratory Procedures | Germ Cells | Genitalia | Urogenital System | Physiology | Biology Document Number: 325574 |
| 23. Title: Training and reference guide for a screening checklist to identify women who are not pregnant. Author: Mueller MP; Lasway C; Yacobson I; Tumlinson K Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 55 p. (USAID Cooperative Agreement No. GPO-A-00-05-00022-00) Abstract: This training and reference guide was developed for family planning service providers interested in using the checklist entitled How to be Reasonably Sure a Client is Not Pregnant, commonly referred to as the "Pregnancy Checklist". Designed to serve as both a training and reference tool, the guide is composed of two parts: a training module and a collection of essential, up-to-date reference materials. This guide is part of a series to train on other checklists, including the Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives, the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), and the Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD. The Pregnancy Checklist was developed to assist service providers in ruling out pregnancy among women who wish to initiate their contraceptive method of choice. This simple job aid is based on criteria endorsed by the World Health Organization (WHO) and provides an alternative to pregnancy testing for women who are not menstruating at the time of their visit to their provider. The Pregnancy Checklist has been shown to be 99 percent accurate in identifying women who are not pregnant. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | FAMILY PLANNING PERSONNEL | FAMILY PLANNING INSTRUCTORS | SCREENING | TRAINING PROGRAMS | USAID | PREGNANCY TESTS | TRAINING OF TRAINERS | FAMILY PLANNING TRAINING | Family Planning Programs | Family Planning | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Laboratory Procedures | Laboratory Examinations and Diagnoses Document Number: 326282 |
| 24. Title: Training and reference guide for a screening checklist to initiate COCs. Author: Mueller MP; Lasway C; Yacobson I; Tumlinson K Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 75 p. (USAID Cooperative Agreement No. GPO-A-00-05-00022-00) Also available in French, http://www.fhi.org/NR/rdonlyres/erqco6dorp7np55a7zumwkvmopnxx7imvf7vnx4soi6tb7yro7yvsgx63ckcddlhjgtnodnhvfu5oj/GuideCOC.pdf Abstract: This training and reference guide was developed for family planning service providers interested in using the Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives, commonly referred to as the "COC Checklist". Designed to serve as both a training and reference tool, the guide is composed of two parts: a training module and a collection of essential, up-to-date reference materials on combined oral contraceptives. This guide is part of a series to train on other checklists, including the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), the Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD, and the checklist entitled How to Be Reasonably Sure a Client is Not Pregnant. The COC Checklist was developed to assist service providers in screening clients who have already been counseled about contraceptive options and who have made an informed decision to use combined oral contraceptives (COCs). This simple job aid is based on guidance provided in the Medical Eligibility Criteria for Contraceptive Use (WHO 2004) and supports the application of these guidelines into actual service delivery practice. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | FAMILY PLANNING PERSONNEL | FAMILY PLANNING INSTRUCTORS | SCREENING | TRAINING PROGRAMS | USAID | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | CONTRACEPTIVE SAFETY | PREGNANCY TESTS | TRAINING OF TRAINERS | FAMILY PLANNING TRAINING | Family Planning Programs | Family Planning | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Safety | Public Health | Laboratory Procedures | Laboratory Examinations and Diagnoses Document Number: 326279 |
| 25. Title: Training and reference guide for a screening checklist to initiate DMPA (or NET-EN). Author: Mueller MP; Lasway C; Yacobson I; Tumlinson K Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 79 p. (USAID Cooperative Agreement No. GPO-A-00-05-00022-00) Also available in French, http://www.fhi.org/NR/rdonlyres/e4zmkogsw2bwbyvrtl5lsowutirie5ndqkejxbsbadm2745n2iyeoqcxk5mj7l2gbud2hyvbyawmub/GuideDMPA.pdf Abstract: This training and reference guide was developed for family planning service providers interested in using the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), commonly referred to as the "DMPA Checklist". Designed to serve as both a training and reference tool, the guide is composed of two parts: a training module and a collection of essential, up-to-date reference materials. The guide is part of a series to train on other checklists, including the Checklist for Screening Clients Who Want to Initiate COCs, the Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD, and the checklist entitled How to Be Reasonably Sure a Client is Not Pregnant. The DMPA Checklist was developed to assist service providers in screening clients who have already been counseled about contraceptive options and who have made an informed decision to use either of two popular injectable contraceptive methods: depot-medroxyprogesterone acetate (DMPA) or norethisterone enantate (NET-EN). This simple job aid is based on guidance provided in the Medical Eligibility Criteria for Contraceptive Use (WHO 2004) and supports the application of these guidelines into service delivery practice. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | FAMILY PLANNING PERSONNEL | FAMILY PLANNING INSTRUCTORS | SCREENING | TRAINING PROGRAMS | USAID | DEPO-PROVERA | CONTRACEPTIVE SAFETY | PREGNANCY TESTS | TRAINING OF TRAINERS | FAMILY PLANNING TRAINING | Family Planning Programs | Family Planning | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Safety | Public Health | Laboratory Procedures | Laboratory Examinations and Diagnoses Document Number: 326280 |
| 26. Title: Training and reference guide for a screening checklist to initiate use of the copper IUD. Author: Mueller MP; Lasway C; Yacobson I; Tumlinson K Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 81 p. (USAID Cooperative Agreement No. GPO-A-00-05-00022-00) Also available in French, http://www.fhi.org/NR/rdonlyres/eovrdrwqvzz3f227gxyinnjwespyfw5lzjphfness32bsi5yfvgahmcqxunm6blbrbrspjkndyagno/GuideDIU.pdf Abstract: This training and reference guide was developed for family planning service providers interested in using the Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD, commonly referred to as the "IUD Checklist". Designed to serve as both a training and reference tool, the guide is composed of two parts: a training module and a collection of essential, up-to-date reference materials on the copper intrauterine device (IUD). This guide is part of a series to train on other checklists, including the Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives, the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), and the checklist entitled How to Be Reasonably Sure a Client is Not Pregnant. The IUD Checklist was developed to assist service providers in screening clients who have already been counseled about contraceptive options and who have made an informed decision to use the copper IUD. This simple job aid is based on guidance provided inthe Medical Eligibility Criteria for Contraceptive Use (WHO 2004) and supports the application of these guidelines into service delivery practice. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | FAMILY PLANNING PERSONNEL | FAMILY PLANNING INSTRUCTORS | SCREENING | TRAINING PROGRAMS | USAID | IUD, COPPER RELEASING | CONTRACEPTIVE SAFETY | PREGNANCY TESTS | TRAINING OF TRAINERS | FAMILY PLANNING TRAINING | Family Planning Programs | Family Planning | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | IUD | Contraceptive Methods | Contraception | Safety | Public Health | Laboratory Procedures | Laboratory Examinations and Diagnoses Document Number: 326281 |
| 27. Title: Utility of blood DNA levels in diagnosis of breast cancer. Author: Nalini R; Silvia CR; Uthappa S Source: Journal of Cancer Research and Therapeutics. 2008 Apr-Jun;4(2):57-59. Abstract: Background: Prognostic factors, including both histopathological and biochemical variables, influence the choice of modality and the course of therapy in breast cancer. The biomarkers found in biological fluids, particularly in blood, apparently hold the best promise for the development of screening assays. Aim: To find out if any correlation exists between blood DNA level and tumor stage, size and grade. Materials and Methods: This case-control study was carried out on 52 female patients in the age-group of 18-70 years. The cases comprised 25 patients with histopathologically confirmed malignant breast cancer, while 27 patients with benign breast tumors served as the control group. Statistical Analysis: We used the Student's 't' test to compare the differences between the blood DNA levels in the two groups. Pearson's test was performed to find out the correlation between blood DNA levels and the TNM stage, tumor size and grade Results: It was observed that blood DNA levels showed statistically significant correlation with the TNM stage, tumor size and grade. Conclusion: The blood DNA level can be utilized as a noninvasive marker to assess tumor aggressiveness. Thus, it can be useful as a prognostic marker and as a marker of tumor burden. Language: English Keywords: INDIA | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | HEMATOLOGIC TESTS | BREAST CANCER | NEOPLASMS | LABORATORY EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Laboratory Procedures | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Diseases Document Number: 329134 |
| 28. Peer Reviewed Title: Early home treatment of childhood fevers with ineffective antimalarials is deleterious in the outcome of severe malaria. Author: Orimadegun AE; Amodu OK; Olumese PE; Omotade OO Source: Malaria Journal. 2008;7:143. Abstract: BACKGROUND: Early diagnosis and prompt treatment including appropriate home-based treatment of malaria is a major strategy for malaria control. A major determinant of clinical outcome in case management is compliance and adherence to effective antimalarial regimen. Home-based malaria treatment with inappropriate medicines is ineffective and there is insufficient evidence on how this contributes to the outcome of severe malaria. This study evaluated the effects of pre-hospital antimalarial drugs use on the presentation and outcome of severe malaria in children in Ibadan, Nigeria. METHODS: Two hundred and sixty-eight children with a median age of 30 months comprising 114 children with cerebral malaria and 154 with severe malarial anaemia (as defined by WHO) were prospectively enrolled. Data on socio-demographic data, treatments given at home, clinical course and outcome of admission were collected and analysed. RESULTS: A total of 168 children had treatment with an antimalarial treatment at home before presenting at the hospital when there was no improvement. There were no significant differences in the haematocrit levels, parasite counts and nutritional status of the pre-hospital treated and untreated groups. The most commonly used antimalarial medicine was chloroquine. Treatment policy was revised to Artemesinin-based Combination Therapy (ACT) in 2005 as a response to unacceptable levels of therapeutic failures with chloroquine, however chloroquine use remains high. The risk of presenting as cerebral malaria was 1.63 times higher with pre-hospital use of chloroquine for treatment of malaria, with a four-fold increase in the risk of mortality. Controlling for other confounding factors including age and clinical severity, pre-hospital treatment with chloroquine was an independent predictor of mortality. CONCLUSION: This study showed that, home treatment with chloroquine significantly impacts on the outcome of severe malaria. This finding underscores the need for wide-scale monitoring to withdraw chloroquine from circulation in Nigeria and efforts intensified at promoting prompt treatment with effective medicines in the community. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | FEVER | MALARIA | HOME CARE | ANTIMALARIAL DRUGS | COMPLICATIONS | HEMATOCRIT | PREVALENCE | DEATH RATE | AGE FACTORS | CENTRAL NERVOUS SYSTEM EFFECTS | ANEMIA | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Body Temperature | Physiology | Biology | Parasitic Diseases | Diseases | Care and Support | Health Services | Delivery of Health Care | Health | Laboratory Proc |