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Title: Kangaroo mother care for low birth weight babies: a prospective observational study.
Source: Journal of Nepal Paediatric Society. 2009 Jan-Jun;29(1):6-9.
Abstract: Introduction: Kangaroo Mother Care is the low cost, humane technique for caring low birth weight babies by direct skin to contact with the mother. Objective: The Prospective observational study was done to see the effect of KMC especially on weight gain on low birth weight babies weighing 2000 grams or less at Special Care Baby Unit of Paropakar Maternity and Women's hospital, Kathmandu. Method: The study was conducted in Special Care Baby Unit (SCBU) of Paropakar Maternity and Women's Hospital over 7 months period May 2007 to Nov. 2008 (from Baishakh 2064 to Kartik 2065). The method of care consisted of skin to skin contact between the mother and the infant. Result: It was observed that babies had good weight gain of average 30gms/day and had short duration of hospital stay of average 9 days. Babies had less morbidities like hypothermia, apnea, skin infections and oral thrush.100% babies had exclusive breast feeding and KMC was acceptable to mothers. Conclusion: Kangaroo Mother Care shows early and good weight gain in low birth weight babies. It is simple, low cost technique and well acceptable by mother and family and can be continued at home.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | LOW BIRTH WEIGHT | TREATMENT | INFANT HEALTH | GESTATIONAL AGE | BREASTFEEDING, EXCLUSIVE | COST EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Health | Fetus | Pregnancy | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 341512

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Peer Reviewed

Title: ACOG Committee Opinion No. 427: Misoprostol for postabortion care.
Author: American College of Obstetricians and Gynecologists
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 1):465-8.
Abstract: The World Health Organization estimates that 67,000 women, mostly in developing countries, die each year from untreated or inadequately treated abortion complications. Postabortion care, a term commonly used by the international reproductive health community, refers to a specific set of services for women experiencing problems from all types of spontaneous or induced abortion. There is increasing evidence that misoprostol is a safe, effective, and acceptable method to achieve uterine evacuation for women needing postabortion care. To reduce maternal mortality, availability of postabortion care services must be increased. Misoprostol must be readily available especially for women who do not otherwise have access to postabortion care. Nurses and midwives can safely provide first-line postabortion care services, including in outpatient settings,provided they receive appropriate training and support. Access to contraception and safe abortion services prevents complications from unsafe abortion and decreases the need for postabortion care. It is much less expensive and far better for women's health to prevent the problem of unsafe abortion rather than to treat resulting complications.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | WOMEN | ABORTION | ABORTION, SPONTANEOUS | POSTABORTION CARE | MISOPROSTOL | HEALTH SERVICES | REPRODUCTIVE HEALTH | MATERNAL HEALTH | MATERNAL MORTALITY | PREVENTION AND CONTROL | NEEDS ASSESSMENT | PROGRAM ACCESSIBILITY | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Delivery of Health Care | Health | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Mortality | Population Dynamics | Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 341050

Title: Female contraception over 40.
Author: The ESHRE Capri Workshop Group
Source: Human Reproduction Update. 2009 May 20;
Abstract: BACKGROUND The majority of women 40-49 years of age need an effective method of contraception because the decline in fertility with age is an insufficient protection against unwanted pregnancy. Although pregnancy is less likely after the age of 40 years, the clinical and social consequences of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS MEDLINE searches were done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS The decline in fecundity in the fifth decade is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special considerations in this age group include the frequency of menstrual irregularity, sexual problems and the possibility of menopausal symptoms, all of which may respond to hormonal methods of contraception. CONCLUSIONS Women should be advised to continue with a contraceptive method until they have reached the menopause with its natural state of sterility.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | MENOPAUSE | FAMILY PLANNING | FEMALE STERILIZATION | BIOLOGICAL AGING | AGE FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Sterilization, Sexual | Physiology | Biology | Population Characteristics
Document Number: 341250

Title: Scientists recommend new design for female condom research.
Author: Family Health International [FHI]
Source: [Research Triangle Park, North Carolina], FHI, [2009]. [2] p. (Research Briefs on the Female Condom)
Abstract: As the result of a USAID-supported workshop organized by the nonprofit organization CONRAD, scientists have proposed a new design for studies testing the effectiveness of innovations in the female condom. For a female condom to gain regulatory approval in the United States, the U.S. Food and Drug Administration (FDA) currently requires that the product be tested in a large -- and often expensive -- phase III contraceptive-effectiveness trial. CONRAD held the workshop specifically so that experts on female condoms and semen biomarkers could explore acceptable alternatives to this type of trial. The experts identified the well-studied biomarker prostate-specific antigen (PSA) as the most promising marker to pursue for this application. The new study design uses PSA to show the presence of semen in the vagina, which should be a more reliable indicator of clinical condom failure than is the incidence of pregnancy or a sexually transmitted infection. A report of the workshop and the details of the study design are published in the journal Contraception. (Excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | STUDY DESIGN | WORKSHOPS | FEMALE CONDOMS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTION RESEARCH | CONDOM FAILURE | SEMEN | ANTIGENS | VAGINA | Developed Countries | North America | Americas | Research Methodology | Education | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Condoms | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Genitalia, Female
Document Number: 331704

Title: Diarrheal disease: solutions to defeat a global killer.
Author: Program for Appropriate Technology in Health [PATH]
Source: Washington, D.C., PATH, 2009. 38 p.
Abstract: Today, the leading causes of death among children under the age of five, particularly in the developing world, are pneumonia and diarrhea. These illnesses are both preventable and treatable. The global health community possesses the interventions and knowledge to save millions of children's lives worldwide. We can do this by reprioritizing diarrheal disease on the global health agenda; educating, increasing awareness, and mobilizing health care providers, policymakers, and the larger global community around the burden of diarrheal disease and the lifesaving interventions that exist today; and by implementing these solutions with a coordinated approach. Proven, lifesaving, prevention and treatment methods [include]: safe water, improved sanitation and good hygiene; vaccines; exclusive breastfeeding and optimal complementary feeding; oral rehydration therapy (ORT) / oral rehydration solution (ORS); zinc treatment and other micronutrients. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | LOW INCOME POPULATION | CHILDREN | DIARRHEA | MALNUTRITION | CHILD MORTALITY | ZINC | WATER QUALITY | CAUSES OF DEATH | SANITATION | TREATMENT | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition Disorders | Mortality | Population Dynamics | Metals | Vitamins and Minerals | Physiology | Biology | Water | Natural Resources | Environment | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 331382

Title: Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria.
Author: Abimiku A; Villalba-Diebold P; Dadik J; Okolo F; Mang E; Charurat M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. METHOD: A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. RESULTS: CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). CONCLUSIONS: Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | HEMATOLOGICAL EFFECTS | RISK FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Health | Disease Transmission Control | Prevention and Control | Risk Reduction Behavior | Behavior | Reproductive Tract Infections | Infections
Document Number: 341452

Title: Maternal and perinatal outcome in teenage pregnancies in Sudan.
Author: Adam GK; Elhassan EM; Ahmed AM; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):170-1.
Abstract: Pregnancy and childbirth in teenage women pose special risks for both mother and baby. As well as significant medical, nutritional, social, and economic risks, teenage pregnancy is associated with increased risks for adverse pregnancy outcomes, such as preterm birth, low birth weight, and death in the neonatal or postnatal periods. There is a paucity of literature regarding the maternal and perinatal outcome of teenage pregnancies in Sudan, Africa. The aim of the present study was to assess the risk of anemia, operative delivery, and perinatal complications (mainly low birth weight) among primiparous teenagers with a singleton delivery compared with a similar group of women aged 20-24 years. (excerpt)
Language: English
Keywords:
SUDAN | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | ANEMIA | LOW BIRTH WEIGHT | MATERNAL AGE | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Pregnancy | Reproduction | Diseases | Birth Weight | Body Weight | Physiology | Biology | Parental Age | Age Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341382

Peer Reviewed

Title: Evaluation of mifepristone as a once a month contraceptive pill.
Author: Agarwal M; Das V; Agarwal A; Pandey A; Srivastava D
Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e27-9.
Abstract: OBJECTIVE: The purpose of this study was to assess the efficacy and safety of mifepristone as a contraceptive pill. STUDY DESIGN: A prospective case-control study was conducted in a tertiary care center of North India. The study group (n = 86) was given 200-mg mifepristone tablets on the 16th day of the menstrual cycle. The control group (n = 92) received combined oral contraceptive (COC) as per protocol. Subjects were followed for drug compliance, satisfaction, side effects, and failure. RESULTS: Acceptability of mifepristone was significantly higher in educated population (P < .001), with fewer side effects (P = .001), good satisfaction (P < .001), and higher compliance rate (P = .05). The oral contraceptive pill group had higher adverse biochemical parameters. CONCLUSION: Mifepristone can be used as a monthly contraceptive pill effectively.
Language: English
Keywords:
INDIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | RU-486 | TIME FACTORS | ADMINISTRATION AND DOSAGE | Asia, Southern | Asia | Developing Countries | Contraceptive Methods | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341243

10.

Title: Spontaneous vesicovaginal fistula caused by genitourinary aspergillosis.
Author: Agarwal N; Seth A; Kulshrestha V; Kochar S; Kriplani A
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):63-4.
Abstract: Genitourinary aspergillosis is rare in patients who are not immunocompromised. A 39-year-old woman presented with vaginal urinary leakage with no history of previous trauma, procedure, or fever. The patient's last delivery had been by cesarean 12 years previously and she had no history of difficult labor. Six months prior to presenting, the patient had been scheduled to undergo abdominal hysterectomy for menorrhagia along with repair of a surgical hernia; only the hernia was repaired at that time as dense adhesions prevented the hysterectomy. The patient had been amenorrheic since that surgery and her incontinence began 6 days prior to presentation. (excerpt)
Language: English
Keywords:
INDIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | FISTULA | AMENORRHEA | VAGINAL ABNORMALITIES | SURGERY | BACTERIAL AND FUNGAL DISEASES | UROGENITAL EFFECTS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Menstruation Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Urogenital System | Physiology | Biology
Document Number: 341383

11.

Peer Reviewed

Title: Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding.
Author: Ahmed T; Svennerholm AM; Al Tarique A; Sultana GN; Qadri F
Source: Vaccine. 2009 Feb 25;27(9):1433-9.
Abstract: The killed oral cholera vaccine Dukoral is recommended for adults and only children over 2 years of age, although cholera is seen frequently in younger children and there is an urgent need for a vaccine for them. Since decreased immunogenicity of oral vaccines in children in developing countries is a critical problem, we tested interventions to enhance responses to Dukoral. We evaluated the effect on the immune responses by temporarily withholding breast-feeding or by giving zinc supplementation. Two doses of Dukoral consisting of killed cholera vibrios and cholera B subunit were given to 6-18 months old Bangladeshi children (n=340) and safety and immunogenicity studied. Our results showed that two doses of the vaccine were safe and induced antibacterial (vibriocidal) antibody responses in 57% and antitoxin responses in 85% of the children. Immune responses were comparable after intake of one and two doses. Temporary withholding breast-feeding for 3 h before immunization or supplementation with 20 mg of zinc per day for 42 days resulted in increased magnitude of vibriocidal antibodies (77% and 79% responders, respectively). Administration of vaccines without buffer or in water did not result in reduction of vibriocidal responses. This study demonstrates that the vaccine is safe and immunogenic in children under 2 years of age and that simple interventions can enhance immune responses in young children.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | INFANT | CHOLERA | ZINC | HUMAN MILK | VACCINES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | AUTOIMMUNE RESPONSE | SAFETY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Contraceptive Effectiveness | Contraception | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Public Health
Document Number: 341051

12.

Peer Reviewed

Title: Biological Validation of Self-Reported Condom Use Among Sex Workers in Guinea.
Author: Aho J; Koushik A; Diakite SL; Loua KM; Nguyen VK; Rashed S
Source: AIDS and Behavior. 2009 Aug 13;
Abstract: Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.
Language: English
Keywords:
GUINEA | RESEARCH REPORT | STATISTICAL REGRESSION | SEX WORKERS | CONDOM USE | BIAS | DATA REPORTING | VALIDITY | VAGINA | SEMEN | ANTIGENS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Data Analysis | Research Methodology | Sex Behavior | Behavior | Risk Reduction Behavior | Error Sources | Measurement | Data Collection | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Genitalia, Male | Immunologic Factors | Immunity | Immune System | Reproductive Tract Infections | Infections | Diseases
Document Number: 342486

13.

Title: Breastfeeding and obesity among Kuwaiti preschool children.
Author: Al-Qaoud N; Prakash P
Source: Medical Principles and Practice. 2009;18(2):111-7.
Abstract: OBJECTIVES: To determine if breastfeeding and its duration are associated with a reduced risk of obesity among Kuwaiti preschool children. SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and 1,199 females) preschool children (3-6 years of age) and their mothers. The data were collected from September 2003 to June 2004. Height and weight measurements were used for defining weight status while other data were collected by questionnaire. RESULTS: There was no significant association of breastfeeding or its duration with either overweight or obesity among preschool children after adjusting for effects of the confounders. The child's gender, age and birth weight were the significant factors influencing current weight. Girls were at 32% higher risk of becoming obese than boys. Children aged 4-5 years were at nearly 3 times higher risk of overweight and obesity than children of less than 4 years. Children with higher birth weight (>or=4 kg) had double the risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg). Maternal obesity was a strong predictor of obesity in the children. A child with an obese mother had nearly 2 times higher risk of being overweight (BMI between the 85th the 95th percentiles) and 3 times of being obese (BMI >or=95th percentile) compared to a child born to a mother with a normal body weight. CONCLUSION: Breastfeeding and its duration are not associated with obesity status. However, there is a positive association between child and maternal obesity.
Language: English
Keywords:
KUWAIT | RESEARCH REPORT | PREVALENCE | CHILDREN | BREASTFEEDING | OBESITY | BODY WEIGHT | CHILD HEALTH | Middle East | Developed Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Physiology | Biology
Document Number: 341031

14.

Title: Prevention of low birthweight.
Author: Alam DS
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68.
Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW.
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341347

15.

Title: Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis.
Author: Alderman H; Ndiaye B; Linnemayr S; Ka A; Rokx C; Dieng K; Mulder-Sibanda M
Source: Public Health Nutrition. 2009 May;12(5):667-73.
Abstract: There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.
Language: English
Keywords:
SENEGAL | RESEARCH REPORT | COHORT ANALYSIS | RURAL POPULATION | CHILD NUTRITION | INTERVENTIONS | NUTRITION PROGRAMS | PROGRAM EFFECTIVENESS | BODY WEIGHT | COMMUNITY HEALTH SERVICES | PROMOTION | BEHAVIOR CHANGE | GROWTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Physiology | Biology | Marketing | Economic Factors | Behavior | Child Development
Document Number: 342116

16.

Title: Headache induced by the use of combined oral contraceptives.
Author: Allais G; Gabellari IC; Airola G; Borgogno P; Schiapparelli P; Benedetto C
Source: Neurological Sciences. 2009 May;30 Suppl 1:S15-7.
Abstract: Although combined oral contraceptives (COCs) are a safe and highly effective method of birth control, they may also give rise to problems of clinical tolerability in migraine patients. Indeed, headache is among the most common side effects reported with the use of COCs, frequently leading to their being discontinued. The latest International Classification of Headache Disorders identified at least two entities evidently related to the use of COCs, i.e., exogenous hormone-induced headache and estrogen-withdrawal headache. As to the former, the newest formulations of COCs are generally well tolerated by migraine without aura patients, but can worsen headache in migraine with aura patients. Headache associated with COCs, generally, tends to improve as their use continues. However, although it is not yet clear if there is an association between headache and the composition of COCs (both in the type and amount of hormones), it has been observed that the incidence of headache during COC use seems greater if migraine is associated with menstrual trigger. The estrogen-withdrawal headache is a headache that generally appears within the first 5 days after cessation of estrogen use and resolves within 3 days, even if in some cases it may appear on the sixth or seventh day after pill suspension and lasts more than 3 days.
Language: English
Keywords:
ITALY | LITERATURE REVIEW | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | HEADACHE | MIGRAINE | INCIDENCE | HORMONES | ESTROGENS | Developed Countries | Europe, Southern | Europe | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Signs and Symptoms | Diseases | Vascular Diseases | Measurement | Research Methodology | Endocrine System | Physiology | Biology
Document Number: 342617

17.

Title: Interventions for pain with intrauterine device insertion.
Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P
Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373.
Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation.
Language: English
Keywords:
UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology
Document Number: 342475

18.

Title: Oral contraceptives and the risk of multiple sclerosis: A review of the epidemiologic evidence.
Author: Alonso A; Clark CJ
Source: Journal of the Neurological Sciences. 2009 May 7;
Abstract: Multiple sclerosis (MS) is more frequent in women than in men, suggesting that sex hormones could play a role in the development of MS. For this reason, several studies have assessed whether use of oral contraceptives modifies the risk of MS. In this article, we review the methodology and results of published epidemiologic studies addressing this issue. On the whole, the existing epidemiologic evidence does not support an important effect of oral contraceptive use on the risk of MS, though it does suggest that oral contraceptives might delay the onset of the disease.
Language: English
Keywords:
UNITED KINGDOM | UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CENTRAL NERVOUS SYSTEM EFFECTS | RISK ASSESSMENT | EPIDEMIOLOGY | Developed Countries | Europe, Western | Europe | North America | Americas | Research Methodology | Demographic Factors | Population | Safety | Public Health | Health | Central Nervous System | Physiology | Biology | Evaluation
Document Number: 341145

19.

Title: Misoprostol for pregnancy termination in grand multiparous women with three cesarean deliveries.
Author: Alsibiani SA
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3;
Abstract: In countries in which women have high parity, pregnancy termination is common in women who have had multiple cesarean deliveries. Although a combination of mifepristone and misoprostol is recommended for late abortion, in Saudi Arabia, mifepristone is not approved or available. There is little information about the safety of misoprostol for the termination of pregnancy or induction of labor in women with scarred uteri and multiple cesarean deliveries. Although there is no recommended dose or mode of administration for misoprostol in patients with scarred uteri and high parity, it is advisable to use a low dose. Misoprostol use in women with scarred uteri can lead to uterine rupture, but few incidences have been reported in the literature. However, caution is advisable. Misoprostol administered orally has a rapid onset of action and increases uterine tone, but contractions are not experienced unless repeated doses are administered. In addition, women usually prefer oral administration. Vaginal administration offers prolonged activity, greatest bioavailability, and a lower incidence of adverse effects. Use of misoprostol for termination of pregnancy in 2 grand multiparous (gravidity N10) women each with 3 previous cesarean deliveries is summarized in Table 1. According to the WHO expert dosage guidelines, the maximum dose was not exceeded in either patient. In patient 1 an intracervical Foley catheter with syntocinon infusion was used to ripen the cervix followed by oral administration of 800 �g of misoprostol. Patient 2 received a single dose of 800 �g of misoprostol vaginally. Favorable results were obtained in both women using a single high dose of misoprostol. The safety of using misoprostol in women with high parity and scarred uteri could not be ascertained from this study. A larger study is needed to confirm the effectiveness and safety of this regimen in patients with high parity who have had more than 2 previous cesarean deliveries. (full-text)
Language: English
Keywords:
SAUDI ARABIA | RESEARCH REPORT | SUMMARY REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | CESAREAN SECTION | ABORTION | MULTIPARITY | MISOPROSTOL | UTERUS | RU-486 | ADMINISTRATION AND DOSAGE | Middle East | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Genitalia, Female | Genitalia | Urogenital System | Hormone Antagonists | Hormones | Drugs
Document Number: 341466

20.

Title: The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis.
Author: Amthor RE; Cole SM; Manary MJ
Source: Journal of the American Dietetic Association. 2009 Mar;109(3):464-7.
Abstract: When the international community declared a famine in Malawi in January of 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five outpatient therapeutic programs were implemented that utilized home-based therapy and ready-to-use therapeutic food. Children with severe malnutrition, defined as the presence of edema and/or a weight-for-height less than 70% of the reference standard, were enrolled in the program. Two senior clinical nurses trained village health aides in each of the five communities. Children visited the health aides biweekly. During the visits, health aides collected demographic and anthropometric information and distributed a 2-week supply of ready-to-use therapeutic food, providing 175 kcal/kg/d. Treatment continued for 8 weeks; children were discharged before 8 weeks if they reached a weight-for-height more than 100% of the reference standard, or required admission to the hospital due to systemic infection or recurrence of edema. Of the 826 children enrolled, 775 (93.7%) recovered, 13 (1.8%) remained malnourished, 30 (3.6%) defaulted, and 8 (0.9%) died. Mean weight gained was 2.7+/-3.7 g/kg/d, height gained 0.3+/-0.9 mm/d, and mid-upper arm circumference gained 0.2+/-0.3 mm/d. Home-based therapy with ready-to-use therapeutic food administered by village health aides is an effective approach to treating malnutrition during food crises in areas lacking health services.
Language: English
Keywords:
DEVELOPING COUNTRIES | MALAWI | RESEARCH REPORT | RURAL AREAS | COMMUNITY | CHILDREN | FAMINE | FOOD SECURITY | NUTRITION DISORDERS | ANTHROPOMETRY | BODY WEIGHT | BODY HEIGHT | MALNUTRITION | HOME CARE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Residence Characteristics | Population Distribution | Youth | Age Factors | Population Characteristics | Demographic Factors | Food Supply | Natural Resources | Environment | Diseases | Measurement | Research Methodology | Physiology | Biology | Care and Support | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine
Document Number: 330803

21.

Peer Reviewed

Title: Safety analysis of the diaphragm in combination with lubricant or acidifying microbicide gels: effects on markers of inflammation and innate immunity in cervicovaginal fluid.
Author: Anderson DJ; Williams DL; Ballagh SA; Barnhart K; Creinin MD; Newman DR; Bowman FP; Politch JA; Duerr AC; Jamieson DJ
Source: American Journal of Reproductive Immunology. 2009 Feb;61(2):121-9.
Abstract: OBJECTIVE: Diaphragms are being considered for use with vaginal microbicide gels to provide enhanced protection against sexually transmitted pathogens. The purpose of this study was to determine whether use of a diaphragm with microbicide or placebo gel causes cervicovaginal inflammation or perturbations in cervicovaginal immune defense. METHOD OF STUDY: Eighty-one non-pregnant women were randomized into three groups and instructed to use Milex (CooperSurgical, Inc., Trumbull, CT, USA)diaphragms overnight for 14 days in combination with one of the two acid-buffering microbicide gels [ACIDFORM (Instead Inc., La Jolla, CA, USA) or BufferGel(trade mark) (BG; ReProtect Inc., Baltimore, Maryland)] or placebo gel (K-Y Jelly); Personal Products Inc., Raritan, NJ, USA). Cervicovaginal lavages (CVLs) were performed prior to study entry and on days 8 and 16. Nine soluble mediators of vaginal inflammation or immune defense were measured in CVLs by Bio-Plex or ELISA. RESULTS: Use of diaphragms with placebo ormicrobicide gel was not associated with increased levels of inflammation markers. Concentrations of secretory leukocyte protease inhibitor (SLPI) were markedly reduced in the BG group. CONCLUSION: Daily use of a diaphragm with placebo or acidifying microbicide gel did not cause cervicovaginal inflammation. However, diaphragm/BG use was associated with markedly reduced levels of SLPI, an important mediator of innate immune defense. Further studies are warranted to establish the safety of diaphragm/microbicide gel combinations.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CASE CONTROL STUDIES | MICROBICIDES | VAGINAL GEL | LUBRICANTS | IMMUNITY, NATURAL | CONTRACEPTIVE SAFETY | VAGINAL DIAPHRAGM | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Studies | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Ingredients and Chemicals | Immunity | Immune System | Physiology | Biology | Safety | Public Health | Vaginal Barrier Methods | Barrier Methods
Document Number: 330234

22.

Peer Reviewed

Title: Menstrual blood loss in women using the frameless FibroPlant LNG-IUS.
Author: Andrade A; Wildemeersch D
Source: Contraception. 2009 Feb;79(2):134-8.
Abstract: BACKGROUND: This study was conducted to report on a menstrual blood loss (MBL) study and iron stores in women with and without heavy menstrual bleeding using the frameless FibroPlant levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception. STUDY DESIGN: An open, prospective, noncomparative MBL study, using FibroPlant releasing 14 mcg of LNG/day for contraception. MBL was assessed by the quantitative alkaline hematin (QAH) technique. RESULTS: The MBL study was conducted in 40 heavy and normally menstruating Brazilian women seeking contraception. MBL was reduced from a mean baseline menstrual volume of 29.7 mL to a mean volume of 1.5 mL after 24 months, while ferritin values increased from a mean value of 31.1 ng/mL (at baseline) to a mean level of 72.5 ng/mL (after 24 months of use). Differences were highly significant (p<.0005). There were no significant differences between those who had normal menstrual bleeding and the heavy bleeders. The heavy bleeders had comparable MBL to thenormal bleeders 3 months after insertion, and by 24 months post-insertion, their ferritin levels were comparable to those of the normal bleeders. Amenorrhea occurred in 80% of women out of 40 after 24 months of use. No pregnancies were recorded. CONCLUSION: The LNG-IUS is effective in reducing MBL in normally menstruating women as well as in women with heavy menstrual bleeding. The authors agree with the recommendations by the UK National Institute for Clinical Effectiveness and the new Finnish guidelines for heavy menstrual bleeding that the LNG-IUS should be positioned as first-line treatment prior to endometrial ablation or hysterectomy.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MENSTRUATION | SERUM IRON LEVEL | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | TIME FACTORS | AMENORRHEA | PREVALENCE | CONTRACEPTIVE EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Hemic System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Measurement
Document Number: 331016

23.

Peer Reviewed

Title: Comparison of HIV type 1 sequences from plasma, cell-free breast milk, and cell-associated breast milk viral populations in treated and untreated women in Mozambique.
Author: Andreotti M; Galluzzo CM; Guidotti G; Germano P; Altan AD; Pirillo MF; Marazzi MC; Vella S; Palombi L; Giuliano M
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):707-11.
Abstract: We analyzed the sequences of the HIV viral populations obtained from plasma, cell-free breast milk, and breast milk cells of HAART-treated (23) and untreated (30) HIV-infected women to obtain information about the origin of the breast milk virus. Sequence analyses of viruses were performed using the TruGene HIV-1 assay. Direct sequences of the reverse transcriptase (RT) and protease (PR) genes were analyzed using the Phylip 3.68 suite of sequence analysis program and pairwise evolutionary distances were calculated with the Kimura two parameter model for estimation of distances. We found that the genetic distances between the plasma and the cell-free breast milk viruses and between the cell-free and cell-associated breast milk viruses for RT were higher in HAART-receiving women than in untreated women, suggesting viral evolution under selective drug pressure in breast milk. Our data support the hypothesis of the presence of an actively replicating viral population in the breast milk compartment, distinct from that present in plasma.
Language: English
Keywords:
MOZAMBIQUE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | HUMAN MILK | HIV | HIV TESTING | LABORATORY PROCEDURES | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342889

24.

Title: Oral Contraceptives: A Risk Factor for Squamous Cell Carcinoma?
Author: Applebaum KM; Nelson HH; Zens MS; Stukel TA; Spencer SK; Karagas MR
Source: Journal of Investigative Dermatology. 2009 Jun 25;
Abstract: Oral contraceptives (OCs) affect the risk of several cancers in women, but have been virtually unstudied for squamous cell carcinoma (SCC). We examined the hypothesis that OCs influence SCC risk in a case-control study among women and also examined whether polymorphisms in the DNA repair gene, Xeroderma pigmentosum group D (XPD), modified the risk. Incident cases of SCC were identified by a network of dermatologists and pathology laboratories. Population-based controls were frequency matched to cases by age and gender (n=261 SCC cases, 298 controls). Overall, OC use was associated with a 60% higher risk of SCC (odds ratio (OR), 1.6; 95% confidence interval (95% CI): 1.0-2.5). ORs for SCC were higher among those who last used OCs >/=25 years before diagnosis (OR: 2.1; 95% CI: 1.2-3.7), and among these women, SCC risk increased with duration of use (OR for /=7 years, 2.7; 95% CI: 0.9-8.5, P(trend)=0.01). Furthermore, the XPD Lys751Gln polymorphism was a significant modifier of the OC-SCC association (P(interaction)=0.03). These findings lead us to hypothesize a potential relationship between OCs and SCC risk, and that this could involve DNA repair pathways.Journal of Investigative Dermatology advance online publication, 25 June 2009; doi:10.1038/jid.2009.168.
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW HAMPSHIRE | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK FACTORS | CANCER | DERMATOLOGICAL EFFECTS | ESTROGENS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Health | Neoplasms | Diseases | Physiology | Biology | Hormones | Endocrine System
Document Number: 341751

25.

Peer Reviewed

Title: Ovarian activity and safety of a novel levonorgestrel/ethinyl estradiol continuous oral contraceptive regimen.
Author: Archer DF; Kovalevsky G; Ballagh SA; Grubb GS
Source: Contraception. 2009 Sep;80(3):245-53.
Abstract: BACKGROUND: A continuous regimen of oral levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg was evaluated for inhibition of ovulation, time to return to ovulation after stopping treatment and safety. STUDY DESIGN: This open-label study was conducted in healthy women aged 18-35 years. Ovulation was documented before treatment, and then participants received oral tablets containing LNG 90 mcg/EE 20 mcg to be taken continuously for three 28-day intervals. Ovarian activity was assessed three times per week during the treatment period with transvaginal ultrasound scans and measurements of serum 17beta-estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone concentrations. Safety assessments included physical examinations, laboratory evaluations and adverse event records. RESULTS: Thirty-seven of the 58 subjects who received treatment met predefined criteria for efficacy analysis. No on-treatment ovulations occurred in the efficacy or intent-to-treat population. There was evidence of ovulation within 37 days of stopping treatment for 46 (98%) of 47 subjects evaluated posttreatment. The final subject with a history of polycystic ovarian syndrome ovulated by Day 66. The safety profile observed during this 84-day continuous regimen was similar to that seen with other low-dose oral contraceptives administered in a cyclic regimen. CONCLUSIONS: The continuous LNG/EE regimen completely inhibited ovulation, with little evidence of follicular development and with rapid return of ovulatory capacity after stopping treatment.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | LEVONORGESTREL | ETHINYL ESTRADIOL | SAFETY | ULTRASONICS | OVARIAN EFFECTS | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342575

26.

Title: Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result.
Author: Arioz DT; Altindis M; Tokyol C; Kalayci R; Saylan A; Yilmazer M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | HPV | CERVICAL CANCER | RISK FACTORS | CYTOLOGIC EFFECTS | SCREENING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341451

27.

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

28.

29.

Peer Reviewed

Title: Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV.
Author: Ayles H; Schaap A; Nota A; Sismanidis C; Tembwe R; De Haas P; Muyoyeta M; Beyers N
Author: Peter Godfrey-Faussett for the ZAMSTAR Study Team
Source: PloS One. 2009;4(5):e5602.
Abstract: BACKGROUND: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation. METHODS AND FINDINGS: 8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19). HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94) and fever (Adj OR 2.04, 95%CI 1.23-3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines. CONCLUSIONS: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | SAMPLING STUDIES | ADULTS | TUBERCULOSIS | HIV INFECTIONS | RESPIRATORY INSUFFICIENCY | PREVALENCE | SCREENING | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | ANTIBIOTICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Viral Diseases | Pulmonary Effects | Physiology | Biology | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment
Document Number: 342445

30.
Title: Emergency contraception: how does it work?
Author: Baird DT
Source: Reproductive Biomedicine Online. 2009;18 Suppl 1:32-6.
Abstract: Emergency (or post-coital) contraception is any substance or device that is used to prevent pregnancy after unprotected intercourse. Currently used hormonal methods of emergency contraception (high-dose combined oral contraceptive pill or levonorgestrel) prevent about 50-80% of pregnancies. Research has demonstrated that these methods inhibit the midcycle surge of LH from the pituitary and, if given at least 2 days before ovulation, ovulation is delayed or prevented. Ovulation still occurs if administration is delayed until ovulation is imminent. Biological data that suggest that the most likely mode of action is by preventing fertilization are supported by the clinical observation that the greater the interval between coitus and administration the greater the chance of pregnancy. There are no data supporting the view that levonorgestrel can impair the development of the embryo or prevent implantation. In contrast, other very effective methods of emergency contraception, such as mifepristone and intrauterine devices, can also inhibit implantation.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | IUD | RU-486 | LEVONORGESTREL | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Contraceptive Methods | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330739


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