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Title: The morning-after pill [letter]
Author: Abell S
Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342.
Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B™, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B™ prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases
Document Number: 331244 Notification

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

Peer Reviewed

Title: Expanding access to intrauterine contraception.
Author: Allen RH; Goldberg AB; Grimes DA
Source: American Journal of Obstetrics and Gynecology. 2009 Jun 13;
Abstract: The intrauterine device is a safe, highly effective, long-lasting, yet reversible method of contraception. Expanding access to intrauterine contraception is an important measure to reduce the rate of unintended pregnancy in the United States. Clinicians should consider intrauterine contraception in appropriate candidates, including women who are nulliparous, adolescent, immediately postpartum or postabortal, and desiring emergency contraception, and as an alternative to permanent sterilization. Barriers to intrauterine contraception such as requiring cervical cancer screening before insertion, routine testing for gonorrhea and chlamydial infection in low-risk women, or scheduling insertion only during menses are unnecessary.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | IUD | CONTRACEPTIVE AVAILABILITY | MISINFORMATION | CONTRAINDICATIONS | INSERTION | PAIN | IUD EXPULSION | NULLIPARITY | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Communication | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 341709

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

Peer Reviewed

Title: Oral compared with intravenous sedation for first-trimester surgical abortion: a randomized controlled trial.
Author: Allen RH; Fitzmaurice G; Lifford KL; Lasic M; Goldberg AB
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 1):276-83.
Abstract: OBJECTIVE: To test the equivalency of oral sedation and intravenous sedation for pain control in first-trimester surgical abortion. METHODS: Women undergoing suction curettage at less than 13 weeks of gestation were randomly assigned to oral sedation, 10 mg of oxycodone and 1 mg of lorazepam, or intravenous sedation, 100 micrograms fentanyl and 2 mg midazolam. All patients received 800 mg of preoperative ibuprofen and a 20-mL paracervical block with 1% lidocaine. The primary outcome was intraoperative pain as measured on a 21-point verbal rating scale that had a range from 0 to 100 (0=no pain and 100=worst pain ever) with an equivalence margin for the treatment group comparison of +/-10. RESULTS: Of 130 women, 65 were randomly assigned to oral sedation and 65 to intravenous sedation. The groups differed at baseline by age and preoperative ratings of depression, stress, and anxiety; however, when adjusted for these differences, the primary results were unaffected. Mean intraoperative pain scores, controlling for age and preoperative depression, stress, and anxiety, were 61.2 for oral sedation and 36.3 for intravenous sedation (mean difference 24.9, 95% confidence interval 15.9-33.9). Other findings included no difference in postoperative adverse effects and less satisfaction with pain control with oral sedation compared with intravenous sedation. CONCLUSION: Oral sedation, as studied, is not equivalent to intravenous sedation for pain control during first-trimester surgical abortion. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00337792 LEVEL OF EVIDENCE: I.
Language: English
Keywords:
MASSACHUSETTS | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | EVALUATION INDEXES | KAP SURVEYS | PREGNANT WOMEN | ANESTHESIA | ABORTION | PREGNANCY, FIRST TRIMESTER | CURETTAGE | ADMINISTRATION AND DOSAGE | PAIN | SIDE EFFECTS | SATISFACTION | Developed Countries | United States of America | North America | Americas | Clinical Research | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Drugs | Signs and Symptoms | Diseases | Psychological Factors | Behavior
Document Number: 330360 Notification

Peer Reviewed

Title: Bleeding patterns associated with non-oral hormonal contraceptives: a review of the literature.
Author: Bachmann G; Korner P
Source: Contraception. 2009 Apr;79(4):247-58.
Abstract: It is generally accepted that poor tolerance to changes in vaginal bleeding associated with hormonal contraceptive use may influence compliance and continuation with the chosen method. However, disparities in the collation and reporting of bleeding data hamper comparison among studies and products. In this review, we systematically assessed MEDLINE and EMBASE for articles assessing parenteral hormonal contraceptives that reported bleeding data based on reference periods as recommended by the World Health Organization (WHO). Overall, 31 studies published between 1986 and October 2007 were included in this review. The use of parenteral hormonal contraception was in general associated with a decrease in bleeding with continued use from Reference Period 1 to 4. However, this decrease was less marked with the combined hormonal depots and both progestin-only and combined hormonal vaginal rings than with progestin-only implants, depots and the levonorgestrel intrauterine system. Overall, reporting vaginal bleeding by 90-day reference periods as recommended by the WHO allows straightforward comparison of bleeding patterns between studies.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | BLEEDING | CONTRACEPTIVE IMPLANTS | VAGINAL RING | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330560

Title: Minimally invasive surgery for children with HIV/AIDS.
Author: Banieghbal B
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. 2009 Feb;19(1):97-101.
Abstract: AIM: Human deficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) have resulted in millions of deaths in Sub-Saharan Africa from opportunist infections. Children are not spared and are similarly affected. Minimally invasive surgery (MIS) can be used, in a selected number of children, as a mean to establish diagnosis or render a treatment. MATERIALS AND METHODS: This study was comprised of a 7-year retrospective analysis of a single pediatric surgeon's experience in South Africa. Forty-eight children, with ages 3 months to 14 years, with HIV/AIDS underwent laparoscopic/thoracoscopic exploration and treatment. RESULTS: Diagnostic laparoscopy and biopsy were the most common procedures (29 cases) indicated for nonspecific abdominal pain or rectal bleeding. The second most common procedure was laparoscopic antireflux fundoplication (10 cases) for damaged lower esophageal sphincter secondary to chronic candidal infection. The remaining procedures were for other rare surgical conditions, seen often in AIDS patients. No significant procedure-related complications occurred, but there were 2 mortalities from the underlying pathology in this cohort. CONCLUSIONS: This is the largest report on MIS for children with HIV/AIDS in the medical literature. It is shown that laparoscopic/thoracoscopic exploration and treatment in children with HIV/AIDS is safe and indicated for establishing the diagnosis and treatment of these unfortunate children.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | SURGERY | LAPAROSCOPY | PHYSICAL EXAMINATIONS AND DIAGNOSES | PAIN | BLEEDING | CANDIDIASIS | GASTROINTESTINAL EFFECTS | COMPLICATIONS | AIDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Examinations and Diagnoses | Signs and Symptoms | Bacterial and Fungal Diseases | Infections | Physiology | Biology
Document Number: 330998

Title: Three-dimensional ultrasound detection of abnormally located intrauterine contraceptive devices which are a source of pelvic pain and abnormal bleeding.
Author: Benacerraf BR; Shipp TD; Bromley B
Source: Ultrasound In Obstetrics and Gynecology. 2009 Jun 29;34(1):110-115.
Abstract: OBJECTIVE: To determine whether intrauterine contraceptive devices (IUDs) that are located abnormally within the myometrium or cervix cause a higher incidence of pelvic pain and abnormal bleeding compared with normally positioned devices. METHODS: Over a period of 9 months, all patients with an IUD presenting at our unit for two-dimensional pelvic ultrasound underwent a three-dimensional (3D) volume reconstruction of the coronal view, to visualize the entire IUD within the cavity. The IUD was deemed malpositioned if any part extended past the cavity, into the myometrium or cervix. The indications for ultrasound were recorded at presentation for the exam. The presenting symptoms of patients with an abnormally located IUD were compared with those with normally positioned ones. RESULTS: Among 167 consecutive patients with an IUD evaluated using the 3D reconstructed coronal view, 28 (16.8%) had an IUD with side arms abnormally located within the myometrium. The abnormal positioning of the IUD arms wasonly detected using the 3D coronal view. A higher proportion of patients with an abnormally located IUD presented with bleeding (35.7%) or pain (39.3%) compared with those with normally positioned IUDs (15.1% with bleeding and 19.4% with pain) (P = 0.02 and 0.03, respectively). Seventy-five percent of patients with an abnormally located IUD presented with bleeding or pain compared with 34.5% of those whose IUD was normally placed (P = 0.0001). Twenty of 21 patients with an abnormally located IUD presenting with pelvic pain or bleeding reported improvement in their symptoms after IUD removal. CONCLUSION: A 3D coronal view of the uterus is useful in the visualization of IUDs. The coronal view showing the entire device and its position within the uterus may help in identifying the cause of pelvic pain and bleeding in patients with an embedded IUD. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.
Language: English
Keywords:
UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | ULTRASONICS | IUD COMPLICATIONS | IUD MIGRATION | BLEEDING | PAIN | MYOMETRIUM | CERVIX | INSERTION | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Treatment
Document Number: 341864

10.

Peer Reviewed

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

11.

12.
Title: Acquiring allergen information from condom manufacturers: a questionnaire survey.
Author: Blyumin ML; Rouhani P; Avashia NJ; Jacob SE
Source: Dermatitis. 2009 May-Jun;20(3):161-70.
Abstract: BACKGROUND: Allergic contact dermatitis from condoms is a problem that carries significant morbidity and that has been increasingly reported due to the use of condoms to prevent sexually transmitted diseases as well as for birth control. OBJECTIVE: The purpose of the study is to evaluate the process by which condom manufacturing companies divulge product allergen information to health care professionals. METHODS: An interviewer-administered telephone questionnaire eliciting the staff member's knowledge of condom allergens was utilized. Eligible respondents were condom manufacturers' service staff over 18 years of age. RESULTS: Complete surveys were obtained regarding 36 (85.7%) of the 42 subtypes of condoms. Telephoning was the primary (75%) method of obtaining allergen information. The majority (63.9%) of the information was obtained within minutes to hours of the initial contact. Nearly two-thirds of the interviews evaluated the condom manufacturers' service staff as good and effective in their knowledge base and in providing product information. CONCLUSION: The study determined that the extent of knowledge, helpfulness, and effectiveness of the customer service personnel in relaying product allergen information to clinicians were generally good. The study additionally generated a reference table outlining the common allergens in major manufactured condoms.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | HEALTH PERSONNEL | FAMILY PLANNING PERSONNEL | CONDOMS | ALLERGIC REACTION | DERMATITIS | INFORMATION | KNOWLEDGE | INTERVIEWS | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Barrier Methods | Contraceptive Methods | Contraception | Signs and Symptoms | Diseases | Sociocultural Factors | Data Collection
Document Number: 341311

13.

14.

Title: Estrogens and the risk of complex regional pain syndrome (CRPS).
Author: de Mos M; Huygen FJ; Stricker BH; Dieleman JP; Sturkenboom MC
Source: Pharmacoepidemiology and Drug Safety. 2009 Jan;18(1):44-52.
Abstract: OBJECTIVE: Since complex regional pain syndrome (CRPS) shows a clear female predominance, we investigated the association between the cumulative as well as current exposure to estrogens, and CRPS. METHODS: A population-based case-control study was conducted in the Integrated Primary Care Information (IPCI) project in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during a visit (using International Association for the Study of Pain Criteria), or had been diagnosed by a specialist. Controls were matched to cases on gender, age, calendar time, and injury. Measures of cumulative endogenous estrogen exposure were obtained by questionnaire and included age of menarche and menopause, menstrual life, and cumulative months of pregnancy and breast-feeding. Current estrogen exposure at CRPS onset was retrieved from the electronic medical records and determined by current pregnancy or by the use of oral contraceptive (OC) drugs or hormonal replacement therapy (HRT). RESULTS: Hundred and forty-three female cases (1493 controls) were included in analyses on drug use and pregnancies, while cumulative endogenous estrogen exposure was studied in 53 cases (58 controls) for whom questionnaire data were available. There was no association between CRPS and either cumulative endogenous estrogen exposure, OC, or HRT use. CRPS onset was increased during the first 6 months after pregnancy (OR: 5.6, 95%CI: 1.0-32.4), although based on small numbers. DISCUSSION: We did not find an association between CRPS onset and cumulative endogenous estrogen exposure or current OC or HRT use, but more powered studies are needed to exclude potential minor associations.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | CASE STUDIES | RECORDS | PAIN | ESTROGENS | HORMONES | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Information Processing | Information | Signs and Symptoms | Diseases | Endocrine System | Physiology | Biology
Document Number: 329753

15.

Title: High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial.
Author: Desantana JM; Sluka KA; Lauretti GR
Source: Clinical Journal of Pain. 2009 Jan;25(1):12-9.
Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study. METHODS: Sixty-four patients undergoing LS for uterine tube ligation were randomly allocated to receive either active TENS or placebo TENS. Postoperative pain was evaluated using a standard 11-point numeric rating scale and the McGill Pain Questionnaire (MPQ)-pain rating index and number of words chosen. Both high frequency (100 Hz) and low frequency (4 Hz) TENS, at strong, but comfortable sensory intensity, were applied for 20 minutes through 4 electrodes placed around the surgical incision immediately after surgery. Pain was assessed before and after application of TENS when patients were at postanesthesia care unit (PACU). RESULTS: Both high and low frequency TENS significantly decreased postoperative pain intensity when compared with before administration of TENS using the numeric rating scale (P=0.001), pain rating index (P=0.001), and number of words chosen (P=0.001) compared with placebo TENS (P=0.001). TENS in combination with standard pharmacologic analgesic treatment was efficacious for postoperative pain relief after LS. CONCLUSIONS: We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | DOUBLE-BLIND STUDIES | CLIENTS | TUBAL LIGATION | LAPAROSCOPY | PAIN | MEDICAL PROCEDURES | ANALGESIA | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Female Sterilization | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Treatment
Document Number: 341433

16.

Peer Reviewed

Title: Complications of surgical abortion.
Author: Diedrich J; Steinauer J
Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):205-12.
Abstract: Surgical abortion is one of the most common procedures performed in reproductive-aged women and when performed by a skilled provider in the appropriate setting, it is one of the safest surgeries. Though the risk of complications is low, it increases exponentially with gestational age. Factors increasing risk of morbidity may be demographic, such as increasing patient age; medical, such as prior cesarean delivery; and procedural, such as inadequate dilation. This chapter will provide information on how to recognize factors that increase risk, steps to minimize risk, and to identify and manage complications promptly.
Language: English
Keywords:
UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | ABORTION | PREGNANCY, SECOND TRIMESTER | MORBIDITY | BLEEDING | POSTABORTION CARE | CERVICAL LACERATION | Developed Countries | North America | Americas | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Diseases | Signs and Symptoms | Health Services | Delivery of Health Care | Health
Document Number: 342243 Notification

17.

Title: Evaluation of postpartum blood loss after misoprostol-induced labour.
Author: Elsedeek MS; Awad EE; Elsebaey SM
Source: International Journal of Obstetrics and Gynaecology. 2009;116:431-435.
Abstract: Objective: To objectively evaluate postpartum blood loss after successful misoprostol induction and compare it with blood loss after oxytocin induction of labour. Design Prospective randomised study. Setting: Labour ward in university maternity hospital. Population A total of 150 women up to third parity with completed 40 weeks of singleton normal pregnancy, average size cephalic fetus. Methods: Cases were randomised between oxytocin induction and misoprostol induction. Blood was collected in suction set and measured in the delivery room starting after delivery of the fetus and was evaluated by pad weighing in the following 6 hours. Pre- and postdelivery haematocrit were measured and difference between the two values was assessed and analysed. Main outcome measures Success of induction, induction delivery interval, postpartum blood loss, and difference between pre- and postdelivery haematocrit. Results: Induced labour was significantly faster with misoprostol induction (P < 0.001). Blood loss and haematocrit difference was significantly greater in the misoprostol group than in oxytocin group (P < 0.02 and 0.001, respectively). Blood loss in both groups was significantly correlated with higher initial Bishop score (P < 0.001 and 0.024, respectively) and short labour duration (P < 0.0002 and 0.0001, respectively). Conclusions Misoprostol induction is associated with increased blood loss especially when used in women with high Bishop score; therefore, it is better reserved for cases requiring cervical ripening.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | MISOPROSTOL | POSTPARTUM | BLEEDING | EVALUATION | Developed Countries | North America | Americas | Studies | Research Methodology | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Puerperium | Reproduction | Signs and Symptoms | Diseases
Document Number: 340207

18.
Title: A Canadian, Multicentre Study Comparing the Efficacy of a Levonorgestrel-releasing Intrauterine System to an Oral Contraceptive in Women With Idiopathic Menorrhagia.
Author: Endrikat J; Shapiro H; Lukkari-Lax E; Kunz M; Schmidt W; Fortier M
Source: Journal of Obstetrics and Gynaecology Canada. 2009 Apr;31(4):340-347.
Abstract: Objectives: To evaluate the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) compared with a combined oral contraceptive containing 1 mg norethindrone acetate and 20 mg ethinyl estradiol (OC1/20) in reducing menstrual blood loss (MBL) in women with idiopathic menorrhagia. Methods: A prospective, randomized, open-label study was conducted in nine centres in Canada. Healthy women over 30 years of age suffering from idiopathic menorrhagia were treated either with LNG-IUS (n = 20) or with OC1/20 (n = 19) over 12 months. The primary endpoint was the change in MBL from baseline to 12 months. Secondary endpoints included treatment success (defined as a MBL score < 100 after 12 months), hemoglobin levels, and the menorrhagia severity score. Results: In both treatment groups, MBL decreased significantly from baseline to 12 months (P < 0.001). For the primary endpoint, the MBL score decreased significantly more in the LNG-IUS group (median from 228 to 13, mean percent change-83%) compared to the OC1/20 group (median from 290 to 72; mean percent change-68%) (P = 0.002) after 12 months. In the LNG-IUS group, 80% of subjects had treatment success compared with 36.8 % in the OC1/20 group (P < 0.009). Both treatments increased hemoglobin concentrations significantly between baseline and 12 months. The menorrhagia severity score was consistently lower in the LNG-IUS group at all study time points and was significantly lower (P = 0.045) at six months. Both treatments were well tolerated. Conclusion: Both the LNG-IUS and the combined oral contraceptive effectively decreased menstrual blood loss in women with idiopathic menorrhagia. The overall clinical benefit was more pronounced with LNG-IUS than with OC1/20.
Language: English
Keywords:
CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | BLEEDING | MENORRHAGIA | TREATMENT | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Menstruation Disorders | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341573

19.

Peer Reviewed

Title: Bleeding pattern, tolerance and patient satisfaction with a drospirenone-containing oral contraceptive evaluated in 3488 women in Europe, the Middle East and Canada.
Author: Endrikat JS; Milchev NP; Kapamadzija A; Georgievska J; Gerlinger C; Schmidt W; Feroze S
Source: Contraception. 2009 Jun;79(6):428-32.
Abstract: BACKGROUND: This study was conducted to assess the bleeding pattern, tolerance and patient satisfaction associated with an oral contraceptive (OC) containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol under real-life conditions. STUDY DESIGN: A multicenter, prospective and observational six-cycle study was conducted in 12 countries in Europe, the Middle East and Canada. The efficacy variables included an assessment of bleeding patterns, premenstrual symptoms of water retention and patient satisfaction as determined by a visual analog scale. RESULTS: A total of 3488 women was enrolled in the study. The percentage of women with intermenstrual bleeding decreased from 27.9% at baseline to 5.4% at the end of Cycle 6, while dysmenorrhea decreased from 67% to 17.7%. Also, amenorrhea decreased from 21.3% to 7.5%. The decreases in all three parameters were statistically significant (p<.0001). Approximately 70% of the women reported abdominal bloating and/or breast tenderness at baseline and less than 38% did so at the end of Cycle 6 (p<.0001). Patient satisfaction increased for all investigated items. Upon completion of the study, 86.2% of the women answered "yes" to continuing treatment with this OC. CONCLUSION: The OC containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol has beneficial effects on bleeding pattern, symptoms of water retention and patient satisfaction.
Language: English
Keywords:
EUROPE | MIDDLE EAST | CANADA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | KAP SURVEYS | WOMEN | BLEEDING | SATISFACTION | ORAL CONTRACEPTIVES, COMBINED | ESTRADIOL | CONTRACEPTIVE SAFETY | AMENORRHEA | METRORRHAGIA | Developed Countries | North America, Northern | Americas | Research Methodology | Studies | Surveys | Sampling Studies | Demographic Factors | Population | Signs and Symptoms | Diseases | Psychological Factors | Behavior | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Estrogens | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health | Health | Menstruation Disorders
Document Number: 341103

20.

Title: A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India.
Author: George C; Yesoda A; Jayakumar B; Lal L
Source: Journal of Clinical Pharmacy and therapeutics. 2009 Feb;34(1):33-40.
Abstract: OBJECTIVE: This prospective, observational, study evaluates the clinical outcomes, drug utilization patterns, and adherence to treatment of patients on highly active anti retroviral therapy (HAART) at a government institution in Kerala, India. METHODS: Patients who met criteria for treatment of HIV/AIDS were enrolled into the study, given free NNRTI-based combination therapy, and were followed for a period of 6 months. Data regarding demographics, clinical outcome, laboratory results, drug utilization, adherence and adverse effects were collected. Analysis was conducted utilizing descriptive statistics, anova, Fisher-exact, andt-test. RESULTS: One hundred and forty-two patients with HIV-1 were enrolled in the study into three treatment groups. The mean age was 37.88 years, 64% of the patients were male, and 92% were married. Group 1 was given zidovudine, lamivudine, and nevirapine [n = 52 (37%)], group 2 was given lamivudine, stavudine, and nevirapine [n = 51 (36%)], and group 3 was given lamivudine, stavudine, and efavirenz [n = 39 (27%)]. The increase in CD4 was 107.46 (SD: 106.25). Mean medication adherence for the 104 patients who completed the study, was 90.7%; for group 1: 92.06%, group 2: 93.37%1, and group 3: 85.71% (P > 0.05). Forty (38%) patients have at least one adverse event to HARRT, with headache being the most common side effect (11.5%). Mortality rate was 3.5% during the course of the study. CONCLUSION: Provision of free NNRTI-based combination therapy to patients in Kerala, India, resulted in greater than 90% adherence leading to better clinical outcomes in terms of increasing CD4 counts and low mortality, for patients consistently attending a treatment clinic.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COST BENEFIT ANALYSIS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | COST EFFECTIVENESS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HEADACHE | SIDE EFFECTS | DEATH RATE | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Evaluation Indexes | HIV | Behavior | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 330372

21.

Peer Reviewed

Title: Use of the Levonorgestrel-IUS in the treatment of menorrhagia: assessment of quality of life in Turkish users.
Author: Gorgen H; Api M; Akca A; Cetin A
Source: Archives of Gynecology and Obstetrics. 2009 Jun;279(6):835-40.
Abstract: OBJECTIVE: The aim of the present study was to measure the treatment of menorrhagia and health-related quality of life (QoL) in Levonorgestrel-releasing intrauterine system (LNG-IUS) in Turkish women. MATERIALS AND METHODS: We recruited 66 premenopausal women, aged 26-55 years, who had sought care in the previous year for menorrhagia. All patients were asked to complete a visual analog scale (VAS) form regarding pelvic pain, sexual life (libido) and general feeling of health. Patients filled the VAS form before LNG-IUS insertion and after 6 months. RESULTS: After the 6-month visit, PBAC score was condirebly decreased (p < 0.001). Six (10%) of the 60 patients PBAC score was higher than 75. VAS score for pelvic pain decreased from baseline to 6-month follow-up (4.32-3.55), and the libido and general feeling of health increased (4.27-4.95 and 3.47-6.87, respectively). CONCLUSION: The LNG-IUS device in the trearment of menorrhagia has cost effective, less side effects and increse in the QoL.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CLIENTS | MENORRHAGIA | TREATMENT | IUD, HORMONE RELEASING | LEVONORGESTREL | IUD SIDE EFFECTS | QUALITY OF LIFE | PAIN | SEX BEHAVIOR | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Menstruation Disorders | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Social Welfare | Economic Factors | Signs and Symptoms | Behavior
Document Number: 342109

22.

Title: Laryngeal aerodynamics associated with oral contraceptive use: Preliminary findings.
Author: Gorham-Rowan M; Fowler L
Source: Journal of Communication Disorders. 2009 May 21;
Abstract: The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p/repetitions were obtained using a circumferentially vented face mask and small translabial tube. All participants were recorded on or near days 7 and 14 of their menstrual cycle. Subglottal pressure (P(SG)) and average airflow rates were obtained to determine laryngeal airway resistance. Glottal airflow measures of peak flow, minimum flow, alternating flow, as well as relative sound level (RSL) were obtained. P(SG) was obtained from the pressure peak associated with/p/. All airflow parameters and RSL were obtained from the vowel portion. No significant differences were found related to day of recording or OC use, indicating that OC use does not significantly affect laryngeal airflow regulation. LEARNING OUTCOMES: The reader will better understand the effects of hormones and oral contraceptives on the female voice, as well as the specific changes in vocal function that may occur in conjunction with the use of oral contraceptives.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUAL CYCLE | ESTROGENS | PROGESTERONE | ORAL EFFECTS | EDEMA | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Menstruation | Reproduction | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Signs and Symptoms | Diseases
Document Number: 341750

23.

Title: Report on the FIGO-SOGP Saving the Mothers and Newborn Health Project in Pakistan. An NFOG concern [editorial]
Author: Grunewald C; Moller B
Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(2):132-3.
Abstract: FIGO is increasing its involvement in female health matters around the world. Funds have been solicited for Saving the Mothers and Newborn Health Projects in 12 developing countries. The obstetrics and gynecology society and midwifery association of each project country has been affiliated to a Western society, in what is called 'twinning'. The Swedish Association of Obstetricians and Gynecologists (SFOG) has twinned with the Society of Obstetricians and Gynaecologists of Pakistan (SOGP). The SFOG board has signed a letter of understanding. A similar arrangement has been created between the Danish society (DSOG) and its Nigerian counterpart. Both twinning projects are supported by NFOG. In Pakistan, achievements so far are promising despite formidable problems in society, health care and security. (excerpt)
Language: English
Keywords:
PAKISTAN | GLOBAL | RESEARCH REPORT | MOTHERS | INFANT | MATERNAL HEALTH | POSTPARTUM | BLEEDING | SAFE MOTHERHOOD | REPRODUCTIVE HEALTH | Developing Countries | Asia, Southern | Asia | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Puerperium | Reproduction | Signs and Symptoms | Diseases
Document Number: 330197

24.

Peer Reviewed

Title: Uterine artery embolization to treat hemorrhage following second-trimester abortion by dilatation and surgical evacuation.
Author: Haddad L; Delli-Bovi L
Source: Contraception. 2009 Jun;79(6):452-5.
Abstract: BACKGROUND: This study was conducted to review cases of second-trimester postabortal hemorrhage (PAH) occurring at a private women's health facility that were treated with uterine artery embolization (UAE). METHODS: A retrospective review was conducted on all second-trimester terminations performed at a private women's health facility between 1999 and 2006. Cases of PAH treated with UAE were reviewed in detail, reviewing progress, operative and discharge notes along with anesthesia records. RESULTS: Fifteen cases of PAH were identified among 3936 second-trimester terminations that were performed. Seven cases were identified in which UAE was used to treat PAH. Etiologies leading to hemorrhage varied in the seven cases as did the presence of coexisting factors such as infection and anatomic lesions. All cases were successfully treated by UAE, requiring no additional surgical intervention. CONCLUSION: Given the success of embolization, we offer this as an alternative to exploratory surgery and hysterectomy and as a first-line approach in cases of PAH after conservative management strategies have failed.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANCY, SECOND TRIMESTER | POSTABORTION | POSTABORTION CARE | BLEEDING | TREATMENT | Developed Countries | North America | Americas | Studies | Research Methodology | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Medical Procedures | Medicine
Document Number: 342598

25.

Peer Reviewed

Title: Scheduled and unscheduled bleeding patterns with two combined hormonal contraceptives: application of new recommendations for standardization.
Author: Hampton RM; Fisher AC; Pagano S; LaGuardia KD
Source: Fertility and Sterility. 2009 Aug;92(2):434-40.
Abstract: OBJECTIVE: To reassess and compare cycle control attained with two combined hormonal contraceptives, norgestimate (NGM)/ethinyl estradiol (EE) 25 microg and norethindrone acetate (NETA)/EE 20 microg, by new general criteria recommendations for all combined hormonal contraceptives. DESIGN: Analysis of bleeding data for cycles 1-6 from a randomized, multicenter trial. SETTING: 221 North American centers. PATIENT(S): Healthy, sexually active women (18-45 years old). INTERVENTION(S): NETA/EE: 1 mg NETA/20 microg EE, days 1-21 of each cycle and 75 mg of ferrous fumarate, days 22-28; NGM/EE: triphasic NGM in 7-day increments (days 1-7: 180 microg; days 8-14: 215 microg; days 15-21: 250 microg) and 25 microg EE, placebo on days 22-28. MAIN OUTCOME MEASURE(S): Cycle control evaluated from patients' daily diaries. RESULT(S): For cycles 1-6, there was a statistically significant lower incidence of unscheduled bleeding/spotting with NGM/EE 25 microg (range 21.0%-34.4%) than with NETA/EE 20 microg (range 33.0%-46.6%). Of the women who had unscheduled bleeding/spotting, the mean number of days per cycle of bleeding/spotting was comparable. A statistically significant higher incidence of scheduled bleeding was seen with NGM/EE 25 microg (95.2%-97.5%) than with NETA/EE 20 microg (78.5%-84.2%). CONCLUSION(S): The NGM/EE 25 microg has a lower incidence and comparable length of unscheduled bleeding and a higher incidence of scheduled bleeding than NETA/EE 20 microg in this post hoc analysis.
Language: English
Keywords:
NORTH AMERICA | RESEARCH REPORT | CLINICAL TRIALS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE ACETATE | BLEEDING | STANDARDS | EVALUATION | RECOMMENDATIONS | Developed Countries | Americas | Clinical Research | Research Methodology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Norethindrone | Contraceptive Agents, Progestin | Signs and Symptoms | Diseases
Document Number: 342585

26.

Peer Reviewed

Title: Cervical dilation in second-trimester abortion.
Author: Hayes JL; Fox MC
Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):171-8.
Abstract: Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors such as gestational age and time allowed for preparation should be considered.
Language: English
Keywords:
UNITED STATES OF AMERICA | MARYLAND | RESEARCH REPORT | CERVICAL DILATATION | RISK FACTORS | CERVICAL EFFECTS | BLEEDING | ABORTION | Developed Countries | North America | Americas | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning
Document Number: 342247 Notification

27.

Title: Application of evidence-based teaching in maternal and child health in remote Vietnam.
Author: Hirst JE; Jeffery HE; Morris J; Foster K; Elliott EJ
Source: International Journal of Gynaecology and Obstetrics. 2009 Feb;104(2):152-5.
Abstract: OBJECTIVE: To develop, implement, and evaluate an evidence-based multidisciplinary teaching program to improve maternal and infant health in remote Vietnam. METHODS: Needs assessments identified prevention of infection, neonatal resuscitation, and prevention of postpartum hemorrhage as primary targets. A 3-day workshop based on the small group, interactive, skills-based SCORPIO method was developed. Participants underwent formative written and performance-based assessments. Qualitative and quantitative evaluation of course content and teaching method was conducted. RESULTS: Two annual workshops were conducted for 58 health professionals, all of whom demonstrated skills acquisition to an adequate standard on completion. The workshops were rated as good or excellent overall by 100% of the participants, who reported that the content would help with their clinical work and that the teaching method was acceptable and easy to understand. CONCLUSION: We demonstrated the SCORPIO method can be adapted to teach knowledge and clinical skills in remote Vietnam. Further work is needed to demonstrate an effect on health outcomes.
Language: English
Keywords:
VIETNAM | RESEARCH REPORT | NEEDS ASSESSMENT | POSTPARTUM WOMEN | BLEEDING | HEALTH EDUCATION | CHILD HEALTH | MATERNAL HEALTH | Asia, Southeastern | Asia | Developing Countries | Evaluation | Puerperium | Reproduction | Signs and Symptoms | Diseases | Education | Health
Document Number: 330824

28.

Title: Spontaneous hepatic hemorrhage secondary to prolonged use of oral contraceptives.
Author: Jaffar R; Pechet L; Whalen GF; Banner BF
Source: Pathology, Research and Practice. 2009 Jul 3;
Abstract: Oral contraceptive pills (OCP) are the most commonly used form of contraception throughout the United States of America. The prolonged usage of oral contraceptives leads to a variety of complications, ranging from subclinical modifications of liver function tests to the development of benign and malignant tumors of the liver. Spontaneous hepatic hemorrhage secondary to oral contraceptive use was only reported once in the early 1980s. We report a case of spontaneous hepatic hemorrhage secondary to prolonged ingestion of combined OCPs followed by multiple pulmonary emboli without underlying thrombophilia.
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | CASE HISTORIES | ORAL CONTRACEPTIVES, SIDE EFFECTS | ADMINISTRATION AND DOSAGE | HEPATIC EFFECTS | BLEEDING | HEMATOMA | PULMONARY EMBOLISM | SURGERY | Developed Countries | North America | Americas | Data Collection | Research Methodology | Contraceptive Safety | Safety | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Physiology | Biology | Signs and Symptoms | Diseases | Embolism | Vascular Diseases
Document Number: 341974

29.
Peer Reviewed

Title: Postpartum haemorrhage and eclampsia: differences in knowledge and care-seeking behaviour in two districts of Bangladesh.
Author: Kalim N; Anwar I; Khan J; Blum LS; Moran AC; Botlero R; Koblinsky M
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):156-69.
Abstract: In high- and low-performing districts of Bangladesh, the study explored the demand-side of maternal healthcare by looking at differences in perceived knowledge and care-seeking behaviours of women in relation to postpartum haemorrhage or eclampsia. Haemorrhage and eclampsia are two major causes of maternal mortality in Bangladesh. The study was conducted during July 2006-December 2007. Both postpartum bleeding and eclampsia were recognized by women of different age-groups as severe and life-threatening obstetric complications. However, a gap existed between perception and actual care-seeking behaviours which could contribute to the high rate of maternal deaths associated with these conditions. There were differences in care-seeking practices among women in the two different areas of Bangladesh, which may reflect sociocultural differences, disparities in economic and educational opportunities, and a discrimination in the availability of care.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | POSTPARTUM | BLEEDING | ECLAMPSIA | KNOWLEDGE | UTILIZATION OF HEALTH CARE | MATERNAL MORTALITY | PREGNANCY COMPLICATIONS | PERCEPTION | SOCIOCULTURAL FACTORS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Puerperium | Reproduction | Signs and Symptoms | Diseases | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Psychological Factors | Behavior
Document Number: 341993

30.

Peer Reviewed

Title: Challenges in managing postpartum hemorrhage in resource-poor countries.
Author: Karoshi M; Keith L
Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):285-98.
Abstract: Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | TRADITIONAL BIRTH ATTENDANTS | POSTPARTUM WOMEN | BLEEDING | EXAMINATIONS AND DIAGNOSES | TREATMENT | MANAGEMENT | Health Personnel | Delivery of Health Care | Health | Puerperium | Reproduction | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Organization and Administration
Document Number: 342241


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