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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

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Peer Reviewed

Title: Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet.
Author: Balan IC; Carballo-Dieguez A; Ventuneac A; Remien RH
Source: AIDS Education and Prevention. 2009 Feb;21(1):14-24.
Abstract: Data on intentional condomless anal intercourse in risky contexts, also known as "barebacking," among ethnic minority MSM, whose rates of HIV infection continue to rise, are extremely limited. In this study, 31 Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex owing to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. Although a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV risk behavior. In this sample, culture did not seem to play a large role in barebacking.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | ETHNIC GROUPS | ANAL SEX | CONDOM USE | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | PARTNER COMMUNICATION | DRUG USE AND ABUSE | HIV TRANSMISSION | PERCEPTION | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Cultural Background | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Information Networks | Communication | Interpersonal Relations | HIV Infections | Viral Diseases | Diseases | Psychological Factors
Document Number: 330344  

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Peer Reviewed

Title: Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men.
Author: Bauermeister JA; Carballo-Dieguez A; Ventuneac A; Dolezal C
Source: AIDS Education and Prevention. 2009 Apr;21(2):156-68.
Abstract: Although condom use is an effective barrier against HIV transmission, some men who have sex with men (MSM) engage in bareback sex (unprotected anal sex in risky contexts) and increase their risk for HIV (re)infection. Understanding MSM's decision to bareback (vis-a-vis condom use) is essential to develop effective HIV/AIDS prevention programs for this population. An ethnically diverse sample of men who bareback (n = 120) was recruited exclusively on the Internet and stratified to include two thirds who reported both unprotected receptive anal intercourse (URAI) and being HIV uninfected. We used exploratory factor analysis to explore the domains within the Decisional Balance to Bareback (DBB) scale, and test the association between DBB and risky sexual behaviors. HIV-positive MSM (n = 31) reported higher costs/losses associated with condom use than HIV-negative men (n = 89). We found two underlying factors in the DBB scale: a Coping with Social Vulnerabilities subscale (eight items; alpha = .89) and a Pleasure and Emotional Connection subscale (five items; alpha = .92). We found a positive association between DBB (i.e. greater gains associated with bareback sex) and URAI occasions, number of partners, and having one or more sero-discordant partners in the past 3 months. We conclude that because MSM may avoid using condoms in order to cope with psychosocial vulnerabilities and create intimacy with other MSM, this population could benefit from alternatives to condoms such as pre/post exposure prophylaxis and rectal microbicides.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | FACTOR ANALYSIS | ANAL SEX | CONDOM USE | HIV TRANSMISSION | DECISION MAKING | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | EMOTIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Data Analysis | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Information Networks | Communication | Psychological Factors
Document Number: 331286  

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Peer Reviewed

Title: Cervical obstruction complicating second-trimester abortion: treatment with misoprostol.
Author: Borgatta L; Sayegh R; Betstadt SJ; Stubblefield PG
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):548-50.
Abstract: BACKGROUND: Cervical cone biopsy or loop electrosurgical excision procedures (LEEP) may lead to cervical scarring, agglutination, or stenosis. Leiomyomas may also obstruct the lower uterine segment such that instruments cannot be passed from the vagina to the gestation. CASE: Two women requested second trimester abortion. Both women had undergone cervical LEEP. In addition, one woman had a 10-cm leiomyoma, which seemed to be obstructing the lower segment. In both, the external cervical os was essentially obliterated. After administration of misoprostol, the cervix softened markedly in 18-24 hours. In both women, the cervix dilated readily and allowed dilation and evacuation of the uterus. CONCLUSION: Misoprostol resulted in the ability to evacuate the uterus vaginally, in a situation that might have otherwise resulted in hysterotomy.
Language: English

Keywords:
MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | CERVICAL EFFECTS | CERVICAL LACERATION | GROWTH | TIME FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Diseases | Child Development | Population Dynamics
Document Number: 330357   Notification

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Peer Reviewed

Title: Group a Streptococcus causing necrotizing fasciitis and toxic shock syndrome after medical termination of pregnancy.
Author: Daif JL; Levie M; Chudnoff S; Kaiser B; Shahabi S
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):504-6.
Abstract: BACKGROUND: Group A Streptococcus is an aerobic gram-positive bacteria known to cause cutaneous infections. Invasive infections can lead to toxic shock syndrome with multiorgan failure and mortality rates of 25-48%. CASE: A healthy, young woman developed necrotizing fasciitis, myonecrosis, and toxic shock syndrome after an elective medical termination of pregnancy. This patient had confirmed group A Streptococcus on blood cultures and underwent surgical debridement. After aggressive surgical treatment, below-the-knee amputation, and antibiotic therapy, the patient survived. CONCLUSION: This case demonstrates the need for prompt recognition and treatment of necrotizing fasciitis/toxic shock syndrome.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | HISPANICS | WOMEN | BACTERIAL AND FUNGAL DISEASES | DERMATITIS | TOXIC SHOCK SYNDROME | ABORTION | GYNECOLOGIC SURGERY | SURGERY | ANTIBIOTICS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Fertility Control, Postconception | Family Planning | Urogenital Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs
Document Number: 330358   Notification

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Title: Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy.
Author: Epplein M; Reed SD; Voigt LF; Newton KM; Holt VL; Weiss NS
Source: Annals of Epidemiology. 2009 Jan;19(1):1-7.
Abstract: PURPOSE: We sought to examine the relationship between recent use of oral contraceptives and hormone therapy and endometrial hyperplasia (EH) risk. METHODS: Cases comprised women diagnosed with complex EH (n = 289) or atypical EH (n = 173) between 1985 and 2003. One age-matched control was selected for each case; excluded were women with a prior hysterectomy or diagnosis of EH or endometrial cancer. Hormone use in the 6 months prior to the date of the case's first symptoms was ascertained using a pharmacy database and medical records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Three (1.1%) cases had used oral contraceptives, compared to 16 (6.0%) controls (OR = 0.2, 95% CI: 0.0-0.6). Fifty-one (16.8%) cases had taken estrogen-only hormone therapy, in contrast to two (0.7%) controls (OR = 37.6, 95% CI: 8.8-160.0). The risk of EH among estrogen plus progestin hormone users did not differ from that of non-users (OR = 0.7, 95% CI: 0.4-1.1). CONCLUSIONS: This study suggests that previous findings of the association of estrogen-only hormone therapy with increased risk of EH and the lack of an association between estrogen plus progestin hormone therapy and EH risk are likely to apply to both complex EH and atypical EH. Further examination of the association between oral contraceptives and EH, with greater numbers of OC users, is warranted.
Language: English

Keywords:
WASHINGTON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | ENDOMETRIAL CANCER | HORMONE REPLACEMENT THERAPY | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Measurement | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Population Dynamics | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods
Document Number: 330386  

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Title: Comparison of Sexual Partnership Characteristics and Associations with Inconsistent Condom Use among a Sample of Adolescents and Adult Women Diagnosed with Chlamydia trachomatis.
Author: Foulkes HB; Pettigrew MM; Livingston KA; Niccolai LM
Source: Journal of Women's Health. 2009;18(3):393-399.
Abstract: Abstract Background: This analysis compared characteristics of female adolescent and adult sexual partnerships and related these characteristics to inconsistent condom use. Methods: Data are from a study of 126 women with prevalent chlamydia infections who reported information about 172 sexual partnerships in the previous 3 months. Characteristics of sexual partnerships included type of partner (main vs. other), duration of sexual relationship (<3 months vs. >/=3 months), partner age difference (<2 years older vs. >/=2 years older), and two scale measures: overlap of social networks (a measure based on how well the participant knew her partner's friends, for example) and intimacy. Results: Compared with adult partnerships, adolescent partnerships were of shorter duration and had less social overlap but were more likely to be classified by the participants as main partnerships. Among adolescents, longer partnership duration was not associated with higher intimacy, yet higher intimacy was significantly correlated with inconsistent condom use. Conclusions: These differences suggest that adolescent females perceive and characterize their sexual relationships differently from adults. This, in turn, may have implications for risk of sexually transmitted infections (STIs). Prevention efforts for adolescents, including interventions and counseling, should consider the nature of their sexual partnerships.
Language: English

Keywords:
CONNECTICUT | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CONTRACEPTIVE PREVALENCE SURVEYS | SEXUAL PARTNERS | ADOLESCENTS, FEMALE | WOMEN | SOCIAL NETWORKS | CONDOM USE | CHLAMYDIA | AGE FACTORS | TIME FACTORS | PERCEPTION | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Behavior | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Population Dynamics | Psychological Factors
Document Number: 330416  

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Peer Reviewed

Title: A 15-Minute Interactive, Computerized Condom Use Intervention With Biological Endpoints.
Author: Grimley DM; Hook EW 3rd
Source: Sexually Transmitted Diseases. 2009 Feb;36(2):73-78.
Abstract: BACKGROUND:: Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. METHODS:: Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. RESULTS:: The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). CONCLUSIONS:: These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff.
Language: English

Keywords:
ALABAMA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | STATISTICAL REGRESSION | THEORETICAL MODELS | BLACKS | COMPUTER PROGRAMS AND PROGRAMMING | GONORRHEA | CHLAMYDIA | CONDOM USE | AUDIOVISUAL AIDS | TIME FACTORS | RISK ASSESSMENT | CONTRACEPTIVE PREVALENCE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Educational Methods | Educational Activities | Education | Population Dynamics | Evaluation | Contraceptive Usage | Contraception | Family Planning
Document Number: 329674  

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Peer Reviewed

Title: The relationship of sexual dyad and personal network characteristics and individual attributes to unprotected sex among young injecting drug users.
Author: Gyarmathy VA; Neaigus A
Source: AIDS and Behavior. 2009 Apr;13(2):196-206.
Abstract: We examine in the heterosexual partnerships (dyads) of IDUs the correlates of engaging in unprotected sex on three levels: individual attributes, social network characteristics, and dyad characteristics. Unprotected sex was significantly less likely to occur in dyads where the participant injected daily or had high safe-sex attitude scores, and in dyads where both members encouraged each other to use condoms. Unprotected sex was significantly more likely to occur in dyads that smoked crack together, shared needles with each other, and where the participant knew that the sex partner had concurrent sex partners. In the sexual dyads of IDUs there is a combined risk of unsafe injecting and unsafe sex. Both injecting and sexual risk, and their combination need to be addressed in interventions that target the sexual partnerships of IDUs. Such interventions should also aim to reduce injected and noninjected crack and other stimulant use associated with high-risk sex.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | SEXUAL PARTNERS | IV DRUG USERS | SOCIAL NETWORKS | COUPLES | HETEROSEXUALS | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | ATTITUDES | CONDOM USE | NEEDLE SHARING | DRUG USE AND ABUSE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Friends and Relatives | Family and Household | Sociocultural Factors | Family Characteristics | Psychological Factors | Risk Reduction Behavior
Document Number: 340121  

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Title: A test that won't die: the serologic test for syphilis [editorial]
Author: Katz LM
Source: Transfusion. 2009 Apr;49(4):617-9.
Abstract: We (the blood community and the regulators) are unable to articulate an answer to the question "how safe is safe enough?" for the set of blood safety measures we have already implemented.We must address this fundamental policy issue to establish priorities for our menu of potential future threats and interventions and to move solutions through development and deploy them with the urgency their importance demands. The experience of four decades with no recognized transfusion-transmitted syphilis, during which we have implemented a manylayered approach to blood safety addressing a substantial proportion of the risk of T. pallidum infection in the donor base, suggests that the time is ripe to reconsider the use of STS. (excerpt)
Language: English

Keywords:
IOWA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | BLOOD DONORS | SYPHILIS | TESTING | SEROCONVERSION | BLOOD TRANSFUSION | SEXUALLY TRANSMITTED DISEASE PREVENTION | United States of America | North America | Americas | Developed Countries | Research Methodology | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Immunity | Immune System | Physiology | Biology | Treatment
Document Number: 331247  

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Peer Reviewed

Title: Adrenal glucocorticoid and androgen precursor dissociation in anorexia nervosa.
Author: Lawson EA; Misra M; Meenaghan E; Rosenblum L; Donoho DA; Herzog D; Klibanski A; Miller KK
Source: Journal of Clinical Endocrinology and Metabolism. 2009 Apr;94(4):1367-71.
Abstract: CONTEXT: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs. OBJECTIVE: The aim of the study was to determine whether adrenal steroidogenesis dysregulation contributes to decreased androgen levels in anorexia nervosa. Design and Setting: We conducted a cross-sectional study in a General Clinical Research Center. STUDY PARTICIPANTS: We studied 20 women with anorexia nervosa [10 women with anorexia nervosa receiving OCPs (AN+E) and 10 not receiving OCPs (AN-E)] and 20 healthy controls [10 healthy controls receiving OCPs (HC+E) and 10 not receiving OCPs (HC-E)]. MAIN OUTCOME MEASURES: We measured DHEA and cortisol levels in response to 250-microg cosyntropin stimulation after 1-mg overnight dexamethasone suppression. RESULTS: Mean basal and stimulated, peak stimulated, and area under the curve (AUC) cortisol levels were higher in AN-E than HC-E, but mean basal and stimulated, peak and AUC DHEA were comparable. Mean AUC and peak cortisol were higher and DHEA AUC was lower in AN+E than AN-E. However, after controlling for cortisol binding globulin levels, peak and AUC cortisol were comparable between AN+E and AN-E. After controlling for albumin levels, AUC DHEA was comparable between AN+E and AN-E. CONCLUSIONS: Adrenal glucocorticoid and androgen precursor secretion are dissociated in anorexia nervosa, with relative hypercortisolemia and a preservation of DHEA secretion. Reduced DHEA response to cosyntropin in women receiving OCPs is attributable to decreased albumin levels. In the setting of relative hypercortisolemia, reduced adrenal androgen precursor secretion is not a mechanism underlying low testosterone levels in anorexia nervosa.
Language: English

Keywords:
MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN | DEFICIENCY DISEASES | BODY WEIGHT | TESTOSTERONE | ORAL CONTRACEPTIVES, SIDE EFFECTS | DEHYDROEPIANDROSTERONE | ANDROGENS | DEXAMETHASONE ACETATE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | Hormones | Endocrine System | Contraceptive Safety | Safety | Public Health | Health
Document Number: 341132  

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Title: Self-reported and P3 event-related potential evaluations of condoms: does what we say match how we feel?
Author: Lust SA; Bartholow BD
Source: Psychophysiology. 2009 Mar;46(2):420-4.
Abstract: Research consistently reveals positive self-reported condom evaluations, yet such evaluations often do not predict condom use. Whereas positive self-reports likely reflect social norms regarding prevention of diseases and pregnancy, psychophysiological measures might better assess spontaneous condom evaluations. Here, participants completed a visual oddball task in which condoms and alcoholic beverages were infrequent targets among neutral, positive, and negative context images. Although self-reported condom evaluations were very positive, condom images presented in a negative context produced a smaller P3 than condom images presented in a neutral or positive context, suggesting that spontaneous condom evaluations were more negative than positive. The P3 elicited by alcohol images indicated positive evaluations. The findings underscore the multifaceted nature of evaluations and point to the utility of ERPs for assessing health-related attitudes.
Language: English

Keywords:
MISSOURI | RESEARCH REPORT | KAP SURVEYS | STUDENTS | CONDOM USE | UNIVERSITIES | SELF-PERCEPTION | ALCOHOL USE AND ABUSE | VALUE ORIENTATION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION | ATTITUDES | PHYSIOLOGY | CENTRAL NERVOUS SYSTEM EFFECTS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Education | Risk Reduction Behavior | Behavior | Schools | Perception | Psychological Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Family Planning | Biology | Central Nervous System
Document Number: 331226  

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Peer Reviewed

Title: Rates of follow-up and repeat pregnancy in the 12 months after first-trimester induced abortion.
Author: Madden T; Westhoff C
Source: Obstetrics and Gynecology. 2009 Mar;113(3):663-8.
Abstract: OBJECTIVE: To estimate the proportion of women who returned for a routine follow-up visit after elective abortion and to identify factors associated with repeat pregnancy in the subsequent year. METHODS: We performed a historical cohort study of 865 women who underwent first-trimester surgical abortion at a hospital-based family planning clinic between March 2003 and February 2004. We collected demographic and clinical data from procedure notes and a computerized hospital patient database. We used univariable and multivariable logistic regression to analyze associations between patient characteristics and repeat pregnancy within 1 year. RESULTS: There were a total of 865 women in our cohort. Of these, 753 (87%) returned to the medical center for care; 485 women returned on time, 268 women returned late, and 112 had no further visit. There were 161 repeat pregnancies; 87 (17.9%) in the on-time group and 74 (27.6%) in the late group (P<.001). There were 85 repeat abortions; 42 (8.7%) in the on-time group and 43 (16.0%) in the late group (P<.001). Multivariable analysis demonstrated that on-time follow-up was associated with a reduction in repeat pregnancy (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.37-0.77) and repeat abortion (OR 0.53, 95% CI 0.33-0.86). A total of 130 women received injectable depot medroxyprogesterone acetate (DMPA) at the time of abortion. The rates of repeat pregnancy and abortion in these women were 13.7% and 6.2%, respectively. Women who received DMPA had a decrease in rates of repeat pregnancy (OR 0.41, 95% CI 0.23-0.73) and repeat abortion (OR 0.45, 95% CI 0.20-0.99). CONCLUSION: Timely follow-up and immediate administration of DMPA are associated with a decrease in repeat pregnancy in the 12 months after first-trimester elective abortion.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | TIME FACTORS | PREGNANCY RATE | DEPO-PROVERA | POSTABORTAL PROGRAMS | Developed Countries | United States of America | North America | Americas | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Population Dynamics | Fertility Measurements | Fertility | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Family Planning Programs
Document Number: 331068  

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Peer Reviewed

Title: Successful management of second-trimester postabortion hemorrhage with an intrauterine tamponade balloon.
Author: Madden T; Burke AE
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):501-3.
Abstract: BACKGROUND: Legally induced abortion is a safe procedure. However, hemorrhage is a significant cause of abortion-related morbidity and mortality. We describe a case in which a uterine tamponade balloon was successfully used to control a second-trimester postabortion hemorrhage. CASE: A gravida 1 para 0 woman underwent dilation and evacuation at 18 weeks of gestation for fetal aneuploidy. Her procedure was complicated by intraoperative hemorrhage not resulting from uterine atony. This was successfully managed by tamponade with a large intrauterine balloon. CONCLUSION: Uterine balloon tamponade should be considered in the management of second-trimester postabortion hemorrhage unresponsive to medical therapy.
Language: English

Keywords:
WASHINGTON | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | PREGNANCY, SECOND TRIMESTER | POSTABORTION | POSTABORTION CARE | BLEEDING | ABORTION | TREATMENT | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning | Medical Procedures | Medicine
Document Number: 330359   Notification

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Peer Reviewed

Title: Demographic and personality factors as predictors of HIV/STD partner-specific risk perceptions: implications for interventions.
Author: Mehrotra P; Noar SM; Zimmerman RS; Palmgreen P
Source: AIDS Education and Prevention. 2009 Feb;21(1):39-54.
Abstract: Although risk perception as a motivator of precautionary behavior is a key component of several health behavior theories, this motivational hypothesis has found mixed support in the HIV/AIDS area. This may be, in part, because risk perceptions are more complex than they are treated in many studies of the motivational hypothesis. The current study examines demographic, personality, and sexual risk factors as predictors of partner-specific (main vs. casual) HIV/STD risk perceptions in a sample of 1,489 young adults. As expected, perceptions of HIV/STD risk were higher in the context of "casual" as compared with "main" partnerships. Although univariate analyses demonstrated that gender, race/ethnicity, sensation seeking, impulsivity, number of partners, and condom use all influenced HIV/STD risk perceptions, only gender, condom use, and race/ethnicity remained significant in multivariate analyses. Implications of these results for the design of efficacious HIV prevention interventions are discussed.
Language: English

Keywords:
KENTUCKY | RESEARCH REPORT | KAP SURVEYS | THEORETICAL MODELS | SEXUAL PARTNERS | YOUTH | DEMOGRAPHIC FACTORS | PERSONALITY | HIV PREVENTION | PERCEPTION | RISK ASSESSMENT | SEXUALLY TRANSMITTED DISEASE PREVENTION | SEX BEHAVIOR | MOTIVATION | RISK BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Age Factors | Population Characteristics | Population | Psychological Factors | HIV Infections | Viral Diseases | Diseases | Evaluation | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections
Document Number: 331082  

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Title: Voice onset time in women as a function of oral contraceptive use.
Author: Morris RJ; Gorham-Rowan MM; Herring KD
Source: Journal of Voice. 2009 Jan;23(1):114-8.
Abstract: Previous studies of the effect of hormonal changes across phases of the menstrual cycle on voice onset time (VOT) have not considered the variable of oral contraceptive use. The purpose of this study was to examine both the effects of menstrual cycle phase and that of oral contraceptive use on VOT. It was hypothesized that women taking oral contraceptives would exhibit smaller VOT differences across the phases of their menstrual cycles. The study was a prospective matched-group experimental design. Participants were 10 women who were on oral contraceptives and 10 who were not. The participants were recorded over two menstrual cycles, on the 10th and 20th day to evaluate their speech during the preovulation and premenstrual phases of their menstrual cycle. Participants produced 10 repetitions of the phrase "Speak ___ to me" containing the target syllables /bae/ and /pae/. Repeated measure ANOVAs revealed no significant differences in VOT between the two groups. Statistical results showed significant interactions between the menstrual cycle phase and the 2 recording months. It is possible that month-to-month differences in hormonal levels and other factors that can affect speech may have a greater effect on VOT than either the taking of oral contraceptives or the phase differences within a menstrual cycle.
Language: English

Keywords:
FLORIDA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | MATCHED GROUPS | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | MENSTRUAL CYCLE | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Control Groups | Demographic Factors | Population | Contraceptive Safety | Safety | Public Health | Health | Menstruation | Reproduction
Document Number: 331291  

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Title: Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner Syndrome.
Author: Murphy EH; Davis CM; Journeycake JM; Demuth RP; Arko FR
Source: Journal of Vascular Surgery. 2009 Mar;49:697-703.
Abstract: OBJECTIVE: May-Thurner syndrome is characterized by left common iliac obstruction secondary to compression of the left iliac vein by the right common iliac artery against the fifth-lumbar vertebra. This anatomic variant results in an increased incidence of left-sided deep venous thrombosis (DVT). Furthermore, while a preponderance of left-sided DVT has been demonstrated in women during pregnancy and oral contraceptive use, patients are not typically screened for this condition after developing a left-sided DVT. As anticoagulation alone is ineffective for DVT treatment in the setting of May-Thurner anatomy, more aggressive treatment is warranted. Failure to diagnosis this condition predisposes these women to the unnecessary risks of recurrent DVT and post-thrombotic syndrome. METHODS: We present the occurrence of 7 adolescent patients with previously undiagnosed May-Thurner syndrome who presented with DVT after the initiation of oral contraceptive steroids (OCP) use. All 7 patients elected to proceed with mechanical thrombolysis/catheter based thrombolysis followed by endovascular stenting and were postoperatively treated with 6 months of warfarin. RESULTS: Mean patient age was 18.3 +/- 3.3 years (range, 16-24 years). Mean time to presentation after initiation of OCP was 5 weeks (range, 2-10 weeks). Mean time to intervention was 16.8 days (range, 10-24 days). All patients were treated with mechanical thrombectomy. Our rate of intraoperative clot resolution was 100%. All 7 patients were treated with self expanding nitinol stents after angioplasty of the iliac vein stenosis with resolution of the stenotic segment. Primary stent patency is 100% (7/7). Mean follow-up time is 13 +/- 13.84 months (range, 6-42 months). There have been no long-term complications related to surgical treatment or anticoagulation. All 7 patients have experienced resolution of left leg swelling and pain and have no evidence of post-thrombotic syndrome or DVT recurrence to date. CONCLUSIONS: Women on OCPs presenting with left-sidediliofemoral DVT should be screened for hypercoagulable disorders and underlying May-Thurner anatomy. Treatment of May-Thurner syndrome should include thrombolysis/thrombectomy and anticoagulation for current DVT in addition to angioplasty and stenting of the underlying obstruction.
Language: English

Keywords:
TEXAS | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | VASCULAR DISEASES | ORAL CONTRACEPTIVES, SIDE EFFECTS | THROMBOSIS | TIME FACTORS | TREATMENT | SURGERY | BLOOD COAGULATION EFFECTS | EDEMA | PAIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Contraceptive Safety | Safety | Public Health | Health | Thromboembolism | Embolism | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Hematological Effects | Hemic System | Physiology | Biology | Signs and Symptoms
Document Number: 329670  

18.
Title: Gene knockouts that affect male fertility: novel targets for contraception.
Author: Naz RK; Engle A; None R
Source: Frontiers In Bioscience. 2009;14:3994-4007.
Abstract: There is an urgent need for a better method of contraception that is accepted, effective, and available, due the population explosion and unintended pregnancy. Various targets are being investigated that can be used for contraception. The ideal target should be non-steroidal, intercourse-independent, non-surgical, reversible, and non-barrier with no side effects. The gene knockout technology is a powerful approach to identify such novel targets. We identified at least 93 genes whose deletion demonstrated an effect on fertility in male mice till 2004 (1). In the present article, we found 71 additional gene knockouts in the database since the last report which demonstrated an effect on male fertility. The majority of these knockouts also demonstrated an effect on non-reproductive organs concomitant with an anti-fertility effect or effect on other organs was not examined. The knockouts of only a few genes/proteins induced a specific effect on fertility without a serious side effect. These genes/proteins may provide novel targets for contraception/contraceptive vaccine development.
Language: English

Keywords:
WEST VIRGINIA | RESEARCH REPORT | CLINICAL RESEARCH | MEN | LABORATORY ANIMALS | GENETICS | REPRODUCTIVE BEHAVIOR | SEX BEHAVIOR | REVERSIBLE STERILIZATION | MALE STERILIZATION | CHROMOSOME ABNORMALITIES | PROTEINS | CONTRACEPTIVE VACCINES | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Biology | Fertility | Population Dynamics | Behavior | Sterilization, Sexual | Family Planning | Neonatal Diseases and Abnormalities | Diseases | Physiology | Contraception, Immunological | Contraception
Document Number: 330601  

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Peer Reviewed

Title: Accuracy of information given by Los Angeles County pharmacies about emergency contraceptives to sham patient in need.
Author: Nelson AL; Jaime CM
Source: Contraception. 2009 Mar;79(3):206-10.
Abstract: BACKGROUND: As emergency contraception (EC) becomes increasingly available without prescription, it is important that women in need be provided accurate information about its use. STUDY DESIGN: A telephone survey of all retail pharmacies in Los Angeles County was conducted by women posing as a 23-year-old who wanted to prevent pregnancy after an unprotected act of intercourse. RESULTS: One thousand four hundred sixty unduplicated pharmacies listed in the Yellow Pages 2007 were called between October 2007 and April 2008. Sixty-nine percent had EC available on site; 19% referred the caller elsewhere. The remainder said nothing could be done or hung up. Multiple calls and multiple recitations of the situation were needed in over one third of calls. Isolated incidents of inappropriate comments occurred. CONCLUSION: While most pharmacies provided information about EC that was consistent with labeling, barriers still exist to both accurate information and timely access to that product.
Language: English

Keywords:
CALIFORNIA | RESEARCH REPORT | SURVEYS | WOMEN | PHARMACISTS | PHARMACY DISTRIBUTION | FAMILY PLANNING EDUCATION | EMERGENCY CONTRACEPTION | TELECOMMUNICATIONS | United States of America | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Education | Contraception | Family Planning | Broadcast Media | Mass Media | Communication
Document Number: 330057  

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Title: Antiepileptic drugs: are women aware of interactions with oral contraceptives and potential teratogenicity?
Author: Pack AM; Davis AR; Kritzer J; Yoon A; Camus A
Source: Epilepsy and Behavior. 2009 Apr;14(4):640-4.
Abstract: Women with epilepsy (WWE)'s knowledge of the interaction between antiepileptic drugs (AEDs) and oral contraceptives (OCs) and the potential teratogenicity of AEDs has received limited study. We conducted a cross-sectional questionnaire study (English or Spanish) among young WWE (18-44 years) to assess demographic characteristics, current AED use, and knowledge of AED interactions with OCs and teratogenicity. We used the Food and Drug Administration's classification system to categorize each AED's teratogenic potential. Participants (n=148) had a mean age of 32 years (SD 8); 32% spoke Spanish and described themselves as Hispanic. Among women prescribed a cytochrome p450-inducing AED, 65% were unaware of decreased OC efficacy. Forty percent of those prescribed Category D AEDs were unaware of potential teratogenic effects. WWE have limited knowledge of the potential interaction between AEDs and OCs and the teratogenic effects of AEDs. Educational efforts should highlight the reproductive health effects of AEDs in WWE.
Language: English

Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN | HISPANICS | ORAL CONTRACEPTIVES, SIDE EFFECTS | DRUG INTERACTIONS | CENTRAL NERVOUS SYSTEM EFFECTS | KNOWLEDGE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Contraceptive Safety | Safety | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Central Nervous System | Physiology | Biology | Sociocultural Factors
Document Number: 341110  

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Peer Reviewed

Title: Characteristics of women who sought emergency contraception at a university-based women's health clinic.
Author: Parrish JW; Katz AR; Grove JS; Maddock J; Myhre S
Source: American Journal of Obstetrics and Gynecology. 2009 May 7;201
Abstract: OBJECTIVE: The purpose of this study was to identify unique characteristics for seeking emergency contraception (EC) among sexually active unmarried women who attended a university-based women's health clinic (WHC). STUDY DESIGN: Three hundred nine consecutive women who attended the women's health clinic for 3 months of the 2006 spring semester completed an anonymous self-administered questionnaire. Fisher exact and the Student t tests were used to assess bivariate associations, and step-wise regression was used to determine independent associations. RESULTS: Women who requested EC were more likely to have previously used EC (P < .001), to have had unprotected sex in the past 6 months (P < .001), to have experienced an unintended pregnancy in the past year (P = .009), and to perceive the need for EC use in the next 3 months (P < .001) but were less likely to use hormonal contraception or an intrauterine device (P < .001). CONCLUSION: Our findings support the need for increased education that wouldinclude the use of and access to effective primary contraceptive methods in conjunction with EC awareness.
Language: English

Keywords:
HAWAII | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | WOMEN | STUDENTS | UNMARRIED | EMERGENCY CONTRACEPTION | UNIVERSITIES | CONTRACEPTIVE HISTORY | PREGNANCY, UNPLANNED | PERCEPTION | CONTRACEPTIVE USAGE | IUD | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Education | Marital Status | Nuptiality | Contraception | Family Planning | Schools | Reproductive Behavior | Fertility | Population Dynamics | Psychological Factors | Behavior | Contraceptive Methods
Document Number: 341146  

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Peer Reviewed

Title: Follicular development in a 7-day versus 4-day hormone-free interval with an oral contraceptive containing 20 mcg ethinyl estradiol and 1 mg norethindrone acetate.
Author: Rible RD; Taylor D; Wilson ML; Stanczyk FZ; Mishell DR Jr
Source: Contraception. 2009 Mar;79(3):182-8.
Abstract: BACKGROUND: Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate. STUDY DESIGN: Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7. RESULTS: Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mmdiameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups. CONCLUSION: In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC.
Language: English

Keywords:
CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE | ADMINISTRATION AND DOSAGE | MENSTRUATION | TIME FACTORS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Population Dynamics
Document Number: 330059  

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Peer Reviewed

Title: An event-level analysis of condom use as a function of mood, alcohol use, and safer sex negotiations.
Author: Schroder KE; Johnson CJ; Wiebe JS
Source: Archives of Sexual Behavior. 2009 Apr;38(2):283-9.
Abstract: Daily self-reports of condom-protected intercourse were analyzed as a function of emotional states, alcohol consumption, and safer sex negotiations in a sample of single, low-income Hispanic students. The sample included 15 women and 17 men who reported a minimum of four sexual episodes as well as inconsistent condom use over a 3-month self-reporting period. The analyses focused on 829 days out of 2,586 daily self-reports on which sexual intercourse was reported. Hierarchical linear modeling was used to predict condom-protected intercourse as a function of mood states, substance use, and safer sex negotiations. Safer sex negotiation was the strongest positive predictor of condom use. Contrary to expectation, unprotected intercourse was less likely to occur in episodes characterized by greater negative affect and more likely in episodes in which greater positive mood was reported. No main effect of alcohol consumption on safer sex was observed; however, an interaction between alcohol consumption and positive mood emerged, indicating that unprotected intercourse was most likely to occur when positive mood was combined with alcohol consumption. The results contradict the assumption that emotional distress predicts engagement in more risky sexual behavior and indicate that safer sex negotiations are likely to outweigh any effects of mood or alcohol consumption on subsequent condom use.
Language: English

Keywords:
TEXAS | RESEARCH REPORT | KAP SURVEYS | EVENT HISTORY ANALYSIS | LINEAR REGRESSION | HISPANICS | STUDENTS | CONDOM USE | PARTNER COMMUNICATION | ALCOHOL USE AND ABUSE | SAFER SEX | EMOTIONS | STRESS | RISK BEHAVIOR | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Analysis | Statistical Regression | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Education | Risk Reduction Behavior | Behavior | Interpersonal Relations | Psychological Factors
Document Number: 330970  

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Peer Reviewed

Title: Barriers associated with the failure to return for intrauterine device insertion following first-trimester abortion.
Author: Stanek AM; Bednarek PH; Nichols MD; Jensen JT; Edelman AB
Source: Contraception. 2009 Mar;79(3):216-20.
Abstract: BACKGROUND: The aim of the study was to identify barriers associated with the failure to return for delayed intrauterine device (IUD) insertion postabortion. STUDY DESIGN: This study had two components: (a) a retrospective cohort study of women who chose an IUD as their postabortion contraceptive method to compare characteristics of those who did and did not receive a device within 6 months of the procedure and (b) a prospective survey of women intending IUD use postabortion to assess actual IUD use at 6 weeks, barriers to access and attitudes on insertion timing. RESULTS: Of the 500 abortion patient charts available for review during the study period, 53 women intended IUD use postabortion. At 6 months, only 32% intending an IUD received one, and there were no significant demographic differences between the groups. For the prospective portion, the response rate at 6 weeks was 54% (27/50), with only 26% (7/27) of responders reporting IUD insertion by this time. The principal reported barrier to IUD insertion was time needed for an additional visit (41%). Most women (67%) desired immediate insertion and believed that they would be more likely to have an IUD inserted if it is performed immediately postabortion (63%). Monthly income was the only statistically significant difference between those who responded to the 6-week follow-up (US$1409.50) and those who did not (US$937.50, p=.05). CONCLUSION: A significant number of women that express a preference for IUD use after first-trimester abortion do not return to obtain a device. Most would prefer to have the option of immediate insertion.
Language: English

Keywords:
OREGON | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | RETROSPECTIVE STUDIES | WOMEN | POSTABORTION | IUD | TIME FACTORS | CONTRACEPTIVE USAGE | PROGRAM ACCESSIBILITY | ATTITUDES | CONTRACEPTIVE PREVALENCE | PREGNANCY, FIRST TRIMESTER | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior | Pregnancy
Document Number: 341128  

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Peer Reviewed

Title: Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta.
Author: Tocce K; Thomas VW; Teal S
Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):568-70.
Abstract: BACKGROUND: As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE: A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta. CONCLUSION: Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered.
Language: English

Keywords:
COLORADO | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | CESAREAN SECTION | PREGNANCY, SECOND TRIMESTER | PREGNANCY COMPLICATIONS | HYSTERECTOMY | INFECTIONS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Diseases | Gynecologic Surgery | Urogenital Surgery
Document Number: 330356   Notification

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Title: Toxic epidermal necrolysis secondary to emergency contraceptive pills [letter]
Author: Weinberger CH; Bhardwaj SS; Bohjanen KA
Source: Journal of the American Academy of Dermatology. 2009 Apr;60(4):708-9.
Abstract:
Language: English

Keywords:
MINNESOTA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | LEVONORGESTREL | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | OPHTHALMOLOGICAL EFFECTS | ADMINISTRATION AND DOSAGE | EMERGENCY CONTRACEPTION | SIGNS AND SYMPTOMS | DERMATOLOGICAL EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Agents, Estrogen | Oral Contraceptives | Contraceptive Methods | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Contraceptive Safety | Safety | Public Health
Document Number: 330701  

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Peer Reviewed

Title: Do instructions for over-the-counter pre-coital female contraceptives promote "perfect use"?
Author: Zite NB; Wallace LS
Source: Contraception. 2009 Mar;79(3):211-5.
Abstract: BACKGROUND: This study was conducted to estimate the readability and related features of English-language over-the-counter (OTC) pre-coital female contraceptive (PFC) instructions. STUDY DESIGN: We identified and purchased all currently available OTC PFCs (n=8), including Encare (Contraceptive Gel and Insert), F.C. Female Condom, Ortho Options (Conceptrol, Delfen and Gyncol II Jelly), Today Sponge and VCF Vaginal Film. Reading grade level was calculated using the Simple Measure of Gobbledygook. Text point size was measured and total number of graphics was tallied. Graphic dimensions were also measured. We also assessed OTC PFC instructions on four main criteria--derived from the "User-Friendliness Tool (UFT)"--including layout features, graphic characteristics, presence of a clear message and presentation of manageable information. RESULTS: Reading level ranged from 8th to 12th grade (mean+/-SD=10.0+/-1.2). Mean page length was 24.4+/-7.0 cm (9.6+/-2.76 in.), while average page width was 20.3+/-13.8 cm (7.99+/-5.43 in.). Average text point size was 7.9+/-2.3 (range=6-12). Illustrations, predominantly line drawings, were used throughout (range=3-11), and most were similar in size to a matchbox. None of the "How to Use" sections scored high in all criteria on the UFT. CONCLUSIONS: "How to Use" sections of OTC PFC instructions should be revised to be easier to read and more user friendly. Ideally, the gap between "typical" and "perfect" contraceptive efficacy could potentially be narrowed if instructions were developed that the large majority of women could easily understand.
Language: English

Keywords:
TENNESSEE | RESEARCH REPORT | EVALUATION | WOMEN | PHARMACY DISTRIBUTION | USER COMPLIANCE | PROMOTION | LANGUAGE | READING | CONTRACEPTIVE METHODS | FEMALE CONTRACEPTION | FAMILY PLANNING EDUCATION | Developed Countries | United States of America | North America | Americas | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Behavior | Marketing | Economic Factors | Communication | Literacy | Educational Status | Socioeconomic Status | Socioeconomic Factors | Contraception | Family Planning | Education
Document Number: 330056  

28.
Title: Progress in introduction of pneumococcal conjugate vaccine--worldwide, 2000-2008.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2008 Oct 24;57(42):1148-51.
Abstract: Pneumococcal disease is a leading cause of childhood morbidity and mortality globally, causing an estimated 0.7-1.0 million deaths annually among children aged <5 years (1). A pneumococcal conjugate vaccine (PCV) that includes seven pneumococcal serotypes (PCV7) first became available in 2000. Studies in the United States have demonstrated that introduction of universal vaccination with PCV7 resulted in a 77% decrease in invasive pneumococcal disease among children aged <5 years and a 39% decrease in hospital admissions for pneumonia among children aged <2 years (2,3). A similar vaccine with two additional serotypes was highly efficacious against pneumonia and invasive disease in clinical trials in Africa and, in one trial, reduced all-cause mortality among children by 16% (4). Low-income countries, which account for >97% of pneumonia cases in children aged <5 years (5), will benefit most from introduction of PCV. This report summarizes the progress made in introducing PCV7 worldwide. As of August 2008, 26 countries offered PCV7 to all children as part of national immunization programs or had PCV7 in widespread use (i.e., with estimated national coverage >50%); however, none of these countries is a low-income or lower-middle income country. The World Health Organization (WHO) and UNICEF have recognized the safety and effectiveness of PCVs and recommend that these vaccines for young children be included in national immunization programs (1). Overcoming the challenges to global introduction remains an urgent public health priority. (excerpt)
Language: English

Keywords:
MINNESOTA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | MEN | OLDER ADULTS | BACTERIAL AND FUNGAL DISEASES | SKELETAL EFFECTS | BLOOD TRANSFUSION | INSECTS | EMBOLISM | SURGERY |