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Biomedical subjects

Diana Mansour

Publications and source records attributed to Diana Mansour.

14 recordsLinked to original sources
PubMed2006

Delivery systems for hormone replacement therapy.

The steroid hormones used for hormone replacement therapy in the menopausal transition and postmenopause can be administered by several different routes using a variety of delivery systems. The conventional approach to administration has been oral, and this is still the standard against which other routes are compared. However, there is a steadily increasing research development and popularity for alternative systems. Such systems can be geared to ultra low-dose delivery for local vaginal effect or higher dosages for systemic effect. Different delivery systems have a range of attributes with varying appeal to different individual women. Such a range of choices can be important for acceptability and compliance. One of the most important attributes of many newer delivery systems is the potential to deliver hormones in a controlled manner over prolonged periods of time, allowing constant low dosages, as well as constant blood and tissue levels. They also have the potential for reducing side effects and metabolic effects. Transdermal, subdermal, intravaginal and intrauterine systems are particularly likely to undergo refinement and further development in the foreseeable future with subsequent increases in popularity.

Dosage Forms↗
PubMed2006

DMPA and BMD.

Explore the source record for details and available documents.

Bone Density↗
PubMed2006

Female sterilisation: is it what women really want or are alternative contraceptive methods acceptable?

OBJECTIVE: An initial audit was conducted in 2001 to monitor all women referred for female sterilisation. This re-audit in 2003 set out to investigate those women who initially chose alternative reversible contraception and ascertain whether they were still using that method or if they or their partner had requested sterilisation. METHODS: A telephone survey of general practitioners was conducted, 2 years after an initial sterilisation counselling appointment, of those women who initially had chosen alternative, reversible forms of contraception. RESULTS: Information regarding current contraception was obtained for 44 (85%) of the cohort of 52 women. Three women and five of their partners (15.4%) had been sterilised in the intervening 2 years. Two women had undergone hysterectomy for gynaecological reasons. Thirty-four (65.4%) women were using reversible contraceptive methods and 31 (59.6%) were still using the same contraceptive method chosen at the sterilisation counselling appointment. Information was not available for eight (15.4%) women. CONCLUSIONS: Female sterilisation counselling within a contraception and sexual health service successfully offers a full range of contraceptive alternatives. This small audit indicates that at least two-thirds of women who choose one of these alternatives will still be using this method 2 years later. Although the number of women in this audit is small, we suggest that this change in service delivery has contributed to a decline in female sterilisation within the district and has led to an increased use of effective, reversible hormonal contraception within the community and hospital services.

Cohort Studies↗
PubMed2006

Migration of Implanon.

OBJECTIVE: To determine whether or not migration of the Implanon rod does occur if correctly positioned and, if indeed migration does occur, to measure the degree of such migration. METHODS: A prospective study of 100 women who requested and had Implanon rods inserted by one fully trained health care professional holding the Faculty of Family Planning and Reproductive Health Care Letter of Competence in Subdermal Contraceptive Implant Techniques. Measurements were made from the insertion site to the distal end of the rods at 3 and 12 months post-insertion. RESULTS: Of the 100 women studied, 95 were seen for follow-up at 3 months. There was no migration of Implanon in 58 (61%) patients. Of the remaining 37 (39%) patients where migration had occurred, 34 showed migration caudally and only three demonstrated cranial migration. With regard to the degree of migration, all but one case showed this to be less than 2 cm either cranially or caudally. At 1-year follow-up 87 patients were seen. No migration was noted in 39 (45%) patients. In the remaining 48 (55%) patients where migration had occurred, 44 showed migration caudally and only four demonstrated cranial migration, which in one case was over 2 cm. With regard to the degree of migration, all but one case showed this to be less than 2 cm either cranially or caudally. The measurement in the single case showing migration over 2 cm at 3 months remained the same at the 1-year follow-up. CONCLUSIONS: These results show that up to 1 year after insertion of Implanon significant migration of the rod does not occur. The degree of migration noted in all cases except one was less than 2 cm. Where migration was noted, in the majority of cases this occurred caudally towards the insertion site. There were no cases of deep migration.

Adolescent↗
PubMed2006

Location and removal of non-palpable Implanon implants with the aid of ultrasound guidance.

BACKGROUND: Implanon insertion appears to be an easy procedure, but in a small minority of cases difficulties have been encountered with removal if the rod is impalpable. METHODS: Patients were referred to the contraceptive and sexual health service with non-palpable Implanon. Following a clinical assessment and examination of the arm where the implant had been inserted, an ultrasound examination was carried out to identify and locate the implant. These implants were subsequently removed, some under general anaesthesia and others under local anaesthesia. RESULTS: Twenty-seven patients were referred to the unit with impalpable Implanon rods. In four cases the rods were palpable and were removed in the clinic setting without the need for further intervention. Positive identification of the implants was achieved in 21 of the remaining 23 cases using ultrasound. No implant was detected in two cases and etonogestrel was not demonstrated serologically in either woman, suggesting non-insertion. All 21 Implanon rods identified by ultrasound were successfully removed. In just over 52% of women a previous attempt at removal had been undertaken prior to referral. CONCLUSIONS: It is possible to identify and locate impalpable Implanon rods with the aid of ultrasound, facilitating their subsequent safe removal. Although previous reports have identified the position of 'lost' implants using ultrasound, this is the first case series to discuss measuring the skin/implant depth. This parameter, together with the precise position of the implant (in muscle or fat), aids removal. All health professionals inserting and removing contraceptive implants should have been appropriately trained.

Adult↗
PubMed2003

Female sterilisation: is it what women really want?

OBJECTIVE: To audit the effectiveness of a female sterilisation counselling clinic. DESIGN: A prospective, observational study of a female sterilisation counselling clinic over a 6-month period to determine the proportions of attenders keeping their appointment, proceeding to sterilisation, and attending for surgery. SETTING: A hospital-based, city centre family planning clinic run by permanent, family planning-trained staff. RESULTS: A total of 226 women had appointments for female sterilisation counselling and most confirmed attendance. Only 153 (68%) women attended; of those 101 (66%) chose to be sterilised, the remainder choosing reversible contraception. Ninety-three (92%) women went ahead with the sterilisation procedure. Thus only 61% of the original attenders were sterilised; this was only 41% of those referred. CONCLUSIONS: The study suggests that many women referred for sterilisation counselling fail to attend. This finding needs to be further explored. For those women who do attend, accurate information and informed counselling is important. Many women are still unaware of highly effective long-term reversible contraception, and following discussion decide against female sterilisation. Services offering counselling for female sterilisation should also be able to provide easy access to a full range of contraceptive methods.

Adult↗
PubMed2002

Integrated summary of Ortho Evra/Evra contraceptive patch adhesion in varied climates and conditions.

OBJECTIVE: To assess the adhesive reliability of the contraceptive patch (Ortho Evra/Evra). DESIGN: Pooled data of 3,319 women from three contraceptive studies of up to 13 treatment cycles; a subset of 325 women of the pooled data from warm and humid climates; and 30 women from a three-period, crossover exercise study. SETTING: 184 centers. PATIENT(S): 3,349 healthy women. INTERVENTION(S): In the contraceptive studies, each treatment cycle consisted of three consecutive 7-day patches (21 days) followed by one patch-free week. During each treatment period in the exercise study, women wore the patch for 7 days and participated in one of six activities (normal activity, excluding bathing; sauna; whirlpool; treadmill; cool-water immersion; or a combination of activities) each day at a supervised health center. MAIN OUTCOME MEASURE(S): Patch adhesion. RESULT(S): In the contraceptive studies, 4.7% of patches were replaced because they fell off (1.8% [1,297 of 70,552 patches]) or became partly detached (2.9% [2,050 of 70,552 patches]); patch replacement rates in centers from a warm, humid climate were 1.7% (85 of 4,877 patches) and 2.6% (128 of 4,877 patches), respectively. Only one of 87 patches (1.1%) completely detached in the exercise study. CONCLUSION(S): The reliability of adhesion of the contraceptive patch is excellent and consistent across all studies; only 1.8% and 2.9% of patches required replacement due to complete or partial detachment, respectively. Heat, humidity, and exercise do not affect adhesion.

Adhesives↗
PubMed2002

The 'tail' of a missing intrauterine contraceptive device.

This case presents a cautionary tale demonstrating the importance of skilled ultrasonography for the correct location of an intrauterine device (IUD) lying within the uterine cavity where the threads are 'lost'. Accurate ultrasound examination can ensure the avoidance of unnecessary x-rays or surgery. The case also acts as a reminder that a missing thread of an IUD does not imply that the device is misplaced.

Device Removal↗