We report a case of an overdose with fetal demise from the intravaginal administration of misoprostol. A 25-yr-old gravid female self-administered 6000 micrograms misoprostol intravaginally and 600 micrograms orally. She rapidly developed shaking chills, abdominal and extremity cramping, emesis, and confusion. Hyperthermia and hypotension developed within 3.5 h after drug administration, with a temperature of 41.4 degrees C (106 degrees F). Ultrasound at 3.5 h after drug administration showed no fetal movement or heart motion. A nonviable fetus was delivered by emergent cesarean section. Treatment of the mother was supportive and included intravaginal decontamination and endotracheal intubation with neuroparalytic therapy to control agitation and hyperthermia. Recovery was complete within 15 h of drug administration.

Abortifacient Agents, Nonsteroidal↗

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HIV treatment adherence in women living with HIV/AIDS: research based on the Information-Motivation-Behavioral Skills model of health behavior.

Close and consistent adherence to anti-HIV medication regimens is necessary to achieve the maximum benefit of these potentially effective treatments. The authors examined cognitive and behavioral factors associated with HIV treatment adherence in a convenience sample of 112 women, 72 of whom were currently taking HIV treatments at the time of the study. Women completed confidential surveys and interviews to assess HIV-related health status, treatment regimens, and cognitive behavioral characteristics derived from the Information-Motivation-Behavioral Skills model of health promotion behaviors. Results showed that women who had missed at least one dose of their HIV medications in the past week reported lower intentions (motivation) to remain adherent and lower adherence self-efficacy (skills). Structural equation modeling showed that motivational and skills-building factors significantly predicted the number of medication doses missed. However, treatment-related information did not predict treatment adherence. In addition, women who had missed a dose of medication in the past week were more likely to have ever used devices and strategies to remind them of doses, but were no more likely to currently use such strategies. Interventions that enhance treatment adherence motivation and build adherence skills may help improve HIV treatment adherence in women receiving anti-HIV therapies.

Adult↗

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The loss response list: a tool for measuring adolescent grief responses.

Single adolescent girls aged 13-19 years participated in pilot (n = 40) and follow-up (n = 164) studies to develop the reliability and validity of the Loss Response List (LRL). The LRL measures physical, emotional, social, and cognitive grief responses by comparing groups based on pregnancy status (never pregnant, pregnant, perinatal loss, and perinatal loss and pregnant). The pilot study revealed significant results on emotional, social, and cognitive grief responses between the perinatal loss and no-perinatal loss groups. Follow-up study results indicated significant differences between the perinatal loss group and the other groups on grief subscales. Significant differences also occurred between perinatal loss and never pregnant groups on depression. The LRL should be useful in gathering information about adolescent grief responses, including perinatal loss.

Adolescent↗

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