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Biomedical subjects

L Bahamondes

Publications and source records attributed to L Bahamondes.

At least 37 records · Page 2Linked to original sources
PubMed1998

Efficacy and acceptability of two monophasic oral contraceptives containing ethinylestradiol and either desogestrel or gestodene.

OBJECTIVE: To assess the contraceptive efficacy, cycle control and acceptability of two monophasic oral contraceptives containing either 30 micrograms ethinylestradiol plus 150 micrograms desogestrel or 30 micrograms ethinylestradiol plus 75 micrograms gestodene. METHODS: In a randomized, open-label, six-cycle, group-comparative, multicenter study performed in Brazil, pregnancies, cycle-control parameters, incidence of side-effects and the presence and severity of acne vulgaris were assessed, and blood pressure and body weight were measured at pretreatment and after one, three and six cycles of oral contraceptive use. RESULTS: Of the 595 women enrolled, 274 (86.7%) in the desogestrel/ethinylestradiol group and 227 (81.4%) in the gestodene/ethinylestradiol group completed the six cycles, providing data for 1753 and 1487 treatment cycles, respectively. Two pregnancies occurred, one of which (in the desogestrel/ethinylestradiol group) was attributed to user failure, whilst the other (in the gestodene/ethinylestradiol group) was thought to result from method failure. Cycle control was observed to be excellent; the incidences of irregular bleeding and minor side-effects were low in both groups and decreased after an initial increase in the first cycle. Pre-existing acne improved in both groups, whereas blood pressure and body weight remained essentially unchanged. CONCLUSIONS: Both desogestrel/ethinylestradiol and gestodene/ethinylestradiol provide effective oral contraception with comparable cycle control and acceptability.

Acne Vulgaris↗
PubMed1997

Return of fertility after discontinuation of the once-a-month injectable contraceptive Cyclofem.

The objective of this study was to evaluate the return of fertility in women who used Cyclofem as a contraceptive method during the introductory studies conducted in Brazil, Chile, Colombia, and Peru. From these four cohorts, 101 women were eligible for the study. Thirty-one were not included in the study either because they refused to be interviewed, had initiated another contraceptive method the month after discontinuation, or were unable to be contacted. A total of 70 women were included in the study. Our results showed that the return to fertility rate after the discontinuation of Cyclofem was 1.4 per 100 women at the end of the first month and reached 82.9 at one year. More than 50% were pregnant at 6 months. Fifty-one (94.4%) pregnancies ended in a live birth, two were spontaneous first trimester abortions, and one was a hydatidiform mole. Return of fertility was not related to the woman's age at the time of discontinuation, her weight, or the number of Cyclofem injections. In conclusion, fertility is restored by 1 month following Cyclofem discontinuation. Users and potential users should be counseled regarding the rapid return of fertility after discontinuing this method of contraception.

Adult↗
PubMed1997

No relationship between the IUD position evaluated by ultrasound and complaints of bleeding and pain.

The objectives of this study were to define the "normal" position of the T-shaped intrauterine device (IUD) in the endometrial cavity, using transvaginal ultrasound, and to compare the IUD's position in women with and without complaints of bleeding and/or pain. Vaginal ultrasound was carried out in women who had used a T-Cu 200 or T-Cu 380 for at least 6 months. Of these women, 236 registered bleeding complaints and/or pain and 245 had no complaints. The distances, IUD-endometrium, IUD-myometrium, and IUD-fundus, were measured in each woman. Our results showed that women with and without complaints presented no significant differences in age, parity, type of IUD, duration of use, previous contraceptive method used, hysterometry, uterine position, or period of the cycle in which the ultrasound was performed. The values of the three distances in users without complaints were widely dispersed. The 90th percentile of the IUD-endometrium, IUD-myometrium, and IUD-fundus distances were 7, 11, and 27 mm, respectively. The curve of the values for the three distances among women with complaints was similar to that of the subjects without complaints. Using the generally accepted measurement of 20 or 25 mm as the limits of normality of the distance IUD-fundus, and the 90th percentile of the distance IUD-endometrium as the gold standard, 77% and 43% of the women were false positives for "incorrect IUD position." Similar results were obtained when the 90th percentile of the distance IUD-myometrium was used as a gold standard. We concluded that the 90th percentiles of the distance IUD-endometrium, IUD-myometrium, and IUD-fundus were 7, 11 and 27 mm, respectively, among users without complaints. The ultrasonographic diagnosis of the IUD position was unable to discriminate between women who did or did not have complaints of bleeding and/or pain. If ultrasound were to be performed in T-shaped IUD users, the IUD-myometrium distance is likely to be the most reliable measurement.

Adult↗
PubMed1997

Self-administration with UniJect of the once-a-month injectable contraceptive Cyclofem.

The objective of this study was to evaluate women's acceptance of and ability to self-administrate the injectable contraceptive Cyclofem using prefilled UniJect devices. A total of 102 women were invited to participate in the study. Fourteen women (13.7%) refused to participate. Of the remaining 88 women, 32 women (31.4%) consented to participate and were trained using oranges but were still afraid of the procedure and ultimately refused to self-administer the injections. Only 56 women (55%) ultimately self-injected Cyclofem with UniJect. They performed a total of 144 injections, all of them on the ventral side of the thigh. When nurses evaluated women's ability to activate the devices, they found that more than 80% were successful in both the group of women that later self-administered the injections and the group that did not. The evaluation of the self-administered injection technique showed that more than 90% of the women correctly self-administered the contraceptive using UniJect. With respect to the opinion of the women about the self-administration of the contraceptive, more than 50% (32 of 56) of women who self-injected preferred to self-administer the injection and said that they wished to continue with the self-administration, one-third (17) reported that they were afraid, and seven women (12.5%) expressed the opinion that the injection in the thigh was more painful than the administration in the buttocks or arm. In conclusion, our study showed that women can be trained to successfully self-administer the monthly injectable contraceptive Cyclofem and generally respond positively to UniJect.

Brazil↗
PubMed1997

Introductory study of the once-a-month, injectable contraceptive Cyclofem in Brazil, Chile, Colombia, and Peru.

An introductory trial with the injectable contraceptive Cyclofem was carried out in Brazil, Chile, Colombia, and Peru, with participation by 3,183 women. Women were followed-up for up to 2 years of use and the data were evaluated by life table analysis. A total of 29,676 women-months were accumulated for up to 2 years. No pregnancies were observed in the 2 years. The discontinuation rates for amenorrhea in the first year ranged from 3.4 in Brazil to 8.1 in Colombia, and for menstrual disturbances from 5.1 in Chile to 9.2 in Brazil. The discontinuation rates for other medical reasons ranged from 7.8 in Brazil to 26.3 in Colombia, and for personal reasons from 17.2 in Chile to 23.5 in Brazil. Continuation rates ranged from 42.3 in Colombia to 52 in Chile. In the second year of observation the rates of discontinuation were lower than those observed in the first year, with the exception of personal reasons in Brazil, which were the same as those observed in the first year. Continuation rates ranged from 19.4 in Brazil to 36.8 in Chile. The comparison of reasons for discontinuation in selected clinics showed that the rate for amenorrhea in one clinic in Chile was more than three times that in others and in Peru was seven times more in one clinic than in another. Regarding menstrual disturbances, in Peru one clinic presented a rate three times higher than the others. The main reasons for discontinuation due to other medical reasons were headache and weight gain. In conclusion, Cyclofem presented a high contraceptive efficacy and an acceptable rate of continuation and discontinuation for up to 2 years in the four countries.

Adult↗
PubMed1996

Uniject as a delivery system for the once-a-month injectable contraceptive Cyclofem in Brazil.

This study assessed the administration of Cyclofem using prefilled Uniject devices. A total of 480 injections were administered divided equally between standard syringes and Uniject. The majority of women (82%) reported that they felt anxious prior to receiving the injection with Uniject. After injection, more than 80% expressed no anxiety about the appearance of Uniject or about the technique of injection. A total of 96.3% of the participants reported slight to no pain with Uniject. In comparison to the standard syringe, 5.6% expressed having had more pain with Uniject. Ninety percent of the service providers reported that Uniject was easy to activate and inject and that it was reassuring for users to know that the syringe and needle had never been used previously. Only two service providers demonstrated difficulties in activating the device. No accidental punctures occurred during the manipulation, and incomplete emptying of the Uniject was not observed. In conclusion, Uniject is a good device for the administration of the injectable contraceptive Cyclofem. It is likely to be appropriate for the delivery of other injectable contraceptives after the necessary stability tests have been performed.

Anxiety↗
PubMed1996

Risk factors for tubal sterilization regret, detectable before surgery.

Brazil has one of the highest prevalence rates of female surgical sterilization in the world. At the same time there is an increased demand for sterilization reversal. In order to understand which women tend to later request reversal of the procedure, a case-control study was carried out comparing 216 women who requested reversal with sterilized women who did not, paired by year of surgery. The relative risk of requesting reversal for women sterilized before age 25 was 18 times that of women sterilized after age 29. The elevated risk remained even after controlling for a number of variables present at the time of surgery. Multiple regression analysis showed that request for reversal was associated with younger age, less information about the procedure, and fewer contraceptive methods known before sterilization. These results support the recommendation that women should be fully informed about the tubal ligation procedure and have access to other contraceptive options before being sterilized.

Adult↗
PubMed1996

The use of vaginal ultrasound to identify copper T IUDs at high risk of expulsion.

A total of 235 women who had a TCu 380A IUD inserted had a vaginal ultrasound scan performed to identify if the IUDs were correctly placed in the uterine fundus. Women identified as having a misplaced IUD had it removed. The remaining women were compared to 201 women who had an IUD inserted and had no ultrasound evaluation, matched by age and parity. Women were followed-up for one year. Gross cumulative discontinuation rates and continuation rates were calculated by life table analysis. Comparison between groups was done by the Gehan test. The study group had 34 IUDs removed because they were misplaced according to the established criteria. The expulsion rate was significantly higher in the control group, also influencing the continuation rate which was lower in the same group. Of the 34 women who had their IUD removed because it was not correctly placed, only 22 requested and had another IUD inserted. The removal of IUD determined by an ultrasound to be incorrectly placed significantly decreased expulsion rates. However, many IUDs may have been removed unnecessarily, probably resulting in many women not returning to the clinic or deciding to use another contraceptive method.

Adult↗
PubMed1995

Follow-up of women seeking sterilization reversal: a Brazilian experience.

OBJECTIVE: To analyze the follow-up of a cohort of women who requested reversal of surgical sterilization. METHODS: This retrospective study was carried out at the State University of Campinas, Brazil. A cohort of 394 women who requested sterilization reversal was followed up for one year after reversal surgery. The analysis includes the percentage of women who completed the steps between the initial consultation up to one year after reversal surgery. RESULTS: After an initial consultation, 55.1% of the patients decided not to continue with the procedures. Of the patients who did undergo laparoscopy (n = 177), 48.6% had no possibility of a successful surgical reversal because the Fallopian tubes were in very poor condition. Only 17.5% of the initial patients requesting reversal ultimately underwent surgery and 3.3% became pregnant. CONCLUSIONS: The analysis of regret about surgical sterilization should include not only women who undergo surgery but also women requesting surgery. Better patient selection and counseling prior to sterilization are necessary in order to prevent increasing rates of sterilization regret in Brazil.

Adult↗
PubMed1995

Performance of copper intrauterine devices when inserted after an expulsion.

A total of 124 women who re-inserted a TCu-200B intrauterine device (IUD) following an expulsion were followed up for 1 year after the IUD re-insertion. The cumulative expulsion rate at 6 months was 21.7 and 31.4 per 100 women at the end of the first year. Women who expelled the first IUD within the first 3 months of use had a significantly higher expulsion rate with the second IUD. Our conclusion is that women who expelled a copper IUD are at a significantly higher risk of expelling the re-inserted IUD than the first IUD. Health workers must also be informed about the high probability of another expulsion when re-inserting an IUD after an expulsion.

Adolescent↗
PubMed1995

The influence of human chorionic gonadotrophin administration upon the next ovarian cycle.

We examined the influence of human chorionic gonadotrophin (HCG), used as an ovulation inducer and/or for supporting the luteal phase, on the next ovarian cycle. Four women received 10,000 IU of HCG at mid-cycle and another four received the same dose plus 1500 IU on the 17th, 19th and 21st days of the cycle. In the menstrual cycle prior to our experiments, venous blood samples were collected and vaginal ultrasound of the ovaries was performed every other day from day 21-28; the same data were also collected on days 1-10 of the experiment cycle. In such a way, control values were obtained. After the administration of HCG, venous blood samples were collected and ultrasound was performed in the same way and on the same days as in the controls. Follicle stimulating hormone (FSH) and luteinizing hormone were determined by radioimmunoassay in all blood samples, and HCG only in samples collected after the experiment. The results showed that only FSH was lower in the late luteal phase after the administration of 10,000 IU of HCG. Follicular diameters were higher during the follicular phase than during the previous cycle only in women who received the low dose of HCG. In addition, one woman presented with detectable HCG in the following ovarian cycle. The use of HCG in the preceding cycle may reduce FSH and develop persistent follicles in the subsequent cycle. We suggest that an ultrasound of the ovaries should be performed before starting a new ovulation induction cycle in a woman who has received HCG in the previous cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Clomiphene↗
PubMed1995

[Evaluation of bone mass in hip fractures measuring lumbar spine and contralateral hip with bone densitometry].

Hip fracture is frequent in postmenopausal women with osteoporosis. The aim of this work was to assess bone mass in women with hip fracture and compare it with that of normal women. Bone densities of lumbar spine (considering areas with and without spondylosis), femoral neck, greater trochanter, and unfractured hip Ward's triangle were measured with a double beam isotopic densitometer. Thirty-one women aged 58-95 years old were studied and compared with normal women studied at the same laboratory. Bone densities in fractured and normal women were 0.82 +/- 0.16 and 0.85 +/- 0.05 g/cm2 in lumbar spine respectively (NS), 0.74 +/- 0.15 and 0.85 +/- 0.05 g/cm2 in lumbar spine without spondylosis respectively (p < 0.001), 0.60 +/- 0.11 and 0.65 +/- 0.08 g/cm2 in femoral neck respectively (NS), 0.49 +/- 0.09 and 0.57 +/- 0.05 g/cm2 in greater trochanter respectively (p < 0.001) and 0.48 +/- 0.12 and 0.52 +/- 0.09 g/cm2 in Ward's triangle respectively (NS). It is concluded that the larger differences in bone density between women with and without hip fracture are observed in the greater trochanter.

Absorptiometry, Photon↗
PubMed1994

Clinical performance of the Copper T200B IUD after reinsertion following life-span expiration.

The purpose of this study was to evaluate the first year clinical performance of the TCu200B IUD in a cohort of women who had the IUD re-inserted immediately after a removal for life-span expiration, compared with a group of initial acceptors, and a cohort of women who continued using the device for more than 60 months. The sample consisted of 1066 users, 339 in each of the two first groups and 388 in the third. Life-table analysis was used to calculate continuation and gross discontinuation rates by reason. Statistical significance of the differences between groups was tested by log-rank method. Pregnancy rates were low, both in the group of re-insertions and first insertions, and no pregnancies occurred in the group using the device beyond the fifth year. The expulsion rate and lost-to-follow-up (LFU) rate were significantly lower in the group of women who used the device beyond the fifth year. In addition, this group showed a significantly higher rate of removal for investigator's choice. These results show that there is no reason to recommend the removal and replacement of the TCu200B before the end of the sixth year of use. When a new IUD is to be inserted after removal for life-span expiration, providers should be instructed to insert it immediately after the removal, because this procedure does not pose additional risks, reduces the number of clinic visits, and relieves the women of the use of a temporary method while waiting for the re-insertion.

Adult↗
PubMed1994

Score prognosis for the infertile couple based on historical factors and sperm analysis.

OBJECTIVE: To identify variables, obtained from historical factors and sperm analysis, associated with greater chances of pregnancy in infertile couples. METHODS: The study was carried out in Córdoba, Argentina. The characteristics of 247 couples consulting for infertility who achieved pregnancy within 3 years of their first visit were compared with those of 312 couples who did not become pregnant. We evaluated the relationship between the age of the woman and her partner, the type and duration of infertility, length of the last three menstrual cycles, history of pelvic surgery in the woman, and testicular volume, sperm density, motility and morphology in her partner, and the achievement of pregnancy. For the analysis, logistic regression was used. RESULTS: Six variables had a predictive value: sperm morphology, the woman's age, type and duration of infertility, her history of pelvic surgery, and duration of menstrual cycles. CONCLUSIONS: The best prognosis for future fertility in infertile couples is correlated with a higher percentage of normal sperm morphology, younger woman's age, secondary infertility, fewer years of infertility, negative history of pelvic surgery, and abnormal menstrual cycles.

Adolescent↗
PubMed1994

Identification of main risk factors for tubal infertility.

OBJECTIVE: To determine the relationship between some reproductive variables and infertility caused by tubal obstruction. DESIGN: A retrospective, case-control study. SETTING: A tertiary care university hospital that is a referral center for infertility patients. PARTICIPANTS: Subjects were interviewed between March 1990 and December 1991. Cases were 215 consecutively recruited infertile women with either evidence of tubal obstruction found at laparoscopy or hydrosalpinx diagnosed by hysterosalpingography. Women with a history of surgical sterilization were excluded. Controls, selected in the same hospital, were women in the puerperium who had no history of infertility. Two controls were matched by age at the time of tubal obstruction diagnosis to each case. RESULTS: History of pelvic surgery and use of alcohol were significantly associated with the risk of infertility caused by tubal obstruction. The use of barrier, oral, and medroxyprogesterone acetate (MPA) contraceptives was associated with a protective effect. When only women with secondary infertility were analyzed, history of pelvic surgery and number of lifetime sexual partners were significant risk factors, and the previous use of oral contraceptives was the only protective factor. CONCLUSIONS: History of pelvic surgery was the most important risk factor for tubal infertility. All precautions must be taken to avoid infection and adhesion formation when pelvic surgery is performed. In addition, women can be protected from tubal infertility by using barrier, oral, or MPA contraceptive methods.

Adult↗
PubMed1993

Performance of the copper T 200 in parous adolescents: are copper IUDs suitable for these women?

The clinical performance of a cohort of 995 parous adolescents, first-time users of the T-Cu 200B was studied and compared with a cohort of paired controls 10 years older, of the same parity. Life-table analysis showed that pregnancy, expulsion rates, as well as removals for bleeding and/or pain were higher in adolescents but within ranges already reported in the literature on this device. Removals for infection were few and not significantly different. Although the clinical performance of the T-Cu 200B in adolescents is not as good as in older women, the performance is similar or better than that reported for other reversible methods in this age group. Our conclusion is that IUDs should not be contraindicated for parous adolescents as long as adequate counseling, screening of risk factors, skillful insertion and follow-up are provided.

Adolescent↗
PubMed1992

Long-term evaluation of the clinical performance of the TCu200B and the TCu380A in Campinas, Brazil.

The clinical performance of the TCu200B and TCu380A was evaluated by life table analysis in a cohort of women who wore an IUD from July 1979 to July 1982. This paper presents the results up to five years of use. No significant differences in age and parity were found between the users in the two groups. Overall performance was very good with both models. The cumulative continuation rate was 83.6, 60.9 and 46.1 at one, three and five years with the TCu200 and 84.0, 64.7 and 49.3 with the TCu380A in the same periods. Differences between both IUDs were not significant. The pregnancy rate was lower with the TCu380A and reached statistical significance from the fourth year on. The authors conclude that both IUDs presented very good performance, the TCu380A being more effective, the only significant difference observed.

Adult↗