Changing contraceptive laws in New York State.
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Pending a full trial, Planned Parenthood of Minnesota may continue to provide minors with contraceptive information and supplies without parental consent unless a minor's parents specifically notify Planned Parenthood that they do not wish their child to receive such services, a Minnesota district court judge ruled on January 16. Maley, et al. v. Planned Parenthood of Minnesota, Inc., Minnesota District Court, Third Judicial District, File No. 37769. 6 couples brought a class action suit against Planned Parenthood on behalf of all Minnesota parents of unemancipated minors to enjoin Planned Parenthood from providing contraceptive services to minors without parental consent. A 1971 law permits a minor to consent to medical treatment if he or she is living apart from and financially independent of his or her parents, is married, or has borne a child and in an emergency. In addition, any minor may consent to diagnosis and treatment of "pregnancy and conditions associated therewith" and venereal disease.
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OBJECTIVES: Sexually transmitted infectious factors attained unquestionable importance in the initiation of the cervical intraepithelial neoplasia. The aim of this study was to evaluate the incidence and impact of Bacterial vaginosis, Chlamydia trachomatis infection in accordance to a life style on clinically and cytologically evaluated cervical lesions. DESIGN/METHODS: Seventy-two young women without any symptoms were included to the study. Women underwent pelvic examination when cervical smears for cytology and Ch.tr. were taken and BV tests were performed. Presence of Chlamydia was estimated by direct immunofluorescent method. Subjects included to the study provided information concerning life style, and gynecological complaints. RESULTS: In both BV(+) or Ch.tr.(+) women, abnormal PapTest results were more frequently observed. All those three factors correlated with declared over 5 lifetime sexual partners. Ch.tr. infection correlated with BC pills using, cigarette smoking and presence of the cervical lesions evaluated as glandular ectopy. Abnormal PapTest result was obtained in 12 subjects. Two, the most abnormal cases were described as LSIL and confirmed by direct biopsy as CIN 1, also with coexistence of C. trachomatis infection and positive for BV. CONCLUSIONS: Ch.tr. infection seems to affect more frequently sexually active, smoking, young women using BC pills, with presence of cervical lesion described as clinically unsuspected glandular ectopy, although with occasionally cytological abnormal findings.
Heart failure is a growing problem and is commonly associated with an older population. A proportion of young people also have heart failure. These patients are quite rarely seen but are increasing in number, and heart failure nurses need to ensure that when these patients present in clinic they have an understanding of their differing needs in comparison with older cardiac patients.
Records of twenty-six patients who presented at the University College Hospital, Ibadan with 'lost' IUDs between 1 July 1980 and 30 April 1982 were analysed. During the 22-month study period there were 3476 IUD insertions. Routine evaluation showed that eighteen IUDs (69.2%) were intrauterine whilst eight IUDs (30.8%) were extrauterine. Seventeen (65.4%) intrauterine devices were recovered by routine D and C. Of the eight extrauterine devices, six (23.1%) were removed by laparoscopy, one (3.8%) was removed by laparotomy and one (3.8%) was removed by colpotomy. It is concluded that it is preferable for all extrauterine devices to be removed in order to discourage psychosomatic symptomatology commonly associated with forgotten devices.
While oral contraceptives have been widely available in rural Thailand since their distribution by lower level paramedical health workers was authorized in 1970, the IUD has been restricted to large, urban clinics staffed by physicians. A study was conducted in 1972-73 to evaluate the performance of nurse-midwives in IUD (Copper T) insertion and to assess the reaction of acceptors and the likely effects on the National Family Planning Program. It was found that nurse-midwives were competent to insert Copper Ts and handle early complications. Acceptor continuation rates were very high and nurse-midwife acceptors clearly preferred IUD insertion by a female health worker. Programmatic evidence suggests that using nurse-midwives more extensively for Copper T insertion would increase IUD acceptance at no cost to the existing loop program.
Animal studies have shown evidence of prenatal hormonal interaction between unlike sexed fetuses, including reduced fertility among females. We evaluated whether the fecundability of female twins is different from that of singletons and whether it differs according to the sex of the co-twin. The study was based on a questionnaire survey of 12,681 female twins born in the period 1953-1976 and an interview survey of 760 female controls born in the period 1953-1966, both in Denmark. Outcome of the first try ever to become pregnant (pregnant, still trying, stopped trying, pregnant despite contraception, and never tried) and the waiting time to pregnancy distribution did not differ among monozygotic, dizygotic same sexed, and dizygotic unlike sexed twins. More twins had a waiting time of less than 2 months, compared with singletons. This difference probably reflects an artifact due to the data collection method, because it disappeared when the cutoff point was changed to include 2 months for singletons, and we found no difference for longer waiting times. Hence, we found no increase in fecundability for twins compared with singletons, nor any reduced fecundability among female twins from unlike sexed pairs.
OBJECTIVE: To examine the relationship between plasma homocysteine, 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphism, and the risk of arterial and/or venous thrombosis in systemic lupus erythematosus (SLE). METHODS: Plasma homocysteine and MTHFR polymorphism were determined in a retrospective cohort of 175 patients with SLE. Associations between homocysteine levels and antiphospholipid antibodies, renal function, and drug therapy were analyzed. RESULTS: Patients with arterial thrombosis had higher homocysteine concentration than nonthrombotic patients (20.6+/-10.2 vs 13.2+/-6.8 micromol/l; p < 0.001). The crude odds ratio for arterial thrombosis for the highest versus lowest quartile of homocysteine was 4.4 (95% CI 1.3-14.9). After adjustment for other risk factors the odds ratio remained significant (3.7; 95% CI 1.2-13.0). Increased plasma homocysteine was not associated with venous thrombosis. A significant correlation was found between homocysteine and creatinine (r=0.57, p < 0.0001) or the use of methotrexate. Homocysteine levels were higher in patients using corticosteroids and lower in patients using oral contraceptive drugs. This finding may be biased by impaired renal function in patients using corticosteroids and the advice to stop estrogen-containing contraceptives in female patients upon an episode of thrombosis. The distribution of MTHFR genotypes was 50% for homozygous wild type, 42% for heterozygous, and 8% for homozygous mutant, with a similar distribution among patients with or without a history of thrombosis. CONCLUSION: Raised levels of homocysteine are associated with arterial thrombosis in patients with SLE. Mutation in the MTHFR gene does not explain the raised levels, and renal failure is by far the most frequent cause.
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OBJECTIVES: This study assessed predictors of the onset of natural menopause in African American women. METHODS: We used mailed questionnaires to collect data at baseline in 1995 and during follow-up from Black Women's Health Study participants. Cox proportional hazards regression was used to assess potential predictors-including experiences of racism-of the onset of natural menopause among 17 070 women aged 35 to 55 years and premenopausal in 1995. RESULTS: The hazard ratio (HR) was 1.43 for current smokers (95% confidence interval [CI] = 1.24, 1.66) and 1.21 (95% CI = 1.06, 1.38) for ex-smokers and significantly less for obese women and oral contraceptive users. Hazard ratios for most questions about racism were elevated by 10% to 30% but were not statistically significant. CONCLUSIONS: Earlier onset of natural menopause among African American women is strongly associated with smoking and inversely associated with body mass index and oral contraceptive use.
Female undergraduates (108) volunteered for a study of hormones and sexuality, 55 of whom were oral contraceptive (OC) users. In this paper, OC users and nonusers are compared on measures of sexual attitudes and behavior, use of erotic fantasy, and gender role. In the second paper, the effects of OC on androgen levels and the relationship between androgens and behavioral measures within each group are reported. OC users were more likely to have a current sexual partner and less likely to be virgins. The two groups did not differ in frequency of masturbation or use of erotic fantasies. OC users reported less restrictive sexual morality and more interest in erotic images. These differences persisted when women without current partners were excluded. Among those in active sexual relationships, OC users reported more frequent sexual intercourse, higher psychosexual motivation and enjoyment, and were more positive in their evaluation of their partners than OC nonusers.
Use of oral contraceptives by married women declined markedly between 1973 and 1982, but analysis of data from the 1988 National Survey of Family Growth shows that this decline stopped between 1982 and 1988. Reliance on female sterilization continued to increase, however, and it remained the leading method among currently married and formerly married women. Among women of all marital statuses, IUD use dropped by two-thirds between 1982 and 1988, from 2.2 million to 0.7 million women. As the proportion of less-educated, low-income, black and Hispanic contraceptive users choosing the IUD decreased, the proportion relying on female sterilization increased. Among college-educated white women, use of female sterilization did not increase; instead, pill use rose in this group. Condom use increased most sharply among teenagers and rose among never-married white and black women, but the pill was still the leading method by far in these groups, regardless of race. Among never-married black women, reliance on sterilization increased significantly between 1982 and 1988, with female sterilization becoming the second leading method. Use of the diaphragm declined sharply over the same period among never-married white women and among those who intended to have more children, as did use of periodic abstinence (rhythm and natural family planning) and foam.