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PubMed2001

Effect of technical traning program on intern physicians' and nurses' knowledge and attitudes regarding emergency contraceptives.

In spite of the effectiveness of modern contraceptives, unwanted pregnancies occur in large number throughout the world and many seek termination so emergency contraceptive methods can be used by women in the first few days, following unprotected intercourse to prevent unwanted pregnancy, induced abortion, and its consequences for women and couples. So this study was conducted to determine the effect of technical training program on upgrading a newly graduate physician and nurses knowledge and attitude regarding emergency contraceptives. The study included 50 intern physicians and 50 intern nurses who are working at El-Shatby maternity university hospital during 1st of march 2001. The study used pre and post test with no control group design. An interview questionnaire sheet was used to assess intern physician and nurses, knowledge about emergency contraceptives while 3 point Likert scale was used to assess the attitude of both groups (physician and nurses) were divided into two sub group. A four hours technical training program were implemented for each group separately on two successive days (2 hours/day). Before implementing the technical training program the study depicted a general lack of knowledge among all physician and nurses regarding emergency contraceptives. Methods added to that the majority of intern physician and nurses 70%, 84% respectively had negative attitude toward emergency contraceptives however, the technical training program had an obvious effect on intern physicians and nurses. Knowledge regarding emergency ,contraceptives. Although improving in the study subjects, Knowledge had a positive impact of their attitude toward emergency contraceptives.

Adult↗
PubMed1996

Ventricular arrhythmias during sexual activity in patients with coronary artery disease.

STUDY OBJECTIVE: Information on appearance or increase of ventricular arrhythmias during intercourse in patients with coronary disease is still inadequate. This prospective study analyzes patients' rhythm disturbances on sexual activity and compares them with occurrences during daily activities and stress testing. PATIENTS: The study included 88 male outpatients with stable coronary disease; ages ranged from 36 to 66 years (mean, 52 years). INTERVENTIONS: Patients underwent ambulatory ECG monitoring, which included sexual activity, and a near-maximal ergometric test. RESULTS: Arrhythmia was found during intercourse in 56% of patients, compared to 38% at exercise. Occurrence or exacerbation of ectopic activity was the dominant pattern in patients with arrhythmia at exercise testing (89%), but this exacerbation was found only in 11% of patients during intercourse. Complex ventricular arrhythmia during sex was detected in 12.5% of patients. CONCLUSIONS: Two main observations may be drawn from the study. First, rhythm disturbances were not exacerbated during intercourse in most patients. Second, if ventricular ectopic activity occurred on intercourse, it was most often simple and essentially similar to disturbances in daily activity.

Activities of Daily Living↗
PubMed1995

Psychosexual characteristics of male university students in Brazil.

Male freshmen (N = 268) at the State University of Campinas (UNICAMP) in the state of Sao Paulo in Brazil responded to a questionnaire concerning aspects of their sexuality from the onset of adolescence. Topics such as physical changes, first ejaculation, masturbation, homosexual manifestations, and sexual practices were investigated, as well as present attitudes toward virginity, intercourse, birth control, abortion, and prevention of AIDS. The quality of the relationship established with parents and the possibilities for dialogue about sex in the family circle were also surveyed. The majority of the subjects revealed satisfactory development in most areas of their sexuality, as well as a good relationship with their parents. Nevertheless, great difficulty was found in dialogue about sex within the family circle. Of these young men, 32% were still virgins at the end of their freshman year, but a considerable number of those already sexually active reported behavior which was inappropriate for the prevention of pregnancy and AIDS. The results are analyzed using psychoanalytic theories of psychosexual development.

Adult↗
PubMed1994

Pregnancy sickness as an adaptation to concealed ovulation.

The hypothesis that pregnancy sickness has evolved to expel dietary toxins (PROFET, 1988; 1992; HOOK, 1976) is critically reviewed. Instead it is proposed that pregnancy sickness and mastalgia have evolved to reduce frequency of sexual intercourse in early pregnancy. Reduction in coital frequency during the first trimester has often been documented. Uterine motility during sexual excitement contrasts with lack of spontaneous myometrial activity in the first trimester, except when uterine cramping sometimes occurs as a result of intercourse. Such cramping would be expected to increase the chances of spontaneous abortion.

Abortion, Spontaneous↗
PubMed2003

Effectiveness of the Yuzpe regimen of emergency contraception by cycle day of intercourse: implications for mechanism of action.

OBJECTIVE: The purpose of this study was to provide evidence about the mechanism of action of the Yuzpe method of emergency contraception by examining effectiveness by cycle day of intercourse relative to ovulation. METHODS: Through a literature search, we identified eight studies that present the number of women treated and outcome of treatment by cycle day of unprotected intercourse relative to expected day of ovulation. Using five sets of external estimates of conception probabilities by cycle day of intercourse among women not using contraception, we assessed and compared the effectiveness of the Yuzpe regimen by whether intercourse occurred on or before the second day before ovulation or afterward, and whether intercourse occurred on or before the first day before ovulation or afterward. RESULTS: In 36 of the 45 pairs of estimates of effectiveness, based on eight separate studies and the eight studies combined and five different sets of conception probabilities by cycle day, effectiveness was higher-and in most cases substantially higher-when intercourse occurred on or before the second day before ovulation (day -2) than when it occurred later. When data were stratified by whether intercourse occurred on or before the day before ovulation (day -1), effectiveness was greater when intercourse occurred early in 43 of 45 pairs. CONCLUSIONS: These results suggest that one hypothesized mechanism of action of the Yuzpe method, inhibiting implantation of a fertilized egg, is unlikely to be the primary mechanism of action.

Coitus↗
PubMedDate not supplied

Slightly modified technique of the original Essed plication procedure for congenital penile deviation.

PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life (LQ) of the original technique with inverted sutures as described by Schroeder-Essed and our slight modification consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: Twenty-six patients with congenital penis deviation were treated for penile deviation by the original Schroeder-Essed plication with inverted sutures (11 patients) and by the described modification (15 patients). In case of modified technique, horizontal and parallel incisions 4 mm to 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex 3-0). Mean age was 21.6 years in the first group and 23.2 years in the second group. Average follow-up was 28 months and 13 months, respectively. The preoperative penile deviation angle was > 25 degrees in all patients without difference between the 2 groups. RESULTS: All patients in both groups reported an improvement in their quality of life and full ability to engage in sexual intercourse. Nine patients (88%) in the first group and 14 patients (93%) in the second group were satisfied with the cosmetic result. In contrast, 10 patients (91%) of the first and 13 patients (87%) of the second group complained of penile shorting. Recurrence of deviation was only noticed in 2 males in the first group (18%). CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

Journal Article↗
PubMed1990

Sexual experience and sexual orientation among Ramathibodi medical students, Thailand.

This study aims at exploring the several sexual experiences and sexual orientation among medical students at Ramathibodi Hospital, Bangkok, Thailand. Questionnaires were given to all medical students during 1982-1988. Almost all, 93 per cent of the males (593/633) and 92 per cent (211/224) of the females completed the questionnaire. All males had had ejaculation. Eighty-four per cent of the males and 28.1 per cent of the females experienced nocturnal sex dreams. Ninety-eight per cent of the males and 47.8 per cent of the females masturbated. Most of the first events occurred incidentally among both sexes. Sixty-one per cent of the males and 1.5 per cent of the females had engaged in sexual intercourse. Most of the males had their first coital experience with prostitutes. Homosexual experience was admitted in 13 per cent of male and 3.4 per cent of female students. Almost 20 per cent of both sexes were either exclusively homosexual or bisexual.

Adult↗
PubMed2003

Sexual health risks among young Thai women: implications for HIV/STD prevention and contraception.

This paper examines factors that may place female Thai adolescents and young adults at risk for HIV, sexually transmitted diseases (STDs), and unintended pregnancies. A total of 832 female vocational students participated in a cross-sectional audio-computer-assisted self-interview (ACASI) survey after providing informed consent. The questionnaire covered: sociodemographic characteristics; knowledge, attitudes, and beliefs related to HIV and STDs; contraceptive practices; sexual experiences and behaviors; and drug use. Oral fluid was tested for HIV antibodies and urine was tested for illicit drugs and for the presence of gonococcal or chlamydial nucleic acids. A total of 359 women (43.1%) reported sexual intercourse history, with an average age at first sex of 17.6 years, and a 2.6 mean number of lifetime sex partners. Twenty-one percent of the entire sample reported coerced sexual contact or intercourse. Among those with sexual intercourse experience, 27.3% (n=98) had been pregnant and the majority of their most recent pregnancies were terminated. Three tested positive for HIV antibodies. Sexually active young Thai women report behaviors or experiences that may expose them to HIV/STD infection and unintended pregnancy in the future. These include unprotected intercourse, sexual coercion, low levels of contraceptive use, and drug and alcohol use. Culturally appropriate interventions that increase their awareness of and ability to respond to these sexual health risks are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Paternity after unilateral cryptorchidism: a controlled study.

OBJECTIVE: To determine if paternity is decreased among formerly unilateral cryptorchid men compared with a control group of men. SUBJECTS AND METHODS: Formerly unilateral cryptorchid men who had orchiopexy between 1955 and 1971 at the Children's Hospital of Pittsburgh and a group of control men have had their medical records reviewed and have been surveyed by questionnaire. RESULTS: Among the men who had ever married and had attempted paternity, significantly more of the unilateral cryptorchid men had been unable to father children (10.5%) than among the control group (5.4%). No difference was found when the groups were compared for the duration of regular intercourse without contraception to conception of their first child. There was no relationship between the age of orchiopexy or lifestyle factors and paternity or between the age of orchiopexy and months of regular unprotected intercourse to conception. Paternity among both groups was related to female-related infertility factors and to the presence of varicoceles. CONCLUSION: When compared with a control group, paternity was compromised after unilateral cryptorchidism. Infertility is about twice as frequent among the unilateral group. There was no evidence of subfertility requiring a longer exposure of regular intercourse without contraception among the fertile subgroup. No correlation was found between age of orchiopexy and paternity.

Adult↗
PubMed1978

Correlates of contraceptive behavior among unmarried U.S. college students.

The contraceptive behavior of 213 sexually active never-married U.S. college students was examined using multiple regression analyses. The type of relationship--casual or steady--was a major determinant of contraceptive use: 77 percent of the respondents involved in steady relationships reported using condoms or the pill, compared with 58 percent of the respondents involved in casual relationships. Frequency of intercourse was the best predictor of contraceptive method used within steady relationships. Several variables emerged as predictors of contraceptive method used within casual relationships, including method used at first coital experience, age, and frequency of intercourse. Situational and background factors were found to have an important impact on adolescent contraceptive behavior and to warrant further research.

Adolescent↗
PubMed1999

The effects of partner insistence of condom usage on perceptions of the partner, the relationship, and the experience.

The present study examined the effects of an individual insisting on condom usage on how he or she is viewed by their partner. Participants were led through a realistic role-play scenario in which, after dating a new partner for "a while", they engaged in sexual intercourse. Results were such that after first time sex, participants indicated feeling more responsible, less at-risk, and less worried when a condom was used than when no condom was used. Participants evaluated their partner as more responsible, more caring, and less likely to have a sexually transmitted disease when a condom was used. Further, when a condom was used, the relationship was evaluated as enhanced, closer, more intimate, and more likely to be long lasting. The insistence of condom use by the participant's partner also resulted in less guilt and regret regarding the sexual experience itself. These results generally held true for both male and female participants.

Adolescent↗
PubMed2004

In vivo distribution of a vaginal gel: MRI evaluation of the effects of gel volume, time and simulated intercourse.

A microbicide is designed to coat the vaginal epithelium and prevent transmission of HIV. Complete coverage is desired for optimal protection. In vivo factors affecting coverage have not yet been studied. This randomized crossover trial evaluates the effect of gel volume and patient activity upon vaginal epithelial coating. Gynol II gel was mixed with a magnetic resonance imaging (MRI) contrast agent. Ten women self-inserted, on separate visits, 3 or 5 mL of gel and underwent serial MRI scanning both before and after simulated intercourse. Gel spread was dependent upon time and volume. There was modest spread during the first hour and greater spread 6 h after insertion. Five milliliters of gel resulted in statistically significantly greater coverage immediately following insertion, within the first 30 min and at 6 h after insertion. Simulated intercourse greatly enhances gel spread. After simulated intercourse, the distribution of the gel at each volume was similar. Less leakage of gel was reported with the smaller volume.

Adult↗
PubMed2005

Distribution of a 3.5-mL (1.0%) C31G vaginal gel using magnetic resonance imaging.

C31G (Savvy) has been developed as a topical vaginal microbicide with broad-spectrum antibacterial and antiviral properties. The objective of this study was to evaluate the distribution of a 1.0% concentration of (3.5 mL) C31G vaginal gel in the human pelvis using magnetic resonance imaging (MRI). Gel delivery with a standard applicator was primarily to the upper vagina and was well tolerated. Vaginal mucosal coverage at 18 min was excellent with 92% linear coverage and 75% surface contact coverage of the vagina. The upper vagina was almost completely covered and gel was also noted in the lower vagina. Coverage 6 h after application was substantially decreased, with 60% of maximal linear coverage and 41% surface contact. There was a very minimal coverage of the vaginal mucosa noted 24 h following insertion. Simulated intercourse resulted in relatively little change in overall distribution at all three time points. Repeat application of the gel may be necessary if intercourse has not occurred within the first few hours after initial insertion.

Administration, Intravaginal↗
PubMed2004

The effects of advance provision of emergency contraception on adolescent women's sexual and contraceptive behaviors.

CONTEXT: Advance provision of emergency contraception (EC) may increase timely access and improve effectiveness, but the impact on adolescent sexual and contraceptive behaviors is not known. OBJECTIVE: To determine whether adolescents given advance EC have higher sexual and contraceptive risk-taking behaviors compared to those obtaining it on an as-needed basis. DESIGN AND SETTING: Randomized trial conducted at urban, hospital-based adolescent clinic in Pittsburgh, PA, from June 1997 to June 2002. PARTICIPANTS: 301 predominantly minority, low-income, sexually active adolescent women, age 15-20 years, not using long-acting contraception. INTERVENTIONS: Advance EC vs instruction on how to get emergency contraception. OUTCOME MEASURES: Self-reported unprotected intercourse and use of condoms, EC, and hormonal contraception ascertained by monthly 10-minute telephone interviews for 6 months post-enrollment. Reported timing of EC use after unprotected intercourse. RESULTS: At both 1- and 6-month followup interviews, there were no differences between advance EC and control groups in reported unprotected intercourse within the past month or at last intercourse. At 6 months, more advance EC participants reported condom use in the past month compared to control group participants (77% vs 62%, P=0.02), but not at last intercourse (advance EC 83% vs control 78%, P=0.34). There were no significant differences by group in hormonal contraception use reported by advance EC or control groups in the past month (44% vs 53%, P=0.19) or at last intercourse (48% vs 58%, P=0.20). At the first followup, the advance group reported nearly twice as much EC use as the control group (15% vs 8%, P=0.05) but not at the final followup (8% vs 6%, P=0.54). Advance EC group participants began their EC significantly sooner (11.4 hours vs 21.8 hours, P=0.005). CONCLUSIONS: Providing advance EC to adolescents is not associated with more unprotected intercourse or less condom or hormonal contraception use. In the first month after enrollment, adolescents provided with advance EC were nearly twice as likely to use it and began EC sooner, when it is known to be more effective.

Adolescent↗
PubMed2005

[Virus in sheep's skin].

In a double sense, the ovine gamma herpesvirus type 2 (OvHV-2) is a virus in sheep's skin. Not only is it present world wide in all sheep breeds but also it causes malignant catarrhal fever (MCF) in cattle pigs, elk, and bison. OvHV-2 cannot be propagated in cell culture. Therefore, new results from OvHV-2 research are based on molecular techniques and may be summarized as follows. OvHV-2 is transmitted by respiratory routes as well as by sexual intercourse. Lambs are infected within the first few months of life. Leucocytes, primarily latently infected lymphocytes, are responsible for disseminating the virus over the entire organism. On rare occasions, virus particles could be visualized by electron microscopy in explanted lymphocyte cultures. Structural antigens were detected by immunohistology in M-cells of diseased rabbits. Immunologically and cell biologically active genes have been detected on the viral genome.The products arising from those are thought to fine balance, the number of latently infected cells in sheep and to keep them alive without causing harm. Thus, it seems that this balance has been found through co-evolution, favoring both virus and natural host. In contrast, other host species that were exclude from the process of co-evolution, are bound to fall from MCF.

Animals↗
PubMed2000

Invited commentary: determining specific sexual practices associated with human herpesvirus 8 transmission.

Laboratory and epidemiologic studies have established human herpesvirus 8 (HHV8) as an etiologic agent of Kaposi's sarcoma. With strong evidence linking HHV8 infection with the number of sexual partners among homosexual men, the challenge now is to determine the specific sexual acts associated with HHV8 transmission. Initial studies of specific practices, however, have differed in their conclusions; the paper by Dukers et al. in this issue of the Journal is the first to associate penile-oral intercourse with HHV8 transmission. Many sources of bias may contribute to the conflicting findings of studies reported to date: HHV8 research still lacks an adequately specific and sensitive serologic assay; identification of relevant exposure periods and measurement of sexual practices are imperfect; and sufficient adjustment for confounding is problematic. These numerous potential biases may be particularly important when trying to detect underlying associations that may be of low-order magnitude. The study by Dukers et al. (Am J Epidemiol 2000;151:213-24) is an important contribution to research on HHV8 transmission, but we do not yet know enough about the possible sexual routes of transmission to recommend avoiding any single behavior. For now, the best prevention advice is to reinforce the more general safe sex practices that have been promoted to prevent human immunodeficiency virus and other sexually transmitted diseases.

Herpesviridae Infections↗
PubMed1996

Does the use of contraception reduce the risk of pregnancy-induced hypertension?

To estimate the impact of the exposure to spermatozoa on the risk of developing pregnancy-induced hypertension, the duration of sexual cohabitation with the father and the use of contraceptive methods were evaluated among 113 primigravid women with pregnancy-induced hypertension and 109 age- and parity-matched controls. The duration of unprotected sexual cohabitation was approximately 50% shorter in women with pregnancy-induced hypertension (2.3 versus 4.7, P < 0.0001), regardless of the contraceptive method previously used. However, the duration of oral contraception use was similar in cases and controls (22.1 versus 23.4 months). Also, of the total group of women who developed pregnancy-induced hypertension, 85.5% (97) became pregnant during the first 3 months of unprotected sexual intercourse in comparison with 54.1% (59) in the control group (P < 0.0001). Results suggest that the risk of pregnancy-induced hypertension in primigravidae is reduced with duration of sexual cohabitation, and therefore with exposure to paternal spermatozoa. However, the protective effect of exposure is not achieved while using oral contraceptives. Considering the present options for nulliparous women, contraception does not appear to be a viable public health policy to reduce the risk of pregnancy induced hypertension.

Adult↗
PubMed2004

Sexual trajectories of abused and neglected youths.

The study objective was to examine whether childhood abuse or neglect is associated with the age of onset of puberty and sexual and romantic behavior. A cohort of children (the Children in the Community study) was randomly selected and studied prospectively from childhood to adulthood. A sample of 816 youths were interviewed in their homes at a mean age of 14, 16, and 22 years in 1983, from 1985 to 1986, and from 1991 to 1994. The outcome measures included age of menarche, signs of male puberty, first being in love, dating, sexual intercourse, and pregnancy reported by youths. Child abuse and neglect were measured by official records and youth reports. A history of two or more incidents of sexual abuse was significantly associated with early puberty and early pregnancy after gender, class, race, paternal absence, and mother's age at the birth of the study child were controlled statistically. Public education regarding risk for premature sexual behavior among youths who have experienced sexual abuse is warranted. Efforts to prevent teenage pregnancy should include monitoring and educating sexually abused children as they enter puberty.

Adolescent↗