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PubMed1992

[Risk of pregnancy in adolescence].

OBJECTIVE: To describe the frequency and distribution of sexual conduct with risk of pregnancy, the degree of information on sexuality and contraceptive methods. To analyze the relationship between sexual conduct with risk of pregnancy and the most relevant variables of social surroundings of the adolescent: family, friends, school, etc. DESIGN: Descriptive survey by means of a questionnaire. LOCATION: Basic Neighbourhood Health Zone (Gran Canaria). TARGET GROUP: Teenage students aged between 14 and 19. Measurements and main results 21% of the population in the survey have sexual relationships, and out of these, 88% run a high risk of becoming pregnant. The information they have is basically theoretical, and practical knowledge is low. Older adolescents (OR, 1,4/year), males (OR 2.08), those with parents with no qualifications (OR 1.88) and those with parents of a high income bracket (OR 4.11) have the most high-risk sexual relationships. CONCLUSIONS: The importance of high-risk sexual conduct in adolescence is underlined, plus the need for information of adolescents, although it does not seem enough, in order to face sexuality with guarantees.

Adolescent↗
PubMed1990

[Focal peliosis of the adult liver in combination with glycogenosis type I (v.Gierke). A case report and review of the recent literature].

Peliosis hepatis is a condition characterized by blood-filled lesions in the liver that can be localized or diffuse in distribution. The predisposing factors for this condition include treatment with anabolic steroids, chemotherapeutic and oral contraceptive agents, catabolic metabolic conditions (e.g., hypoglycemia) and certain immunological disorders. This disease probably represents a non-specific immunological response to a variety of noxious agents and has been successfully induced in experimental animals. The increased tendency towards liver rupture following blunt trauma and resuscitation procedures may have important medicolegal consequences. We present a case of peliosis hepatis in a patient with type I glycogen storage disease (von Gierke).

Adult↗
PubMed1984

[Unilateral nevoid telangiectasia syndrome. Study of cutaneous estrogen receptors].

We present four observations of unilateral nevoid telangiectasia syndrome, pointing out its common cervicothoracic distribution and its relation with hyper-estrogenic conditions, both physiological (puberty, pregnancy, use of contraceptive pills), and pathologic (post-alcoholic hepatic cirrhosis). We also comment on its differential diagnosis with similar diseases. A study of estrogenic receptors in the affected skin was carried out, thus supplying further data for the ethiopathogenesis of the process.

Adolescent↗
PubMedDate not supplied

The relationship of migraine and stroke.

Migraine, a common disorder of uncertain pathogenesis, is linked to ischemia in a variety of ways. In some cases the relationship is coincidental. In others, migraine may be causally related to stroke, although the mechanism of migrainous stroke, if not due to arterial dissection, is unclear. In young women, additional risk factors for stroke such as cigarette smoking, use of combined oral contraceptives and anticardiolipin antibody immunoreactivity may potentiate migraine, especially migraine with aura, as a stroke risk factor. The complexity of the relationship is highlighted in certain genetic conditions such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and mitochondrial encephalopathy with lactic acidosis and stroke in which migraine and stroke are both prominent clinical features.

Adolescent↗
PubMed1998

GPs, schoolgirls and sex. A cross cultural background comparison of general practitioner attitudes towards contraceptive service provision for young adolescent females in Scotland.

No previous studies have examined the influences of cultural background on the provision of contraceptive services to females under 16 years of age. A research project was undertaken to investigate any differences between general practitioners trained in the United Kingdom and those trained in the Indian sub-continent in relation to contraceptive service provision to females under 16 years of age. A self-completion postal questionnaire survey was distributed to 230 unrestricted principal general practitioners across Scotland. Subjects were identified from the Medical Register. Half of the sample consisted of all those working in Scotland who had been trained in the Indian sub-continent. The other half were a comparable group that had been trained in the United Kingdom and were selected by quasi-random quota sampling. The response rate was 57 per cent (131/230). General practitioners in the study who had trained in the Indian sub-continent were found to be significantly less likely to provide contraceptive services to a female under 16 years of age than those who had trained in the United Kingdom. Cultural background may be influential in general practitioner provision of contraceptive services to females below the legal age of consent for sexual intercourse. In order to obtain more conclusive evidence a larger study is necessary. Such investigations must be undertaken with appropriate sensitivity and social awareness.

Adolescent↗
PubMedDate not supplied

Awareness, attitude and practice of contraception among secondary school girls in Calabar, Nigeria.

BACKGROUND: Adolescents are disposed to unprotected sexual activity and as a consequence, there is an increasing incidence of unwanted pregnancy among adolescent school girls in Nigeria. This study was carried out to assess the awareness, attitude and use of contraceptives among secondary school girls in Calabar, Nigeria and to determine how attitude affects its use. METHODS: Data was obtained using self administered semi-structured questionnaires distributed to 480 secondary school girls out of which 450 were properly filled and returned. These were analysed using percentages and chi-square was used to test for significance. RESULTS: The study revealed that contraceptive awareness was high. The main sources of contraceptive information were books/magazines (37%) and friends (26%). Three hundred and thirty-three (74%) girls had a negative attitude (misconceptions) towards contraceptives, while 117 (26%) girls said contraceptives were essential/useful. Sixty-six girls (14.7%) admitted that they were currently sexually active and 42 (9.3%) of them used contraceptives. There was a statistically significant association between positive attitude/beliefs and use of contraceptives (P < 0.05). CONCLUSION: We recommend the provision of accurate contraceptive information to dispel these misconceptions and the establishment of adolescent reproductive health services which should be strictly confidential to encourage acceptability and optimum utilization.

Adolescent↗
PubMed1995

[The distribution of cervical cancer mortality in Spain (1981-1986). An ecological study].

BACKGROUND: The aim of the present study was to analyze the geographic distribution of mortality by cervical cancer in Spain from 1981-1986 and to examine the relationship with a group of variables such as per capita income, the occurrence of sexually transmitted diseases, the number of hotel rooms, and the prescriptions of oral contraceptives at a provincial level. METHODS: The causes standardized of death for cervical cancer in each Spanish province during the period from 1981 to 1986 were estimated. Multivariate analysis by Poisson regression was performed to determine the relationship between mortality and the variables collected. To do so the provinces were classified into four categories according to quartile distribution of each independent variable considered with the relative risk for each category created being estimated. RESULTS: A characteristic mortality pattern was observed in cervical cancer with the greatest mortality being found in the island and some coastal provinces and the lowest mortality in the peninsular inland provinces. Upon simple analysis of the relationship of mortality with the ecologic variables an important positive association was found with the number of hotel rooms and, to a lesser degree, with the oral contraceptive prescriptions, provincial per capita income, the percentage of urban population and the rate of illiteracy. CONCLUSIONS: A distribution of mortality by cervical cancer which appears to correspond to a certain leisure-tourism pattern, in addition to greater urban and lesser cultural development is reported. This may be in agreement with the hypothesis that cervical cancer is more frequent in more urban areas in which women demonstrate greater promiscuity and relaxation of sexual behaviours, together with the persistence of a low education level.

Bias↗
PubMed2005

Use of the levonorgestrel-releasing intrauterine system and breast cancer.

OBJECTIVE: The effect of exogenous hormones on the incidence of breast cancer has been extensively studied. Most studies regarding hormonal contraception have focused on combined oral contraceptives, and there is paucity of literature regarding nonoral and progestin-only contraceptives. The present study analyzed the relationship between breast cancer and use of the levonorgestrel-releasing intrauterine system. METHODS: This study was based on data gathered from a large postmarketing study on levonorgestrel-releasing intrauterine system users (n = 17,360) carried out in Finland. The results present an incidence comparison between levonorgestrel system user data and the data on average Finnish female population (derived from the Finnish Cancer Registry), between 30 and 54 years of age. RESULTS: Based on the 95% confidence intervals for the incidences of breast cancer, and the Fisher exact test, there is no indication of a difference between the levonorgestrel system users and average Finnish female population in any of the 5-year age groups. The incidence rate per 100,000 woman-years was for the age groups 30-34 years 27.2 and 25.5, for 35-39 years 74.0 and 49.2, for 40-44 years 120.3 and 122.4, for 45-49 years 203.6 and 232.5, and for 50-54 years 258.5 and 272.6, in the levonorgestrel system group and in Finnish female population, respectively. CONCLUSION: The results suggest that the use of the levonorgestrel-releasing intrauterine system is not associated with an increased risk of breast cancer.

Adult↗
PubMed2001

Hormonal factors and risk of aneurysmal subarachnoid hemorrhage: an international population-based, case-control study.

BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) is more common in women than in men, but the role of hormonal factors in its etiology remains uncertain. The aim of this study was to examine the relationship between hormonal factors and risk of SAH in women. METHODS: This was a prospective, multicenter, population-based, case-control study performed in 4 major urban centers in Australia and New Zealand. Two hundred sixty-eight female cases of first-ever aneurysmal SAH occurred during 1995-1998. Controls were 286 frequency-matched women from the general population of each center. Outcome measures included risk of SAH associated with use of oral contraceptive pills (OCPs), hormone replacement therapy (HRT), and various endogenous hormonal factors including menstrual patterns, parity, age at birth of first child, and breast-feeding practices. RESULTS: Cases and controls did not differ with regard to menstrual and reproductive history except in age at birth of first child, where older age was associated with reduced risk of SAH (odds ratio [OR], 0.63; 95% CI, 0.43, 0.91). Relative to never use of HRT, the adjusted OR for ever use of HRT was 0.64 (95% CI, 0.41, 0.98), which did not alter significantly after further adjustment for possible confounding factors. Borderline evidence of an inverse association was detected for past use of HRT (adjusted OR, 0.59; 95% CI, 0.30, 1.13) and current use of HRT (adjusted OR, 0.67; 95% CI, 0.40, 1.13), but there was no evidence of an association for use of OCPs (adjusted OR, 0.97; 95% CI, 0.58, 1.60). CONCLUSIONS: The risks of SAH are lower in women whose first pregnancy is at an older age and women who have ever used HRT but not OCPs. The findings suggest an independent etiologic role for hormonal factors in the pathogenesis of aneurysmal SAH and provide support for a protective role for HRT on risk of SAH in postmenopausal women.

Age Distribution↗
PubMed2001

Preliminary examination of oral contraceptive use among university-aged females.

The etymology and use of oral contraceptives (OCs) has greatly influenced the sexual practices and social lives (e.g., decisions concerning childbearing, careers) of adolescent and adult women. In addition, OCs have the potential to benefit or harm its users depending upon the utilization practices and characteristics/lifestyle habits of the women consuming them. A 28-item questionnaire was distributed to female students at a university in Central Ontario and examined: (1) socio-demographic information; (2) background information concerning oral contraceptive use (e.g., length of time taking the pill, concerns about pill use, side effects while on the pill); and (3) procedure for taking the pill (e.g. maximizing effectiveness and safety). Preliminary analysis indicated that females may not be equipped with adequate knowledge or receiving the necessary support to practice the most efficacious behaviours surrounding pill use.

Adolescent↗
PubMed1993

Case-control study of risk factors for cervical squamous-cell neoplasia in Denmark. III. Role of oral contraceptive use.

The role of oral contraceptive (OC) use in relation to the risk of cervical neoplasia (squamous cell) was investigated in a population-based case-control study in Denmark of 586 women with histologically verified cervical carcinoma in situ (CIS), 59 women with invasive cervical cancer from Copenhagen, and 614 controls drawn at random from the female population in the study area. Ever use of OCs was associated with an increased crude risk for carcinoma in situ (relative risk [RR] = 1.8, 95 percent confidence interval [CI] = 1.3-2.5). The crude risk in relation to invasive carcinoma was 1.6 (CI = 0.7-3.5). After adjustment for potential confounders (excluding human papillomavirus), the risks were marginally increased, but not statistically significant (CIS: RR = 1.4, CI = 0.9-21: invasive: RR = 1.3, CI = 0.5-3.3). The risk increased with duration of use; compared with never users, the adjusted RR for carcinoma in situ was 1.9 (CI = 1.1-3.1) for women who had used OCs for six to nine years, and 1.7 (CI = 1.0-2.7) for women who used OCs for 10 years or more. This was independent of years since last use since both recent and non-recent long-term users were at an increased risk. This trend in risk with duration did not apply to the same extent to invasive lesions. The observation that the risks related to OC use were found both in women who had ever had a Pap smear and in women who had never been screened previously may speak against detection bias as an important factor.

Adult↗
PubMed2002

Reproductive and menstrual history and papillary thyroid cancer risk: the San Francisco Bay Area thyroid cancer study.

Thyroid cancer rates are three times higher in women than men during the period between puberty and menopause, suggesting that the etiology of thyroid cancer may be related to female sex hormones and reproductive function. However, the results from epidemiological studies have been mixed. To assess this hypothesis, data on menstrual history, pregnancy history, and exogenous hormone use were analyzed from a population-based, case-control study conducted in the San Francisco Bay Area. Of 817 incident thyroid cancer patients (cases), ages 20-74 years, who were diagnosed in 1992-1998 and 793 controls, identified by random-digit dialing and frequency matched to cases on age and race/ethnicity, 608 (74%) cases and 558 (70%) controls were interviewed. Of these cases, 544 were of papillary histology and included in the present analysis. Women who reported onset of menarche before age 12 or after age 14 were at about 50% increased risk for papillary thyroid cancer; however, this effect differed among age- and ethnic-specific subgroups. Among parous women younger than age 45, risk was elevated for several variables measuring recency of pregnancy. Risk was reduced for women who had ever used oral contraceptives [odds ratio (OR), 0.73; 95% confidence interval (CI), 0.52-0.97], but there was no trend with duration of use. Although it remains unclear how sex hormones influence thyroid carcinogenesis, these relationships warrant further investigation.

Adult↗
PubMed1989

Parental sex preference and its effects on fertility intention and contraceptive use in Calcutta.

This study investigated parental sex preference and its effects on fertility intention and contraceptive use in Calcutta. It also investigated the socioeconomic differentials of these effects. Data on 4536 married women of childbearing age came from a cross-sectional survey of slum and non-slum areas conducted in 1970. Desired numbers of sons and daughters in the slum area were 1.89 and 1.30, respectively, and in the non-slum area, 1.63 and 1.17, respectively. 35% of slum women and 30% of non-slum women wanted to have more children, and 22% of slum women and 45% of non-slum women were reported to use contraceptives. The authors estimate that in the absence of parental sex preference, 11% fewer slum women and 12% fewer non-slum women would desire more children. On the other hand, 20% more slum women and 8% more non-slum women would use contraceptives in absence of parental sex preference.

Asia↗
PubMed1996

Ovarian cancer incidence (1989-1991) and mortality (1954-1993) in The Netherlands.

OBJECTIVE: To examine ovarian cancer incidence and mortality in the Netherlands, and to relate trends in mortality to changes in parity and use of oral contraceptives. METHODS: Age-standardized and age-specific incidence and mortality rates are presented using incidence data from the Netherlands Cancer Registry, 1989-1991, and mortality data from the Netherlands Central Bureau of Statistics, 1954-1993. RESULTS: In the period 1989-1991, age-standardized incidence of ovarian cancer was 14.9 per 10(5) woman-years. The majority (89%) of these tumors had an epithelial origin. Two-thirds of all newly diagnosed ovarian cancers already showed extension to the pelvis or beyond at diagnosis. From the period 1954-1958 to 1969-1973, age-standardized mortality rates increased from 10.6 to 13.1 per 10(5) woman-years. Thereafter, a decline was noted to 11.4 per 10(5) woman-years in the period 1989-1993. Age-specific mortality rates showed a pattern of rising mortality in the elderly, whereas mortality in the younger age categories was declining. The number of live births has declined gradually, and oral contraceptive use has increased. CONCLUSION: Incidence of ovarian cancer is high in the Netherlands, but comparable to other countries in north-western Europe and North America. Mortality rates are rising in the elderly and declining in the young. Further research is needed concerning the effects of oral contraceptives, fertility drugs, and hormone replacement therapy on the incidence and mortality of ovarian cancer.

Adult↗
PubMed1991

[Trends and correlates of fertility decline in the NIES].

"Trends and correlates of dramatic fertility declines in the NIES [newly industrialized economies of Asia] from the 1960s to the 1980s are examined in this paper. Specifically, we first look at changes in the fertility effects of such demographic factors as age structure of fertility, age pattern of marriage, and marital fertility. Next, as major proximate determinants of fertility, we examine changes in contraception and induced abortion. We then examine the fertility effects of changes in infant mortality and family planning programs. Finally, by examining changes in such socioeconomic factors as educational attainment and female labor force participation as well as attitudinal changes toward marriage and the family, we seek to infer their effects on fertility declines in the NIES." The data primarily concern Hong Kong, the Republic of Korea, Singapore, and Taiwan. (SUMMARY IN ENG)

Abortion, Induced↗
PubMed2003

Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study.

Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. A total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 Bogota, Colombia, women aged 13-85 years followed between 1993 and 2000 (mean follow-up, 5.3 years). HPV DNA detection and viral load determination were based on a GP5+/GP6+ polymerase chain reaction enzyme immunoassay. Rate ratio estimates for HPV clearance were calculated by using methods for interval-censored survival time data. Analyses were based on 316 type-specific HPV infections. HPV 16 had a significantly lower clearance rate than infections with low-risk types (rate ratio (RR) = 0.47, 95% confidence interval (CI): 0.32, 0.72), HPV types related to HPV 16 (types 31, 33, 35, 52, 58) had intermediate clearance rates (RR = 0.62, 95% CI: 0.47, 0.94), and other high-risk types did not show evidence of slower clearance compared with low-risk types. Infections with single and multiple HPV types had similar clearance rates. There was no evidence of a dose-response relation between clearance and viral load. Observed was slower clearance in parous women (RR = 0.64, 95% CI: 0.47, 0.89) and faster clearance in ever users of oral contraceptives (RR = 1.38, 95% CI: 1.07, 1.77).

Adolescent↗