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PubMed1988

Effect of combined contraceptive steroid on rat brain ascorbate-acetylcholine with reference to protein restriction.

To evaluate the effects of combined contraceptive steroids on brain ascorbic acid and acetylcholine during protein restriction with respect to normal dietary condition the rats were subjected to normal (18% casein) and protein restricted (5% casein) diet for 28 days. Subsequently they were treated with combined contraceptive steroids for 28 days. Smear study were performed throughout the periods of dietary regimen and the drug treatment. Ascorbic acid and acetylcholine concentration of six discrete regions of brain were estimated from all groups of rats. At normal dietary state the combined contraceptive steroids significantly increase the ascorbic acid and decrease the acetylcholine concentration in the brain areas. At this state diestrus phase was indicated by smear study. After steroid treatment during protein restriction significant decrease of ascorbic acid and significant increase of acetylcholine concentration occurred in the brain areas. Proestrus and estrus phases were continued as indicated by smear study. It may therefore be presumed that contraceptive steroids affect the brain regional ascorbic acid and acetylcholine in an opposite manner during normal and protein restricted dietary condition.

Acetylcholine↗
PubMed1977

Six-year continuation rates for CU-T-200 users.

The long-term (six years) contraceptive effectiveness of the Cu-T-200 is evaluated based on 833 first insertions performed by physicians and nurse-midwives. IUD event rates (pregnancy, expulsion, pain/bleeding removal or removal for medical reasons) did not increase with increasing duration of use. The results of the study indicate that the Cu-T-200 is a safe and effective contraceptive for at least six years after insertion.

Adult↗
PubMed1981

Breast cancer and oral contraceptives: findings in Royal College of General Practitioners' study.

The incidence of breast cancer was studied among women taking part in the continuing cohort study organised by the Royal College of General Practitioners. An overall relative risk of 1.19 (not significant) was found in those who had used oral contraceptives. The risk ratio in women under 35 years old was 2.81, but this too was not significant. There was evidence that the estimated increased risk for younger women could be a chance occurrence. No convincing evidence of any adverse effects of oral contraceptives on breast cancer has been shown, but because of the long latent period of this tumour there is a need for longer observation.

Adolescent↗
PubMed1995

Adolescent medicine in pediatric practice: a survey of practice and training.

This study was designed to assess the relation between training in adolescent medicine, during and after residency, and self-reported practice of adolescent medicine. This is a cross-sectional study. A questionnaire was mailed to all members of the South Carolina Chapter of the American Academy of Pediatrics. After 2 mailings, 198 (83%) questionnaires were returned. Adolescent medicine training in residency was associated with more adolescent patients enrolled in a practice (P < 0.01) and more adolescent patient visits (P < 0.01) but not with an increase in perceived competence in the practice of adolescent medicine. Adolescent medicine continuing medical education was associated with seeing more adolescent patients and with increased competence in many areas, including contraceptives, suicide, and school problems (P < 0.05). training in adolescent medicine during and after residency is associated with treating more adolescent patients. Continuing medical education also is associated with increased perceived competence in areas related to adolescents.

Adolescent Medicine↗
PubMed2003

Gene fusion of molecular adjuvant C3d to hCGbeta enhances the anti-hCGbeta antibody response in DNA immunization.

OBJECTIVE: To express the hCGbeta-C3d3 fusion protein in a CHO cell continual expression system to investigate further the adjuvant effects of C3d on contraceptive vaccination. METHOD: We constructed a plasmid pcDNA3-hCGbeta-C3d3 which contains three copies of murine C3d cDNA and the hCGbeta gene by cloning the chimerical hCGbeta-C3d3 cDNA into the eukaryotic vector pcDNA3 downstream of the CMV promoter. The plasmid was transfected into a COS-7 cell transient expression system and a CHO cell continual expression system. RIA was used to detect hCGbeta in the culture supernatant. Western blot and Raji cell immunohistochemical assays were performed to evaluate the expressed protein. Then, 6-8-week-old female BALB/c mice were inoculated intramuscularly with pcDNA3-hCGbeta and pcDNA3-hCGbeta-C3d3, and ELISA was used to assess anti-hCGbeta IgG antibody in serum. RESULTS: In 72 h after COS-7 cells were transfected with the plasmid pcDNA3-hCGbeta-C3d3, 1.0x10(5) cells could secrete 152 ng of the recombinant protein (calculated by hCGbeta contained). The transfected CHO cells, which were then screened by G418, could continuously secrete the fusion protein at 660 ng/10(6) cells/48 h. The hCGbeta-C3d3 protein was purified by anti-hCGbeta immunoaffinity chromatography. Raji cell immunohistochemical assay demonstrated that both the hCGbeta and C3d3 were successfully fused. After DNA immunization intramuscularly, the anti-hCGbeta IgG antibody titer in the pcDNA3-hCGbeta-C3d3 immunized group was 243-fold higher than that of the pcDNA3-hCGbeta immunized group. CONCLUSION: We have expressed the hCGbeta-C3d3 protein successfully, both in a transient expression system (COS-7 cells) and in a stable expression system (CHO cells). The C3d3 molecular adjuvant can enhance significantly the immunogenecity of hCGbeta antigen in DNA immunization.

Animals↗
PubMed1996

Contraceptive choice, sexually transmitted diseases, HIV infection, and future fecundity.

Because contraception affects not only the risk of unplanned pregnancy but also that of sexually transmitted infections, the choice of particular methods is important to future fertility. However, certain trade-offs are necessary. Contraceptives with the best record of preventing pregnancy provide little protection against sexually transmitted diseases (STDs). Conversely, those barrier methods with higher failure rates for pregnancy can reduce the risk of acquiring or transmitting an STD. For example, condoms used correctly and consistently provide the best protection against infection. Although spermicides reduce lower genital tract bacterial STDs, their effectiveness against HIV is still unknown. In contrast to barrier methods, the IUD is associated with an increased risk for developing upper genital tract infection, primarily in the first month after insertion. Current literature raises paradoxical questions regarding the role of hormonal contraception in STDs and pelvic inflammatory disease. Moreover, epidemiological studies are equivocal regarding the public health value of recommending dual methods of contraception, one to prevent unplanned pregnancy and the other to prevent STDs. Investigations to date have focused on the use of the male condom added to other methods of contraception. In general, where participants were using primary methods other than the condom, the more effective the primary contraceptive method was in preventing pregnancy, the lower the level of consistent use of the male condom. Continued biologic and behavioral research will be necessary to disentangle these complex relationships.

Biology↗
PubMed1988

Minnesota Multiphasic Personality Inventory-rated depression and the incidence of breast cancer.

Using data from the Walnut Creek Contraceptive Drug Study (a prospective study begun in 1969 and continuing to the present), Minnesota Multiphasic Personality Inventory-(MMPI) measured scores for depression of 8932 women were studied in relation to the incidence of breast cancer. No statistically significant association between MMPI scores for depression and the subsequent development of breast cancer was found. There was neither an association of risk of breast cancer with repression/sensitization as measured on the MMPI nor with scores on the MMPI lie scale. This study is unique because it represents the largest reported prospective cohort in which the association between depression and breast cancer development has been examined.

Adult↗
PubMed2000

Update on the medical treatment of endometriosis.

The treatment of women with endometriosis can be a challenge. Therapeutic strategies must be tailored to the individual symptoms, age, and desire for fertility. Medical therapy continues to be based on endocrine treatment, such as oral contraceptives, progestins, danazol, and GnRH agonists. Unfortunately, recurrence rates are high after discontinuation of therapy. Recent clinical research on GnRH analogues plus add-back therapy has produced favorable results. Long-term treatment of patients using this approach has successfully reduced pain while minimizing symptoms of hypoestrogenism and adverse metabolic effects, such as loss of bone mineral density. Currently, GnRH analogues given with add-back therapy seems to be the most effective long-term approach to the treatment of symptomatic endometriosis. In the future, other modalities, such as medicated vaginal rings, inhibitors of steroidogenic enzymes, and GnRH antagonists, will most likely be options.

Contraceptives, Oral↗
PubMed2003

New methods of hormonal contraception.

Several new hormonal contraceptive methods have recently been approved by the Food and Drug Administration. most new methods combine the high efficacy of oral contraceptives with the longer-term delivery methods that eliminate the need to take a pill each day. New methods also offer reversibility and resumption of fertility if desired. This article discusses these new methods and reviews the literature on efficacy and side effects.

Contraception↗
PubMed2003

Training and supporting pharmacists to supply progestogen-only emergency contraception.

OBJECTIVE: To describe and evaluate the training and support provided to the first cohort of community pharmacists to supply progestogen-only emergency contraception (POEC) under a Patient Group Direction (PGD) in Lambeth, Southwark and Lewisham, London. DESIGN: The study comprised (a) a systematic analysis of written and oral data from pharmacists before and during training, and at 5 and 13-14 months after launch; (b) analysis of telephone calls to clinical support and (c) analysis of written pharmacy records. SUBJECTS: A total of 20/22 pharmacists in the first training cohort; 6/23 pharmacists who applied but were not accepted were also followed up. RESULTS: A formal course with role-play was a successful training method, and the course also served as a team-building exercise. Subsequent interviews demonstrated that pharmacists had understood the concept of client confidentiality and gained confidence over time in the use of the PGD. The on-call consultants received 152 calls in the first 12 months of the scheme. Over 80% of the calls concerned clinical criteria (notably including 22% that were queries about oral contraceptives). Frequency ranged from one to eight calls per week with 28% made at weekends. In over half (60%) of the calls the pharmacist was subsequently able to make a supply. Queries over client management resulted in several changes in the protocol. The primary expressed concern for all pharmacists at all time points was how clients might 'misuse' or 'abuse' the service, and this remained a concern despite the fact that it also applies to other routes of supply of POEC. However, the PGD cohort was more positive on local benefits than pharmacists who were not selected. CONCLUSIONS: Training and support have enabled this often-underused group of professionals to participate in an extended reproductive health service. Mobile phones are an essential support tool.

Cohort Studies↗
PubMed2003

Pharmacists and POEC.

Explore the source record for details and available documents.

Contraceptives, Postcoital, Hormonal↗
PubMed1990

Solutions: The Role of the Private Practitioner.

I. Continuity and Communication II. Financial Considerations III. Adolescent Gynecology IV. Contraceptive Counseling: A Dissenting View This article discusses four subjects that are essential considerations for physicians and other health care providers to deal successfully with adolescent patients. The first focuses on the integration of adolescents into a general pediatric practice. The second section examines financial considerations in the provision of adolescent health care. The third discusses confidentiality, common problems, and adolescent sexuality as part of adolescent gynecology. The fourth section discusses contraceptive counseling and suggests that more consideration be given to those factors innate to the adolescent psyche in counseling contraceptive methods.

Journal Article↗
PubMed2002

Characterization of a novel receptor mutation A-->T at exon 4 in complete androgen insensitivity syndrome and a carrier sibling via bidirectional polymorphism sequence analysis.

The complete androgen insensitivity syndrome (AIS) is a sub-type of X-linked male pseudohermaphroditism resulting from total dysfunction of the androgen receptor. Affected patients are phenotypically female despite a 46,XY genotype; gonadal tissue displays a classic Sertoli cell-only pattern on microscopic examination. We describe the diagnosis and management of a 19(1/2)-year-old patient who presented for primary amenorrhea and absent cervix, identified incidentally during a routine Pap test. Serum total testosterone was elevated (725 ng/dl) and the karyotype was 46,XY. Molecular investigation for specific gene defect(s) causing disruption and functional incapacity of the androgen receptor was undertaken for the proband and her only sibling. From this we discovered a previously unknown hemizygous mutation (A-->T) in exon 4 of the androgen receptor gene, associated with replacement of asparagine (AAT) with tyrosine (TAT) in the resultant androgen receptor protein [N705Y]. Bidirectional, non-isotopic sequence analysis of exon 4 was next undertaken for the proband's sister who was found to be heterozygous for this mutation. Psychological and genetic counseling was provided to both individuals; the patient underwent an outpatient laparoscopic orchiectomy without complication. She continues to receive oral hormone replacement therapy following an oral contraceptive model. In this report, the clinical approach to AIS is outlined from a reproductive endocrinology perspective with special emphasis on psychological counseling and laboratory methods employed to confirm the diagnosis at the molecular level. We also outline other recently described mutations of the androgen receptor gene (Xq11-12) which have been associated with AIS.

Adult↗
PubMedDate not supplied

[Liver hemangioma: the need for a well-defined differential diagnosis and the therapeutical timing dilemma].

Liver is frequently affected by hemangiomas originated during the embryonal period from defects in the maturation of the endothelia of the capillary system. These benign tumors may result asymptomatic for the whole life (4-7% of incidental autoptical reports), but in some cases they are liable to a spontaneous or traumatic rupture, with haemorrhagic complications which make an urgent laparotomy necessary. The rupture may be caused by different reasons, such as the critical size reached by the endothelia, the development of the mass due to the continuous pulsatility or the hormonal stimuli (puberty, pregnancy or oral contraceptives).

Adenoma↗