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PubMed1982

Venous and arterial thromboembolic disease in women using oral contraceptives.

Vascular plasminogen activator was measured by means of a new chromogenic assay in 24 women who had suffered from oral contraceptive-associated thrombotic disease and was compared to that in a control group of 78 premenopausal women. Vascular plasminogen activator levels were significantly reduced in the subjects who had venous thrombosis but not in the five women who had arterial thrombosis (0.04 +/- 0.03 versus 0.38 +/- 0.31, respectively) when compared to the levels in the control group (0.19 +/- 0.20). Since vascular activator levels distribute in a non-Gaussian manner, cases and controls were also stratified into deciles. Seventeen subjects who had suffered from venous thrombosis were stratified in the lowest three deciles, and two subjects, in the fourth and fifth deciles. Subjects who had suffered from arterial thrombosis were in the fourth or higher deciles. The conclusion is that, although there is a correlation between low levels of vascular plasminogen activator and venous thrombosis, no such correlation exists for arterial thrombosis.

Adult↗
PubMed2004

Preparation and characterization of starch/cyclodextrin bioadhesive microspheres as platform for nasal administration of Gabexate Mesylate (Foy) in allergic rhinitis treatment.

Bioadhesive and biodegradable microspheres were obtained by chemical cross-linking with epichlorohydrin of an alkaline solution of a mixture of starch and alpha-, beta-, or gamma-cyclodextrin (CyD). Microspheres were characterized by scanning electron microscopy, swelling degree, and water retention. The percentage of the effective CyD in microspheres was estimated by measuring the amount of iodine and typical organic compounds (TOCs) retained in the hydrophobic cavity of CyD. Gabexate Mesylate (trade name Foy); GM), an antiallergic drug, was included in microspheres by soaking in an aqueous solution containing the drug, followed by solvent evaporation or lyophilization. UV, IR, and DSC data indicated that despite the fact that GM is a hydrophilic drug, its hydrophobic moiety close to the benzene ring is able to penetrate the CyD cavity and to form stable inclusion complexes. Values of the association equilibrium constant for GM binding to CyD, obtained by UV differential spectroscopy, indicated that the affinity of the drug for alpha- and gamma-CyD is higher than that for beta-CyD. In vitro, GM was gradually released during 1h. Even if the release rate of the drug is relatively fast, the microspheres might actually provide the best platform since the material adheres to the nasal mucosa which was proved by adhesion tests. The GM integrity was checked by comparing its anti-trypsin activity before and after release.

Adhesives↗
PubMed2000

Bcl-2, Fas and caspase 3 expression in endometrium from levonorgestrel implant users with and without breakthrough bleeding.

Women using the progestin-only contraceptive Norplant often suffer from unpredictable bouts of breakthrough bleeding, which usually occurs from a thin atrophic endometrium. The role of cellular apoptosis in the endometrial response to Norplant has not been investigated. The aim of the present study was to use immunohistochemistry to produce semi-quantitative scores for expression of the apoptosis-related proteins Bcl-2, Fas and caspase 3 in endometrium from 16 controls and 42 women using Norplant with minimal or major breakthrough bleeding problems. The results showed no difference in endometrial immunostaining for any of the three proteins between Norplant users with and without breakthrough bleeding. There was also no evidence of endometrial endothelial cell immunostaining for any of the proteins. Bcl-2 was the only protein to show a cyclical pattern, with higher expression in the proliferative compared to secretory glands. All three proteins showed different expression levels in control functionalis versus basalis, with the survival protein Bcl-2 being higher in basalis, and the death receptor Fas and the proteolytic enzyme caspase 3 being higher in the functionalis. Overall, the results suggest that apoptosis is regulated differently in functionalis compared to basalis, and that atrophic Norplant-exposed endometrium appears more like functionalis than basalis with respect to expression of Fas and caspase 3. There was no evidence for a role for apoptosis in the mechanisms that underlie progestin-induced endometrial breakthrough bleeding.

Apoptosis↗
PubMed1980

[Not Available].

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Bangladesh↗
PubMedDate not supplied

[Human papillomavirus infection, a possible biological marker of sexual behavior among university students].

OBJECTIVE: To estimate the prevalence of Human papillomavirus (HPV) among university students and to use it as a biological marker to assess sexual behavior. MATERIAL AND METHODS: A cross-sectional study was carried out between 2000 and 2001 among 194 students at Universidad Autónoma del Estado de Morelos, Mexico. A data collection instrument was applied and genital samples were taken to detect oncogenic HPV DNA. Data were analyzed using the chi-squared test and odds ratios. RESULTS: Overall HPV prevalence was 14.4%. Women who had had two or more sexual partners during the previous year showed a greater risk of HPV infection (OR 6.0, 95% CI 1.7-21.1), as did women who had used oral contraceptives and spermicides at their latest intercourse (OR 3.0, 95% CI 1.0-8.7). Males who consumed cocaine were at a greater risk of HPV infection (OR 7.6, 95% CI 1.3-45.1). CONCLUSIONS: HPV prevalence is relatively high. HPV is a reliable biological marker of sexual behavior among females. A greater sample size may be needed to assess its reliability among men.

Adolescent↗
PubMedDate not supplied

[School absenteeism in adolescent girls due to gynecologic diseases and conditions].

A distribution is made of excuse for the non-attendance at school of adolescent girls, by which two groups of health disorders could be distinguished, one group including excuses for the non-attendance of up to one day for painful syndromes, contraception, menstrual trouble, examinations for suspected pregnancy, vaginal candidiasis, condyloma, pediculosis, and the inflammation of the urinary bladder, and the other group including excuses for the non-attendance of 2-5 days for non-specific inflammations of the vagina, vulva and cervix, abortion, pelvic inflammatory disorders, vaginal trichomoniasis, and injuries. Rarely encountered disorders were dealt with from case to case. The highest average number of excuse days (4.8) related to abortion. The excuse made most frequently (220) were those relating to painful syndromes, 48.1% of the total number of the excuse, averaging 1.2 days per excuse. The total average per excuse was 1.6 days.

Absenteeism↗
PubMed1995

[Epidemiology of pulmonary embolism].

There are few conditions in medicine as difficult to diagnose as pulmonary embolism. This is certainly not due to the rarity of the disease which is probably as common as myocardial infarction in France. The circumstances surrounding pulmonary embolism and the risk factors of deep venous thrombosis have been well identified. The risk of thromboembolic venous disease has been assessed for each type of surgery. The methods of treatment and prevention have progressed over a number of years. However, in practice, these advances have not "transformed" the frequency of the disease or reduced its mortality. Further progress could come from improved identification of patients at risk, especially by biological tests and new abnormalities of blood coagulation.

Adult↗
PubMed1998

Influence of gender on the pharmacokinetics and pharmacodynamics of drugs.

Historically, women, the elderly, and minorities were underrepresented in clinical drug trials. Information on possible gender-related differences in the pharmacokinetics of drugs is often lacking, although for some drugs significant differences could be demonstrated. In women, absorption, protein binding, volume of distribution, and metabolism of drugs may differ due to hormonal influences on physiological functions. Sex-related differences could be shown for phase I (cytochrome P450) as well as phase II (especially glucuronidation) reactions. Since many women world-wide take oral contraceptives, data should be provided to determine to what extent other drugs are influenced by estrogens and progestogens or to what extent the other drugs may attenuate the contraceptive efficacy. Moreover, estrogens interact with various enzymes and receptors, e.g. at the endothelial function as well as dopaminergic receptor sites, and may therefore attenuate or enhance drug effects or even drug side-effects. For a number of drugs it is well recognized, that women suffer more frequently from side-effects, however, it is often not clear, if this is due to gender differences in the pharmacokinetics or pharmacodynamics of the responsible drug. Very little is known about these gender-related differences and the possibility that women may show a different pattern of treatment response than men. As a result, drug approval authorities now require more data on the pharmacokinetics of novel drugs in women as well as a sufficient accrual of women in efficacy and outcome trials.

Aging↗
PubMed1997

Effect of oral contraceptives on haemostasis variables.

Combined oral contraceptives (COCs) have effects on a large number of haemostasis variables. We have summarised literature data on effects of COCs containing 30-35 micrograms ethinyl estradiol for the third generation of progestogens (PGs): desogestrel, gestodene and norgestimate. It is concluded that about 15 variables show a shift in distribution of the order of magnitude of their interindividual variation coefficient. When comparing the third generation of PGs with the second one (norgestrel, levonorgestrel) stronger increases are noted for the former for some haemostatic variables. Also differences between desogestrel and gestodene for factor VII were apparent. It indicates that the role of PGs in the effects of COCs is significant and their design may in addition to reduction of oestrogen dosage be important in reducing haemostatic complications. The survey on molecular and cellular mechanisms by which the sex steroids might operate showed a great lack of knowledge. Only for factor XII has a functional oestrogen response element in the DNA definitely been identified. The study of molecular markers of coagulation and fibrinolysis have shown a distinct increased activation of coagulation (F 1 + 2, FPA) and fibrinolysis (PAP), and an increased fibrin turn-over (increased FDPs); platelet products are not found increased (beta TG, PF-4). The increase in fibrinolysis represent a counterforce, but individual changes in variables in coagulation and fibrinolysis do not correlate indicating independent effects and no evidence for a individually regulated balance. A first step in further research might be in understanding the increase in coagulation activation (F 1 + 2) which has so far not been satisfactorily related to changes in blood concentrations of haemostatic factors and possibly local factors.

Biomarkers↗
PubMed1993

Lp(a) levels and antiestrogen antibodies in women with and without thrombosis in the course of oral contraception.

Several reports have shown that lipoprotein(a) is associated with ischemic diseases. Two characteristics might explain this association. Firstly, Lp(a) is an LDL-like lipoprotein which may be implicated in the atherosclerotic process and secondly, Lp(a) possesses an additional apolipoprotein(a) whose structure is close to that of plasminogen and might confer to the molecule prothrombotic properties. It seemed of interest to see whether Lp(a) was a risk factor in oral contraceptive users with thrombotic complications, a group of young women with presumably little or no atherosclerosis. Three groups of women were compared: 25 of them served as controls and did not use oral contraceptives (OC) (group 1); 25 women were healthy current users of OC (group 2); 35 women suffered thrombotic complications in the course of OC (group 3). Mean levels of Lp(a), estimated by RID, were not found to be significantly different in the 3 groups: 19 +/- 18, 20 +/- 23 and 16 +/- 22 mg/dl, respectively. Levels above 30 mg/dl were similarly distributed. Among the other risk factors studied, antiestrogen antibodies were absent in group 1, present in 24% of group 2 and 71.4% of group 3 (P < 0.01). Serum cholesterol levels were similar in the 3 groups: 209 +/- 33, 220 +/- 41, 213 +/- 45 mg/dl respectively. Mean serum triglyceride levels were higher in group 2 than in group 1 (61 +/- 18 and 83 +/- 32, P < 0.01), and higher in group 3 than in group 2 (116 +/- 66 and 83 +/- 32, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Polycystic ovaries--a common finding in normal women.

The prevalence of polycystic ovaries (PCO) in normal women of reproductive age was determined by pelvic ultrasound scanning of 257 volunteers who considered themselves to be normal and who had not sought treatment for menstrual disturbances, infertility, or hirsutism. All women had completed a menstrual history questionnaire. 99 women were on oral contraceptives at the time of the study. Of the 158 subjects who were not on oral contraceptives 18% had irregular cycles. 116 (73%) women had normal ovaries and 36 (23%) had PCO. 5 women had multifollicular ovaries and 1 had small, unstimulated ovaries. Only 1 woman with normal ovaries had an irregular menstrual cycle. Of the women with PCO, 76% had irregular cycles, and 6 of the 8 with regular cycles were hirsute. Women with and those without PCO differed in distribution of serum LH concentrations although the median values were similar. 25% of women with PCO had LH concentrations which exceeded the upper limit of the normal range. Thus PCO are common in normal women. Some of these women may have clinical and biochemical markers of PCO, which suggest that PCO in women who consider themselves to be normal is part of the same clinical spectrum as the classic Stein-Leventhal syndrome.

Adolescent↗
PubMed1988

Body size, reproductive factors, and breast cancer survival.

Mortality rates among 838 white female breast cancer patients were examined for relationships to personal characteristics assessed at time of diagnosis. These included weight and body mass index, oral contraceptive use, and prior menstrual and reproductive events. Multivariate analyses were used to determine the importance of these characteristics in predicting death rates specific for age and extent of disease at time of diagnosis. Weight was associated with poor prognosis among premenopausal patients, but not among postmenopausal patients. Premenopausal women weighing more than 140 lbs at diagnosis had death rates 1.7 times those of lighter women (P = 0.04). This effect was not explained by differences in the distribution of disease stage between the two groups. Body mass index was positively associated with mortality in both premenopausal and postmenopausal patients. In the entire group, the death rate ratio was 1.4 (P = 0.02) for obese (body mass index greater than 30.4 X 10(-3) lbs/in.2) vs lean women. Among premenopausal patients, parous women had higher mortality rates than nulliparous women (death rate ratio = 2.0, P = 0.06). Although the data were sparse, death rates were higher for women having a full-term pregnancy within 2 years of diagnosis than for premenopausal women with earlier pregnancies. Oral contraceptive use, age at menarche, age at first full term birth, and age at menopause were unrelated to mortality.

Adult↗
PubMed1981

Epidemiology of trisomy 21: population, peri- and antenatal data.

In Down's syndrome, incidence of 1 0/00-2 0/00 have been reported in chromosomal surveys of consecutive liveborn infants and in population studies. Much attention has been focused on the influence of the decline in mean maternal age on the incidence of Down's syndrome. Decline in incidence and unchanged incidences have been reported. For mothers over 35 years old, a rise in incidence has been found in recent years in some societies. Environmental factors or seasonal fluctation might cause this trend. Data from antenatal diagnosis show a 30% higher incidence of Down's syndrome for age groups over 35 than population studies do. Late abortions of trisomic fetuses, a high perinatal mortality, and a small rise in incidence for higher maternal ages in recent years may account for this fact. With the growing tendency toward younger maternal age at childbirth, paternal factors also have to be considered. Between 10% and 30% paternal failures have been found by nondisjunction studies applying chromosomal variants. The rate of paternal failures may reflect environmental influences and young maternal age distribution. Recently, an increase in trisomy 21 children of mothers in the age group 30-39 who are pill users has been observed. The positive sex ratio of male Down's syndrome patients has been reversed in patients born to mothers using hormonal contraception. The mortality rate, in Down's syndrome is still high in early childhood, especially perinatally and in the 1st year of life. For the late 1940s in Denmark, newborns with Down's syndrome had a mortality rate of 53% in the 1st year of life. In the late 1960s and early 1970s, the rate had fallen to 22%. The main causes of death were congenital heart disease in connection with infections, especially pneumonia. Cot death might be more common in Down's syndrome. After the age of 1 year, mortality is reduced considerably and more and more cases will survive early childhood and live to rather old ages.

Adult↗
PubMed1983

Ovarian cancer. Geographical, host and environmental factors. An overview.

The incidence of ovarian cancer is reviewed among different races and ethnic groups. We present the effect of socio-economic class, age, endocrinological factors, menstrual cycle, reproductive history, familial, and genetic factors, viral infections, chemical carcinogens, and previous exposure to radiation on the incidence of ovarian cancer. There is evidence that environmental factor affects the distribution of various types of ovarian cancer. Migration may also change the susceptibility to this disease and the mean age was varied between countries being lowest where incidence was highest. The disease appeared to have a familial incidence. The protective effect of oral contraceptive steroids and the role of asbestos as a chemical carcinogen are discussed.

Adolescent↗