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At least 1,603 records · Page 89Linked to original sources
PubMed1968

Contraceptive action of continuous low doses of norgestrel.

Norgestrel in a dose of 50 mug. was administered daily to 188 women during 2,250 menstrual cycles. Only two pregnancies occurred because of failure of the method, giving a failure rate of 1.1 pregnancies per 100 woman-years. The method was acceptable to most of the subjects, and side-effects, other than menstrual irregularity, were minimal; 68% of the cycles were 28 +/-5 days in length and 21% were less than 23 days. There did not appear to be any increased incidence of amenorrhoea. The antifertility action of continuous administration of low doses of progestogen may be due to an effect on corpus luteum function, in addition to the effects on cervical mucus, endometrium, and tubal transport of ova. The optimum dose of norgestrel appears to be in the range of 50-75 mug./day.

Adolescent↗
PubMed1986

Adult-onset amenorrhea: a study of 262 patients.

A series of 262 patients with amenorrhea of adult onset are reported. Hypothalamic suppression followed by inappropriate positive feedback, and then hyperprolactinemia and ovarian failure are the most frequently encountered etiologies. Other etiologies are diverse and numerically less frequent. Amenorrhea after use of oral contraceptives, or postpill amenorrhea, occurred in 77 (29%) of all patients. The average age of presentation, prior menstrual history, associated morbidity, and subsequent reproductive potential of each diagnostic group are reported. Adult-onset amenorrhea has a less significant impact on future wellbeing than was reported for a similar-sized group of patients whose amenorrhea developed as a result of pubertal aberrancy.

Adult↗
PubMed1998

Topiramate: pharmacokinetics and pharmacodynamics.

Topiramate is a structurally novel anti-epileptic drug with at least 3 postulated mechanisms of action including: 1) potentiation of GABA responses, 2) impairment of AMPA/kainate glutamate receptors and 3) suppression of high frequency action potential firing. It has a favourable pharmacokinetic profile with rapid absorption, good bio-availability, linear pharmacokinetics, relatively long half-life and limited pharmacokinetic drug interactions. However, topiramate can reduce the estrogen component of oral contraceptive medications. Women may require birth control preparations containing 50 micrograms of estrogen. Topiramate clearance is reduced in severe renal failure and increased by enzyme-inducing anti-epileptic drugs. The dose of topiramate may have to be reduced in renal failure or when withdrawing enzyme inducers.

Animals↗
PubMed2000

Acceptability of suction curettage and mifepristone abortion in the United States: a prospective comparison study.

OBJECTIVE: We sought to compare the acceptability of suction curettage abortion with that of medical abortion with mifepristone and misoprostol in American women. STUDY DESIGN: We performed a prospective, serially enrolled, cohort analysis. The study population consisted of 152 subjects receiving mifepristone and misoprostol and 174 subjects undergoing suction curettage abortion aged > or =18 years with intrauterine pregnancies of up to 63 days' estimated gestation. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit. RESULTS: Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (mean rank, 121 vs 149; P <.01) but were no more likely to recommend the method they had just experienced to a friend (97% vs 93.3%). If a future abortion was required, however, 41.7% of subjects undergoing surgical abortions indicated they would opt for a medical abortion, whereas only 8.6% of subjects receiving medical abortions would choose a surgical abortion (P <.001). Failure of the abortion decreased satisfaction in the medical group and increased the likelihood of choosing a surgical abortion for a subsequent procedure (P <.001). Surgical subjects who experienced more anxiety than expected during the abortion were more likely to choose a medical procedure for a subsequent abortion (P <.01). CONCLUSION: Women receiving mifepristone and misoprostol were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. Failure of a medical abortion and increased anxiety during surgical abortion were associated with preference for the alternative technique in a future procedure.

Abortifacient Agents, Nonsteroidal↗
PubMed1989

Drug-induced acute liver disease.

Fifty-three patients with drug-induced acute liver disease are reported. There were 35 females and 18 males with a mean age of 41 years. All but one patient had jaundice or hyperbilirubinaemia and 51 had abnormal liver enzymes. Histologically 38 patients (72%) had cholestatic injury while 15 had cytotoxic parenchymal damage. Methyldopa, chlorpropamide, chlorpromazine, halothane and the contraceptive pill accounted for 60% of cases. Fifty-one patients recovered after drug withdrawal while 2 died of hepatic failure. Drug-induced liver injury must be considered in patients presenting with evidence of hepatic disease as the majority will recover on withdrawal.

Acute Disease↗
PubMed1977

Scintigraphic patterns of gallium-67 uptake in the breast.

A review of 542 67Ga scans was undertaken to determine the incidence of 67Ga uptake in the "normal" breast, to establish factors modifying the uptke of 67Ga, and to define patterns of "normal" vs. pathologic accumulation. Nonpathologic uptake of 67Ga was demonstrated in 29 patients (12% of female patients) and was most often associated with conditions stimulating prolactin production or related to estrogenic hormone administration. This type of uptake was symmetrical but of varying pattern depending on the underlying stimulus. Pathologic uptake of 67Ga was demonstrated in 3 cases and always resulted in asymmetrical appearance of the breasts.

Acute Kidney Injury↗
PubMed2001

Use of levetiracetam in special populations.

A subset of the 27 safety and pharmacokinetic studies of levetiracetam has been conducted in selected special populations: children, the elderly, and people with renal or hepatic impairment. The results of these studies indicate that higher doses need to be used for children (on a per-weight basis), and individuals with renal dysfunction require dosage modifications related to creatinine clearance. Individuals with hepatic impairment do not require modifications from standard doses. Little information is available on the effect of levetiracetam on the developing fetus, so cautious use during pregnancy is recommended until more information is available. Additional studies will refine the recommendations for use of levetiracetam in these special populations.

Adult↗
PubMed1985

[Vitamin A in the serum of healthy probands and clinical groups].

The estimation of vitamin A in serum of patients suffering from different diseases (M. Crohn, Hypothyroidism, Hyperthyroidism, Liver cirrhosis, Renal insufficiency, Carcinoma of Prostate, ENT-Carcinomas) and healthy controls by means of a recent developed method (HPLC) is reported. Decreased and increased vitamin A serum levels had been reported in literature during different diseases but we could not reveal identical results in all cases. Significantly lowered values were only estimated in patients suffering from liver cirrhosis whereas increased vitamin A serum levels were determined during renal insufficiency. In hypo- or hyperthyroidism there was no difference from healthy persons. In patients with Crohn's disease the distribution of vitamin A concentrations in serum was bimodal, probably depending on extension and localization of the process. Patients with carcinoma of the prostate had only minor deviations from the normal value, whereas patients with tumors of the larynx had in part very low vitamin A concentrations with a bimodal distribution. Causes for the deviations and consequences for the assessment of the vitamin A status of patients under intravenous alimentation are discussed.

Contraceptives, Oral, Hormonal↗
PubMed1999

The contribution of Asian scientists to global research in andrology.

AIM: To present a personal account of the involvement of the World Health Organization (WHO) in the collaborative development in Asia of those areas of andrology concerned with male contraception and reproductive health. METHODS: The andrology training through workshops and institution support undertaken by the WHO Human Reproduction Programme (HRP) and how they contributed to the strengthening of andrology research in Asia are summarised. RESULTS: The author' s experience and the Asian scientific contributions to the global research in the following areas are reviewed: the safety of vasectomy and the development of new methods of vas occlusion; gossypol and its failure to become a safe, reversible male antifertility drug; Tripterygium and whether its pure extracts will pass through the appropriate toxicology and phased clinical studies to become acceptable contraceptive drugs; hormonal methods of contraception for men. CONCLUSION: The WHO policy of research capacity building through training and institution strengthening, together with the collaboration of Asian andrologists, has created strong National institutions now able to direct their own programmes of research in clinical and scientific andrology.

Antispermatogenic Agents↗
PubMed2003

Miscommunication between healthcare providers and patients may result in unplanned pregnancies.

Our objective was to examine the impact of prior healthcare provider counseling on previous use of contraception and knowledge of emergency contraception in women seeking surgical abortion. We performed a retrospective analysis of 342 patient charts from women seeking an office abortion in a private practice setting from January 1999 to June 2001. Data extracted included demographic information, primary method of contraception over the preceding few months, compliance with that method, contraceptive history, knowledge of emergency contraception and postabortion contraception. Patients were primarily white (69%) and unmarried (63%) and had private insurance that covered abortion services (72%). Only 19% of women were using a birth control method with no recognized potential failure. Twenty-two percent of women were using their birth control method correctly but experienced an event that put them at risk for pregnancy, 32% were using their birth control method incorrectly and 27% were using no birth control method at all. Miscommunication between patients and their healthcare provider(s) negatively affected use of a primary contraceptive method in 14% of patients. Of the 77% of women who did not know about emergency contraception, nearly two thirds had an identifiable event for which emergency contraception could have been used. Healthcare providers may contribute to the occurrence of unintended pregnancy if they provide poor medical advice or miscommunicate with patients.

Abortion, Legal↗
PubMed1984

High-output right ventricular failure secondary to hepatic arteriovenous microfistulae. Selective arterial embolization treatment.

A patient with diffuse hepatic arteriovenous microfistulae suffered from secondary high-output right ventricular failure, pulmonary hypertension, and ascites, all of which could be managed by selective embolization of the hepatic artery. The vascular lesion of the liver seems to be essential, although hemorrhagic hereditary telangiectasia , perhaps aggravated by administration of oral contraceptives, may be considered contributory factors in this case.

Arteriovenous Fistula↗
PubMed1992

Contraception.

The principle of vaccination for the purposes of fertility regulation is scientifically elegant and socially compelling. Factors such as economic production, convenience of use, relatively long-lasting but reversible protection, low failure rate and the avoidance of mechanical devices or exogenous hormones make this approach a potentially attractive option for family planning programmes in both developing and developed countries. The major efforts in research and development have involved the prospect of active immunization against specific antigens of sperm, oocyte, zygote and early embryo, and the pregnancy hormone human chorionic gonadotrophin (hCG). Several anti-hCG vaccines have entered clinical trials. They operate by preventing or interrupting pregnancy at the peri-implantation stage probably by neutralizing the luteotrophic effect of hCG. The most refined vaccine is one directed against the unique C-terminal peptide on the beta-subunit of hCG. This vaccine provokes antibodies that are specific for hCG and do not cross-react with human luteinizing hormone (hLH). Preclinical studies in baboons and data from a phase I human trial indicate that this method is free of side-effects and provides the promise of a duration of effectiveness of up to 12 months. Future research will optimize the anti-hCG approach, utilize new vaccine delivery systems and broaden the spectrum of target antigens of potential utility for contraceptive vaccines.

Antigens↗
PubMed1997

How safe is oral isotretinoin?

Since oral isotretinoin (Roaccutane/Accutane) is the only therapy to address all major acne causes, it remains the most effective antiacne therapy available. Due to this unique efficacy and its potential side effects that are predictable and can be managed easily and effectively, it is widely used also in acne patients suffering from serious systemic diseases. As the primary mechanism of action of oral isotretinoin is suppression of sebaceous gland activity, mucocutaneous side effects such as dry lips, nasal passages and eyes are predictable. Pretreatment counseling and concomitant use of moisturizing agents usually manage these side effects effectively; in unusual cases of particularly poor tolerability, dose adjustments suffice. Severe side effects are rare, the most common being aches and pains requiring no therapy, aspirin or paracetamol. As with other retinoids, reliable contraception is mandatory for women of childbearing potential. Acne patients with serious concomitant systemic disease, such as insulin-dependent diabetes, epilepsy or spina bifida, transplant patients, patients with renal failure, multiple sclerosis motor neuron disease and other can also safe be treated with a standard cumulative dose of 120 mg/kg per treatment course.

Acne Vulgaris↗