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PubMed1983

Predicting contraceptive behavior from attitudes: a comparison of within- versus across-subjects procedures.

Within- versus across-subjects procedures for predicting behavior from attitudes were contrasted. Each procedure requires a comparison among attitudes in order to generate a prediction; the comparison is either among the same attitudes held by different people (across subjects) or among different attitudes held by the same person (within subject). It was hypothesized that the within-subject model provides a more adequate explanation of behavior from attitudinal constructs and, hence, more accurate prediction of behavior from attitudes than does the across-subjects model. To test this view, a sample of 349 married couples was administered a questionnaire containing measures of three attitudinal components--affect, cognition, and conation--toward each of four contraceptive methods--oral contraceptives, IUD, diaphragm, and condoms. Contraceptive behavior was assessed 1 year later. In support of the hypothesis, the within-subject predictions bore a significantly stronger relation to the behavioral criteria than did the across-subjects predictions. This effect was consistent for each of the three components of attitude, for the prediction of behavior and behavioral intention, for male and female respondents, and for a variety of contraceptive behaviors. In addition, both the within- and the across-subjects analyses demonstrated a clear rank ordering in the predictive validity of the three attitudinal components: Conation was a better predictor of behavior than was affect, which, in turn, was better than cognition.

Affect↗
PubMed2001

Haemoglobin status of adult non-pregnant Kazakh women living in Kzyl-Orda region, Kazakhstan.

OBJECTIVE: To estimate the prevalence of anaemia among adult non-pregnant women in the Kzyl-Orda region of Kazakhstan, and to determine the association between haemoglobin concentration and anthropometric, socioeconomic, reproductive and dietary factors. DESIGN: A cross-sectional study using a randomly selected sample. Subjects were interviewed, and finger-prick blood samples and anthropometric measurements were collected. Associations between haemoglobin concentration and anthropometric and questionnaire data were evaluated by sequential linear regression analysis. SETTING: Health centres in Kazalinsk, Djalagash and Zhanakorgan districts of Kzyl-Orda region, Kazakhstan. SUBJECTS: Three-thousand six-hundred and twenty-five non-pregnant women aged 18-45 y randomly selected from health centre records. RESULTS: Iron deficiency anaemia, as reflected by low haemoglobin levels (Hb<12 g/dl), was detected in 40.2% of the total sample. There was a significant curvilinear relationship between haemoglobin concentration and age, with the nadir of the curve in the 30-40 y age-group. Haemoglobin concentration was found to be positively associated with body mass index (BMI) and socioeconomic factors. Significant negative associations were found between haemoglobin concentration and duration of menses, use of the intra-uterine contraceptive device and the consumption of tea. CONCLUSIONS: This study demonstrates that iron deficiency anaemia is present at considerable levels among adult women living in Kzyl-Orda region, Kazakhstan, and provides important baseline information for future research and public health interventions. SPONSORSHIP: Funding was provided by the United States Agency for International Development, Office of Nutrition, the United Kingdom Department for International Development, and the Polden-Puckham Trust.

Adolescent↗
PubMed2003

Ovarian pregnancy: report of four cases and review of the literature.

Ovarian ectopic pregnancy is rarely seen; it constitutes only 0.5-3% of all ectopic pregnancies and the incidence is only 1 for every 7000-40,000 deliveries. We herein report four cases of primary ovarian pregnancy encountered during the last 10 years in Miyazaki prefecture, Japan. The patients in all of these cases were admitted to their local hospitals with increased lower abdominal pain and intraperitoneal bleeding, and had surgery for total or partial oophorectomy. Grossly and microscopically, chorionic villi were exclusively found in the ovary but not in the fallopian tube, so that we diagnosed these cases as primary ovarian pregnancies. None of the patients were known to have used an intrauterine contraceptive device, which have been suggested as the cause of ovarian pregnancies in several studies. The incidence of ovarian pregnancy is recently increasing, and pathologists will have increased chances to diagnose this disease.

Abdominal Pain↗
PubMed1999

Urinary undiversion for pelvic actinomycosis: a long-term follow up.

BACKGROUND: A 43-year-old woman who had been using intrauterine contraceptive devices for the past 10 years underwent an emergency operation for bowel and urinary obstruction. METHODS/RESULTS: Frozen section analysis showed undifferentiated adenocarcinoma. Incomplete tumorectomy, ileal resection, partial cystectomy, colostomy and bilateral ureterocutaneostomy were palliatively performed. Postoperatively, periodic acid-Schiff and Grocott-Gomori methenamine tests revealed Actinomyces and the final diagnosis was pelvic actinomycosis. Treatment with penicillin G administered intravenously relieved her symptoms and the lesion was dramatically improved. The patient underwent colostomy closure and urinary undiversion. CONCLUSIONS: Five years after urinary undiversion, the patient's renal function has been maintained and she can void without incontinence and dysuria.

Actinomycosis↗
PubMed1986

Candida chorioamnionitis diagnosed by amniocentesis with subsequent fetal infection.

Isolation of Candida albicans from the vaginal secretions of pregnant women occurs with an incidence of 5-23%. Intrauterine infection caused by Candida during pregnancy is relatively rare; only 81 cases, all diagnosed after delivery, have been reported. We report six cases of candidal chorioamnionitis diagnosed by amniocentesis and confirmed by histologic studies, associated with preterm labor and delivery of five viable infants. Three of the six maternal patients had intrauterine contraceptive devices in situ. Three infants had a diagnosis of congenital cutaneous candidiasis and two had congenital systemic candidiasis, one with monilial pneumonia, and one with meningitis and septicemia. All viable neonates were treated successfully. The sixth, a very immature infant, died soon after delivery. Torulopsis (Candida) glabrata was isolated from this amniotic fluid. C. Albicans is a pathogen that potentially may cause chorioamnionitis and has been associated with high mortality (94%) in infants weighing less than 1500 gm. Use of amniocentesis in patients with preterm labor may allow early detection of subclinical candidal chorioamnionitis, thus guiding appropriate perinatal management.

Adolescent↗
PubMed1984

[Endometrial cytology using the new Abradul instrument].

Abradul is a new plastic instrument for endometrial biopsies. The instrument is easy to handle and the technique of its use is similar to the procedure for insertion of an intra-uterine contraceptive device. The advantage of Abradul over other instruments is that tubal cornua can be reached easily. The instrument was used in three gynecological offices 290 times especially for the recognition of silent endometrial cancers and its precursors. Malignant and premalignant changes can be well differentiated in the cytology from benign samples. The authors recommend the instrument for the early diagnosis of cancer in some age and risk groups. The instrument can be useful for the diagnosis of the functional state of the endometrium.

Adolescent↗
PubMed2000

Uterine hemorrhage in a menopausal female associated with an arteriovenous malformation and myometritis.

A case is described of vaginal bleeding in a 67-year-old female as the first manifestation of a uterine arteriovenous malformation (AVM). Although bleeding is the commonest presentation of an AVM, this is the first case known to have been precipitated by florid myometritis associated with the long-standing presence of an intra-uterine contraceptive device (IUCD). Uterine imaging studies utilising ultrasound scan with color Doppler were instrumental in suggesting the source of bleeding in this case. Subsequently, the patient suffered a torrential hemorrhage which necessitated hysterectomy.

Aged↗
PubMed2001

The place of autotransfusion in management of ectopic pregnancy--10 years experience.

Between the period January 1989 to December 1998, a total of 119 cases of ectopic gestations and 11 389 deliveries were managed. The incidence of ectopic gestation was 1.04%, or one in 96 deliveries. Tubal gestation constituted 97.47% (n = 116), while abdominal and ovarian gestation were 1.68% (n = 2) and 0.84% (n = 1) respectively. The age range was 16-42 years, with mean age of 27 years. The modal age group was 26-30 years; 10.18% (n = 12) were associated with intrauterine contraceptive devices. Abdominal pain was the most common symptom in 96% (n = 98) while abdominal and cervical excitation tenderness occurred in 97.10% and 72.6%, respectively. Autotransfusion was used in correction of anaemia in 62.75% (n = 64) while 37.25% (n = 38) received both autotransfusion and donated homologous blood. Maternal death rate was 0.84% (n = 1).

Journal Article↗
PubMed2006

Vesical calculus formation around a migrated copper-T 380-A.

The authors report a case of intravesical migration of an intrauterine contraceptive device (IUD) with secondary stone formation in a 28-year-old woman who presented with recurrent urinary tract infections. After incomplete removal of the migrated copper-T 380-A from the pelvic cavity by laparoscopy, cystoscopy was performed and the arms of the IUD with the calculus formed around them were removed via the cystoscope. Intravesical migration of an IUD should be suspected in any woman with an unretrieved device and with recurrent urinary symptoms.

Adult↗
PubMed2005

What women want and what their doctors need--how do women evaluate the quality of contraceptive methods and products introduced by their gynaecologist? A different perspective.

Is a doctor really aware of women's expectations and needs when choosing their contraceptive? When faced with making a decision about which contraceptive to chose, women often turn to their doctor for information and guidance. This is particularly the case with oral hormonal contraceptives. Nowadays women often demand more than just a pill that will provide reliable contraception--they expect additional benefits such as good cycle control, improvement in dysmenorrhoea and if possible a beneficial effect on hair and skin. The increased choice of available oral contraceptives places additional pressure on doctors to fully understand the products they are prescribing, in terms of both the physiological and the psychological effects they may have on their patients. Clinical guidelines need to be in place in order to manage any day-to-day problems that may arise. In addition doctors need to re-evaluate their relationship with their patients in order to provide what women really want.

Attitude to Health↗
PubMed2006

Gynaefix frameless IUD: Cause of bowel resection.

A case of a lost GyneFix intrauterine contraceptive device (IUD) is described, in which laparoscopy failed to identify the device and laparotomy had to be carried out to remove the IUD, which was embedded in the small bowel necessitating bowel resection. Awareness of this complication is necessary, and advanced training is required in order to minimize risks. A description of the GyneFix device, the possible adverse effects and incidence of complications, the importance of post-insertion follow-up, and the need for awareness of the possibility of migration through the bowel are discussed.

Adult↗
PubMed1980

Congenital Torulopsis glabrata infection in man.

A case of congenital infection by Torulopsis glabrata in a premature 0.52-kg female infant born at 23 weeks' gestation to a 37-year-old, gravida 7 mother is reported. The infant succumbed to an intrauterine pneumonia and fungemia. Acute chorioamnionitis was present. Budding yeasts were found in the lungs and amniotic membranes and in large numbers within the lumen of the gut. The role of a retained intrauterine contraceptive device in predisposing to the ascending infection is discussed.

Adult↗
PubMedDate not supplied

Streptococcus pneumoniae infections of the female genital tract and in the newborn child.

Streptococcus pneumoniae is not a part of the resident vaginal flora. However, in some women S. pneumoniae can be a transient part of the vaginal flora, and pelvic infection can occur, especially if a predisposing condition exists (e.g., use of an intrauterine contraceptive device, a recent birth, or gynecologic surgery). In the preantibiotic era, pneumococcal genital infection was more common than today, and the rate of lethality was high--26% for localized infection and 74% for peritonitis. During the last 25 years, all 24 patients reported worldwide survived their pneumococcal genital infections, including nine patients at our hospital; in contrast, five of 12 women died between 1938 and 1952. Pneumococci can rarely be isolated as the only pathogen in cases of bartholinitis. Neonatal S. pneumoniae disease with an early onset has an intrapartum pathogenesis. Of 23 reported pediatric patients (including one whom we treated), 48% died and 13% survived with neurologic sequelae. The prognosis for these children has not improved during the last 10 years.

Female↗
PubMedDate not supplied

Tubo-ovarian abscess: contemporary approach to management.

Two hundred and thirty-two patients with tubo-ovarian abscesses (TOAs) were evaluated. Ruptured TOAs were documented in seven (3%) of the patients. One hundred and seventy-five patients with TOAs were treated with antibiotics alone; for 15 of these patients, TOAs were confirmed by laparoscopy. The remaining 57 patients required surgical intervention: drainage (five patients), unilateral salpingo-oophorectomy (19) and total abdominal hysterectomy and bilateral salpingo-oophorectomy (33). A unilateral TOA was present in 163 patients (70%). Seventy-six patients with TOAs used intrauterine contraceptive devices, and in this group, 54 (71%) patients had unilateral TOAs. The most common microorganisms that were recovered from these TOAs were Escherichia coli, Bacteroides fragilis, Bacteroides species, Peptostreptococcus, Peptococcus, and aerobic streptococci. Sixty-eight percent of the patients treated with an antimicrobial regimen that included clindamycin had a decrease in the size of the TOA, while only 36.5% of those receiving antimicrobial regimens without clindamycin had a decrease in the size of the TOA (P less than .01). Long-term follow-up information (two to 10 years) was available for 58 of the patients treated with antibiotics alone. Eighteen (31%) required subsequent surgery; 12 had persistent TOAs; and six, chronic salpingo-oophoritis. Intrauterine pregnancy was documented in eight (13.8%) patients. Of the 19 patients treated with unilateral adnexectomy, two ultimately required hysterectomy and contralateral adnexectomy, while three patients in this group subsequently became pregnant (one ectopic and two intrauterine).

Abscess↗