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https://www.readbyqxmd.com/read/28810976/women-s-health-knowledge-and-skills-among-transitional-year-internship-trained-military-medical-officers-serving-as-independent-health-care-providers
#1
Ryan J Heitmann, Crystal B Hammons, Alison L Batig
BACKGROUND: Women comprise 14.5% of active duty service members. Delivery of women's health services is a critical component to personal, medical, and mission readiness. Our objective was to evaluate the knowledge, skills, and practices pertaining to basic elements of women's/reproductive health issues among transitional internship-trained general medical officers in the Army, Navy, and Air Force. MATERIALS AND METHODS: This is a cross-sectional survey study of transitional internship-trained graduates from 2012 to 2015 who transitioned to an operational assignment as an independent provider after internship graduation...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28796898/comparison-of-the-levonorgestrel-releasing-intrauterine-system-hysterectomy-and-endometrial-ablation-for-heavy-menstrual-bleeding-in-a-decision-analysis-model
#2
REVIEW
Michelle Louie, Jennifer Spencer, Stephanie Wheeler, Victoria Ellis, Tarek Toubia, Lauren D Schiff, Matthew T Siedhoff, Janelle K Moulder
BACKGROUND: A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. OBJECTIVES: To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. SEARCH STRATEGY: A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years...
August 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28783867/absence-of-effect-of-intravaginal-miconazole-clindamycin-nonoxynol-9-and-tampons-on-the-pharmacokinetics-of-an-anastrozole-levonorgestrel-intravaginal-ring
#3
Rüdiger Nave, Stefan Klein, André Müller, Xinying Chang, Joachim Höchel
A study was performed to investigate the effect of an intravaginally administered antimycotic, an antibiotic, and a spermicide plus the co-usage of tampons on the pharmacokinetics (PK) of levonorgestrel (LNG) and anastrozole (ATZ) administered as an intravaginal ring (IVR) releasing 1050 μg ATZ per day and 40 μg LNG per day. In this parallel-group, randomized, open-label study, healthy premenopausal women received an IVR as the main treatment. Comedications were administered on 3 consecutive evenings during treatment with IVR on days 9-11 (group A, 400 mg miconazole; group B, 100 mg clindamycin; group C, 75 mg nonoxynol-9); tampon co-usage (group D) was performed on days 20-23...
August 7, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28780893/abnormal-uterine-bleeding-in-perimenopause
#4
S R Goldstein, M A Lumsden
Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon...
August 7, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28780215/knowledge-of-and-interest-in-the-copper-intrauterine-device-among-women-seeking-emergency-contraception
#5
Christine Edwards, Dilzayn Panjwani, Ciara Pendrith, Anna Ly, Sheila Dunn
OBJECTIVE: Emergency contraception (EC) includes hormonal pills (levonorgestrel or ulipristal acetate) and the copper IUD (Cu-IUD). The Cu-IUD is more effective for EC than hormonal pills but remains underused, possibly because of lack of knowledge or interest. The objective of this study was to examine knowledge of and interest in the Cu-IUD for EC among Canadian women seeking EC. METHODS: The study used a cross-sectional convenience survey of English-speaking women presenting for EC at two sexual health clinics in Toronto...
August 2, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28774663/fast-track-vs-delayed-insertion-of-the-levonorgestrel-releasing-intrauterine-system-after-early-medical-abortion-a-randomized-trial
#6
Riina Korjamo, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast track (≤ three days) or delayed (2-4weeks) insertion following mifepristone and misoprostol medical abortion. STUDY DESIGN: In this pilot trial we randomized 108 women≤63days gestation to fast-track (n=55) or delayed (n=53) insertion. Follow-up visits occurred at 2-4weeks, three months and one year. We assessed total and partial expulsion at three months and one year, adverse effects and bleeding profiles...
July 31, 2017: Contraception
https://www.readbyqxmd.com/read/28766313/interventions-for-emergency-contraception
#7
REVIEW
Jie Shen, Yan Che, Emily Showell, Ke Chen, Linan Cheng
BACKGROUND: Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012. OBJECTIVES: To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28761925/recurrent-atypical-polypoid-adenomyoma-and-pregnancy-a-new-conservative-approach-with-levonorgestrel-releasing-intrauterine-system
#8
Eugenio Solima, Valeria Liprandi, Gaia M Belloni, Michele Vignali, Mauro Busacca
•Levonorgestrel IUD was effective in treatment of recurrent APA.•No side effects were reported.•No impairments on a subsequent pregnancy were reported.
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28759402/access-to-emergency-contraception-after-removal-of-age-restrictions
#9
Tracey A Wilkinson, Porsche Clark, Sally Rafie, Aaron E Carroll, Elizabeth Miller
BACKGROUND: Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female adolescents with the 2012 study, using the same study design. METHODS: Female mystery callers posing as 17-year-old adolescents in need of EC used standardized scripts to telephone 979 pharmacies in 5 US cities...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28757409/beyond-plan-b-a-qualitative-study-of-canadian-pharmacists-emergency-contraception-counselling-practices
#10
Karen Wong, Susan Hum, Lisa McCarthy, Sheila Dunn
OBJECTIVE: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). METHODS: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto...
July 28, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28754438/cost-effectiveness-of-treatments-for-heavy-menstrual%C3%A2-bleeding
#11
Jennifer C Spencer, Michelle Louie, Janelle K Moulder, Victoria Ellis, Lauren D Schiff, Tarek Toubia, Matthew T Siedhoff, Stephanie B Wheeler
BACKGROUND: Heavy menstrual bleeding affects up to one third of women in the United States, resulting in a reduced quality of life and significant cost to the health care system. Multiple treatment options exist, offering different potential for symptom control at highly variable initial costs, but the relative value of these treatment options is unknown. OBJECTIVE: The objective of the study was to evaluate the relative cost-effectiveness of 4 treatment options for heavy menstrual bleeding: hysterectomy, resectoscopic endometrial ablation, nonresectoscopic endometrial ablation, and the levonorgestrel-releasing intrauterine system...
July 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28741624/hormonal-cycle-and-contraceptive-effects-on-amygdala-and-salience-resting-state-networks-in-women-with-previous-affective-side-effects-on-the-pill
#12
Jonas Engman, Inger Sundström Poromaa, Lena Moby, Johan Wikström, Mats Fredrikson, Malin Gingnell
The mechanisms linking ovarian hormones to negative affect are poorly characterized, but important clues may come from the examination of the brain's intrinsic organization. Here, we studied the effects of both the menstrual cycle and oral contraceptives (OCs) on amygdala and salience network resting-state functional connectivity using a double-blind, randomized, and placebo-controlled design. Hormone levels, depressive symptoms, and resting-state functional connectivity were measured in 35 healthy women (24...
June 25, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#13
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28732067/thromboembolic-adverse-event-study-of-combined-estrogen-progestin-preparations-using-japanese-adverse-drug-event-report-database
#14
Shiori Hasegawa, Toshinobu Matsui, Yuuki Hane, Junko Abe, Haruna Hatahira, Yumi Motooka, Sayaka Sasaoka, Akiho Fukuda, Misa Naganuma, Kouseki Hirade, Yukiko Takahashi, Yasutomi Kinosada, Mitsuhiro Nakamura
Combined estrogen-progestin preparations (CEPs) are associated with thromboembolic (TE) side effects. The aim of this study was to evaluate the incidence of TE using the Japanese Adverse Drug Event Report (JADER) database. Adverse events recorded from April 2004 to November 2014 in the JADER database were obtained from the Pharmaceuticals and Medical Devices Agency (PMDA) website (www.pmda.go.jp). We calculated the reporting odds ratios (RORs) of suspected CEPs, analyzed the time-to-onset profile, and assessed the hazard type using Weibull shape parameter (WSP)...
2017: PloS One
https://www.readbyqxmd.com/read/28730844/correlation-between-uterine-artery-doppler-indices-and-menstrual-irregularities-among-levonorgestrel-releasing-intrauterine-system-and-depot-medroxyprogesterone-acetate-users-a-prospective-observational-study
#15
Mohamed Rezk, Alaa Al-Halaby, Mohamed Emarh, Mohamed Shawky
OBJECTIVE: To ascertain whether menstrual irregularities among users of levonorgestrel releasing intrauterine system (LNG-IUS) and depot medroxyprogesterone acetate (DMPA), were associated with changes in uterine artery Doppler indices or not. METHODS: This three-year prospective observational study included 102 women using LNG-IUS and 104 women using DMPA for contraception. Participants were followed at regular intervals over three years with performance of transvaginal ultrasound to measure uterine artery pulsatility index (PI) and resistance index (RI) before starting the method and at six months, 12 months, two and three years thereafter...
July 21, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28730840/the-safety-of-available-and-emerging-options-for-emergency-contraception
#16
Jessica K Lee, Eleanor Bimla Schwarz
Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expert Opinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown...
July 21, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28728451/esc-expert-statement-on-the-effects-on-mood-of-the-natural-cycle-and-progestin-only-contraceptives
#17
G S Merki-Feld, D Apter, G Bartfai, G Grandi, K Haldre, M Lech, R Lertxundi, I Lete, P Lobo Abascal, S Raine, F Roumen, D Serfaty, L P Shulman, S Skouby, J Bitzer
Hormonal fluctuations during the natural cycle, as well as progestins used for hormonal contraception, can exert effects on mood especially in vulnerable women. Negative effects of levonorgestrel-releasing intrauterine contraception on mood are rare.
July 21, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28721311/from-kaua-i-to-hawai-i-island-interisland-differences-in-emergency-contraceptive-pill-availability
#18
Holly Bullock, Mary Tschann, Jennifer Elia, Bliss Kaneshiro, Jennifer Salcedo
Emergency contraceptive pills (ECPs) are medications used after unprotected intercourse, underprotected intercourse, or sexual assault to decrease the risk of pregnancy. Availability of ECPs in Hawai'i's retail pharmacies was last assessed in 2007, following over-the-counter access to levonorgestrel ECPs (LNG-ECP) for women age 18 years or older and prior to U.S. Food and Drug Administration (FDA) approval of prescription-only ulipristal acetate (UPA). We conducted a county-by-county subanalysis from a larger observational population-based study on statewide availability of ECPs in Hawai'i's pharmacies...
July 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28712591/normalizing-ovulation-rate-by-preferential-reduction-of-hepato-visceral-fat-in-adolescent-girls-with-polycystic-ovary-syndrome
#19
Lourdes Ibáñez, Luis Del Río, Marta Díaz, Giorgia Sebastiani, Óscar J Pozo, Abel López-Bermejo, Francis de Zegher
PURPOSE: Polycystic ovary syndrome (PCOS) is an increasingly prevalent disorder in adolescent girls, commonly presenting with hirsutism/oligomenorrhea, commonly treated with an oral contraceptive (OC), and commonly followed by oligoanovulatory subfertility. We tested whether an intervention targeting the reduction of hepato-visceral adiposity is followed by a higher ovulation rate than OC treatment. METHODS: This randomized, open-label, single-center, pilot proof-of-concept study (12 months on treatment, then 12 months off) was performed in adolescent girls with hirsutism and oligomenorrhea (PCOS by National Institutes of Health; no sexual activity; N = 36; mean age 16 years, body mass index 23...
July 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28712325/pharmacodynamics-of-combined-estrogen-progestin-oral-contraceptives-2-effects-on-hemostasis
#20
Manuela Farris, Carlo Bastianelli, Elena Rosato, Ivo Brosens, Giuseppe Benagiano
The pharmacodynamic effects of various combined oral estrogen-progestin combinations (COC) are examined for their components alone or in the various combined formulations. Special emphasis is given to products containing natural estrogens. Areas covered: Recent information on the effect of androgens, estrogens, progestins, as well as various COC combinations on the coagulation cascade will be reviewed aiming at providing an updated picture. The present article reviews hemostatic changes occurring during use of classic and modern combinations of estrogens (ethinyl estradiol, estradiol, estradiol valerate and estetrol) and new progestins (desogestrel, gestodene, dienogest, drospirenone, nomegestrol acetate), compared to classic compounds, such as levonorgestrel...
August 7, 2017: Expert Review of Clinical Pharmacology
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