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https://www.readbyqxmd.com/read/29138033/randomized-trial-of-high-and-low-fidelity-simulation-to-teach-intrauterine-contraception-placement
#1
Siripanth Nippita, Miriam J Haviland, Sara F Voit, Judith Perez-Peralta, Michele R Hacker, Maureen E Paul
BACKGROUND: High fidelity simulation creates conditions that resemble real circumstances, and can help teach procedures such as intrauterine contraception placement. Its impact on skill retention has not been studied. OBJECTIVE: To evaluate novice learners' skills, attitudes, and knowledge on placement of intrauterine contraception when trained using a high-fidelity commercially available simulator compared with a low-fidelity simulator. STUDY DESIGN: We recruited senior nurse practitioner students and interns in obstetrics and gynecology and family medicine inexperienced with intrauterine contraception placement...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29133336/psychological-behavioural-and-physiological-effects-of-three-long-acting-reversible-contraception-larc-methods-protocol-for-an-ancillary-study-of-the-echo-randomised-trial
#2
Mandisa Singata-Madliki, G Justus Hofmeyr, Florence Carayon-Lefebvre d'Hellencourt, Theresa Anne Lawrie
INTRODUCTION: This is the protocol for an ancillary study to the multicentre Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial, a three-arm randomised trial comparing the effects of depot medroxyprogesterone acetate (DMPA), the levonorgestrel (LNG) implant and the copper intrauterine device (IUD) on HIV incidence (NCT02550067 pre-results). The ancillary study will compare other non-contraceptive effects of these three long-acting, reversible contraceptions about which there is little existing comparative evidence...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133081/-medical-treatment-of-endometriosis-hormonal-treatment-of-pain-impact-on-evolution-and-future-perspectives
#3
Sophie Geoffron, Guillaume Legendre, Emile Daraï, Nathalie Chabbert-Buffet
CONTEXT: Endometriosis is a chronic painful disease, for which hormone therapy is usually offered as a first line option to women not willing to conceive. OBJECTIVES: To analyse and synthesize the literature, from 2006 onwards, on pain control, and disease evolution in oemn using combined hormonal contraceptives, progestins and GnRH analogs. Data on other current and future treatment perspectives is included as well. SOURCES: Medline (Pubmed), the Cochrane Library, and endometriosis treatment recommendations published by European Society of Human Reproduction and Embryology (ESHRE), National Institute for health and Care Excellence (NICE), American College of Obstetricians and Gynecologists (ACOG), Royal College of Obstetricians and Gynaecologists (RCOG) and Société des Obstétriciens et Gynécologues du Canada (SOGC)...
November 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29121217/effect-of-ulipristal-acetate-and-mifepristone-at-emergency-contraception-dose-on-the-embryo-endometrial-attachment-using-an-in-vitro-human-trophoblastic-spheroid-and-endometrial-cell-co-culture-model
#4
Hang-Wun Raymond Li, Ying-Xing Li, Tian-Tian Li, Hongjie Fan, Ernest Hung-Yu Ng, William Shu-Biu Yeung, Pak-Chung Ho, Kai-Fai Lee
STUDY QUESTION: Do both ulipristal acetate (UPA) and mifepristone inhibit embryo-endometrial attachment at concentrations corresponding to the emergency contraception (EC) dose? SUMMARY ANSWER: Both UPA and mifepristone at concentrations corresponding to the EC dose do not have an inhibitory effect on embryo implantation, although mifepristone at a higher concentration appeared to have such an effect. WHAT IS KNOWN ALREADY: Levonorgestrel is commonly used for EC, but it only acts through inhibition of ovulation...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29117764/counseling-and-in-advance-provision-of-levonorgestrel-emergency-contraceptive-pills-decrease-the-rate-of-unplanned-pregnancy-during-breastfeeding-a-randomized-controlled-trial
#5
Omar M Shaaban, Ahmed M Abbas, Hanaa R Mahmoud, Entsar M Yones, Shaimaa G Hassen, Mahmoud S Zakherah
OBJECTIVE: To evaluate the effect of counseling and in-advance provision of levonorgestrel emergency contraceptive pills (LNG-ECPs) during postpartum counseling on the incidence of occurrence of unplanned pregnancy during breastfeeding. MATERIALS AND METHODS: The current study is an open-label, parallel, randomized controlled trial carried out in a university hospital in Egypt. All women who delivered and planning to birth-space and breastfeed for at least 1 year were approached for participation during postpartum hospital stay...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29112497/-controversies-about-the-mechanism-of-postcoital-levonorgestrel-evidences-according-to-the-decrease-of-pregnancies
#6
Emilio J Alegre-Del Rey, Silvia Fénix-Caballero, Jorge Díaz-Navarro
No abstract text is available yet for this article.
November 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29108079/prevalence-and-correlates-of-emergency-contraceptive-use-in-transitional-albania
#7
Dajana Roshi, Salvatore Italia, Genc Burazeri, Helmut Brand
Objectives The two emergency contraceptive drugs ("morning-after pill") ulipristal acetate and levonorgestrel are available without prescription in many European countries. In Albania, ulipristal acetate is not marketed yet and levonorgestrel has still prescription-only status. The objective of this study was to assess the prevalence and socioeconomic correlates of emergency contraceptive (EMC) use, collect sales figures, and gain information on the women's way of purchasing EMCs in post-communist Albania. Methods For this cross-sectional study, self-administered questionnaires were made accessible to women in Albania in March 2015 by hard copy or online via social networks...
November 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29102173/interactive-effects-of-increased-temperature-pco2-and-the-synthetic-progestin-levonorgestrel-on-the-fitness-and-breeding-of-the-amphipod-gammarus-locusta
#8
P G Cardoso, E M Loganimoce, T Neuparth, M J Rocha, E Rocha, F Arenas
Given the lack of knowledge regarding climate change-chemical exposure interactions, it is vital to evaluate how these two drivers jointly impact aquatic species. Thus, for the first time, we aimed at investigating the combined effects of increased temperature, pCO2 and the synthetic progestin levonorgestrel on survival, growth, consumption rate and reproduction of the amphipod Gammarus locusta. For that, a full factorial design manipulating temperature [ambient temperature and warming (+4 °C)], pCO2 [normocapnia and hypercapnia (Δ pH 0...
October 25, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/29097224/pharmacy-access-to-ulipristal-acetate-in-major-cities-throughout-the-united-states
#9
Maryssa Shigesato, Jennifer Elia, Mary Tschann, Holly Bullock, Eric Hurwitz, Yan Yan Wu, Jennifer Salcedo
OBJECTIVE: Ulipristal acetate (UPA) is a prescription emergency contraceptive pill (ECP). Despite the potential for UPA to reduce the risk of unintended pregnancies, a recent study in Hawaii demonstrated less than 3% of pharmacies stocked UPA and less than 23% reported the ability to order it. The primary outcome of our study was to assess the availability of UPA in a sample of large cities nationwide. STUDY DESIGN: We conducted a telephone-based secret shopper study of 533 retail pharmacies sampled proportionally from ten large cities in five geographic regions across the US...
October 30, 2017: Contraception
https://www.readbyqxmd.com/read/29092828/how-we-treat-heavy-menstrual-bleeding-associated-with-anticoagulants
#10
Kochawan Boonyawat, Sarah H O'Brien, Shannon M Bates
Anticoagulant-associated heavy menstrual bleeding (HMB) is an underrecognized but not uncommon problem in clinical practice. Premenopausal women should be advised of the potential effect of anticoagulant therapy on menstrual bleeding at the time of treatment initiation. Consequences of HMB should be assessed and treated on an ongoing basis. In the acute setting, the decision to withhold anticoagulants is based on an individual patient's risk of thrombosis and the severity of the bleeding. For women who require long-term anticoagulation, the use of levonorgestrel intrauterine system, tranexamic acid (during menstrual flow), high dose progestin-only therapy, and combined hormonal contraceptives are effective for controlling HMB; the risk of thrombosis during anticoagulant therapy with these treatments is not well studied, but is likely to be low...
November 1, 2017: Blood
https://www.readbyqxmd.com/read/29077194/metformin-for-endometrial-hyperplasia
#11
REVIEW
Naomi S Clement, Thomas Rw Oliver, Hunain Shiwani, Juliane Rf Sanner, Caroline A Mulvaney, William Atiomo
BACKGROUND: Endometrial cancer is one of the most common gynaecological cancers in the world. Rates of endometrial cancer are rising, in part because of rising obesity rates. Endometrial hyperplasia is a precancerous condition in women that can lead to endometrial cancer if left untreated. Endometrial hyperplasia occurs more commonly than endometrial cancer. Progesterone tablets currently used to treat women with endometrial hyperplasia are associated with adverse effects in up to 84% of women...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29066045/medical-therapy-for-fibroids-an-overview
#12
REVIEW
Vikram Sinai Talaulikar
Uterine fibroids are the most common benign tumours in women of reproductive age group and are a cause of significant healthcare burden. Although surgical treatments have been the traditional gold standard for symptomatic uterine fibroids, several medical therapeutic approaches have been used to achieve symptom suppression in women who wish to preserve their uterus or are at elevated risk of complications during surgery. Medical therapies used for uterine fibroids include tranexamic acid, NSAIDs, contraceptive steroids, progesterone coil, GnRH analogues, aromatase inhibitors, SERMs and progesterone receptor modulators...
September 28, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29055780/pregnancy-outcomes-associated-with-extended-use-of-the-52-mg-20%C3%AE-g-day-levonorgestrel-releasing-intrauterine-system-beyond-60months-a-chart-review-of-776-women-in-brazil
#13
Luis Bahamondes, Arlete Fernandes, M Valeria Bahamondes, Cassia T Juliato, Moazzam Ali, Ilza Monteiro
OBJECTIVE: To assess the contraceptive performance of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Bayer Oy, Turku, Finland) among women who maintain the same device without changes after 60months. STUDY DESIGN: This is a chart review study in which we assessed the charts of 766 women who continue the same LNG-IUS for contraception beyond 60months. The women were evaluated at the Family Planning clinic, University of Campinas Medical School, Campinas, SP, Brazil from November 1990 to March 2011...
October 18, 2017: Contraception
https://www.readbyqxmd.com/read/29051119/novel-dissolving-microneedles-for-enhanced-transdermal-delivery-of-levonorgestrel-in-vitro-and-in-vivo-characterization
#14
Gangtao Yao, Guilan Quan, Shiqi Lin, Tingting Peng, Qingqing Wang, Hao Ran, Hangping Chen, Qian Zhang, Lili Wang, Xin Pan, Chuanbin Wu
Dissolving microneedles (DMN) have been studied as a drug delivery system to enhance the transport of drug molecules across the skin with almost no pain. However, the poor dissolving ability of microneedles in the skin and low drug loading have limited their potential application. The aim of this study was to develop a novel dissolving microneedle system with improved dissolving ability for the delivery of poorly water soluble contraception drug, levonorgestrel (LNG). Chitosan and beta-sodium glycerophosphate (β-GP) were incorporated in the formulation of microneedles...
October 16, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29042818/cycle-control-with-an-extended-regimen-oral-contraceptive-combining-levonorgestrel-and-ethinyl-estradiol-that-includes-continuous-low-dose-ethinyl-estradiol-instead-of-the-traditional-hormone-free-interval
#15
Rossella E Nappi, Paloma Lobo Abascal, Jennifer Hsieh, Marie-Christine Micheletti
PURPOSE: To evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI). PATIENTS AND METHODS: This post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29038072/amenorrhea-rates-and-predictors-during-one-year-of-levonorgestrel-52mg-intrauterine-system-use
#16
Philip D Darney, Gretchen S Stuart, Michael A Thomas, Carrie Cwiak, Andrea Olariu, Mitchell D Creinin
OBJECTIVE: Evaluate amenorrhea patterns and predictors of amenorrhea during the first year after levonorgestrel 52mg intrauterine system (IUS) placement. STUDY DESIGN: This cohort analysis includes 1714 nulliparous and parous women who received a Liletta® levonorgestrel 52mg IUS in a multicenter trial to evaluate efficacy and safety for up to 8years. Participants maintained a daily diary with bleeding information. We assessed bleeding patterns in 90-day intervals; amenorrhea was defined as no bleeding or spotting in the preceding 90days...
October 13, 2017: Contraception
https://www.readbyqxmd.com/read/29036770/emergency-contraception-oral-and-intrauterine-options
#17
Kirsten I Black, Safeera Y Hussainy
BACKGROUND: Emergency contraception can be used to prevent pregnancy where contraception has not been used, or there has been contraceptive misuse or failure. Australian women have three options for emergency contraception: two types of oral pills (levonorgestrel [LNG]-containing pill and ulipristal acetate [UPA]) and the copper intrauterine device (IUD). Both pills are available from pharmacies without prescription, whereas the copper IUD requires insertion by a trained provider. OBJECTIVE: The objective of this article is to describe the indications, efficacy and contraindications for use of the three emergency contraceptive methods available in Australia...
October 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28994639/migraine-menopause-and-hormone-replacement-therapy
#18
E Anne MacGregor
Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen 'withdrawal' as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28991943/are-oral-emergency-contraceptives-a-safe-and-effective-form-of-long-term-birth-control
#19
REVIEW
Connie Kraus, Christopher Hooper-Lane
Yes, but not as effective as some other methods. Annual pregnancy rates in women using pericoital levonorgestrel 150 mcg to 1 mg range from 4.9% to 8.9%; menstrual irregularity is the most common adverse effect (strength of recommendation [SOR]: B, Cochrane review of lower-quality trials). In women younger than 35 years who have sexual intercourse 6 or fewer times per month, correct and consistent use of pericoital levonorgestrel 1.5 mg results in an annual pregnancy rate of 11% (SOR: B, one large prospective, open-label trial)...
October 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28963092/comparing-the-effects-of-oral-contraceptives-containing-levonorgestrel-with-products-containing-antiandrogenic-progestins-on-clinical-hormonal-and-metabolic-parameters-and-quality-of-life-in-women-with-polycystic-ovary-syndrome-crossover-randomized-controlled
#20
Mina Amiri, Fatemeh Nahidi, Davood Khalili, Razieh Bidhendi-Yarandi, Fahimeh Ramezani Tehrani
BACKGROUND: Oral contraceptives (OCs) have been used as a first-line option for medical treatment in women with polycystic ovary syndrome (PCOS). Despite theoretical superiority of products containing antiandrogenic progestins compared to OCs containing levonorgestrel (LNG), the clinical advantage of these compounds remains unclear. OBJECTIVE: The aim of this study was to compare the effects of OCs containing LNG with products containing antiandrogenic progestins including cyproterone acetate, drospirenone, and desogestrel on clinical, hormonal, and metabolic parameters and quality of life in women with PCOS...
September 29, 2017: JMIR Research Protocols
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