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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
#1
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/28774663/fast-track-vs-delayed-insertion-of-the-levonorgestrel-releasing-intrauterine-system-after-early-medical-abortion-a-randomized-trial
#2
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/28755966/characteristics-of-idiopathic-urethral-strictures-a-link-to-remote-perineal-trauma
#3
Boyd R Viers, Travis J Pagliara, Charles A Rew, Lauren Folgosa Cooley, Christine Y Shiang, Jeremy M Scott, Allen F Morey
OBJECTIVE: To characterize the physical features and reconstructive outcomes of a series of idiopathic urethral stricture (IUS) cases in an effort to elucidate the nature of this common, yet poorly understood entity. METHODS: We retrospectively reviewed our urethroplasty database to identify men undergoing initial urethral reconstruction from 2007-2014 at one of three hospitals (N=514). Patients were stratified by stricture etiology including IUS, acute trauma, iatrogenic, hypospadias, balanitis xerotica obliterans, and radiation...
July 26, 2017: Urology
https://www.readbyqxmd.com/read/28754438/cost-effectiveness-of-treatments-for-heavy-menstrual%C3%A2-bleeding
#4
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/28749780/the-prevalence-of-extended-spectrum-beta-lactamase-producing-multidrug-resistant-escherichia-coli-in-poultry-chickens-and-variation-according-to-farming-practices-in-punjab-india
#5
Charles H Brower, Siddhartha Mandal, Shivdeep Hayer, Mandeep Sran, Asima Zehra, Sunny J Patel, Ravneet Kaur, Leena Chatterjee, Savita Mishra, B R Das, Parminder Singh, Randhir Singh, J P S Gill, Ramanan Laxminarayan
BACKGROUND: Agricultural use of antimicrobials in subtherapeutic concentrations is increasing in response to the rising demand for food animal products worldwide. In India, the use of antimicrobials in food animal production is unregulated. Research suggests that many clinically important antimicrobials are used indiscriminately. This is the largest study to date in India that surveys poultry production to test for antimicrobial resistance and the occurrence of extended-spectrum (ESBLs) modulated by farming and managerial practices...
July 20, 2017: Environmental Health Perspectives
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
#6
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/28696796/lng-ius-12-a-19-5-levonorgestrel-releasing-intrauterine-system-for-prevention-of-pregnancy-for-up-to-five-years
#7
Anita L Nelson
Globally, intrauterine devices (IUDs) are the second most commonly used form of reversible contraception because of their high efficacy, safety, convenience and cost effectiveness. The levonorgestrel releasing intrauterine system with daily average release of 20 mcg (LNG-IUS 20) is the popular choice because of its favorable bleeding patterns and many noncontraceptive benefits. A three year (LNG-IUS 8) became available three years ago. More recently, the LNG-IUS 12 was added. This new IUD shares a smaller frame, narrow inserter and lower rate of amenorrhea with the LNG-IUS 8, but it offers the five years of contraceptive protection of the LNG-IUS 20...
August 2, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28693985/cardiovascular-risk-markers-among-obese-women-using-the-levonorgestrel-releasing-intrauterine-system-a-randomised-controlled-trial
#8
Lucimara Facio Nobre Zueff, Anderson Sanches de Melo, Carolina S Vieira, Wellington P Martins, Rui A Ferriani
According to international guidelines, women with obesity without other comorbidities can safely use any hormonal contraceptive (HC). However, limited information is available about contraceptive safety for women with obesity since obesity is an exclusion criterion of most contraceptive clinical trials. As such little is known about the possible risks of HC exposure for women with obesity without comorbidities. One way to assess possible long-term risks in this population, even prior to the development of any clinical disease, is to measure alterations in subclinical atherosclerosis markers...
July 7, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/28692170/expulsions-and-adverse-events-following-immediate-and-later-insertion-of-a-levonorgestrel-releasing-intrauterine-system-after-medical-termination-of-late-first-and-second-trimester-pregnancy-a-randomised-controlled-trial
#9
Riina Korjamo, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To compare expulsions and adverse events (AEs) between immediate and delayed insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) following medical termination of pregnancy (MTOP). DESIGN: Randomised controlled trial. SETTING: Helsinki University Hospital, Finland, Jan 2013-Dec 2014. POPULATION: 102 (gestational age 64-84 days, late first trimester) and 57 (gestational age 85-140 days, second trimester) women requesting MTOP and LNG-IUS contraception...
July 10, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28683602/postoperative-levonorgestrel-releasing-intrauterine-system-insertion-after-gonadotropin-releasing-hormone-agonist-treatment-for-preventing-endometriotic-cyst-recurrence-a-prospective-observational-study
#10
Min Kyoung Kim, Seung Joo Chon, Jae Hoon Lee, Bo Hyon Yun, SiHyun Cho, Young Sik Choi, Byung Seok Lee, Seok Kyo Seo
OBJECTIVE: The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. STUDY DESIGN: The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28675069/clarification-of-the-role-of-the-jaydess-skyla-lng-ius-13-5mg-and-kyleena-lng-ius-19-5mg-as-intrauterine-contraceptive-systems
#11
Norman D Goldstuck
Jaydess/Skyla and Kyleena are 'low dose' levonorgestrel releasing intrauterine systems(LNG-IUS). They differ from Mirena and other similar LNG-IUSs in terms of pharmacological properties and physical dimensions. There are currently no defined guidelines to decide when to use Jaydess or Kyleena or Mirena. Areas covered: MEDLINE, POPLINE, PubMed and clinicaltrials.gov were searched using the terms 'Jaydess', 'Skyla', LNG-IUS 13.5mg and 'Kyleena' LNG-IUS 19.5mg. Only clinical research articles as opposed to generalised reviews and opinion papers on the newer LNG-IUSs were considered for review...
July 11, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28650566/immediate-versus-delayed-initiation-of-the-levonorgestrel-releasing-intrauterine-system-following-medical-termination-of-pregnancy-1-year-continuation-rates-a-randomised-controlled-trial
#12
R Korjamo, M Mentula, O Heikinheimo
OBJECTIVE: To assess the 1-year continuation rates and new pregnancies following immediate versus delayed insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) after medical termination of pregnancy (MTOP) up to 20 weeks of gestation. DESIGN: A randomised controlled trial. SETTING: Helsinki University Hospital, Finland, January 2013 to December 2014. POPULATION: A total of 267 women requesting MTOP and planning LNG-IUS for post-MTOP contraception...
June 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28624570/effects-of-intrauterine-contraception-on-the-vaginal-microbiota
#13
Christine M Bassis, Jenifer E Allsworth, Heather N Wahl, Daniel E Sack, Vincent B Young, Jason D Bell
OBJECTIVES: There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. STUDY DESIGN: DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months...
June 15, 2017: Contraception
https://www.readbyqxmd.com/read/28618723/evaluation-of-quality-of-life-and-cost-effectiveness-of-definitive-surgery-and-the-levonorgestrel-intrauterine-system-as-treatment-options-for-heavy-menstrual-bleeding
#14
Cevdet Adigüzel, Sevtap Seyfettinoğlu, Deniz Aka Satar, Sefa Arlier, Eda Eskimez, Fatma Kaya, Hakan Nazik
BACKGROUND/AIM: This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). MATERIALS AND METHODS: Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617060/levonorgestrel-releasing-intrauterine-system-lng-ius-12-for-prevention-of-pregnancy-for-up-to-five-years
#15
REVIEW
Anita L Nelson
A new five-year low dose, smaller-framed, levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 12) has been introduced to complement the currently available systems. Areas Covered: This article will provide an overview of this new intrauterine system - its composition and its mechanisms of action as well as the results of the Phase II and III clinical trials of its efficacy, safety and tolerability. Expert Commentary: This new LNG-IUS 12 provides five-year contraceptive protection a pregnancy rate (less than 1%) in first year of use, which puts it into the top tier with the existing LNG-IUS 20 products; however, the LNG-IUS 12 does not have the high rates of amenorrhea often seen with the higher dose devices...
August 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28586411/incidence-and-treatment-of-heavy-menstrual-bleeding-in-general-practice
#16
Marian J van den Brink, Anne Linde Saaltink, Feikje Groenhof, Boudewijn J Kollen, Marjolein Y Berger, Yvonne Lisman-van Leeuwen, Janny H Dekker
Background.: Heavy menstrual bleeding (HMB) is a common problem in women of reproductive age. In 2008, the Dutch guideline for general practitioners (GPs) was revised to recommend the levonorgestrel intrauterine system (LNG-IUS) as a first-choice treatment for HMB. However, GP prescribing practices have not been studied in depth. Objectives.: To investigate the incidence and initial treatment of HMB in general practice, and to identify if there were changes in prescribing practices after the revision of the national guideline in 2008...
June 6, 2017: Family Practice
https://www.readbyqxmd.com/read/28586290/non-contraceptive-benefits-of-intrauterine-levonorgestrel-administration-why-not
#17
Lorenzo Sabbioni, Felice Petraglia, Stefano Luisi
Levonorgestrel intrauterine systems (LNG-IUS) represent a modern therapy for an array of preexisting gynecological conditions, though they were first marketed in Finland in 1990. However, there are countries in which their use is extremely limited by social and cultural factors. This manuscript describes the possible reasons for this misuse, taking in consideration the clinical noncontraceptive benefits of intrauterine levonorgestrel in routinary practice. Medical diseases in which LNG-IUS represent a treatment include abnormal uterine bleeding, iron-deficiency anemia, endometrial hyperplasia, uterine fibroids, adenomyosis, endometriosis, and coagulopathies...
June 6, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28549400/bemfola-%C3%A2-fixed-dose-pens-potentially-reduce-drug-wastage-and-associated-costs-of-infertility-treatment
#18
Graham Foxon, Paul Mitchell, Nikki Turner, Anne McConnell, Helen Kendrew, Julian Jenkins
Bemfola(®) is a recombinant follicle-stimulating hormone (FSH) used during infertility treatment. One main differentiator between FSH products is their delivery device; consisting of multi-dose pens (Gonal-f(®)), vials or multi-dose preparations (Menopur(®)), or adjustable daily disposable dose pens (Bemfola(®)). To determine the potential impact of delivery device on drug wastage during infertility treatment this study retrospectively analysed Gonal-f(®) and Menopur(®) prescription and usage data from five UK clinics...
May 26, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28545268/-efficacy-and-impact-on-quality-of-life-of-different-drug-treatments-after-partial-resection-of-rectovaginal-endometriosis
#19
T Li, X X Xu, Y Dai, J J Zhang, J H Lang, J H Leng
Objective: To evaluate different postoperative medications as maintenance treatment for rectovaginal endometriosis (RVE) patients after conservative surgery. Methods: RVE patients who underwent transvaginal partial excision from January 2007 to September 2016 with regular outpatient follow-up were retrospectively screened. Those followed by a levonorgestrel-releasing intrauterine system (LNG-IUS) insertion or oral contraceptive drospirenone/ethinylestradiol (DRSP/EE) 3 mg/30 μg administration were enrolled...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28544668/intolerance-of-uncertainty-in-eating-disorders-a-systematic-review-and-meta-analysis
#20
REVIEW
Melanie Brown, Lauren Robinson, Giovanna Cristina Campione, Kelsey Wuensch, Tom Hildebrandt, Nadia Micali
Intolerance of uncertainty is an empirically supported transdiagnostic construct that may have relevance in understanding eating disorders. We conducted a meta-analysis and systematic review of intolerance of uncertainty in eating disorders using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We calculated random-effects standardised mean differences (SMD) for studies utilising the Intolerance of Uncertainty Scale (IUS) and summarised additional studies descriptively...
May 23, 2017: European Eating Disorders Review: the Journal of the Eating Disorders Association
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