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PubMed2000

[Causes for accepting or not accepting contraceptive methods in the immediate postabortion].

OBJECTIVE: To determine the causes that motivate acceptance or not-acceptance of contraceptiva methods in the immediate post abortion period. Material and methods. 191 questionnaires were applied to immediate post abortion patients, in the "Luis Castelazo Ayala" Gynecology and Obstetrics Hospital of the Instituto mexicano del Seguro Social. Patients were divided by two groups: acceptants (n = 75) and not-acceptants (n = 116). Both groups were compared with Student's t test and contrast of proportions. RESULTS: There were not significant differences in the general characteristics of both groups like age, age at menarche, beginning of sexual intercourse, age of marriage or free union, school grade, age at first pregnancy, number of pregnancies, gestational age of the last pregnancy that ended in abortion, previous use of contraceptiva methods and previous experience with them and whether or not they wanted a new pregnancy. The contraceptive method was offered to all patients in the acceptant group. Information was given to 45.33% of them and was considered satisfactory in 75.00%. In contrast, not-acceptants that received information were only 26.72% (p < 0.05) and all of them (100.00%) considered it inadequate (p < 0.05). In 20.68% of the women the method was not offered (p < 0.05). Medical contraindications were present in only 6.03%. The accepted methods were intrauterino device (64.00%), parentheral methods (16.00%), oral contraceptives (13.33%), surgical sterilization (5.33%) and condoms (1.33%). The contraceptive coverage of post abortion patients was 39.27% in this period. CONCLUSIONS: The use of contraceptive methods in post abortion patients can be increased if it is offered systematically to all patients who have had an abortion. Information given to patients must be understandable and sufficient to dissipate fears and ciarify doubts regarding the contraceptive method; contraceptive options must be offered according to the reproductive expectancies and using the informed consent to reinforce the acceptance of the chosen method.

Abortion, Spontaneous↗

PubMed1990

Clinical experience with the progestogen-only pill.

Experience with the progestogen-only pill (POP) in a family planning clinic is presented. From the clinic records, 408 women were identified who had opted to use a POP. Of these, 50 women had used the POP during lactation and these were excluded from the analysis. The remaining 358 women used the POP for up to 150 months, giving a total of 18,125 women-months of use. Three pregnancies occurred, giving a Pearl Index of 0.2 per 100 women-years. Non-menstrual side effects were minor and were reported by 77 women. For the women who discontinued the POP, the main reason was menstrual irregularity (47.5%). However, despite the long-term use by most of the women, almost 40% maintained a mostly regular menstrual pattern. Our findings suggest that the POP provides a very acceptable method of oral contraception for many women and that it should be more actively promoted.

Adult↗

PubMed1993

A five-year clinical evaluation of Norplant contraceptive subdermal implants in Bangladeshi acceptors.

A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Dhaka, Bangladesh. The study was designed to evaluate the contraceptive efficacy, safety and overall acceptability of Norplant implants. Six hundred women were enrolled in the clinical trial, which began in 1985 at three study sites. Follow-up visits were scheduled at 1, 3, and 6 months after Norplant implant insertion, and every six months thereafter until removal or at the end of five years. There were no post-insertion pregnancies during Norplant implant use in this study. After five years of Norplant implant use, there was no clinically significant change in body weight, systolic or diastolic blood pressure. Less than 3% of the women ever reported having any significant medical problems such as migraine, respiratory or cardiac problems during the study. The gross cumulative continuation rate was 41.2 per 100 women at the end of five years. The two most frequently reported reasons for discontinuation during the study were menstrual problems and desired pregnancy. Of the women who completed the five-year user satisfaction questionnaire, the majority of the women (86.3%) planned to continue using contraception after study completion. Of these women, approximately one-third said they planned to use another Norplant set. The findings presented suggest that the Norplant system is a highly effective, safe and acceptable method among Bangladeshi women.

Adolescent↗

PubMed1985

Interruption of early pregnancy by an anti-progestational compound, RU 486.

RU 38-486 (17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)-17 alpha-(1-propynyl)estra-4,9-dien-3-one), an antiprogestational compound, was given to 33 women seeking termination of pregnancy. The patients were divided into two groups, 24 patients in group I with amenorrhoea up to 7 6/7 wk = 55 days, and 9 patients in group II with 8-10 wk amenorrhoea. The patients received 200 mg orally per day for 4 days. The start, duration and amount of bleeding were determined for 14 days. beta-HCG, plasma progesterone, estradiol and cortisol were determined at day 0 and day 7. All patients started to bleed during treatment. The frequency of complete abortion was 79% (19 out of 24 patients) in group I. In group II 33% (3 out of 9 patients) had a complete abortion. Most of the patients experienced only minor side-effects in terms of mild uterine pain and bleeding as in a spontaneous abortion. However, 2 patients in group II with 8 and 9 2/7 wk amenorrhoea suffered from heavy bleeding, requiring blood transfusion and curettage. In the patients with complete abortion, beta-HCG, estradiol and progesterone decreased significantly within 1 week. Cortisol concentrations remained within the normal range at day 0 and day 7. Treatment with RU 486 provides an acceptable method of early abortion, especially in women who refuse operative treatment and prefer a 'spontaneous abortion'. In 22 women RU 486 was administered from day 24 to day 27 of the menstrual cycle as a late 'morning-after pill' in the same dosage. All women except one started to bleed before day 28 and observed a normal menstrual period. One woman stayed amenorrhoeic for 2 months; she was not pregnant but apparently had an anovulatory cycle with a low progesterone level.

Abortion, Induced↗

PubMed2005

Influence of local anaesthesia on pain and distress induced by two bloodless castration methods in young lambs.

To assess short- and long-term effects of bloodless castration methods with and without local anaesthesia, behavioural and cortisol responses of lambs were used as indicators of pain and distress. Seventy lambs, aged 2-7 days, were control-handled or castrated by Burdizzo or rubber ring methods with and without local anaesthesia. Either 5 mL of diluted lidocaine (4 mg/kg) or physiological sodium chloride solution was distributed in both spermatic cords and the scrotal neck. The serum cortisol response was monitored for 48 h, and behavioural and clinical traits were followed for three months. Local anaesthesia tended to reduce behavioural and cortisol responses after Burdizzo castration and provided a significant reduction after rubber ring castration. Prolonged pain after rubber ring castration with anaesthesia was not evident. If combined with local anaesthesia, both the rubber ring and the Burdizzo methods are acceptable methods for castration of lambs up to one week of age.

Anesthesia, Local↗

PubMed1999

A 5-year clinical evaluation of Norplant implants in Senegal.

The principal objective of this 5-year clinical study of Norplant implants was to introduce these implants into the family planning program in Senegal and to determine their overall acceptability and safety in Senegalese acceptors. A total of 300 subjects were enrolled into the trial from August 1986 to July 1991. All the women were followed-up for 5 years or until the implants were removed. The pooled cumulative discontinuation rate was 40.8 +/- 2.91 per 100 women resulting in a continuation rate of 59.2 +/- 2.91 per 100 women. Thirteen subjects (4.3%) were lost during the follow-up. Seven pregnancies were reported throughout the 5 years leading to a cumulative pregnancy rate of 3.3 +/- 1.25 per 100 women. Menstrual problems were the reason most often given for early removal during the first 2 years. After year 2, desire for another pregnancy was the main reason for implant removal. The results presented in this study show that the Norplant implant system is a safe, effective, and acceptable method that meets the needs of the Senegalese family planning program.

Adult↗

PubMed2005

Application of immunoaffinity column as cleanup tool for an enzyme linked immunosorbent assay of phosphinothricin-N-acetyltransferase detection in genetically modified maize and rape.

We have developed a new immunoassay method to detect genetically modified (GM) maize and rape containing phosphinothricin-N-acetyltransferase (PAT). PAT encoded by Bialaphos resistance gene (bar) was highly expressed in soluble form in Escherichia coli BL21(DE3) and purified to homogeneity by Ni2+ affinity chromatography. A simple and efficient extraction and purification procedure of PAT from GM maize and rape was developed by means of the immunoaffinity column (IAC) as a cleanup tool. Purified polyclonal antibodies against PAT was produced and coupled covalently to CNBr-activated Sepharose 4B. Both the binding conditions and elution protocols were optimized. The IAC was successfully employed to isolate and purify the PAT from the various tissues of GM maize (Bt11 and Bt176) and rapes (MS1/RF1 and MS8/RF3). Enzyme linked immunosorbent assay (ELISA) procedures were established further on to measure the PAT protein. GM maize cannot be differentiated from non-GM maize by ELISA. But IAC-ELISA allowed 0.5% GMOs to be detected in MS1/RF1 and MS8/RF3 and 10% GMOs to be detected in Bt11 and Bt176, which makes this method an acceptable method to access PAT protein in GM rapes and maize.

Acetyltransferases↗

PubMed1992

A long-term study of mortality in men who have undergone vasectomy.

BACKGROUND: Vasectomy is a reliable and widely accepted method of contraception, but there is some uncertainty and few data about a possible long-term adverse effect on health. METHODS: We examined the relation between vasectomy and mortality rates from cardiovascular disease, cancer, and all causes in a retrospective cohort of husbands of members of the Nurses' Health Study. In 1989 we obtained data by questionnaire on 14,607 men who had undergone vasectomy as of 1976 and 14,607 men who had not. RESULTS: Among the men who were free of cancer at the start of the study, 1052 died: 446 of cardiovascular disease, 341 of cancer, and 265 of other causes. Vasectomy was associated with reductions in mortality from all causes (age-adjusted relative risk, 0.85; 95 percent confidence interval, 0.76 to 0.96) and mortality from cardiovascular disease (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.92). Vasectomy was unrelated to mortality from all forms of cancer (relative risk, 1.01; 95 percent confidence interval, 0.82 to 1.25). Among men who had a vasectomy at least 20 years earlier, the procedure had no relation to mortality from all causes (relative risk, 1.11; 95 percent confidence interval, 0.92 to 1.33) or that from cardiovascular disease (relative risk, 0.85; 95 percent confidence interval, 0.63 to 1.16). However, mortality from cancer was increased in men who had a vasectomy at least 20 years earlier (relative risk, 1.44; 95 percent confidence interval, 1.07 to 1.92). The excess risk of cancer in these men was due primarily to lung cancer. None of the observed associations were confounded by smoking habits, body-mass index, alcohol consumption, or educational level. CONCLUSIONS: Vasectomy is not associated with an increase in overall mortality or mortality from cardiovascular disease. Our study also found no increase in overall mortality from cancer after vasectomy, but there was an apparent increase in the risk of cancer 20 or more years after vasectomy that requires further study.

Adult↗

PubMed1995

Clinical evaluation of Norplant in Kumasi, Ghana.

A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Kumasi, Ghana. A total of 100 acceptors were enrolled in the clinical trial, which began in 1987. There were no pregnancies during the first two years of use. Only nine post-insertion medical problems were reported during the first two years of use. One woman in this study requested removal for menstrual pattern changes through two years of use. As assessed through user-satisfaction questionnaires administered at approximately six months of use, there has been an overall positive user experience with Norplant in this study. Although the sample size in this study is small, our results seem to be consistent with other studies and it appears that Norplant offers an effective, safe and acceptable method of contraception for Ghanaian women.

Adult↗

PubMed1999

[Stapler hemorrhoidectomy. A new alternative to conventional methods].

Conventional, generally accepted methods of hemorrhoidectomy as the methods of choice in the therapy of IIIrd and IVth degree hemorrhoids often involve problems of attaining sufficient mucosa preservation or are technically highly complex. A new surgical procedure, stapler hemorrhoidectomy, is less risky, permits the preservation of more mucosa, and takes significantly less time (only 5 to 15 minutes) than conventional procedures. Especially important is the high degree of acceptance on the part of patients and operators. The operation is based on the principle of a mucosectomy at least 2 cm above the dentate line. A purse-string suture placed 3-4 cm above the dentate line is tied around the stapler shaft (Ethicon Endosurgery SDH 33). Then the resection and stapling of the mucosa are carried out. This procedure effectively reduces mucosa and blocks the end branches of the upper rectal artery, thus stopping venous and arterial blood flow of the hemorrhoidal plexus. During the period April-September 1998 we treated 42 patients with an average age of 55.5 years using stapler hemorrhoidectomy. We treated IIIrd-IVth degree hemorrhoids (in 29% of cases), partial (in 22% of cases) and circular mucosa prolapse (in 49% of cases). The complication rate was 14%; we observed one case of bleeding, two submucosal hematomas, one partially interrupted suture, one short incontinence (I degree after Parks), and one partial recurrence. All complications occurred at the start of application of the new method and could be brought under control with no difficulties; after a short time the patients were without any discomforts whatsoever. In particular, post-operative pain was generally slight, measuring by means of the visual analog scale (VAS) ranging from 0-100. From the day of the operation until the 21st postoperative day the pain score ranged from 0 to 35. The use of analgetics was significantly less, with 50% of the patients not using analgetics on and following the 1st postoperative day. First experiences with stapler hemorrhoidectomy have shown that patients with distinct hemorrhoids and/or mucosa prolapse benefit greatly by this procedure, when indications and operative techniques are correctly used.

Adult↗

PubMed2004

On the use of Bennett's acceptance ratio method in multi-canonical-type simulations.

A common strategy for mapping coexistence curves is to employ multi-canonical (MUCA) sampling to simulate along a macrostate path connecting two phases. Central to this approach is the task of accurately calculating the importance weights used in the MUCA procedure, which are needed for both effective sampling and accurate determination of phase boundaries. The purpose of this study is to develop a strategy for determining the importance weights that is built upon Bennett's optimized acceptance ratio method. This approach is shown to be closely related to transition matrix schemes, and is used to compute the vapor-liquid equilibrium of a Lennard-Jones fluid and the liquid-liquid equilibrium of a n-hexane/n-perfluorohexane mixture. For the Lennard-Jones system, the importance weights as a function of the number of particles "N" (at fixed temperature and volume) are obtained by using Bennett's method to estimate free energy differences between N and N+1 particle systems over the desired range of N values. In this application, the method is found to perform slightly better than a related transition matrix scheme. For the n-hexane/n-perfluorohexane liquid mixture, the method is designed to obtain weights as a function of composition (for fixed temperature, pressure, and total number of particles); in this case, the method is found to outperform the Gibbs ensemble approach.

Journal Article↗

PubMed2004

Fine-needle aspiration in PreservCyt: a novel and reproducible method for possible ancillary proteomic pattern expression of breast neoplasms by SELDI-TOF.

Proteomic profiles of tumor protein expression by the surface enhanced laser desorption-ionization time of flight (SELDI-TOF) methodology have been shown to have a potential usefulness for protein discovery as well as screening, diagnosis, prognosis and therapeutic considerations of cancer from several organ systems. Fine-needle aspiration (FNA) specimens from tumor samples is an accepted method to diagnose the cells of interest but often can be a limited assessment due to quantity of the sample. The current use of fresh or rapidly frozen specimens for proteomic profiling can be burdensome for clinicians to collect and submit specimens. The current study tests the hypothesis that placement of FNA and other cytological material in PreservCyt may be an acceptable method of sample handling for protein profiling evaluation by this method though it may not be suitable for true protein discovery or characterization. Excised fresh breast tissue for evaluation and/or treatment of a variety of breast lesions were sampled by FNA technique and placed into PreservCyt. These samples were then homogenized under denaturing conditions and evaluated by the SELDI-TOF methodology. Most samples collected showed a satisfactory quantity of protein for analysis by the SELDI-TOF methodology. Protein patterns from a variety of benign and malignant lesions revealed reproducible patterns on triplicate testing. Benign lesions had similar protein patterns across age groups in this limited series that may have potential diagnostic significance. In conclusion, FNA of breast tissue placed in PreservCyt is a potentially acceptable method of sample handling for evaluation by the SELDI-TOF methodology for establishment of reproducible protein patterns. Preliminary results from a spectrum of breast lesions suggest these patterns may have potential for ancillary testing for diagnostic consideration of breast lesions. This collection methodology could simplify sample gathering for further testing of all types of cytological specimens by the SELDI-TOF methodology. Larger studies will be needed to assess this methodology as a diagnostic aid.

Adult↗

PubMed2004

The effect of esthetic consultation methods on acceptance of diastema-closure treatment plan: a pilot study.

BACKGROUND: The authors conducted a study to determine which of four consultation methods helped patients best understand a proposed treatment plan for maxillary anterior diastema closure. METHODS: The authors presented 24 subjects with four types of consultation in random order: before-and-after photographs of other patients, diagnostic models with wax setups, resin-based composite/esthetic preview/mock-ups and computer-imaging simulations. After viewing each method, the authors asked the subjects about treatment acceptability. At the end of the demonstrations of all four methods, the authors asked the subjects which consultation method helped them best understand the proposed treatment plan. RESULTS: A total of 87.5 percent of the subjects indicated that they would accept the proposed treatment plan after they were shown the computer-imaging simulation, 50 percent said they would after they were shown the resin-based composite/esthetic preview/mock-up, 41.7 percent said they would after they were shown photographs of other patients, and 25 percent said they would after they were shown diagnostic models with wax setups. When asked which method helped them best understand the proposed treatment, 54.2 percent of the subjects selected computer-imaging simulation, 33.3 percent selected resin-based composite/esthetic preview/mock-ups, and 12.5 percent selected before-and-after photographs of other patients. None of the subjects selected diagnostic models with wax setups. A chi2 test for goodness of fit indicated that these differences were statistically significant. CONCLUSION: Subjects preferred computer-imaging simulation to the other three consultation methods, and they indicated that computer-imaging simulation provided a better understanding of the proposed treatment plan for diastema closure. CLINICAL IMPLICATIONS: The use of computer-imaging simulation enhances the patient's understanding of a proposed treatment plan concerning maxillary anterior diastema closure.

Adolescent↗

PubMed2005

Mass community screening for diabetic retinopathy using a nonmydriatic camera with telemedicine.

BACKGROUND: Diabetic retinopathy is a leading cause of blindness. Studies have shown the value of screening and early, timely treatment. Our aim was to measure the effectiveness and degree of acceptance of community screening for diabetic retinopathy using telemedicine. METHODS: In this prospective, population-based cross-sectional study, diabetics recruited through a regional multimedia campaign were surveyed and screened for retinopathy using a nonmydriatic camera and evaluated through telemedical imaging. RESULTS: Of the 291 diabetics recruited over a 3-week period (37% by the regional diabetes association and 30% by the media), 49.4% reported having their most recent eye examination within 1 year, 30.7% between 1 to 2 years, 9.7% over 2 years, and 10.1% had never had an exam. 98.6% found our screening method acceptable, with 95.1% wanting to return for their next screening and 91.2% stating it would increase their compliance to annual screening. INTERPRETATION: Telemedicine provided a reliable and highly acceptable method for diabetic retinopathy screening. It can attract a significant number of people with diabetes and potentially recruit patients who would otherwise be missed by the current methods of vision screening.

Adolescent↗

PubMedDate not supplied

[Anterior intertrochanteric ossification after total hip arthroplasty].

AIM: Heterotopic paraarticular ossifications are usually identified by an anterior-posterior radiograph of the corresponding hip and are consecutively classified by the well accepted methods of Brooker, Arcq or deLee. In these methods ossifications are solely evaluated by the means of a single a-p radiograph, hence a major part of ossifications located in the anterior intertrochanteric region cannot be evaluated. Our study deals with the incidence of ossifications exclusively verifiable by an axial radiograph. METHOD: In the present study 209 patients' axial radiographs were retrospectively analysed by using our simple method of classification. In the axial projection these ossifications are situated anterior of the intertrochanteric region, therefore we created the term "anterior intertrochanteric ossification (AIO)". After developing a simple topographic scheme we classified these appearances by localisation and size. RESULTS: After total hip arthroplasty by using the transgluteal approach ossifications situated in the anterior intertrochanteric region can develop. These ossifications appear as bone islands, shield or clip like (without fixed connection to the femoral cortical bone) or as solid exostoses. Due to their strict anterior localisation these formations are often solely verifiable by the means of an axial (Lauenstein) radiograph. We were able to identify anterior intertrochanteric ossifications (AIO) in 97 out of 209 patients (48.4 %), 27 patients (13 %) developing an anterior intertrochanteric ossification were classified grade 0 according to the methods of Brooker, Arcq and deLee. CONCLUSION: According to the widely accepted methods of classification of paraarticular ossifications depending on a single a-p radiograph of the corresponding hip, 13 % of paraarticular ossifications would remain undocumented because of their strict anterior intertrochanteric position.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1991

Control of ticks.

A number of different acaricides provide highly effective control of tick populations on dogs and cats. These acaricides are formulated as sprays, dips, dusts, or shampoos for use on the animal. Further protection of the animal from reinfestation with ticks can be achieved with the use of acaricide-impregnated flea and tick collars. Some of these acaricides are registered with the EPA for indoor and outdoor use as controls for free-living populations of ticks. Caution should be used when applying these materials. The label directions for the application of the acaricide and disposal of the acaricide containers should always be followed. Removal of underbrush and leaf litter, thinning trees, and frequently mowing grasses help reduce the number of free-living ticks. Any reduction in the amount of wildlife food sources and cover areas potentially decreases populations of ticks and thus reduces the potential of these ticks parasitizing a dog or cat. Application of an acaricide for area-wide control of free-living ticks in the spring, summer, and autumn also reduces the number of ticks. New approaches to area-wide control of ticks by use of acaricides that are focused on controlling the ticks attached to small mammal hosts are discussed. Although research has shown that reductions in tick numbers can be achieved using these methods, acceptance of these methods by regulatory agencies and the public requires further research.

Animals↗

PubMed1982

Ethnic variation in adolescent use of a contraceptive service.

This paper compares black, Hispanic, and white teenagers' experiences with a contraception service in New York City. Data were obtained from 3858 patients who made nearly 12,000 visits to the program during its first 3 years of operation. Patients' reasons for using the contraception facility, their visit patterns, clinic continuation rates, methods accepted, patterns of method utilization, as well as their pregnancy rates and intentions for pregnancy resolution are examined. Black patients had more clinic visits than white and Hispanic patients, and their duration of program contact was the longest. Several method preference differences existed among the three ethnic groups. Pregnancy rates while the patients were in contact with the program were highest among blacks, followed by Hispanics and then whites. Service delivery directions suggested by these findings are discussed.

Adolescent↗

PubMed2002

Use of the Vettest 8008 and refractometry for determination of total protein, albumin, and globulin concentrations in feline effusions.

BACKGROUND: Pleural and peritoneal effusion is a common clinical finding in feline practice. Determination of fluid albumin (ALB) and globulin (GLOB) concentrations in addition to total protein (TP) concentration can be helpful in diagnosing or ruling out certain diseases in cats, especially feline infectious peritonitis (FIP). OBJECTIVE: The objective of this study was to compare effusion TP, ALB, and GLOB results obtained by a refractometer and a bench-top dry chemistry analyzer with those results obtained by a reference method. METHODS: Twenty-six pleural and 14 peritoneal effusion samples were analyzed from 40 cats with various diseases. TP and ALB concentrations were determined by a reference automated wet chemistry analyzer (Kone Specific, Kone Instruments, Espoo, Finland), a bench-top dry chemistry analyzer (Vettest 8008, IDEXX Laboratories Ltd, Chalfont St Peter, UK), and a refractometer (Atago SPR-T2, Atago Co, Tokyo, Japan). GLOB, albumin to globulin (A/G) ratio, and globulins as a percentage of total proteins (GLOB%) were calculated. Results were analyzed by paired t tests, difference plots, and Deming s regression analysis. RESULTS: Correlation coefficients (r) for TP with Vettest versus Kone and refractometer versus Kone methods were.97 and.94, respectively. GLOB and GLOB% values were significantly higher and A/G ratios were significantly lower with Vettest versus Kone methods. Correlation coefficients for ALB, GLOB, GLOB% and A/G ratio with Vettest versus Kone methods were.86,.93,.82, and.73, respectively. Although correlation with other methods was good, the refractometer underestimated TP concentrations in 3 samples. CONCLUSIONS: The refractometer is an acceptable method for determination of TP concentration in feline effusions. The Vettest 8008 also is an acceptable method for the determination of TP and ALB concentrations, however, calculated A/G ratios obtained with the Vettest are unacceptable.

Albumins↗