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Contraceptive Pill (contraceptive + pill)
Kinds of Contraceptive Pill Selected AbstractsVulvar Vestibulitis Syndrome and Estrogen Dose of Oral Contraceptive PillsTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2007Alexander Greenstein MD ABSTRACT Introduction., Vulvar vestibulitis syndrome (VVS) is a diverse, multifactorial phenomenon. Its precise etiology is unknown. Aim., To define the association between oral contraceptive (OC) estrogen dosage and VVS. Methods., Women diagnosed as having VVS participated in the study. Main Outcome Measures., Data on type and usage of oral contraceptive pills (OC) were obtained by a questionnaire, and they were compared for the data on OC usage in the general population. Results., Available commercial data on Israeli women taking OC showed that 51% of them use low-dose estrogen (,20 µg) OC and 49% use higher-dose estrogen (30,35 µg) OC. Of the 132 women in the study, 86 (65%) used OC: 68 (79%) used low-dose estrogen OC (P < 0.002 compared to the general population), while only 18 (21%) used high-dose estrogen OC (P < 0.002 compared to the general population). Conclusion., Significantly more patients who are treated in our clinic for VVS use low-dose estrogen than those who use high-dose estrogen OC. Greenstein A, Ben-Aroya Z, Fass O, Militscher I, Roslik Y, Chen J, and Abramov L. Vulvar vestibulitis syndrome and estrogen dose of oral contraceptive pills. J Sex Med 2007;4:1679,1683. [source] Response of the Female Vocal Quality and Resonance in Professional Voice Users Taking Oral Contraceptive Pills: A Multiparameter ApproachTHE LARYNGOSCOPE, Issue 10 2006Kristiane M. Van Lierde PhD Abstract Objective/Hypothesis: The purpose of this study was to analyze the vocal quality and resonance (nasality and nasalance values) during the menstrual cycle in professional voice users using oral contraceptive pills (OCPs). Although professional voice users are more sensitive and aware of their vocal quality, no changes of voice and resonance characteristics were expected because OCPs create a stable hormonal balance throughout the menstrual cycle. Study Design: The authors conducted a comparative study of 24 healthy, young professional voice users using OCPs. One assessment was performed between the 10th and 17th day of pill intake, when hormonal levels reached a steady state. The second assessment was performed during the first 3 days of menses, when no pills were taken and hormonal levels were minimized. Methods: Subjective (perceptual evaluation of voice and nasality) and objective (aerodynamic, voice range, acoustic, Dysphonia Severity Index [DSI], nasometer) assessment techniques were used. Results: The Mann-Whitney U test showed no significant difference between the perceptual evaluation of the voice and the nasality in the two assessments. The paired Student t test showed no significant difference regarding the maximum phonation time, the vocal performance, the acoustic parameters, and the DSI. Conclusions: These findings indicate that OCPs do not have an impact on the objective and subjective voice and resonance parameters in young professional voice users. This information is specifically relevant to professional voice users who are more aware of vocal quality changes and ear, nose and throat specialists/voice therapists who treat professional voice users with voice problems/disorders. Further research regarding the impact of increased vocal load during the premenstrual or menstrual phase in professional voice users using OCPs should be considered. [source] Perception of risk of adverse drug reactions by medical students: influence of a 1 year pharmacological courseBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2007G. Durrieu What is already known about this subject ,,Previous studies have pointed out the question of effective training and information for health professionals on adverse drug reactions (ADRs). ,,This lack of training is known to induce inadequate use of drugs and noncompliance of patients. What this study adds ,,Our study was the first to evaluate the perceived risk of ADRs among young medical students and to investigate the impact of university pharmacology courses on their perception of this risk. ,,The aim of our study was not to assess a definite level of perception of risk for the different drug classes but to determine whether the perceived risk of ADRs differs after attending pharmacology courses. ,,Our results show that the pharmacological training allows young medical students to be aware of potentially serious ADRs, especially related to drugs considered as relatively safe, such as NSAIDs and aspirin. Aims To investigate how adverse drug reactions (ADRs) to several classes of drugs are perceived by young medical students before and after a 1 year pharmacology course. Methods The whole cohort of 92 medical students (63 females and 29 males) was questioned during their third year. A visual analogue scale was used to define a score (ranging from 0 to 10) of perceived risk of ADRs associated with each drug class before and at the end of the pharmacological training period. Results Before the pharmacology course, hypnotics were ranked as the most dangerous drugs by the medical students, followed by antidepressants and anticoagulants. Contraceptive pills were listed in the last position. After pharmacological training, antidepressants moved into the first position, followed by anticoagulants and hypnotics. When all different drug classes were taken as a whole, the mean (±SD) of median scores of the perceived risk were 4.8 (±1.3) before and 5.8 (±1.5) at the end of the pharmacology course (P < 0.0001). Except for antidiabetics, antihypertensive drugs, tranquillizers, corticosteroids and hypnotics, the perceived risk significantly increased after the pharmacology course for the other drugs. The highest increases were observed for contraceptive pills (+104%, P < 0.01), NSAIDs (+86%, P < 0.01) and aspirin (+56%, P < 0.01). Conclusions Pharmacological training allows young medical students to be aware of potentially serious ADRs associated with drugs, in particular with drugs considered relatively safe (such as NSAIDs and aspirin) by nonhealth professionals. [source] O-10 Endometrial cells in cervical smears: cytological features associated with clinically significant endometrial pathologyCYTOPATHOLOGY, Issue 2007R. N. Tiam Introduction:, To establish the significance of cytological features which could predict clinically significant endometrial pathology, and therefore guide reporting practice in cervical samples. Methods:, A retrospective review of SurePath liquid-based cytology (LBC) cervical samples between 2002 and 2006, obtained at screening and colposcopy. These smears contained normal endometrial cells present at inappropriate times of the menstrual cycle, endometrial cells with atypia (borderline change) and with features suspicious / diagnostic of endometrial carcinoma (glandular neoplasia). False negative and false positive cases detected on subsequent histology were also included. The control group comprised negative samples and a few abnormal smears. All smears were randomly assigned and blinded to menopausal status, age, use of oral contraceptive pill and hormone replacement therapy and presence of intrauterine device. Each smear was reviewed for 16 cytologic criteria and a cytological diagnosis was given for each. Results:, A total of 219 smears were available for review; 137 were negative, out of which 85 contained normal endometrial cells, 41 contained endometrial cells with atypia, 10 contained endometrial cells with features suggestive of adenocarcinoma and 31 contained endometrial cells with features diagnostic of adenocarcinoma. The feature most associated with benign endometrial cells is top hat with central cell condensation. In contrast, the features associated with malignant endometrial cells are smooth nuclear membrane, pale chromatin, small nucleoli and scalloped borders. Discussion:, The criteria identified in this study do not definitively define a neoplastic process, but appear to be helpful in individual cases. This study emphasises that endometrial changes should be always interpreted with the relevant clinical information, which would otherwise lead to overdiagnosis in premenopausal women. [source] Medical treatment of hirsutismDERMATOLOGIC THERAPY, Issue 5 2008Ulrike Blume-Peytavi ABSTRACT:, Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6,9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation. [source] Levetiracetam in the Treatment of Idiopathic Generalized EpilepsiesEPILEPSIA, Issue 2005Richard Grünewald Summary:, Since its introduction into clinical practice in 1999, levetiracetam, the S enantiomer of piracetam, has rapidly found a secure place, initially in the therapy of partial onset seizures and subsequently in the treatment of idiopathic generalized epilepsies (IGE). It has many of the properties of an "ideal" antiepileptic drug, including rapid absorption, linear pharmokinetics, and sparse drug interactions. Tolerabiliy is generally excellent in both adults and children, although tiredness is a common dose-limiting adverse effect. Occasionally the drug can precipitate behavioral abnormalities, especially in patients with learning disability. There is a wide safety margin in overdose. In common with most antiepileptic drugs its mode of action remains uncertain. Levetiracetam binds to a specific site in the brain, influences intracellular calcium currents and reverses negative allosteric modulators of GABA- and glycine-gated currents in vitro. Its effectiveness has been demonstrated in animal models of epilepsy and in clinical trials of partial onset and IGE. Treatment of IGEs may be straightforward, with many patients demonstrating an excellent and robust response to valproate monotherapy. However, there remains a significant minority of patients for whom valproate is unsuitable, including those who experience unacceptable adverse effects (e.g., weight gain or hair loss) and women of childbearing age in whom the teratogenic potential of valproate is unacceptable. Therapeutic response to lamotrigine in this group is often disappointing, and many clinicians now are turning to the choice of levetiracetam. Efficacy in generalized tonic,clonic seizures and myoclonus is usually apparent and some patients experience improvement in typical absences. Experience of combinations of levetiracetam with other antiepileptic drugs is limited in IGE and the responses are largely anecdotal. In our hands, patients with refractory IGEs may respond to combinations of levetiracetam with valproate, lamotrigine, and phenobarbital, and adverse effects when they occur are usually limited to tiredness. Levetiracetam does not interact with the oral contraceptive pill, simplifying treatment in women of childbearing age. Although animal data look encouraging, questions over levetiracetam's teratogenic potential and overall safety in pregnancy will remain for many years to come. [source] An investigation of the association of the prothrombin G20210A gene mutation and inflammatory bowel disease: Factor II and IBDINFLAMMATORY BOWEL DISEASES, Issue 2 2001Neil Haslam Abstract Background A thrombotic etiology for inflammatory bowel disease (IBD) has been proposed as a result of its association with thromboembolic complications, smoking, the oral contraceptive pill, and the response of ulcerative colitis (UC) patients to heparin. We have previously demonstrated an increased prevalence of the Factor V Leiden mutation in UC and wished to investigate the frequency of the recently discovered prothrombin G20210A gene mutation in IBD. The aim of the study was to investigate the hypothesis that the prothrombic state associated with the prothrombin G20210A gene mutation is involved in the etiology of IBD. Patients and Methods A prospective cohort study of patients attending the Bristol Royal Infirmary and Gloucestershire Royal Hospital's IBD clinics was performed. Thirty-nine patients with IBD (24 with Crohn's disease and 15 with UC) and 100 historical controls were screened for the presence of the prothrombin gene mutation using a heteroduplex-based polymerase chain reaction technique. None of the patients with IBD had a personal history of thromboembolism, while three of them had a family history. Results No IBD patients had the prothrombin gene mutation compared with four (4%) controls (allelic frequency 2%). Conclusion There does not appear to be an association of the prothrombin gene mutation with IBD and therefore it is unlikely to be involved in the etiology of IBD. [source] Erythema multiforme due to progesterone in a low-dose oral contraceptive pillBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2005R. Suzuki No abstract is available for this article. [source] Breastfeeding duration related to practised contraception in the NetherlandsACTA PAEDIATRICA, Issue 1 2009Jacobus P Van Wouwe Abstract Aim: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. Methods: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. Results: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3,27.0), the adjusted OR 14.5 (9.3,22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6,19.9) and 11.7 (7.6,17.9). Of all breastfeeding women, 20,27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. Conclusion: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised. [source] Liver dysfunction in Turner's syndrome: prevalence, natural history and effect of exogenous oestrogenCLINICAL ENDOCRINOLOGY, Issue 2 2008Olympia Koulouri Summary Objectives, Raised liver enzymes are a common feature of Turner's syndrome (TS), but the cause remains unclear. We studied the hepatic function in a large cohort of women with TS and tested the effect of increasing doses of hormone replacement therapy (HRT) on liver function tests (LFTs). Design and patients, LFTs were assessed in three studies. A cross-sectional review of liver function of 125 women (median age: 31 years), a longitudinal study of 30 women (mean follow-up period: 8 years) and a dose,response study of 14 women with TS and 11 controls with hypogonadism, who received oral 17-,-oestradiol (E2) 1, 2 and 4 mg daily in a cyclical formulation for 12 weeks each. Measurements, Clinical features, oestrogen use and metabolic parameters were compared to liver enzymes (,-glutamyl transferase (GGT), alanine aminotransferase (ALT) and alkaline phosphatase (ALP)), albumin and bilirubin. LFTs were also measured during each treatment interval of the dose,response study. Hepatic autoimmunity was sought in the cross-sectional study. Results, When compared to the control population, as opposed to reference ranges, 91% of women with TS demonstrated liver enzyme elevation, with a yearly incidence of 2·1%. LFTs correlated positively with cholesterol (P < 0·001), BMI (P = 0·004) and type of oestrogen therapy (P = 0·04). Increasing doses of HRT resulted in a significant decrease in GGT, ALT, bilirubin and albumin. No evidence of excessive hepatic autoimmunity was found. Conclusion, The prevalence of raised liver enzymes in TS may have been underestimated by the use of reference ranges rather than matched controls. Obesity and hyperlipidaemia are associated with raised LFTs, as well as the use of HRT compared to the oral contraceptive pill (OCP). Exogenous oestrogen both as OCP and HRT improves liver function. Liver dysfunction in TS is likely to be a form of hepatic steatosis and intervention trials are now indicated. [source] Influence of environmental stress on skin tone, color and melanogenesis in Japanese skinINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2005K. Kikuchi Introduction It is needless to say that one of the most potent environmental stress for melanogenesis of the human skin is the effect of ultraviolet (UV) light from the sunlight. Characteristic skin aging as a result of this UV light is recognized as photoaging. Clinical features in photoaging are wrinkles, skin laxity, coarseness, leathery, yellowing, lentigenes, mottled pigmentation, telangiectasia, sebaceous hypertrophy and purpura. There is an apparent difference in clinical features in photoaging among different races, i.e. between Caucasians, African American and Asians that include Japanese. Not only photo skin type but also environmental factors, such as climate, latitude, altitude and their habit of sunbathing, smoking and skin care influence the characteristic development of their photoaging. Racial difference in photoaging Caucasians tend to develop skin laxity and fine wrinkles more than Asians [1]. Asians tend to produce coarser wrinkles than the Caucasians although their development is rather late in life. There is also a difference in the skin color. Pigmentation is an earliest and prominent skin changes in Asians [1] and it increases with age [2]. In contrast, pigmentation is not apparent in the Caucasians although redness probably because of an increase in cutaneous vascularization becomes prominent in middle aged Caucasians [2]. Chung reported that seborrheic keratosis is a major pigmentary lesion in men, whereas hyperpigmented macules are prominent features in women in Koreans [3]. Melanogenesis pigmentation disorders in Japanese Ephelides (freckles) are commonly found in those with photo skin type I who have fair skin and red eyes and blond hair. They are also found in the Japanese. Clinical feature reveals that multiple small pigmentary macules on sun-exposed areas mainly on the mid-portion of the face. These lesions seem to be familial, becoming apparent even in early childhood after sun exposure. Melasma is an acquired pigmentary disorder commonly found in middle aged Japanese women characterized by irregular brown macules and patches on the sun-exposed areas on the face typically as bilaterally present macules on the cheeks. An increase in sex hormones as a result of pregnancy and intake of contraceptive pills is one of the etiological factors to develop melasma. Sun exposure also worsens it. Nevus of Ota is also a common pigmentary disorder found in the Japanese. It is usually unilateral, blue-brown to slate-gray pigmentary macules on the eyelid and cheek that appear in early childhood or in puberty. Acquired dermal melanocytosis is also a pigmentary disorder, in which dermal melanocytes are found as shown in nevus of Ota, characterized by bilateral brown to blue-gray macules on the forehead, temple, eyelid and malar areas in middle aged Japanese women. This tends to be misdiagnosed as melasma. Solar lentigo is an acquired pigmented macule induced by sun exposure. Solar lentigines are usually multiple, circumscribed brown macules. There are two types of solar lentigo. One is a small macular type, characterized by multiple, small brown macules whose diameter is less than 5 mm, being similar to ephelides (freckles). The other type is a large macular type, characterized by a few round to oval, brown macules whose diameter is beyond 1 cm. Some of their surface are hyperkeratotic and become elevated to produce seborrheic keratosis. Again, the early sign of photoaging in Japanese is pigmentated spots and these pigmentation disorders increase with age. Among the pigmentary changes, nevus of Ota, acquired dermal melanocytosis, melasma and large macular type of solar lentigo are characteristic skin changes found in the Japanese in addition to ephelides and small macular type of solar lentigo. Seasonal changes of the various functional properties of the skin including skin color assessed by non-invasive bioengineering techniques [4]. When we consider skin tone, color and melanogenesis, UV light from the sunlight is the most potent environmental stress, although we cannot forget also the important influence of environmental relative humidity affects our skin functions as well as its appearance. We investigated seasonal influences on the various properties of the skin in 39 healthy Japanese females consisting of different age groups. Their skin is thought to be affected by the UV light in summer, and by the exposure to the dry and cold air in winter. Materials and methods Biophysical, non-invasive measurements, including transepidermal water loss (TEWL) as a parameter for the barrier function of the stratum corneum (SC), high frequency conductance as a parameter for the hydration state of the SC, skin color and casual surface lipid levels, were conducted during late summer and winter months. Skin color was determined with a chromameter according to the L*a*b* CIE 1976 system, where L* is an attribute on the luminance scale, a* that on the red versus green scale and b* that on the yellow versus blue scale. All the measurements were conducted in an environment controlled-chamber (21 ± 1 °C room temperature, and 50 ± 3% relative humidity). Results The barrier function of the SC was found to be significantly impaired in winter on the cheek as compared with that measured in summer, whereas no such seasonal change was apparent both in the hydration state of the SC and sebum levels on the cheek. In the assessment of the skin color on the cheek, a significant increase in a* (redness) and a decrease in b* (yellowness) were observed in winter. In contrast, on the flexor forearm, the values of L* (luminescence) increased in winter, but no seasonal change was noted in the values of a* and b*. In this study, skin changes with aging were also found by the non-invasive bioengineering methods. The value of TEWL on the cheek tended to increase with age, whereas no significant change was observed in the value of TEWL on the forearm. In the assessment of skin color, b* value on the cheek significantly increased with age whereas a* and L* values on the cheek did not show any significant change with age. Summary of this study We think that such an increase in yellowness with aging of the cheek skin is a phenomenon unique to the Japanese (Asians) since an increase in b* value was not observed in Caucasians [2]. The facial skin that is always exposed shows barrier impairment in a dry and cold winter environment and demonstrates increased yellowness in skin color because of a prolonged exposure to the UV light from the sun in the summer season. The non-invasive bioengineering methods are useful to demonstrate even invisible seasonal changes occurring in the same individuals and changes with age occurring in the skin. References 1.,Goh, S.H. The treatment of visible signs of senescence: the Asian experience. Br. J. Dermatol.122, 105,109 (1990). 2.,LeFur, I., Numagami, K., Guinot, C. et al. Age-related reference values of skin color in Caucasian and Japanese healthy women according to skin site. Pigment Cell Res. 7, 67 (1999). 3.,Chung, J.H., Lee, S.H., Youn, C.S. et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch. Dermatol. 137, 1043,1051 (2001). 4.,Kikuchi, K., Kobayashi, H., Le Fur, I. et al. Winter season affects more severely the facial skin than the forearm skin: comparative biophysical studies conducted in the same Japanese females in later summer and winter. Exog. Dermatol. 1, 32,38 (2002). [source] Assessment of progestin-only therapy for endometriosis in macaqueJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008G. Maginnis Abstract Background, Endometriosis is a condition where endometrium-like tissue forms lesions at ectopic sites outside the uterus. In women, oral contraceptive pills and progestins are often prescribed as therapy for early stage endometriosis. In contrast, in macaques the disease is frequently advanced at the time of diagnosis and ovariectomy is the standard therapy. However, surgery is contraindicated in many patients. A review of 15 endometriosis cases over the past 10 years at the Oregon National Primate Research Center (ONPRC) revealed that 5 failed to show improvement after ovariectomy and were subsequently euthanized. Therefore, our goal was to assess the feasibility of treating endometriosis in macaques with chronic progesterone (P) as an alternative therapy for the disease. Methods, Seven adult rhesus macaques with advanced endometriosis were identified by clinical symptoms and endometriosis was confirmed by abdominal palpation, ultrasound examination, and/or aspiration of menstrual blood from abdominal cysts. The patients were chronically treated with Silastic capsules that released 5,7 ng P /ml in blood for up to 20 months. During treatment the patients were assessed daily and scored numerically for appetite, activity, attitude, abdominal discomfort and menstruation by the Clinical Veterinary staff. The patients were then re-examined by abdominal palpation and ultrasound for the disease at the end of treatment. Results, During the first 2 weeks of treatment, endometriotic symptoms improved significantly in all the patients (P < 0.05). This was associated with a significant increase in body weight and significant reduction in abdominal discomfort and menstrual bleeding. Two of the patients gradually developed increased symptoms of the disease after 5 months of treatment. Post-treatment abdominal examination revealed that 2/5 patients continued to have an abdominal mass even though symptoms were suppressed. Conclusions, We conclude that continuous P treatment of rhesus monkeys provides therapeutic benefit to reduce symptoms of endometriosis and may provide an option for cases where ovariectomy is contraindicated. Supported by RR-00163. [source] Vulvar Vestibulitis Syndrome and Estrogen Dose of Oral Contraceptive PillsTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2007Alexander Greenstein MD ABSTRACT Introduction., Vulvar vestibulitis syndrome (VVS) is a diverse, multifactorial phenomenon. Its precise etiology is unknown. Aim., To define the association between oral contraceptive (OC) estrogen dosage and VVS. Methods., Women diagnosed as having VVS participated in the study. Main Outcome Measures., Data on type and usage of oral contraceptive pills (OC) were obtained by a questionnaire, and they were compared for the data on OC usage in the general population. Results., Available commercial data on Israeli women taking OC showed that 51% of them use low-dose estrogen (,20 µg) OC and 49% use higher-dose estrogen (30,35 µg) OC. Of the 132 women in the study, 86 (65%) used OC: 68 (79%) used low-dose estrogen OC (P < 0.002 compared to the general population), while only 18 (21%) used high-dose estrogen OC (P < 0.002 compared to the general population). Conclusion., Significantly more patients who are treated in our clinic for VVS use low-dose estrogen than those who use high-dose estrogen OC. Greenstein A, Ben-Aroya Z, Fass O, Militscher I, Roslik Y, Chen J, and Abramov L. Vulvar vestibulitis syndrome and estrogen dose of oral contraceptive pills. J Sex Med 2007;4:1679,1683. [source] Response of the Female Vocal Quality and Resonance in Professional Voice Users Taking Oral Contraceptive Pills: A Multiparameter ApproachTHE LARYNGOSCOPE, Issue 10 2006Kristiane M. Van Lierde PhD Abstract Objective/Hypothesis: The purpose of this study was to analyze the vocal quality and resonance (nasality and nasalance values) during the menstrual cycle in professional voice users using oral contraceptive pills (OCPs). Although professional voice users are more sensitive and aware of their vocal quality, no changes of voice and resonance characteristics were expected because OCPs create a stable hormonal balance throughout the menstrual cycle. Study Design: The authors conducted a comparative study of 24 healthy, young professional voice users using OCPs. One assessment was performed between the 10th and 17th day of pill intake, when hormonal levels reached a steady state. The second assessment was performed during the first 3 days of menses, when no pills were taken and hormonal levels were minimized. Methods: Subjective (perceptual evaluation of voice and nasality) and objective (aerodynamic, voice range, acoustic, Dysphonia Severity Index [DSI], nasometer) assessment techniques were used. Results: The Mann-Whitney U test showed no significant difference between the perceptual evaluation of the voice and the nasality in the two assessments. The paired Student t test showed no significant difference regarding the maximum phonation time, the vocal performance, the acoustic parameters, and the DSI. Conclusions: These findings indicate that OCPs do not have an impact on the objective and subjective voice and resonance parameters in young professional voice users. This information is specifically relevant to professional voice users who are more aware of vocal quality changes and ear, nose and throat specialists/voice therapists who treat professional voice users with voice problems/disorders. Further research regarding the impact of increased vocal load during the premenstrual or menstrual phase in professional voice users using OCPs should be considered. [source] Knowledge, use and attitudes towards emergency contraceptive pills among swedish women presenting for induced abortionBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2002Gunilla Aneblom Objective To investigate the knowledge, experiences and attitudes towards emergency contraceptive pills (ECP) among women presenting for induced abortion. Design Survey by self-administered waiting room questionnaires. Setting Three large hospitals in the cities of Uppsala, Västerås and Örebro in Sweden. Population 591 Swedish-speaking women consecutively attending the clinics for an induced abortion during a four-month period in 2000. Results The response rate was 88% (n= 518). As many as 43% had a history of one or more previous abortions and 43% were daily smokers. Four out of five women, 83%, were aware of ECP, but only 15 women used it to prevent this pregnancy. Fewer, 38%, knew the recommended timeframes for use and 54% had knowledge of the mode of action. The two most common sources of information about ECP were media and friends. One out of five, 22%, had previously used the method, and at the time of conception, 55% would have taken ECP if it had been available at home, and 52% were positive to having ECP available over the counter. Conclusions Emergency contraception is well known but is still underused. Lack of awareness of pregnancy risk may be one limiting factor for its use. Making ECP available over the counter may be an important measure towards better availability. Information strategies to the public are needed before ECP will be a widely used back-up method. [source] Perception of risk of adverse drug reactions by medical students: influence of a 1 year pharmacological courseBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2007G. Durrieu What is already known about this subject ,,Previous studies have pointed out the question of effective training and information for health professionals on adverse drug reactions (ADRs). ,,This lack of training is known to induce inadequate use of drugs and noncompliance of patients. What this study adds ,,Our study was the first to evaluate the perceived risk of ADRs among young medical students and to investigate the impact of university pharmacology courses on their perception of this risk. ,,The aim of our study was not to assess a definite level of perception of risk for the different drug classes but to determine whether the perceived risk of ADRs differs after attending pharmacology courses. ,,Our results show that the pharmacological training allows young medical students to be aware of potentially serious ADRs, especially related to drugs considered as relatively safe, such as NSAIDs and aspirin. Aims To investigate how adverse drug reactions (ADRs) to several classes of drugs are perceived by young medical students before and after a 1 year pharmacology course. Methods The whole cohort of 92 medical students (63 females and 29 males) was questioned during their third year. A visual analogue scale was used to define a score (ranging from 0 to 10) of perceived risk of ADRs associated with each drug class before and at the end of the pharmacological training period. Results Before the pharmacology course, hypnotics were ranked as the most dangerous drugs by the medical students, followed by antidepressants and anticoagulants. Contraceptive pills were listed in the last position. After pharmacological training, antidepressants moved into the first position, followed by anticoagulants and hypnotics. When all different drug classes were taken as a whole, the mean (±SD) of median scores of the perceived risk were 4.8 (±1.3) before and 5.8 (±1.5) at the end of the pharmacology course (P < 0.0001). Except for antidiabetics, antihypertensive drugs, tranquillizers, corticosteroids and hypnotics, the perceived risk significantly increased after the pharmacology course for the other drugs. The highest increases were observed for contraceptive pills (+104%, P < 0.01), NSAIDs (+86%, P < 0.01) and aspirin (+56%, P < 0.01). Conclusions Pharmacological training allows young medical students to be aware of potentially serious ADRs associated with drugs, in particular with drugs considered relatively safe (such as NSAIDs and aspirin) by nonhealth professionals. [source] |