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Pharmacist recommendations for emergency contraception in Belgium: a simulated user study. 比利时药剂师对紧急避孕药具的建议:模拟用户研究。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-09 DOI: 10.1080/13625187.2024.2345114
Gabrielle Vander Steen, Jeanne Ropers, Charlotte Rousseau, Aurélie Joris, Christine Gilles, Serge Rozenberg, Yannick Manigart

Background: Emergency contraception reduces the risk of unintended pregnancy, after unprotected sexual intercourse or contraceptive failure. In Belgium, emergency contraception is available without a prescription and pharmacists play therefore a crucial role in dispensing emergency contraception.

Aim: This study assesses the dispensing practices of emergency contraception by pharmacists in two regions of Belgium.

Method and design: Simulated patient study, using a predefined scenario, evaluating a request for emergency contraception. The scenario involves a 25-year-old woman not using contraception, who had unprotected sexual intercourse 84 h (3.5 days) ago. Her last menstrual period was 10 days ago.

Population: 260 pharmacies were randomly selected. Principal outcome: proportion of pharmacists who deliver the adequate emergency contraception. We considered the following responses as adequate: Prescribing ulipristal acetate or redirecting to another pharmacy, in case of unavailability, or referring for a copper IUD.

Results: We analysed the data obtained in 216 pharmacies (216/260 = 83.1%). In 64% of cases, adequate dispensing of emergency contraception (dispensing of ulipristal acetate or referral for intrauterine device insertion) occurred. There was an association between correct dispensing and asking appropriate questions, such as the date of the last menstrual period and the date of the risky sexual intercourse.

Conclusion: More than one-third of visited pharmacies did not distribute appropriate emergency contraception, underlining the need for improvement. We hypothesise that this may be achieved with appropriate training, use a dispensing checklist.

背景:紧急避孕药可降低无保护性交或避孕失败后意外怀孕的风险。在比利时,紧急避孕药具无需处方即可获得,因此药剂师在发放紧急避孕药具方面发挥着至关重要的作用。目的:本研究评估了比利时两个地区药剂师发放紧急避孕药具的做法:方法与设计:模拟患者研究,采用预先设定的情景,对紧急避孕申请进行评估。该情景涉及一名未采取避孕措施的 25 岁女性,她在 84 小时(3.5 天)前发生了无保护性交。对象:随机抽取 260 家药房。主要结果:提供适当紧急避孕药具的药剂师比例。我们认为以下答复为适当:开具醋酸氢氯噻呋酯处方,或在无法提供的情况下转到另一家药店,或推荐使用铜质宫内节育器:我们分析了从 216 家药房获得的数据(216/260 = 83.1%)。在 64% 的病例中,紧急避孕药具的配发是适当的(配发醋酸氯普司他酯或转介放置宫内节育器)。正确配药与询问适当的问题有关,如最后一次月经的日期和危险性交的日期:结论:超过三分之一的受访药店没有发放适当的紧急避孕药具,这说明有必要加以改进。我们假设,通过适当的培训和使用配药核对表可以做到这一点。
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引用次数: 0
Prevention of nodules and enhancement of antibody response to genetically engineered recombinant vaccine against Human Chorionic Gonadotropin (hCG) for contraception. 避孕用人绒毛膜促性腺激素(hCG)基因工程重组疫苗可预防结节并增强抗体反应。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-21 DOI: 10.1080/13625187.2024.2359127
Priyanka Tiwari, Mala Srivastava, Rohini Sehgal, Sunesh Kumar, Angamuthu Selvapandiyan, Anupma Kumari, Jagdish C Gupta, Gursaran Parshad Talwar

Objective: Human Chorionic Gonadotropin (hCG) plays a crucial role in embryo implantation and in maintenance of pregnancy. An immuno-contraceptive approach involves the use of a recombinant hCGβ-LTB vaccine formulated with adjuvant Mycobacterium indicus pranii (MIP), to prevent pregnancy without disturbing ovulation, hormonal profiles, and menstrual cycles in women. The present work in mice was designed to address issues encountered in clinical trials conducted with hCGβ-LTB vaccine, with focus on two primary concerns. Firstly, it aimed to determine the optimal vaccine dosage required to induce a high level of anti-hCG antibodies. Secondly, it aimed to assess the safety profile of the vaccine, specifically injection site reactions in the form of nodules, observed in some of the subjects.

Methods and results: Studies undertaken indicate that a 2 µg dose of the protein version of the vaccine, administered in mice through the intramuscular route, can induce high anti-hCG titres. Furthermore, administering a booster dose enhances the antibody response. Our findings suggest that the concentration and frequency of administration of the adjuvant MIP can also be reduced without compromising vaccine efficacy.

Conclusion: The issue of nodule formation at the injection site can be mitigated either by administering the vaccine along with MIP intramuscularly or injecting hCG vaccine and MIP at separate intradermal sites. Thus, protein vaccine administered at a 2µg dose via the intramuscular route addresses both efficacy and safety concerns.

目的:人绒毛膜促性腺激素(hCG)在胚胎着床和维持妊娠中起着至关重要的作用。一种免疫避孕方法是使用重组 hCGβ-LTB 疫苗与佐剂 MIP(Mycobacterium indicus pranii)配制,在不干扰女性排卵、荷尔蒙特征和月经周期的情况下预防怀孕。目前的小鼠研究旨在解决使用 hCGβ-LTB 疫苗进行临床试验时遇到的问题,重点关注两个主要问题。首先,它旨在确定诱导高水平抗 hCG 抗体所需的最佳疫苗剂量。其次,它旨在评估疫苗的安全性,特别是在一些受试者身上观察到的结节形式的注射部位反应:研究表明,通过肌肉注射途径给小鼠注射 2 µg 剂量的蛋白型疫苗可诱导高抗 HCG 滴度。此外,注射加强剂量可增强抗体反应。我们的研究结果表明,在不影响疫苗效力的情况下,佐剂 MIP 的浓度和给药次数也可以减少:结论:通过肌肉注射疫苗和 MIP,或在皮内不同部位注射 hCG 疫苗和 MIP,可以缓解注射部位形成结节的问题。因此,通过肌肉注射 2µg 剂量的蛋白疫苗可同时解决有效性和安全性问题。
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引用次数: 0
The personal experience of female obstetricians and gynaecologists with contraceptive use influences the guidance and prescription of contraceptive methods: a web-survey. 妇产科女医生使用避孕药具的个人经历对避孕方法的指导和处方的影响:一项网络调查。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-30 DOI: 10.1080/13625187.2024.2349038
Mariana R M Canela, Luiz G O Brito, Agnaldo Lopes Silva-Filho, Luis Bahamondes, Cássia R T Juliato

Objective: To evaluate the influence of the personal experience of female obstetricians and gynaecologists (Obst/Gyns) who utilise contraceptive methods on the provision of these methods.

Methods: An anonymous online web-based survey was carried out with female Obst/Gyns. The instrument contained questions about their current and previous contraceptive methods use, factors that influenced the choice and satisfaction with the ongoing method, as well as the occurrence of adverse events. They were also asked whether the experience of any adverse events influenced their decision in prescribing any particular contraceptive method.

Results: 476/9000 (5.3%) female Obst/Gyns answered the survey. The most common contraceptive in use was the 52-mg levonorgestrel-intrauterine device (52-mg LNG-IUD) (34%), followed by non-Long-Acting Reversible Contraception hormonal methods (21.2%). More than half of the respondents (57.6%) reported having some adverse effects and 18.7% reported that the personal experience of an adverse effect with the use of a contraceptive method influenced the prescription of that method.

Conclusion: Half of female Obst/Gyns encountered adverse events linked to contraceptive usage. Additionally, almost one-fifth believe that their own encounter with adverse effects from a contraceptive method impacts their decision to prescribe the same method.

目的:评估使用避孕方法的妇产科女医生的个人经历对提供这些方法的影响:评估使用避孕方法的女性妇产科医生(Obst/Gyns)的个人经历对提供这些方法的影响:方法: 对女性妇产科医生进行匿名在线网络调查。调查内容包括她们当前和以往使用的避孕方法、影响选择的因素、对当前方法的满意度以及不良事件的发生情况。她们还被问及,任何不良事件的经历是否影响了她们开具任何特定避孕方法处方的决定:476/9000(5.3%)名妇产科女医生回答了调查。最常用的避孕方法是 52 毫克左炔诺孕酮宫内节育器(52 毫克 LNG-IUD )(34%),其次是非长效可逆避孕激素方法(21.2%)。半数以上的受访者(57.6%)表示曾有过一些不良反应,18.7%的受访者表示个人在使用某种避孕方法时的不良反应经历影响了对该方法的处方:结论:半数妇产科女医生遇到过与使用避孕药具有关的不良反应。此外,将近五分之一的妇产科医生认为,她们自己在使用避孕方法时遇到的不良反应会影响她们开具相同避孕方法处方的决定。
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引用次数: 0
Abortion pill marketing and sourcing on twitter following Dobbs v. Jackson supreme court ruling. 多布斯诉杰克逊一案最高法院判决后,twitter 上的堕胎药营销和来源。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI: 10.1080/13625187.2024.2354868
Tiana J McMann, Michael R Haupt, Nicolette Le, Marielle E Meurice, Jiawei Li, Raphael E Cuomo, Tim K Mackey

Objective: This study examines abortion-related discourse on Twitter (X) pre-and post-Dobbs v. Jackson ruling, which eliminated the constitutional right to abortion.

Study design: We used a custom data collection tool to collect tweets directly from Twitter using abortion-related keywords. We used the BERTopic language model and examined the top 30 retweeted and top 30 textually similar tweets from relevant topic clusters using an inductive coding approach. We also conducted statistical testing to assess potential associations between abortion themes.

Results: 166,799 unique tweets were collected from December 2020-December 2022. 464 unique tweets were coded for abortion-related themes with 154 identified as relevant. Of these, 66 tweets marketed abortion pills, 17 tweets were identified as offering consultations, and 91 tweets were relevant to self-managed abortion. All marketing and consultation tweets were posted post-Dobbs decision and 7 (7.69%) of self-managed tweets were posted pre-Dobbs versus 84 (92.30%) posted post-Dobbs. A positive association was found between tweets offering a medical consultation with tweets marketing abortion pills and discussing self-managed abortion.

Conclusion: This study detected online marketing of abortion pills, consultations and discussions about self-managed abortion following the Dobbs v. Jackson ruling. These results provide more context to the type of abortion-related information that is available online.

研究目的本研究探讨了多布斯诉杰克逊案(Dobbs v. Jackson)判决前后推特(X)上与堕胎相关的言论,该判决取消了宪法规定的堕胎权:研究设计:我们使用定制的数据收集工具,直接从 Twitter 上收集使用堕胎相关关键词的推文。我们使用了 BERTopic 语言模型,并采用归纳编码方法检查了相关主题集群中转发量最高的 30 条微博和文本相似度最高的 30 条微博。我们还进行了统计测试,以评估流产主题之间的潜在关联:我们在 2020 年 12 月至 2022 年 12 月期间收集了 166799 条推文。对 464 条独特的推文进行了人工流产相关主题编码,其中 154 条被确定为相关主题。其中,66 条推文营销堕胎药,17 条推文被确定为提供咨询,91 条推文与自我管理堕胎相关。所有营销和咨询推文都是在多布斯决定后发布的,7 条(7.69%)自我管理推文是在多布斯决定前发布的,而 84 条(92.30%)是在多布斯决定后发布的。提供医疗咨询的推文与推销堕胎药和讨论自我管理堕胎的推文之间存在正相关:本研究发现,在多布斯诉杰克逊案判决后,网上出现了推销堕胎药、咨询和讨论自我管理堕胎的推文。这些结果为网上流产相关信息的类型提供了更多的背景信息。
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引用次数: 0
The use of a pill containing ethinylestradiol-norgestimate improves female sexuality despite the decrease in circulating androgens: a pilot study. 使用含有炔雌醇-炔诺酮的避孕药可提高女性的性能力,尽管循环中的雄激素减少了:一项试验研究。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-28 DOI: 10.1080/13625187.2024.2369833
Maurizio Guida, Luciano Quercitelli, Pasquale De Franciscis, Mariano Fiorenza, Alice Sgandurra, Antonio La Marca, Giovanni Grandi

Purpose: To evaluate the initial impact of a combined oral contraceptive (COC) containing norgestimate (NGM) on female sexuality and on circulating androgen levels in users.

Materials and methods: Six months modification in the McCoy Female Sexuality Questionnaire (MFSQ) and testosterone (T) and dehydroepiandrosterone sulphate (DHEAS) serum levels in women starting a monophasic pill containing ethinyl-estradiol (EE) 35 µg and NGM 0.250 mg.

Results: The study was completed by 36 subjects. There was a significant increase in MFSQ during treatment (p < 0.0001) (and its domains with the exclusion of vaginal lubrication domain) with concomitant decreases in T (-4.45%, p < 0.0001) and DHEAS (-19.41%, p < 0.0001) serum levels.

Conclusions: Contraception with EE/NGM was associated with a short term non-deteriorating effect on sexuality despite the evident decrease in androgen levels. Female sexuality during COC use is a complex topic and is not only linked with changes in serum androgen levels.

目的:评估含有炔诺酮(NGM)的复合口服避孕药(COC)对女性性欲和使用者体内循环雄激素水平的初步影响:开始服用含炔雌醇(EE)35微克和炔诺酮(NGM)0.250毫克的单相避孕药的女性,在六个月内对麦考伊女性性能力问卷(MFSQ)以及睾酮(T)和硫酸脱氢表雄酮(DHEAS)血清水平进行修改:36 名受试者完成了研究。在治疗期间,MFSQ 有明显增加(p p p p 结论):尽管雄性激素水平明显下降,但使用 EE/NGM 避孕对性欲的影响在短期内不会下降。使用化学避孕药期间的女性性能力是一个复杂的话题,不仅与血清雄激素水平的变化有关。
{"title":"The use of a pill containing ethinylestradiol-norgestimate improves female sexuality despite the decrease in circulating androgens: a pilot study.","authors":"Maurizio Guida, Luciano Quercitelli, Pasquale De Franciscis, Mariano Fiorenza, Alice Sgandurra, Antonio La Marca, Giovanni Grandi","doi":"10.1080/13625187.2024.2369833","DOIUrl":"10.1080/13625187.2024.2369833","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the initial impact of a combined oral contraceptive (COC) containing norgestimate (NGM) on female sexuality and on circulating androgen levels in users.</p><p><strong>Materials and methods: </strong>Six months modification in the McCoy Female Sexuality Questionnaire (MFSQ) and testosterone (T) and dehydroepiandrosterone sulphate (DHEAS) serum levels in women starting a monophasic pill containing ethinyl-estradiol (EE) 35 µg and NGM 0.250 mg.</p><p><strong>Results: </strong>The study was completed by 36 subjects. There was a significant increase in MFSQ during treatment (<i>p</i> < 0.0001) (and its domains with the exclusion of vaginal lubrication domain) with concomitant decreases in T (-4.45%, <i>p</i> < 0.0001) and DHEAS (-19.41%, <i>p</i> < 0.0001) serum levels.</p><p><strong>Conclusions: </strong>Contraception with EE/NGM was associated with a short term non-deteriorating effect on sexuality despite the evident decrease in androgen levels. Female sexuality during COC use is a complex topic and is not only linked with changes in serum androgen levels.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"160-162"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of etonogestrel subcutaneous implant in Sardinia, Italy: women's compliance and satisfaction. 意大利撒丁岛使用依托诺孕酮皮下植入物的情况:妇女的依从性和满意度。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-24 DOI: 10.1080/13625187.2024.2354248
Giampiero Capobianco, Elisa Sanna, Alessandra Gulotta, Giuseppe Virdis, Francesco Dessole, Ivana Maida, Massimo Madonia, Francesco Cudoni, Marco Petrillo

Purpose of the article: The main aim of the study was to analyze the population of women who used etonogestrel implant, the reason that led them to this type of contraception, and the degree of compliance with it. Materials and methods: We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015-2021). We submitted the women a series of questions by telephone questionnaire (range 10-72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant.

Materials and methods: We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015-2021). We submitted the women a series of questions by telephone questionnaire (range 10-72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant.

Results: The average age of placement of etonogestrel implant was 33.8 ± 3.45 years. As regards level of education, 16/47 (34%) of the women had a university degree, 21/47 (44%) had a high school diploma and 10/47 (21%) had a secondary school diploma. The 12/47 (25%) of the women were, at the time of the counselling, unemployed and only 8% did not use in the past contraceptive methods other than etonogestrel implant. The 92% of women choose etonogestrel implant because it offered safe, comfortable and long-lasting contraception. Among the main side effects evaluated, we reported spotting in 24 out of 47 (51%), headache in 4 out of 47 (8.5%). The 85% of the women recommended etonogestrel implant to their friends as a contraceptive method, with an approval rating for the implant, expressed a rating from 1 to 10 with the mean that was 7.79, the median 8.

Conclusions: Our results are of interest because they derive from a region of Italy in which the Long acting reversible contraception (LARC) is strongly underused. Etonogestrel implant was a safe and effective, long-acting, reversible hormonal contraception (LARC) and majority of women recommended the etonogestrel implant to their friends as a contraceptive method.

文章目的研究的主要目的是分析使用依托孕烯皮下埋植剂的妇女人群、导致她们使用这种避孕方式的原因以及对这种避孕方式的依从性。材料和方法我们对 6 年内(2015-2021 年)植入依托诺孕酮皮下埋植剂的女性(47 人)进行了回顾性研究。我们通过电话问卷向这些妇女(植入后 10-72 个月不等,平均 40 个月)提出了一系列问题,以调查与依托孕烯植入相关的合并症和副作用:我们对 6 年内(2015-2021 年)植入依托诺孕酮皮下植入物的女性(47 名)进行了回顾性研究。我们通过电话问卷向这些妇女(植入后 10-72 个月不等,平均 40 个月)提出了一系列问题,以调查与依托孕烯植入相关的合并症和副作用:结果:植入依托孕烯的平均年龄为(33.8 ± 3.45)岁。在教育程度方面,16/47(34%)的妇女拥有大学学位,21/47(44%)拥有高中文凭,10/47(21%)拥有中学文凭。在接受咨询时,12/47(25%)的妇女没有工作,只有 8%的妇女过去没有使用过除伊托诺孕酮皮下埋植剂以外的其他避孕方法。92%的妇女选择伊托诺孕酮皮下埋植剂,因为它能提供安全、舒适和持久的避孕效果。在评估的主要副作用中,我们发现 47 人中有 24 人(51%)出现点滴出血,47 人中有 4 人(8.5%)出现头痛。85%的妇女向她们的朋友推荐了依托孕烯植入剂作为避孕方法,她们对植入剂的认可度从 1 到 10 分不等,平均值为 7.79,中位数为 8.结论:我们的研究结果很有意义,因为这些结果来自意大利的一个地区,在该地区,长效可逆避孕药具(LARC)的使用率非常低。依托孕烯植入剂是一种安全有效的长效可逆荷尔蒙避孕药(LARC),大多数妇女都向她们的朋友推荐依托孕烯植入剂作为避孕方法。
{"title":"Use of etonogestrel subcutaneous implant in Sardinia, Italy: women's compliance and satisfaction.","authors":"Giampiero Capobianco, Elisa Sanna, Alessandra Gulotta, Giuseppe Virdis, Francesco Dessole, Ivana Maida, Massimo Madonia, Francesco Cudoni, Marco Petrillo","doi":"10.1080/13625187.2024.2354248","DOIUrl":"10.1080/13625187.2024.2354248","url":null,"abstract":"<p><strong>Purpose of the article: </strong>The main aim of the study was to analyze the population of women who used etonogestrel implant, the reason that led them to this type of contraception, and the degree of compliance with it. Materials and methods: We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015-2021). We submitted the women a series of questions by telephone questionnaire (range 10-72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant.</p><p><strong>Materials and methods: </strong>We carried out a retrospective study on women who had etonogestrel subcutaneous implant placed (n°47) over a 6-year period (2015-2021). We submitted the women a series of questions by telephone questionnaire (range 10-72 months after placements, mean 40 months) that investigated the comorbidities and side effects related to etonogestrel implant.</p><p><strong>Results: </strong>The average age of placement of etonogestrel implant was 33.8 ± 3.45 years. As regards level of education, 16/47 (34%) of the women had a university degree, 21/47 (44%) had a high school diploma and 10/47 (21%) had a secondary school diploma. The 12/47 (25%) of the women were, at the time of the counselling, unemployed and only 8% did not use in the past contraceptive methods other than etonogestrel implant. The 92% of women choose etonogestrel implant because it offered safe, comfortable and long-lasting contraception. Among the main side effects evaluated, we reported spotting in 24 out of 47 (51%), headache in 4 out of 47 (8.5%). The 85% of the women recommended etonogestrel implant to their friends as a contraceptive method, with an approval rating for the implant, expressed a rating from 1 to 10 with the mean that was 7.79, the median 8.</p><p><strong>Conclusions: </strong>Our results are of interest because they derive from a region of Italy in which the Long acting reversible contraception (LARC) is strongly underused. Etonogestrel implant was a safe and effective, long-acting, reversible hormonal contraception (LARC) and majority of women recommended the etonogestrel implant to their friends as a contraceptive method.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"171-176"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nonpalpable implant removals at centre of experience in France: a cohort study. 法国经验中心的非可触及植入物取出:一项队列研究。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-30 DOI: 10.1080/13625187.2024.2349039
Gautier Chene, Pia Akl, Ana Gjorgjievska-Delov, Emanuele Cerruto, Stephanie Moret, Erdogan Nohuz

Objective(s): Management and localisation strategies to remove nonpalpable contraceptive implants may be difficult. We aimed to evaluate our imaging modalities to identify deep implant and patient outcomes related to removal.

Study design: In this retrospective study, we reviewed all cases referred to our specialised centre for nonpalpable contraceptive implants from January 2018 to August 2022.

Results: Out of the cohort studied, 47 female subjects exhibited nonpalpable implants. The implant was nonpalpable for thirty-six patients (76,6%) immediately after the insertion whereas it was not palpable several months after the insertion for eleven patients (23.4%). Twelve patients (25.5%) had one or more failed removal attempts before referral.All 47 implants were successfully visualised via ultrasound in the upper arm: 40 implants (85.1%) were located in the subdermal tissue, 4 (8.5%) were intrafascial and 3 (6.4%) were intramuscular. Depth of the implant was 4.0 mm [1.7 - 12.0]. No clinical factors were statistically associated with differences in depth or location (subdermal vs subfascial). Removal procedures were mainly under local anaesthesia in 74.5% of cases in an outpatient setting. There were two Clavien-Dindo grade 1 complications (one case of cutaneous scar dehiscence and one transient postoperative neuropathic complaint in the upper arm resolved within 3 months under analgetics).

Conclusions: Identification of deep implants requires following the ultrasound modality protocol. Ultrasound detection makes easy and safe implant removal. Training programs for the insertion as well as for the removal of correct and incorrect inserted implants should be continued and developed all around the world.

研究设计:在这项回顾性研究中,我们回顾了自2018年1月至2022年8月期间因不可触及的避孕植入物而转诊至本专业中心的所有病例:在所研究的群体中,有 47 名女性受试者表现出植入物无法触及的情况。有 36 名患者(76.6%)在植入后立即无法触及植入物,而有 11 名患者(23.4%)在植入数月后无法触及植入物。12 名患者(25.5%)在转诊前曾尝试过一次或多次移除植入物,但均以失败告终:所有 47 个植入体均可通过超声波在上臂成功观察到:40 个植入体(85.1%)位于皮下组织,4 个(8.5%)位于筋膜内,3 个(6.4%)位于肌肉内。植入深度为 4.0 毫米 [1.7 - 12.0]。在统计学上,没有临床因素与植入深度或位置(皮下与筋膜下)的差异相关。74.5%的病例在门诊环境下进行了局部麻醉。有两例克拉维恩-丁多 1 级并发症(一例皮肤疤痕开裂,一例术后上臂一过性神经痛,在镇痛药作用下 3 个月内缓解):结论:深部植入物的识别需要遵循超声模式规程。结论:深部植入物的识别需要遵循超声模式方案,通过超声检测可以轻松安全地取出植入物。应在全球范围内继续开展和发展关于正确插入和错误插入植入物的插入和移除培训计划。
{"title":"Nonpalpable implant removals at centre of experience in France: a cohort study.","authors":"Gautier Chene, Pia Akl, Ana Gjorgjievska-Delov, Emanuele Cerruto, Stephanie Moret, Erdogan Nohuz","doi":"10.1080/13625187.2024.2349039","DOIUrl":"10.1080/13625187.2024.2349039","url":null,"abstract":"<p><strong>Objective(s): </strong>Management and localisation strategies to remove nonpalpable contraceptive implants may be difficult. We aimed to evaluate our imaging modalities to identify deep implant and patient outcomes related to removal.</p><p><strong>Study design: </strong>In this retrospective study, we reviewed all cases referred to our specialised centre for nonpalpable contraceptive implants from January 2018 to August 2022.</p><p><strong>Results: </strong>Out of the cohort studied, 47 female subjects exhibited nonpalpable implants. The implant was nonpalpable for thirty-six patients (76,6%) immediately after the insertion whereas it was not palpable several months after the insertion for eleven patients (23.4%). Twelve patients (25.5%) had one or more failed removal attempts before referral.All 47 implants were successfully visualised <i>via</i> ultrasound in the upper arm: 40 implants (85.1%) were located in the subdermal tissue, 4 (8.5%) were intrafascial and 3 (6.4%) were intramuscular. Depth of the implant was 4.0 mm [1.7 - 12.0]. No clinical factors were statistically associated with differences in depth or location (subdermal vs subfascial). Removal procedures were mainly under local anaesthesia in 74.5% of cases in an outpatient setting. There were two Clavien-Dindo grade 1 complications (one case of cutaneous scar dehiscence and one transient postoperative neuropathic complaint in the upper arm resolved within 3 months under analgetics).</p><p><strong>Conclusions: </strong>Identification of deep implants requires following the ultrasound modality protocol. Ultrasound detection makes easy and safe implant removal. Training programs for the insertion as well as for the removal of correct and incorrect inserted implants should be continued and developed all around the world.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"163-170"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia. E4/DRSP对自我报告的经前和经期生理和情绪症状的影响:来自欧洲和俄罗斯第三阶段临床试验的数据。
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-21 DOI: 10.1080/13625187.2024.2359117
Johannes Bitzer, Céline Bouchard, János Zatik, Steven Weyers, Terhi Piltonen, Larisa Suturina, Inna Apolikhina, Kristina Gemzell-Danielsson, Maud Jost, Mitchell D Creinin, Jean-Michel Foidart

Purpose: To describe the effects of estetrol (E4) 15 mg/drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms.

Materials and methods: We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 - 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ-t-scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain.

Results: Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (-1.4), Water Retention (-3.3) and Negative Affect (-2.5); and for menstrual Pain (-3.5), Water Retention (-3.4), and Negative Affect (-2.7) (all p < 0.01). For switchers, no changes were significant except an increase in premenstrual (+1.0, p = 0.02) and menstrual (+1.5, p = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect).

Conclusion: E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes.

目的:描述雌烯雌酚(E4)15 毫克/屈螺酮(DRSP)3 毫克对经前和经期生理和情绪症状的影响:我们使用了在欧洲和俄罗斯进行的第三阶段试验(NCT02817828)中的月经困扰问卷(MDQ)数据,参与者(18 - 50 岁)使用 E4/DRSP 长达 13 个周期。我们评估了开始治疗者和转换治疗者(前 3 个月使用过激素避孕药)经前(最近一次月经来潮前 4 天)和经期(最近一次月经来潮)4 个 MDQ 领域的 MDQ-t 分数从基线到治疗结束的平均变化,并对每个领域中的个别症状进行了移位分析:在 1,553 名接受治疗的参与者中,1,398 人(90.0%)(包括 531 人(38%))完成了两个 MDQ。开始治疗者的经前疼痛(-1.4)、水潴留(-3.3)和负性情绪(-2.5)有所改善;经期疼痛(-3.5)、水潴留(-3.4)和负性情绪(-2.7)(所有 p p = 0.02)和经期水潴留(+1.5,p = 0.003)有所改善。我们观察到,在痉挛、背痛和疲劳(疼痛领域)、乳房疼痛或触痛和肿胀(潴留领域)以及情绪波动和易怒(负面情绪领域)方面,超过 40% 的参与者的症状强度发生了变化:结论:E4/DRSP 启动者在疼痛、水滞留和消极情绪方面有明显改善,尤其是那些基线症状较严重的人从中受益。转换者的变化很小。
{"title":"Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia.","authors":"Johannes Bitzer, Céline Bouchard, János Zatik, Steven Weyers, Terhi Piltonen, Larisa Suturina, Inna Apolikhina, Kristina Gemzell-Danielsson, Maud Jost, Mitchell D Creinin, Jean-Michel Foidart","doi":"10.1080/13625187.2024.2359117","DOIUrl":"10.1080/13625187.2024.2359117","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the effects of estetrol (E4) 15 mg<b>/</b>drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms.</p><p><strong>Materials and methods: </strong>We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 - 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ-<i>t</i>-scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain.</p><p><strong>Results: </strong>Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (-1.4), Water Retention (-3.3) and Negative Affect (-2.5); and for menstrual Pain (-3.5), Water Retention (-3.4), and Negative Affect (-2.7) (all <i>p</i> < 0.01). For switchers, no changes were significant except an increase in premenstrual (+1.0, <i>p</i> = 0.02) and menstrual (+1.5, <i>p</i> = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect).</p><p><strong>Conclusion: </strong>E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"150-159"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retraction of peer-reviewed articles, a difficult but crucial choice: our experience from The European Journal of Contraception & Reproductive Health Care. 撤回经同行评审的文章,一个困难但关键的选择:《欧洲避孕与生殖保健杂志》的经验。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-01 Epub Date: 2024-04-02 DOI: 10.1080/13625187.2024.2333421
Frans Roumen, Giovanni Grandi, Johannes Bitzer
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引用次数: 0
Migration of etonogestrel subcutaneous contraceptive implants: systematic review and recommendations for practice. 依托诺孕酮皮下避孕植入物的迁移:系统综述和实践建议。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-01 Epub Date: 2024-05-07 DOI: 10.1080/13625187.2024.2342919
Édith Guilbert, Hélène Arguin, Mathieu Bélanger

Introduction: Migration is a rare but serious complication of the etonogestrel contraceptive implant, and little is known about its extent.

Purpose: To document and characterise cases of etonogestrel contraceptive implant migration in the scientific literature.

Methods: A systematic review of Medline, Embase and Global Health databases was carried out between January 2000 and January 2023 to identify articles presenting implant migrations. Narrative reviews, conference abstracts and articles not written in English or French were excluded.

Results: Forty-five articles, mostly published since 2016, were identified (eight case series and 37 case reports), for a total of 148 independent cases of migration: in pulmonary blood vessels (n = 74), in non-pulmonary blood vessels (n = 16) and extravascular (n = 58). Many patients are asymptomatic and migration is often an incidental finding. A non-palpable implant and symptoms related to implant location (intra- or extra-vascular) may be indicative of migration. Inadequate insertion and normal or underweight appear to increase the risk of migration. Scientific societies and authors offer practical strategies to deal with implant migration.

Conclusion: Professionals who insert and remove contraceptive implants must be adequately trained. They need to be on the lookout for implant migration, and promptly refer patients to appropriate care if migration is suspected.

导言:目的:在科学文献中记录并描述依托孕烯避孕植入物移位的病例:方法:对 2000 年 1 月至 2023 年 1 月期间的 Medline、Embase 和 Global Health 数据库进行了系统性回顾,以确定有关植入物移位的文章。结果:45 篇文章大多发表于 2000 年 1 月至 2023 年 1 月:结果:共发现 45 篇文章(8 篇系列病例和 37 篇病例报告),其中大部分是 2016 年以来发表的文章,共有 148 个独立的移位病例:肺血管(74 例)、非肺血管(16 例)和血管外(58 例)。许多患者没有症状,移位往往是偶然发现的。无法触及植入物以及与植入物位置(血管内或血管外)相关的症状可能表明存在移位。植入不当、体重正常或过轻似乎会增加移位的风险。科学协会和作者提供了处理植入体移位的实用策略:插入和取出避孕植入物的专业人员必须接受过充分的培训。他们需要警惕植入体移位,如果怀疑植入体移位,应立即将患者转到适当的医疗机构。
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引用次数: 0
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European Journal of Contraception and Reproductive Health Care
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