The strategic approach to contraceptive introduction

Lesbian, gay, and bisexual educators have faced many barriers in their professions, including harassment, discrimination, and even nationwide antigay political campaigns. Recently, lesbian, gay, and bisexual educators, particularly on college campuses, have challenged such stigmatization by coming out. Because previous research has demonstrated that interpersonal contact with lesbians, gay men, and bisexuals is related to less heterosexist attitudes, the current study investigated the impact of a gay instructor's coming out on his students' attitudes toward lesbians and gay men. Data were collected from 156 undergraduate students enrolled in an Introductory Psychology course, 40 of whom were taught by a gay instructor. Herek's (1984, 1994b) Attitudes Toward Lesbians and Gay Men (ATLG) scale was used to measure students' relative levels of heterosexism and was administered to students at the beginning and end of the semester. Midway through the semester, the gay instructor disclosed his gay identity to his students as part of a lesson about sexual orientation. Results from the postcourse survey indicated that students in the gay instructor's course section exhibited improved attitudes. Conversely, students enrolled in the same course in sections taught by heterosexual instructors demonstrated no change in their attitudes. Implications of these findings are discussed, and it is argued that gay instructors' coming out may positively affect their students' attitudes toward lesbian, gay, and bisexual people. However, these efforts by individual instructors must only be a small part of more comprehensive institutional efforts by university communities to address homophobia and heterosexism in educational settings.     

Popular and traditional contraceptive methods

This review gives the mode of action, efficacy, causes of failure, advantages, drawbacks, and geographical areas of wide use of abstinence, withdrawal, postcoital douche, lactation, condom, cervical cap, spermicides, and rhythm. The effectiveness of these methods ranges from 15-20 failures/100 woman-years for withdrawal, 30-60% for douche, 8-17% for lactation, 10-20% for condom, 8% theoretically for cap, 15-25% for spermicides and 3-15% for C-film, and 7-40% for rhythm. Coitus interruptus is used widely in Eastern Europe and the Mid-East. The only recommended application for douche is for a broken condom. Caps, made of lucite, celluloid, or metal, are used chiefly in Germany, and have the advantage of being left in place for days at a time. Spermicides usually contain nonylphenoxypolyethoxyethanol, and foam and C-film are probably the best products in effectiveness and convenience. Rhythm may be based on calendar, body temperature, or both, and its use in declining. The traditional methods should be taught and advertised, especially in countries and locales where medical services are inaccessible, such as developing countries and urban ghettos.     

Drug use during lactation

Breast-feeding is an essential physiologic process that provides ideal nutrition to the infant as well as protection against disease. All drugs are excreted into breast milk and are bioavailable to the infant. However, most medications do not pose significant risk to the nursing infant, and breast-feeding should be continued despite medication use in most cases. These decisions should be made using a stepwise approach Pharmacists should be aware of which drugs are contraindicated and which drugs should be used cautiously, in addition to which drugs should be recommended if necessary during lactation information on use of specific drugs is presented in this article. With knowledge of the principles of drug passage into breast milk, the goal of the pharmacist should be to minimize the infant's exposure to drugs while supporting the mother's desire to continue breast-feeding.     

Significance of lipid consumption during lactation

Human milk lipids are the main source of energy to support optimum growth of the breast-fed infant. The content and composition of milk lipids come from three main sources of fatty acids: the diet, mobilization of body fat stores and fatty acid synthesis de novo by the mammary gland. On account of these, the consumption and composition of the lipids from the diet and also the nutritional state, specifically the body fat percentage of the lactating woman, are elements that maintain a close relation with the content and composition of milk lipids which translates into the energy content given to the baby. The evidence suggests that the body fat stores significantly provide the demand imposed by lactation, and under suboptimal nutritional conditions where body fat stores are depleted, dietary lipid consumption is essential. It is necessary to elucidate the physiological regulatory mechanisms involved in the utilization of dietary lipids on milk synthesis. This information will be of great practical value, since it may allow the development of optimum diets for lactating women.     

Nutrition during oral contraceptive use

During the last 3 years the number of prisoners in Finland, has risen, being for the moment 105 per 100,000 inhabitants, one of the highest rates in Europe. This is dependent not only on the increase in criminality, but on the traditionally very severe scale of punishments applied. The penal institutions now have a 50% overloading. The actual situation of forensic and penal psychiatric work is characterized by overloaded services, long waiting lists and a generally irritated atmosphere.     

Treatment of migraine during pregnancy and lactation

Migraine onset, frequency and severity are influenced by hormonal changes throughout the various female reproductive life events, including pregnancy. Migraine may worsen during the first trimester, but usually improves thereafter. The treatment of migraine during pregnancy and lactation is difficult because of the risks to the fetus and newborn. This paper reviews migraine throughout the female reproductive life events, as well as the acute and prophylactic treatment of the pregnant and lactating migraineur.     

Oral contraceptive use during the perimenopausal years

Few guidelines exist for the use of estrogen, particularly low-dose oral contraceptives, during the perimenopausal years. Use of low-dose oral contraceptive pills in women over 35 years of age provides protection against unwanted pregnancy, maintains a stable hormonal environment and decreases abnormal menstrual bleeding. Other noncontraceptive health benefits of oral contraceptives include a reduction in bone loss and protection against iron deficiency anemia, dysmenorrhea, benign breast disease, endometrial cancer and epithelial ovarian cancer. This article discusses potential risks of oral contraceptive use in this age group, as well as recommendations about when and how to change from contraceptive therapy to postmenopausal hormone replacement therapy.     

Safety of intrauterine contraceptive devices during MR imaging

OBJECTIVE: We report a case of candidiasis of the upper urinary tract that presented as acute renal failure associated with septic syndrome. The patient initially required hemodialysis. Right hydronephrosis and perirenal collection were observed on ultrasound examination. METHODS: A percutaneous nephrostomy was performed. Nephrostomy urine cytology and cultures were positive for Candida tropicalis. An anterograde pyelography showed a 'fungus ball' in the urinary tract. RESULTS: Therapy with oral fluconazole and percutaneous amphotericin B achieved excellent results. CONCLUSIONS: Candidiasic urinary infection of the upper urinary tract often produces obstructive uropathy requiring percutaneous nephrostomy, which can also be used to instill amphotericin B. Combination therapy with amphotericin B and fluconazole can achieve excellent results.     

A clinico-radiological correlation of breast diseases during lactation and the significance of unilateral failure of lactation

OBJECTIVES: The Ishikawa endometrial cancer cell line is hormonally responsive, expressing estrogen and progesterone receptors (ER, PR) when grown in traditional monolayer culture. The purpose of this paper is to demonstrate a three-dimensional spheroid culture system for cancer cells. We used this system to determine the response of the Ishikawa cell line to estradiol-17 beta (E), tamoxifen (T), megestrol acetate (MA), and progesterone (P). METHODS: Ishikawa cells were incubated in polyurethane culture bags using phenol red-free media containing ethanol (0.1%, controls), E (1 mumol, or 1 nmol), T (1 mumol, or 10 nmol), MA (1 mumol, or 10 nmol), or P (1 mumol). Cellular morphology was assessed by hematoxylin and eosin staining, and expression of estrogen and progesterone receptors was determined immunohistochemically using an immunoperoxidase technique. RESULTS: Cells in control cultures demonstrated minimal organization and lacked hormone receptors. In contrast, cells exposed to either E or T displayed significant glandular formation, with multicellular, microvilli-rich, columnar epithelia exhibiting polarized nuclear arrangements. Within 4 weeks, E- and T-treated cultures showed upregulated nuclear staining for PR, with little ER present. Cells treated with MA or P showed less glandular organization but expressed ER with PR downregulation. CONCLUSIONS: These data support the use of this novel three-dimensional culture system to study the modulation of tumor cell biologic activity in response to hormonal agents. Future applications of this model include examining in vitro responsiveness of cancer cell lines to additional biologic agents and chemotherapeutic regimens.     

浅谈烧结点火器与节能途径

本文论述了烧结点火器结构与烧结有关的节能途径     

Changes of plasma osmotic pressure during lactation in rats

It is known that blood and plasma volume increase during lactation. The present paper examines whether an increase in plasma volume is accompanied by the change in plasma composition or attributed to hydro-dilution. Six dam-nursed pups and six dam-removed pups housed individually were designated as lactating rats and control rats, respectively. The plasma osmotic pressure and hematocrit value (Ht) were measured in the rats on days 3, 5, 7, 10, 13 and 18 of lactation. The total plasma protein (TP) and serum sodium concentration were also measured as they are factors affecting the plasma osmotic pressure. In addition, milk yield was estimated by the Morag technique. On day 5 and after day 10, the osmotic pressure of the lactating rats was found to be significantly lower than that of the control rats. The serum sodium concentration (days 5 and after day 10) and Tp values (days 3, 10 and 18) of the lactating rats were significantly lower than those of the control rats. Except on day 5, the Ht values of the lactating rats were significantly lower than those of the controls. During the period between days 3 and 10, milk yield was increased and it become steady (18 g/12 hr) on days 10 and 18. On and after day 10 when rats secreted a large amount of milk, it is considered that a decrease in the plasma osmotic pressure was mainly attributed to the reduction of sodium concentration by hydro-dilution. The Ht values indicate that an increase in blood volume is mainly through plasma volume rather than blood cell volume in lactating rats.     

Effect of post-coital contraceptive methods on the endometrium and the menstrual cycle

STUDY OBJECTIVE: To evaluate the effect of treatment with ethinylesteradiol-levonorgestrel or danazol on ovarian function, gonadotrophin release and endometrial development during the time when a pregnancy may occur following unprotected intercourse. METHODS: Women with regular menstrual cycles were followed during one control, one treatment and one follow-up month. The women obtained either a combination of 0.5 mg levonorgestrel and 0.1 mg ethinylestradiol (Yuzpe regimen: n = 16) or 600 mg danazol orally and repeated after 12 hours (n = 16). The treatment was administered on either cycle day (cd) 12 or day LH +2. An endometrial biopsy was obtained once on cd LH +6 to +8 in the subjects treated on cd LH +2 both in control and treatment cycles, and morphometric analysis was performed. The concentrations of LH, pregnandiol (P2G), and estrone (EIG) glucuronide were followed daily in morning urine during control and treatment cycles. RESULTS: Following treatment with the Yuzpe regimen on cd 12 the LH surge was either undetectable (three subjects), postponed to cd 16 to 22 (three subjects) or cd 38 to 39 (two subjects) with lower P2G and LH levels than in the control cycle. Following preovulatory treatment with danazol, no LH peak could be detected in four subjects and in the remaining four subjects the LH peak varied between cd 13 and cd 24. The mean area under the curve for LH was significantly lower, the levels of EIG were slightly higher and the P2G levels were unaffected in comparison with the control cycle. Neither of the two treatments administered on cd LH +2 affected the hormonal pattern and only a discreet effect on the development of the endometrium was seen after the EE/LNG treatment. CONCLUSION: The findings indicate that the contraceptive effect of postcoital treatment with EE/LNG and danazol is mainly due to an inhibition or delay of ovulation and insufficient corpus luteum function. The direct effect on the endometrium is limited, if any.     

Is milk production impaired by dieting during lactation?

To determine the feasibility of a weight-loss program during lactation, 33 healthy, well-nourished, breast-feeding women were enrolled. Twenty-two women completed the 10-wk study, losing a mean (+/- SD) of 4.8 +/- 1.2 kg. Mean energy intake during the study was nearly 2.25 MJ (538 kcal) below the mean daily baseline intake of 9.64 +/- 2.48 MJ (2303 +/- 592 kcal). The sum of three maternal skinfold thickness, waist, and hip measurements were significantly smaller (P = 0.0001) at study completion. Mean daily milk production was 759 +/- 142 mL/d at baseline and 802 +/- 189 mL/d at week 10. The infants gained an average of 21 g/d, or 1.48 +/- 0.40 kg overall. The mean percent fat of milk at baseline and 10 wk was 4.06 +/- 2.15 and 4.00 +/- 2.56, respectively. The mean daily nitrogen content of milk at baseline and study completion was 1.82 +/- 0.32 and 1.62 +/- 27 g/L. These findings suggest that modest weight loss by healthy breast-feeding women does not adversely affect either quantity or quality of milk consumed by their infants.     

The treatment of prolactinomas during pregnancy and the lactation period

Thanks to its good long-term results, surgery is the method of choice to treat subcutaneous ruptures of the Achilles tendon. Reconstructed tendons present typical morphological and functional US patterns which depend partly on the kind of surgical reconstruction and partly on the time passed since surgery. The authors report the results of the clinical and US follow-up of a series of 62 surgical patients treated in 7 years for the subcutaneous rupture of the Achilles tendon. The patients were 55 men and 7 women, whose mean age was 36 years (range: 25-65 years). The left-hand side was affected in 38 patients and the right-hand side in 24 patients. All patients were operated on using an end-to-end suture and reinforcement plastic surgery pulling down a gastrocnemius tendon flap. To homogenize the results, all the US exams were performed by the same operator, in the presence of the orthopedic specialist and under the same conditions: both the involved and the contralateral Achilles tendons were studied, longitudinal and transverse scans were performed with the foot in max. plantar and dorsal flexion and, whenever possible, dynamic scans were also performed making the sural triceps contract against resistance. The following parameters were studied clinically: pain (which was absent in 39 patients, occasional in 11, after stress in 9 and on walking in 3 patients), skin scar trophism (which was eutrophic in 53.23% of patients, keloid in 27.42% and hypertrophic in 19.35% of patients), ankle joint excursion (plantar flexion was impaired in 32.3% and dorsal flexion in 36% of patients), walking on tiptoe (in all, 22.6% of patients complained of difficulties walking on tiptoe) and, finally, work activity resumption (which all patients achieved). US depicted the surgical tendons as much bigger than the contralateral ones (3-4 times on the average), which increase in volume lasted throughout the follow-up. In 75% of patients the echo structure of the surgical tendons was inhomogeneous, with scattered hypoechoic and hyperechoic areas. In the extant 25% of patients, nearly all of them followed-up for over 6 years, US depicted a clear-cut hyperechoic area whose size and echo structure were similar to the healthy tendons'. Our results strongly suggest that tenorrhaphy and flap plastic surgery be used to repair subcutaneous ruptures of the Achilles tendon. US proved to be the most reliable and feasible method also in the follow-up. The US images of the patients submitted to surgery more than 6 years earlier revealed fibrillate reorganization patterns and tendon restructuring. These processes involve both ends of the sutured tendon and not the reinforcement flap, which further confirms the exclusively mechanical, and not biological, function of the latter.     

Levonorgestrel-releasing intrauterine device-wearing women express contraceptive glycodelin A in endometrium during midcycle: another contraceptive mechanism?

Intrauterine devices (IUDs) exert contraceptive action by interfering with sperm transport, ovum development, fertilization and implantation. Glycodelin A (GdA) is a uterine glycoprotein that has local contraceptive activity by inhibiting sperm-egg binding. GdA is normally absent from endometrium during the fertile midcycle and it is not expressed until the fifth postovulatory day. The phase of menstrual cycle addressed in this study covers the phase when conception is most likely to follow an unprotected intercourse and when GdA is normally absent. We present here evidence that levonorgestrel-releasing IUD (LNg-IUD) is accompanied by 'inappropriate' expression of GdA in endometrium between days 7 and 16 of the menstrual cycle (six out of six cases). The same was also found in copper-releasing IUD (Cu-IUD)-wearing women, but less frequently (four out of 11 cases, P < 0.0345, Fisher's exact test). In-situ hybridization localized GdA mRNA into endometrial glands in the midcycle endometrium, confirming the cellular site of synthesis. Based on the potent inhibitory activity of GdA on sperm-egg binding, the presence of GdA in uterine glands of IUD wearers may lead to prior exposure of sperm to contraceptive GdA, thus contributing to the contraceptive activity of the IUD.     

Treatment of bleeding problems associated with progestin-only contraceptives: survey results

Simple, well-documented, effective and inexpensive management approaches are needed for the short-term control of bleeding in progestin-only contraceptive (POC) users. Long-term continuation may improve if acceptable approaches are found to ameliorate these short-term bleeding problems. Family planning providers and researchers were surveyed on the treatment regimens they used for POC-associated bleeding disturbances. Results from this limited survey indicate that no clear indication exists regarding the duration and, severity of bleeding and spotting requiring pharmacologic intervention. Counseling was seen as a critical factor when considering treatment for these problems. This report presents the results of this survey on the different treatment regimens being used by providers throughout the world to treat POC-associated bleeding disturbances.     

Dynamics of serum immunoglobulin concentrations in sheep during pregnancy and lactation

The relationship between endurance time and the mean force of contraction was investigated in intermittent and sustained static contractions over a long period of time (60 min). For intermittent static contractions the endurance limit of the mean force of contraction was found to be 14.0%, and for sustained static contractions it was 7.9% of the maximal force of contraction. Weak subjects appear to have a higher endurance limit of force than strong subjects.