Depot medroxyprogesterone acetate. Patterns of use and reasons for discontinuation

In some countries, sperm counts in normal human semen seem to have declined over the last 50 years. If this decline is real and due to environmental factors, falls might also be seen in sperm numbers in the semen of farm animals. Sperm counts are available for bull, boar and ram from the early 1930s, obtained using techniques similar to those used for human semen. Data have been obtained from the literature between 1932 and 1995 from 137 studies involving bulls, 76 involving boars and 130 involving rams. All were normal adult animals, from which semen was collected regularly but at a frequency which would not be likely to cause a fall in sperm counts. The references were obtained systematically from Animal Breeding Abstracts, and where possible the original articles were consulted to obtain mean values for each study; where the original reference was not easily obtainable, values were taken from the abstract. The bull data showed no correlation of sperm count with year of publication (r2 = 0.000), for the boars there was a slight but non-significant positive correlation (r2 = 0.041), and for the sheep there was a slight, but significant, rise in sperm counts with time (r2 = 0.124 for sperm counts and 0.126 for total sperm per ejaculate; not all authors gave both values). It would appear that, if the fall in human sperm counts is real, then it must be due to something which is not affecting farm animals.     

A prospective study of drugs and pregnancy. 4. Miscellaneous drugs

The results are presented of a prospective study on drug use during pregnancy involving antibiotics, analgesic drugs and iron and vitamin preparations. The study was conducted in Malm? between 1963 and 1965. No unfavourable effect of the use of antibiotics, mainly penicillin and sulphonamides, could be demonstrated. Among 15 women who had an infant with hypospadias, three had used penicillin during the first trimester, but this may well be coincidental. Analgesic drug use shows a variability which resembles that previously described for psychopharmaca. No effect on the malformation rate or infant survival could be found. A possible lengthening of the mean duration of pregnancy occurred after the use of analgesic drugs during the 2nd or 3rd trimesters. Women who are going to have a dead or malformed infant use iron and/or vitamin preparations less often during late pregnancy than women who prove to have a normal infant. When such drugs were used, the percentage of pregnancies ending in birth before the 38th week is reduced, and the birth weight among term babies is higher. The associations between pregnancy outcome and the use of iron and vitamin preparations is probably indirect, due to social factors associated with drug use.     

Psychology and psychotropic drugs.

Discusses issues that need to be considered in psychology's internal debate on whether to seek the right to prescribe psychotropic drugs. For example, psychology offers a decisive alternative to medical model. Within this philosophy of psychology, psychiatry's treatment of the person as an organism misses the essential humanity of psychological life. With the exception of some psychoanalysts, psychiatrists are seen from this theoretical perspective as fundamentally misguided in their use of psychotropic drugs which merely mask the symptoms rather than face the genuinely human problem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics and psychedelic drugs.

Argues that the traditional opposition of psychologists to psychedelic drug use ignores social realities. Despite professional status, psychologists have no real control over who will use psychedelics. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depot medroxyprogesterone acetate pioneers. A retrospective study at a North Carolina Health Department

This article examines the characteristics of the first group of depot medroxyprogesterone acetate (DMPA) acceptors after US Food and Drug Administration (FDA) approval of the method and evaluates their continuation rates and factors associated with discontinuation. This was a population based retrospective study based on 12 months of clinic data for 510 women who began using DMPA in 1993 at a large county health department. Cumulative 12 month life table rates were calculated for the entire group and were then stratified by selected characteristics. The 4, 8, and 12 month continuation rates were 67%, 46%, and 35%, respectively. More than half of these women discontinued because of bleeding and nonbleeding side effects (25% and 28%, respectively). Almost 20% of these women were considered discontinuers because they waited longer than 16 weeks to return for an injection. As measured in this study, continuation rates for this first group of DMPA acceptors were low. The next step is to determine if the characteristics and patterns of use of these "pioneer" acceptors are representative of more recent acceptors, and if lessons learned from this group will lead to higher continuation rates.     

Evaluation of the susceptibility of dermatophytes to antifungal drugs: a new technique

The evaluation of the minimal inhibitory concentration (MIC) for pathogenic fungi is still a technically difficult assay. Insufficient standardization of the technique is often the basis of problems which appear. Culture characteristic of dermatophytes do not favour techniques usually used in bacteriology (Steers agar dilution method). A study was undertaken to compare the Steers agar dilution method and a new culture method to evaluate the minimal inhibitory concentration of antifungal compounds on several species of dermatophytes. The new method involves dilution of the antifungal drug in solid medium in a Petri dish. Standardized agar cylinders are cut from the plates and filled with inocula of the same size cut from plates of dermatophyte cultures. Such inocula facilitate analysis of the fungus in its natural growth conditions in vitro without being submitted to a disruptive preparative technique. The MIC values were similar for the two methods of evaluation in spite of important differences between the inocula. The new technique is reliable, quick, and highly reproducible. It is more efficient than the Steers agar dilution method because it enables assays to be run on several strains simultaneously and avoids labour-intensive procedures for the preparation of the inocula.     

Depot medroxyprogesterone acetate or oral contraception in postpartum adolescents

The purpose of the study was the evaluation of low-dose spiral CT in the detection and assessment of contours of pulmonary nodules. In a prospective investigation 71 consecutive chest CT examinations were acquired both at 30 and 200 mA. Films were interpreted independently by two radiologists. According to the size, nodules were divided into four categories: 10 mm; nodule shape was registered. With both protocols, 240 nodules were detected. The correlation coefficient for both methods was 0.89. Discrepancies were found most frequently in nodules near to pulmonary vessels. Nodule size estimation did not differ more than one size category. Eight spiculated nodules were identified by both techniques. Low-dose spiral CT of the chest has a high sensitivity in the detection of pulmonary nodules. If clinical circumstances require dose minimization, low-dose spiral CT may be advocated as an alternative screening method to conventional dose spiral CT.     

The autokinetic word technique.

The autokinetic effect is utilized to explore the minimum limits of structure necessary to elicit interpretable responses of a projective nature, in an experimental situation. Ss were asked to report words written by a small, stationary light source presented in a darkened room. All Ss reported words being written by the point of light. (PsycINFO Database Record (c) 2010 APA, all rights reserved)