Knowledge and Awareness of Emergency Contraception in Adolescents

Study ObjectiveThe purpose of this study was to (1) describe the awareness of emergency contraception among adolescent females, (2) identify factors that are associated with accurate knowledge of emergency contraception and (3) describe prior use of emergency contraception among adolescent females.DesignCross-sectional study.SettingThe study procedures were carried out at Kapiolani Medical Center's Teen Clinic in Honolulu, Hawaii, which is comprised of an ambulatory university-based resident clinic.ParticipantsEnglish-speaking females who were between the ages of 14 and 19 were invited to participate.InterventionsThis study utilized a self-administered, anonymous survey that contained questions regarding emergency contraception as well as questions on reproductive and sexual health.Main Outcome MeasureThe primary outcome was percentage of adolescent women who were aware of emergency contraceptives.ResultsA total of 100 surveys were distributed and collected. Fifty-six percent of respondents had an awareness of emergency contraception and 69.6% of these adolescents were able to correctly list an emergency contraceptive method. Older teens were more likely to have an awareness of emergency contraception but we did not find any other factors that were associated with accurate knowledge of emergency contraception. Adolescents who had used emergency contraception in the past found it to be acceptable.ConclusionsDespite being at high risk for unintended pregnancy, adolescents in this population had lower rates of emergency contraceptive awareness in than has been reported in adults.     

Shell-vial culture and pp65 antigenemia assay in the detection of cytomegalovirus in the first blood sample of renal transplant recipients

The aim of the study was to compare the efficacy of pp65 antigenemia assay and the shell-vial culture (SVC; viremia) for the diagnosis of cytomegalovirus (CMV) infection in renal transplant recipients, comparing the results obtained in the first blood sample and the total number of blood samples analyzed in this group of patients. During the study period, 70 renal transplant recipients were studied: 44 (62.8%) with CMV infection. The method of sedimentation in a dextran solution for leukocyte extraction was used in the pp65 antigenemia assay. The MRC-5 shell-vial assay was used for CMV isolation from leukocytes (viremia). Eighty blood samples were examined from 70 renal transplant recipients: Of the 44 positive samples studied, in 77.5% of cases, both the antigenemia assay and the SVC were positive. In 16.2%, only the antigenemia assay was positive, and, in 6.2%, only the SVC was positive. In all blood samples studied, the antigenemia was present in 93.7% of cases, and the SVC was present in 83.7% (P = 0.04). If the results obtained in only the first blood sample taken for the diagnosis are studied, then we observe that the antigenemia assay was positive in 39 patients (88.6%), whereas the SVC was positive in 41 patients (93.1%), although the difference was not statistically significant (P = 0.39). It is concluded that the inoculation of all of the leukocytes extracted from blood samples in the SVC seems to produce a slight increase in the sensitivity of the cell culture and that the SVC becomes positive before the antigenemia for the detection of CMV in peripheral blood, especially in the first blood sample. J. Med. Virol. 55:240–242, 1998. © 1998 Wiley-Liss, Inc.     

Comparative study of flex heart rate in colombian children and in pregnant,lactating, and non-pregnant,nonlactating women

The heart rate (HR) value employed to separate resting and active portions of the calibration curves used to estimate energy expenditure (EE) from minute-by-minute HR recordings is called the flex-HR. The present study has characterized it, the resting HR and the average daily HR during the awake portion of the day (12–14 h) by comparing age, gender and nutritional status effects related to measured maximum oxygen consumption (V̇ max; ml/min/kg body weight)in school-aged Colombian children (145 boys and 132 girls), 6–16 years of age. The same HR variables have been individually measured in nutritionally normal, nonpregnant, nonlactating (NPNL; n = 48), pregnant (n = 26), and lactating (n = 18) women, 19–43 years of age, on three occasions separated by 3 months. In general, the flex-HR followed the differences observed in resting and average daily HRs. All three values decreased with age in children, were higher in girls than boys, and did not exhibit differences between nutritionally normal and undernourished children. All three HRs had a statistically significant negative relationship with V̇ max in boys but not in girls. NPNL and lactating women showed no significant change in the mean values of the repeated HR measurements but exhibited maximum individual differences of flex-HR of −56 to +42 beats/min. Pregnant women had higher HRs in all 3 rounds of measurement compared to NPNL subjects. The data support the generalization that the flex-HR method of estimating EE is appropriate in groups of subjects but not in individuals, and that individual calibration of subjects close to the time of application to the making of EE measurements is an important feature of its use. Am. J. Hum. Biol. 9:647–657, 1997. © Wiley-Liss, Inc.     

Novel peroral direct digital cholangioscopy‐assisted lithotripsy using a monorail technique through the overtube in patients with surgically altered anatomy (with video)

Efficacy of cholangioscopy‐assisted lithotripsy for difficult stones such as huge stones, multiple large stones and an impacted stone in patients with non‐altered anatomy has been reported. Herein, we describe peroral direct digital cholangioscopy (PDCS)‐assisted electrohydraulic lithotripsy (EHL) with a new technique in patients with surgically altered anatomy. Five patients received PDCS‐assisted EHL with the monorail technique due to failed conventional stone extraction. Balloon enteroscope was removed, leaving the stiff guidewire in the bile duct and an overtube with inflated balloons. The cholangioscope was then inserted into the bile duct over the wire through the overtube. After direct visualization of the stone, PDCS‐assisted EHL was carried out. This technique was named the ‘monorail technique’. Complete removal of biliary stones in one session was accomplished in four patients and only one case required two sessions. There was no adverse event in any of the cases. PDCS‐assisted EHL using the monorail technique was effective and safe for difficult biliary stones in patients with surgically altered anatomy.