scholarly journals The postcoital test in the development of new vaginal contraceptives†

2020 ◽  
Vol 103 (2) ◽  
pp. 437-444
Author(s):  
Christine K Mauck ◽  
Kathleen L Vincent

Abstract Postcoital tests (PCTs) have been used for over a century in the clinical evaluation of infertile couples, and for nearly 70 years in the evaluation of new vaginal contraceptive products. PCTs have been largely replaced by more modern methods in the study of infertility, but they remain the most useful way to obtain preliminary data on the effectiveness of vaginal contraceptive products. The World Health Organization has described important aspects of the procedure. It involves collection of cervical mucus at a certain time point after intercourse and the counting and characterization of sperm found in the mucus. A wide range of progressively motile sperm (PMS) has been associated with pregnancy rates in infertility studies. Eligibility for contraceptive trials includes the requirement that couples achieve a certain threshold number of PMS per high power field at midcycle in a baseline cycle without the test product. The primary endpoint, or definition of a satisfactory result in test cycles, is predefined. A literature review identified 10 PCT studies of vaginal contraceptives involving nine test products. Phase II trials of vaginal contraceptives have not been deemed feasible in the development of any vaginal contraceptive to date. A PCT study of a test product can be predictive of contraceptive efficacy, although ultimate contraceptive effectiveness is influenced by the ease of use of the product, along with patient compliance. PCT results similar to results seen with products that later showed satisfactory performance in efficacy trials is the best indicator of likely success of a test product.

2019 ◽  
Vol 70 (7) ◽  
pp. 2330-2334
Author(s):  
Mihaela Ciopec ◽  
Adina Negrea ◽  
Narcis Duteanu ◽  
Corneliu Mircea Davidescu ◽  
Iosif Hulka ◽  
...  

Arsenic content in groundwater�s present a wide range of concentration, ranging from hundreds of micrograms to thousands of micrograms of arsenic per litter, while the maximum permitted arsenic concentration established by World Health Organization (WHO) is 10 mg L-1. According to the WHO all people, regardless of their stage of development and their social economic condition, have the right to have access to adequate drinking water. The most efficient and economic technique used for arsenic removal is represented by adsorption. In order to make this remediation technique more affordable and environmentally friendly is important to new materials with advance adsorbent properties. Novelty of present paper is represented by the usage of a new adsorbent material obtained by physical - chemical modification of Amberlite XAD polymers using crown ethers followed by iron doping, due to well-known affinity of arsenic for iron ions. Present paper aims to test the obtained modified Amberlite polymer for arsenic removal from real groundwater by using adsorption in a fixed bed column, establishing in this way a mechanism for the adsorption process. During experimental work was studied the influence of competing ions from real water into the arsenic adsorption process.


2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.


Toxins ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 451
Author(s):  
José María Gutiérrez ◽  
Laura-Oana Albulescu ◽  
Rachel H. Clare ◽  
Nicholas R. Casewell ◽  
Tarek Mohamed Abd Abd El-Aziz ◽  
...  

A global strategy, under the coordination of the World Health Organization, is being unfolded to reduce the impact of snakebite envenoming. One of the pillars of this strategy is to ensure safe and effective treatments. The mainstay in the therapy of snakebite envenoming is the administration of animal-derived antivenoms. In addition, new therapeutic options are being explored, including recombinant antibodies and natural and synthetic toxin inhibitors. In this review, snake venom toxins are classified in terms of their abundance and toxicity, and priority actions are being proposed in the search for snake venom metalloproteinase (SVMP), phospholipase A2 (PLA2), three-finger toxin (3FTx), and serine proteinase (SVSP) inhibitors. Natural inhibitors include compounds isolated from plants, animal sera, and mast cells, whereas synthetic inhibitors comprise a wide range of molecules of a variable chemical nature. Some of the most promising inhibitors, especially SVMP and PLA2 inhibitors, have been developed for other diseases and are being repurposed for snakebite envenoming. In addition, the search for drugs aimed at controlling endogenous processes generated in the course of envenoming is being pursued. The present review summarizes some of the most promising developments in this field and discusses issues that need to be considered for the effective translation of this knowledge to improve therapies for tackling snakebite envenoming.


Blood ◽  
2012 ◽  
Vol 120 (4) ◽  
pp. 748-760 ◽  
Author(s):  
Cassandra D. Josephson ◽  
Suzanne Granger ◽  
Susan F. Assmann ◽  
Marta-Inés Castillejo ◽  
Ronald G. Strauss ◽  
...  

Age-group analyses were conducted of patients in the prophylactic platelet dose trial (PLADO), which evaluated the relation between platelet dose per transfusion and bleeding. Hospitalized patients with treatment-induced hypoproliferative thrombocytopenia were randomly assigned to 1 of 3 platelet doses: 1.1 × 1011, 2.2 × 1011, or 4.4 × 1011 platelets/m2 per transfusion, given for morning counts of ≤ 10 000 platelets/μL. Daily hemostatic assessments were performed. The primary end point (percentage of patients who developed grade 2 or higher World Health Organization bleeding) was evaluated in 198 children (0-18 years) and 1044 adults. Although platelet dose did not predict bleeding for any age group, children overall had a significantly higher risk of grade 2 or higher bleeding than adults (86%, 88%, 77% vs 67% of patients aged 0-5 years, 6-12 years, 13-18 years, vs adults, respectively) and more days with grade 2 or higher bleeding (median, 3 days in each pediatric group vs 1 day in adults; P < .001). The effect of age on bleeding differed by disease treatment category and was most pronounced among autologous transplant recipients. Pediatric subjects were at higher risk of bleeding over a wide range of platelet counts, indicating that their excess bleeding risk may be because of factors other than platelet counts. This trial was registered at www.clinicaltrials.gov as #NCT00128713.


2014 ◽  
Vol 58 (10) ◽  
pp. 5643-5649 ◽  
Author(s):  
Katherine Kay ◽  
Eva Maria Hodel ◽  
Ian M. Hastings

ABSTRACTIt is now World Health Organization (WHO) policy that drug concentrations on day 7 be measured as part of routine assessment in antimalarial drug efficacy trials. The rationale is that this single pharmacological measure serves as a simple and practical predictor of treatment outcome for antimalarial drugs with long half-lives. Herein we review theoretical data and field studies and conclude that the day 7 drug concentration (d7c) actually appears to be a poor predictor of therapeutic outcome. This poor predictive capability combined with the fact that many routine antimalarial trials will have few or no failures means that there appears to be little justification for this WHO recommendation. Pharmacological studies have a huge potential to improve antimalarial dosing, and we propose study designs that use more-focused, sophisticated, and cost-effective ways of generating these data than the mass collection of single d7c concentrations.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 987-987
Author(s):  
Hu Ching-Li

It is important to recall the definition of health embodied in the Constitution of the World Health Organization (WHO) over 45 years ago: "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition." Among the Organization's mandated functions is "to promote maternal and child health and welfare and to foster the ability to live harmoniously in a changing total environment." The challenge of that task is no less today than it was then. Historically, societies have evolved various patterns of family structure for social and economic functions. In preindustrial societies there evolved a great concordance between these functions, with many of the health, developmental, and socialization functions taking place first within the family and then within the immediate community. The rapid social changes of both the industrial and information revolutions have changed drastically the functions of the family, and have shifted many of the health, developmental, and social functions to nonfamily institutions, from which families are often excluded or marginally involved. Much of the international attention to child health in this last decade has been directed at simple interventions to prevent the nearly 13 million deaths each year of children under 5: universal child immunization; the control of diarrheal and acute respiratory diseases; and infant and young child nutrition, particularly breast-feeding.


2021 ◽  
Vol 19 ◽  
Author(s):  
Mohamed Said Boulkrane ◽  
Victoria Ilina ◽  
Roman Melchakov ◽  
Mikhail Arisov ◽  
Julia Fedotova ◽  
...  

: The World Health Organization declared the pandemic situation caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) in March 2020, but the detailed pathophysiological mechanisms of Coronavirus disease 2019 (COVID-19) are not yet completely understood. Therefore, to date, few therapeutic options are available for patients with mild-moderate or serious disease. In addition to systemic and respiratory symptoms, several reports have documented various neurological symptoms and impairments of mental health. The current review aims to provide the available evidence about the effects of SARS-CoV-2 infection on mental health. The present data suggest that SARS-CoV-2 produces a wide range of impairments and disorders of the brain. However, a limited number of studies investigated the neuroinvasive potential of SARS-CoV-2. Although the main features and outcomes of COVID-19 are linked to severe acute respiratory illness. The possible damages on the brain should be considered, too.


Author(s):  
Fernanda Karla Nascimento ◽  
Roberta Alvarenga Reis ◽  
Alexandre Saadeh ◽  
Fran Demétrio ◽  
Ivaneide Leal Ataide Rodrigues ◽  
...  

Objective: to describe attributes associated with the Quality of Life of Brazilian transgender children and adolescents according to their own perception. Method: descriptive study conducted with 32 participants between eight and 18 years old, who were either interviewed or participated in focus groups. The statements were transcribed, grouped with the aid of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software, version 0.7 alpha 2 and described according to the definition of Quality of Life by the World Health Organization concerning to the mental, physical, and social dimensions. Results: it was possible to identify the family nucleus as the main social support for transgender children and adolescents. However, the experience of prejudice and discrimination were negative attributes associated with Quality of Life. Conclusion: the statements indicate that lives of transgender children and adolescents are impacted by social, physical, and mental factors due to the stigma and discrimination experienced. It is expected to contribute to the formulation of public policies related to transgender children and adolescents and expand the discussion on the citizens’ duties and rights in relation to transsexuality.


2011 ◽  
pp. 25-33
Author(s):  
Rosangela Invernizzi ◽  
Agnese Filocco

Myelodysplastic syndromes (MDS) are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO) classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.


2003 ◽  
Vol 7 (6) ◽  
Author(s):  

The European health for all database provides easy and rapid access to a wide range of basic health statistics (indicators) for the 51 Member States of the World Health Organization (WHO) European Region. It was developed by the WHO Regional Office for Europe in the mid 1980s to support the monitoring of health trends in the Region. The database is a helpful tool for international comparison and for assessing the health situation and trends in any European country in an international context.


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