CONTRACEPTION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Contraception: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83843-7 1. Contraception-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on contraception. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CONTRACEPTION ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Contraception................................................................................ 6 E-Journals: PubMed Central ....................................................................................................... 63 The National Library of Medicine: PubMed ................................................................................ 64 CHAPTER 2. NUTRITION AND CONTRACEPTION .......................................................................... 109 Overview.................................................................................................................................... 109 Finding Nutrition Studies on Contraception ............................................................................ 109 Federal Resources on Nutrition ................................................................................................. 114 Additional Web Resources ......................................................................................................... 114 CHAPTER 3. ALTERNATIVE MEDICINE AND CONTRACEPTION .................................................... 119 Overview.................................................................................................................................... 119 National Center for Complementary and Alternative Medicine................................................ 119 Additional Web Resources ......................................................................................................... 126 General References ..................................................................................................................... 130 CHAPTER 4. DISSERTATIONS ON CONTRACEPTION ...................................................................... 131 Overview.................................................................................................................................... 131 Dissertations on Contraception ................................................................................................. 131 Keeping Current ........................................................................................................................ 137 CHAPTER 5. CLINICAL TRIALS AND CONTRACEPTION ................................................................ 139 Overview.................................................................................................................................... 139 Recent Trials on Contraception ................................................................................................. 139 Keeping Current on Clinical Trials ........................................................................................... 142 CHAPTER 6. PATENTS ON CONTRACEPTION ................................................................................ 145 Overview.................................................................................................................................... 145 Patents on Contraception........................................................................................................... 145 Patent Applications on Contraception....................................................................................... 158 Keeping Current ........................................................................................................................ 185 CHAPTER 7. BOOKS ON CONTRACEPTION .................................................................................... 187 Overview.................................................................................................................................... 187 Book Summaries: Federal Agencies............................................................................................ 187 Book Summaries: Online Booksellers......................................................................................... 188 The National Library of Medicine Book Index ........................................................................... 195 Chapters on Contraception ........................................................................................................ 196 CHAPTER 8. MULTIMEDIA ON CONTRACEPTION ......................................................................... 199 Overview.................................................................................................................................... 199 Video Recordings ....................................................................................................................... 199 Audio Recordings....................................................................................................................... 200 Bibliography: Multimedia on Contraception ............................................................................. 200 CHAPTER 9. PERIODICALS AND NEWS ON CONTRACEPTION ...................................................... 203 Overview.................................................................................................................................... 203 News Services and Press Releases.............................................................................................. 203 Newsletters on Contraception.................................................................................................... 205 Newsletter Articles .................................................................................................................... 206 Academic Periodicals covering Contraception ........................................................................... 207 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 209 Overview.................................................................................................................................... 209 U.S. Pharmacopeia..................................................................................................................... 209 Commercial Databases ............................................................................................................... 211
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APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 215 Overview.................................................................................................................................... 215 NIH Guidelines.......................................................................................................................... 215 NIH Databases........................................................................................................................... 217 Other Commercial Databases..................................................................................................... 221 APPENDIX B. PATIENT RESOURCES ............................................................................................... 223 Overview.................................................................................................................................... 223 Patient Guideline Sources.......................................................................................................... 223 Finding Associations.................................................................................................................. 235 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 237 Overview.................................................................................................................................... 237 Preparation................................................................................................................................. 237 Finding a Local Medical Library................................................................................................ 237 Medical Libraries in the U.S. and Canada ................................................................................. 237 ONLINE GLOSSARIES................................................................................................................ 243 Online Dictionary Directories ................................................................................................... 246 CONTRACEPTION DICTIONARY........................................................................................... 247 INDEX .............................................................................................................................................. 317
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with contraception is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about contraception, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to contraception, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on contraception. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to contraception, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on contraception. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON CONTRACEPTION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on contraception.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and contraception, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “contraception” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Contraception in Women With Diabetes Mellitus Source: Diabetes Spectrum. 6(2): 80-86. March-April 1993. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: In this article, the author brings readers up-to-date on the current contraceptive options for the women with diabetes, previously impaired glucose tolerance, or previous gestational diabetes mellitus. The author stresses that the concept of total reproductive care must be developed for women with diabetes and those with prior GDM. Topics covered include the metabolic effects of estrogen and progestin; oral contraceptives and gestational diabetes mellitus; oral contraceptives and insulindependent diabetes mellitus (IDDM); oral contraceptives and noninsulin-dependent
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diabetes mellitus (NIDDM; the long-acting progestins, Depoprovera and Norplant; intrauterine devices; and barrier methods and sterilization. The author concludes that effective family planning programs can manage and reduce both contraceptive and diabetes risks for these patients. 2 tables. 44 references. •
Oral Contraception and Adolescent Women With Insulin-Dependent Diabetes Mellitus: Risks, Benefits, and Implications for Practice Source: Diabetes Educator. 22(4): 374-378. July-August 1996. Contact: Available from American Association of Diabetes Educators. 100 West Monroe, 4th floor, Chicago, IL 60603. (800) 338-3633 or (312) 424-2426. Fax (312) 424-2427. Summary: In this article, the author reviews oral contraceptive issues for teens with diabetes. The author provides practice implications for health professionals who are in a favorable position to influence the quality of diabetes and general health care for these adolescents. Topics include adolescent sexuality in general and in adolescents with diabetes; the use of oral contraceptives (OC) and their impact on diabetes; and the risks and benefits of using oral contraception in adolescents with diabetes. The author notes that adolescents frequently have poor impulse control, and many adolescents with diabetes who feel bleak about their future anyway may have a live-for-today attitude that interferes with effectively using contraceptive planning and improving glycemic control. On the other hand, women who are able to maintain optimal metabolic control regarding their diabetes also may do well with other health-related issues, such as the use of birth control. The author encourages health care providers to become comfortable discussing sexual issues with teens as part of a holistic approach to diabetes care. 39 references. (AA-M).
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Contraception: Part of Planning a Health Baby Source: Diabetes Self-Management. 18(1): 15-18, 20, 23, 26-27, 29. January-February 2001. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: This article addresses the issue of contraception among people who have diabetes. For women who have diabetes and their partners, using birth control while planning a pregnancy can allow a woman the time she needs to get her blood glucose in the best control possible. This reduces the risks of birth defects to the baby and preserves the health of a woman prior to conception. Despite these important reasons for using birth control, the unplanned pregnancy rate for women with diabetes is 76 percent. This high rate of unintended pregnancy has been influenced by myths and misconceptions about diabetes, pregnancy, and birth control. Common myths are that women who have diabetes cannot get pregnant or cannot use birth control. Both myths are untrue, and women and their partners have a range of birth control options. No birth control option is off limits to a woman with diabetes just because she has diabetes. These options include nonhormonal methods and hormonal methods. Nonhormonal methods include natural methods such as abstinence, coitus interruptus, and fertility awareness and barrier methods such as the diaphragm, the cervical cap, male and female condoms, and one type of intrauterine device. Hormonal methods include contraceptive implants, injections, and pills. Two new hormonal contraceptive methods are expected to be available soon. One is an estrogen/progestin injection that has a 1 month duration, and the other is a 7 day contraceptive patch. In addition, the article offers suggestions for planning a pregnancy, identifies sources of help in preparing for a healthy pregnancy, and lists resources on contraceptive choices. 3 tables.
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Hormonal Choices After Gestational Diabetes: Subsequent Pregnancy, Contraception, and Hormone Replacement Source: Diabetes Care. 21(Supplement 2): B50-B55. August 1998. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article assesses the effects of subsequent states of excess hormone exposure, that is, subsequent pregnancy, hormonal contraception, and hormonal replacement therapy, on the development of diabetes in women with prior gestational diabetes mellitus (GDM). The article reviews current literature on the effect of parity, hormonal contraception, and hormonal replacement therapy in healthy women and women with previous gestational diabetes and current diabetes. Subsequent pregnancy in women with prior GDM appears to triple the risk of subsequent diabetes, while lowdose progestin and estrogen combination oral contraceptives do not appear to clinically increase risk. Hormonal replacement therapy appears to lead to the greatest reduction in coronary artery disease in women at greatest risk, that is, those who have developed diabetes. Careful followup and metabolic surveillance should be provided when prescribing hormonal contraception or replacement therapy. In women with prior GDM, exposure to repeat pregnancy poses a greater risk for subsequent diabetes than either an exposure to low-dose progestin and estrogen combination oral contraceptives or to postmenopausal hormonal therapy, both of which do not appear to increase the risk of diabetes. Women must be educated about their individual risk of developing diabetes based on their identifiable risk factors. In addition, their general health status, including any cardiovascular risk factors, should be evaluated. 27 references. (AA-M).
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Contraception: Preventing Pregnancy and Disease Source: Diabetes Forecast. 54(8): 32-34. August 2001. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article discusses contraceptive options available for women with diabetes who are sexually active. Oral contraceptives are made from synthetic forms of estrogen and progesterone, two hormones involved with regulating the menstrual cycle. Although very effective and convenient to use, some women who have diabetes find that oral contraceptives affect blood glucose control, so they may have to adjust their diabetes treatment. In addition, oral contraceptives have some other side effects, including rising cholesterol or triglycerides, causing problems with clotting and circulation, and failing to provide protection from infectious diseases. Another form of contraception is the barrier method. Two common barrier methods are the diaphragm and condom. These methods, which do not interfere with blood glucose control, must be used every time a woman has intercourse and must be used correctly to be effective. Implantable devices are also another form of contraception. The intrauterine device (IUD) and Norplant are two devices available. The IUD, which does not affect blood glucose control or cause cholesterol or triglycerides levels to rise, is an attractive option for women who are no longer having children or who have just one sex partner. Norplant is a medication that comes in six small capsules surgically implanted under the skin of the arm. Depo-Provera, another medication that prevents pregnancies, requires getting an injection from a doctor every 3 months. The article includes a list of questions women can use to help them choose a contraceptive that is right for them.
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Birth Control Choices Source: Diabetes Self-Management. 8(3): 6-8, 10-12, 14-16. May-June 1991. Contact: Available from R.A. Rapaport Publishing Company. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article provides information on the various methods of birth control available to women with diabetes. Topics include pregnancy planning; choosing a method of contraception; the process of human reproduction; barrier methods including diaphragms, condoms, contraceptive sponges, cervical caps, and vaginal spermicides; oral contraceptives; the intrauterine device; fertility-awareness methods; ineffective methods; sterilization; and contraceptive implants. Two final sections consider birth control methods currently in the research and trial phases and a comment on making the right choice. The contact addresses for three family planning organizations are included.
Federally Funded Research on Contraception The U.S. Government supports a variety of research studies relating to contraception. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to contraception. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore contraception. The following is typical of the type of information found when searching the CRISP database for contraception: •
Project Title: ACROSOMAL MATRIX, FERTILIZATION
EXOCYTOSIS AND
MAMMALIAN
Principal Investigator & Institution: Gerton, George L.; Research Professor; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 28-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant): Sperm competent for fertilization can become capacitated, bind to the zona pellucida (ZP) of an egg in a specific manner, and complete acrosomal exocytosis. Failure to carry out these functions results in infertility. Although the interactions between the ZP and the plasma membrane overlying the sperm acrosome have been considered important for sperm-egg recognition and signaling, recent results have prompted a reassessment of current paradigms concerning these interactions. The broad, long-term objective of this proposal is to understand how the acrosome functions in fertilization. The general hypothesis is that acrosomal exocytosis 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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leads to the exposure of acrosomal matrix proteins that become a de facto extracellular matrix (ECM) on the surface of the sperm head, and that the dynamic interactions of this newly-exposed sperm ECM with the egg ECM (the ZP) govern sperm-egg recognition and sperm penetration of the ZP. Specific Aim 1 is to investigate acrosomal exocytosis using novel, sensitive analytical approaches to monitor OAM and PM fusion events in live sperm. The possibility will be examined that spontaneous acrosomal exocytosis is initiated during capacitation, a poorly defined maturation process that normally takes place within the female reproductive tract but can be mimicked experimentally. The hypothesis is that acrosomal exocytosis is initiated during capacitation and, in the absence of stimulatory factors, is a slow, discontinuous and Ca- dependent process. However, in the presence of stimulatory factors (e.g., ZP), acrosomal exocytosis is completed at an accelerated rate. Specific Aim 2 is to characterize the interactions of the acrosomal matrix with the zonae pellucidae of mammalian eggs. Components of the AM will be studied to determine if they possess ligand-binding properties that enable them to bind to the ZP of unfertilized eggs. Specific Aim 3 is to determine how structural properties and exocytosis-associated processing of AM components, e.g., sp56, affect their function. Structural determinants of sp56 will be studied to learn which domains are essential for binding of sperm to ZP glycoproteins by examining the structurefunction relationships of mutated recombinant sp56 proteins. In addition, mutant mice null for the sp56 gene will be created to determine if sp56 is essential for fertilization. The proposed experiments will develop new technologies for the study of molecular mechanisms of acrosomal exocytosis. Results from these experiments may provide new ways to address the poor ZP binding of sperm from some human infertility patients and may offer new avenues for contraception through the disruption of purposeful spermZP binding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADOLESCENT CONTRACEPTION
MISCONCEPTIONS
ABOUT
HORMONAL
Principal Investigator & Institution: Clark, Liana R.; Assistant Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 30-JUN-2004 Summary: PROFESSIONAL GOAL: The overall goal of this patient-oriented research career development award proposal is to contribute to the professional, academic, and research development of Dr. Liana Clark. In addition to the proposed project exploring the concerns and misconceptions about hormonal contraception, Dr. Clark will also pursue research training at the University of Pennsylvania. She will take courses toward the Master's degree in Clinical Epidemiology and Biostatistics, as well as courses in bioethics and financial issues in medicine. Under the mentorship of Dr. Loretta Jemmott, Dr. Clark hopes to use this award to establish herself as an academic leader in the area of adolescent sexual risk behaviors. SPECIFIC AIMS OF CONTRACEPTION PROJECT: This project will use both cross sectional and longitudinal study design to: a) identify the attitudes, concerns and misconceptions of adolescents regarding hormonal methods of contraception (Norplant, Depo-Provera and the oral contraceptive pill); b) determine the gender, racial/ethnic, sexual history, and sociodemographic factors associated with attitudes, concerns and misconceptions about hormonal contraception; and c) determine how strongly these attitudes, concerns and misconceptions predict nonuse of, or noncompliance with hormonal contraception. This study will have two parts: (1) a baseline component that includes three stages designed to identify adolescent attitudes, concerns and misconceptions about hormonal contraception and the gender,
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racial/ethnic, sexual history, sociodemographic features associated with holding such concerns; and (2) a follow-up component to determine whether hormonal contraceptive use and/or compliance is related to attitudes, concerns and misconceptions about these methods of contraception. HYPOTHESES: 1. The majority of adolescents studied will have concerns and misconceptions about hormonal contraception. 2. Minority adolescents (African-American and Hispanic) will have greater negative attitudes, concerns and misconceptions about hormonal contraception than will white nonHispanic adolescents. 3. Adolescents who have strongly negative attitudes, concerns and misconceptions about hormonal contraception will be less likely to choose to use these methods. 4. Adolescents who have negative attitudes, concerns and misconceptions about hormonal contraception will be less compliant with the use of these methods. CONCLUSIONS: By targeting the negative attitudes, concerns and misconceptions regarding hormonal contraception, we will be better able to encourage use of these highly effective methods by adolescents. Increased usage and improved compliance with Depo-Provera, Norplant and the oral contraceptive pill will result in an overall decrease in the rate of unintended adolescent pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: APPLICATION OF TRANSGENIC TECHNOLOGIES TO BABOONS Principal Investigator & Institution: Mccarrey, John R.; Professor of Cell & Molecular Biology; Southwest Foundation for Biomedical Res San Antonio, Tx 782450549 Timing: Fiscal Year 2002; Project Start 15-MAY-2002; Project End 30-APR-2004 Summary: (provided by applicant): The long-term goal of this project is to develop technology to produce transgenic baboons and to make this technology available at the Southwest Regional Primate Research Center and elsewhere to provide a powerful genetic, developmental and physiological nonhuman primate model system for biomedical research. Specific applications of this technology relevant to areas of reproductive biology and contraception and genetics of complex diseases are described herein. However, the availability and optimization of this technology will revolutionize experimental approaches in a wide variety of biomedical areas in nonhuman primate research. Standard methodology currently used to produce transgenics in smaller animals such as mice is prohibitively impractical in nonhuman primates. The approach used will be based on a recently developed technique of producing transgenesis by ICSI as first developed in the mouse by Yanagimachi and coworkers, and recently applied to rhesus monkeys by Schatten and coworkers. A method based on pronuclear injection of IVF embryos will be tested. Recent progress in optimizing superovulation ultrasound monitoring of ovarian stimulation, oocyte harvest, production of embryos by IVF and ICSI and introduction of transgenes into baboon embryos using ICSI is summarized. The goal of the research proposed in this R21 application is to further optimize these technologies for use in the baboon, and in so doing to enhance the efficiency of this approach in nonhuman primates in general. The specific aims of this application include optimization of the following methodologies in the baboon: 1) production of embryos in vitro by IVF and ICSI and subsequent culture to cleavage and blastocyst stages, 2) transfer of IVF embryos to female recipients to foster development to term, and 3) the production of transgenic embryos, including analyses of expression and integration of the transgene and demonstration of tissue-specific transgene expression in embryos. These aims are designed to demonstrate the feasibility and to optimize the efficiency of producing transgenic baboon embryos and the potential to carry these to term to yield transgenic offspring. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AUTO/PARACRINE MECHANISMS IN HUMAN IMPLANTATION Principal Investigator & Institution: Giudice, Linda C.; Professor; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 02-MAY-2002; Project End 31-MAR-2007 Summary: For successful implantation in humans, the endometrium must be adequate prepared by steroid hormones to allow attachment of the embryo to the epithelium, passage through the epithelium, and invasion of the trophoblast into the maternal stroma. We have had a long-standing interest in the insulin-like growth factor (IGF) family and its role in the invasive phase of human implantation. IGF-II is exclusively expressed by the invading trophoblast, and it regulates restraints of invasion produced by the maternal decidua. Two inhibitors of IGF action, IGF binding protein (IGFBP)-1 and IGFBP-1, are made by the decidua. We have identified an enzyme that cleaves IGFBP-4 and decreases its affinity for IGF-II and identified it as a known protein with unknown function, pregnancy-associated plasma protein-A (PAPP-1). Its naturally occurring inhibitor is also a major product of the invading trophoblast in human pregnancy. In this grant we propose to investigate the hypothesis that IGFBP-4 proteolysis increases IGF-II bioavailability in the placental bed to enhance IGF-II action on the decidua, resulting in regulation of maternal restraints on invasion. In addition to the invasive phase, we have initiated studies relevant to paracrine dialogs between the endometrial epithelium and stroma important during the window of implantation. Our recent gene profiling of human endometrial biopsy specimens reveals marked upregulation of IGF and wnt family mRNAs during the implantation window. Wnts are important in epithelial- mesenchymal interactions, and we have identified selective expression of wnt family members in human endometrial epithelial and stroma. IGF-II and wnt signaling may interface through a common, pathway, suggesting a role for stromal-derived. IGF-II interacting with epithelium-derived wnt on effects on the stroma during the implantation window. Herein, we propose: (1) during the invasive phase of implantation to investigate the function(s) of IGF-II, IGFBP-4, PAPP-A, and its inhibitor at the decidual: trophoblast interface; (2) during the window of implantation, to investigate the role of wnt and IGF-II signaling in epithelial-stromal communication. We work with the human model because of uniqueness of implantation in humans. These studies have relevance to infertility, ectopic pregnancy, and contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AUTOIMMUNE OOPHORITIS: CONSEQUENCES OF GAMETE VACCINES Principal Investigator & Institution: Tung, Kenneth S.; Professor; Pathology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 28-FEB-2007 Summary: (provided by applicant): A major long-term goal of my laboratory is to develop a safe and effective human contraceptive vaccine. To this end, we have taken a two pronged approach: 1) To develop an effective method of reversible contraception, and 2) To assure safety of the vaccine by identifying and resolving potential problems associated with contraceptive vaccination. A chimeric peptide (CP2) that contained a native ZP3 B cell epitope (335-342) and a foreign T cell epitope has proved to be an efficacious vaccine that does not in duce ovarian autoimmune disease in adult animals. CP2 immunization led to 70% reduction in female fertility that was reversible, and their ovaries were free of pathology. However, we have now encountered a new problem associated with the CP2 vaccine. Although the ovaries of adult mice immunized with
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CP2 were free of pathology, the ovaries of their progeny developed AOD, and in some cases there was loss of oocytes. It is unclear is why progenic AOD [autoimmune ovary disease] should occur only in B6AF 1 neonates but not the neonate of five other inbred strains and one outbred strain. Nor do we understand why progenic AOD should occur only in mice with Ab to one ZP3 B cell epitope [ZP3 (335-342)] but not with Ab to anotherZP3 B epitope [ZP3 (l7I-l80)]. These findings have prompted the hypothesis that progenic AOD represents a unique occurrence confined to a unique mouse strain in response to a unique ZP3 B cell epitope. In the proposed research, we will determine the generalizability of progenic AOD, understand the mechanism of neonatal ovarian injury, elucidate the basis for its unique occurrence, and define its long-term effect. At the same time, our goal is to identify new oocyte antigen (Ag) and examine their potential as candidate Ag in a new, safe and effective ZP contraceptive vaccine. In Aim 1, we will determine the natural history and generalizability of progenic AOD, the fertility of postpubertal mice with a antecedent progenic AOD, the variations in the murine neonatal response to CP2 antibody, and the occurrence of progenic AOD in the primate. Aim 2 will identify new ZP B cell epitopes that confer contraception without progenic AOD. In Aim 3, we will further investigate the mechanism of progenic AOD, and identify the mechanism responsible for the unique occurrence of progenic AOD. Specifically, we will determine the immunogenetic regulation of the immune response to CP2, and the influence of the B cell epitope specificity of the ZP Ab on the induction of progenic AOD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOCHEMISTRY FERTILIZATION
OF
SPERM-EGG
INTERACTION
AND
Principal Investigator & Institution: Vacquier, Victor D.; Marine Biology Research Div; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-JUN-1978; Project End 31-MAY-2002 Summary: The objective of this research is to gain fundamental knowledge of the cell biology and biochemistry of sperm-egg interaction. Sea urchins and abalone are used because they are nonmammalian, yet exhibit striking similarities to mammalian gamete interaction. The cell biology and biochemistry of sperm-egg interaction is one of the least understood fundamental biological processes. Basic knowledge gained by this research may be used in the future development of novel methods of contraception in mammals. In sea urchins this proposal focuses on the interaction of REJ (the sperm membrane receptor for egg jelly) with ARI (the acrosome reaction inducing glycoprotein purified from egg jelly). 50% of REJ is homologous to the human polycystic kidney disease protein PKD1. Study of how REJ regulates sperm ion channels may aid in the understanding of this significant human disease. In abalone, this project focuses on the egg vitelline envelope ligand for lysin, the sperm protein which dissolves the egg envelope by a nonenzymatic mechanism. This study may aid in understanding the biochemical mechanism mammalian sperm use to penetrate the egg zona pellucida. The specific aims for sea urchin sperm are: 1. To identify sperm membrane proteins associated with the 210kDa receptor for egg jelly (REJ). 2. To clone, sequence and characterize the proteins associated with REJ. 3. To determine the functions of the protein modules of REJ. 4. To characterize the acrosome reaction inducer (ARI) from sea urchin egg jelly which binds sperm REJ. 5. To isolate and characterize the oligosaccharide of ARI which binds to REJ. 6. To use syntaxin and synaptotagmin, which we have cloned from sperm, to identify proteins associated with exocytosis of the acrosomal vesicle. The specific aims for the abalone ligand for lysin are: 7. To study the
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biochemistry and ultrastructure of the vitelline envelope ligand (VE-L) for lysin. To determine the affinities of homospecific and heterospecific combinations of lysins and VE-Ls. 8. To clone, sequence and characterize the cDNA for the VE-L. 9. To determine if the binding of lysin to VE-L is based on protein or carbohydrate components of the VEL. 10. To cleave the VE-L into the smallest fragment retaining affinity for lysin. To isolate and characterize this fragment. To cocrystallize lysin complexed with this fragment for x-ray diffraction analysis. 11. To determine which residues of lysin are responsible for its species-specific dissolution of the egg vitellin envelope (VE). 12. To determine the mechanism by which lysin dissolves the VE. Is it based on the stereospecific severing of hydrogen bonds, or hydrophobic interaction? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAIN GENES GOVERNING REPRODUCTION Principal Investigator & Institution: Steiner, Robert A.; Professor; Obstetrics and Gynecology; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-APR-1993; Project End 30-JUN-2003 Summary: In mammals, reproductive activity is initiated and maintained by physiological factors associated with nutrition, adiposity, and metabolism; however, little is understood about mechanisms that mediate the integration of metabolism and reproduction. Leptin is a newly discovered satiety hormone and metabolic activator, which has recently been shown to have stimulatory effects on the reproductive system and has been postulated to serve as an important conduit linking the body~s metabolic and reproductive control systems. The overall goal of this research is to understand the cellular and molecular mechanisms of leptin~s action on the neuroendocrine reproductive axis-focusing on 4 hypothalamic regions-the arcuate, dorsomedial, paraventricular, and medial preoptic nuclei. The specific aims are first, to elucidate the role of proopiomelanocortin neurons and the melanocortin type 4 receptor in mediating leptin's effect on reproductive function and to identify their anatomical substrate; second, to examine the functional significance of agouti- related protein (ARP) in mediating leptin~s action in the brain and to trace the cellular pathway of ARP~s action in the hypothalamus. These studies will be performed with laboratory rats and different lines of transgenic mice as the experimental animals. The methods used to accomplish these objectives will include various in vivo pharmacological and endocrine manipulations, hormone assays, single- an double-label in situ hybridization, antisense oligonucleotide blockade of neuropeptide synthesis, neuronal tract tracing, and the creation and analysis of several new lines of mutant/transgenic mice bearing alterations in one or more genes related to leptin's signaling mechanism. Learning more about the mechanisms of leptin's action on the brain may help us to understand the molecular basis of certain disorders of human reproduction (e.g., hypothalamic amenorrhea and infertility linked to metabolic wasting diseases such as diabetes mellitus) and may even provide a rationale for the development of better methods of contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BREAST TUMOR INHIBITION BY ANTIPROGESTINS Principal Investigator & Institution: Wiehle, Ronald D.; Zonagen, Inc. 2408 Timberloch Pl, B-4 the Woodlands, Tx 77380 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2003 Summary: (provided by applicant): The use of antiestrogens in women for the treatment of breast cancer, although far from ideal, is one of the few therapies currently available.
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Contraception
The following revised proposal outlines experiments to be performed under a SBIR that would clarify the properties of certain new antiprogestins as adjuvant therapies analogous to current therapies utilizing tamoxifen and SERMs. In May 1999, a Licensing Agreement between Zonagen and the NICHD was finalized to develop new antiprogestins. We expect that the new generation of compounds will be used for a number of indications where the etiology is dominated by progesterone. The promise of the first antiprogestin, RU 486, has gone unfulfilled because of its extensive antiglucocorticoid effects and the political backlash to its use as an abortifacient. Indications for antiprogestin use could include oral contraception, labor induction, cervical ripening, hormone replacement therapy (HRT), and treatment of uterine fibroids, endometriosis, and especially breast cancer. It is the overall aim of this proposed SBIR to determine effects on the growth of previously established rodent breast cancers with the ultimate intention of introducing a new adjuvant treatment for human breast cancer. The rat model has been shown to respond to antiprogestins such as RU 486 with a decrease in the growth of lesions following treatment. There is a need to determine whether our lead compound. CDB-4124, has the same anticancer properties as RU 486 as a proof-of-principle. Moreover, we need to determine the doseresponse of that lead compound. Phase II would determine whether a secondary class of compounds have similar activity, whether the best compound(s) reduce the ultimate size and appearance of lesions if used prior to frank appearance, and their synergism with antiestrogens. Additionally, the possibility that antiprogestins can inhibit breast tumor growth and development would greatly enhance the potential of such compounds for chemoprevention and other long-term therapies (fibroids, endometriosis, HRT) and such a drug should find wide and unqualified acceptance among women. PROPOSED COMMERCIAL APPLICATION: Antiprogestational compounds from the Licensing Agreement could fill Zonagen's developmental pipeline with drugs for those diseases and, potentially, several other indications. New antiprogestins discovered by NICHD and realized as drugs through this proposed SBIR, satisfy the need to bring the results of government-sponsored science into the public domain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAREER DEVELOPMENT AWARD IN INTERNATIONAL WOMEN'S HEALTH Principal Investigator & Institution: Stringer, Elizabeth M.; Obstetrics and Gynecology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 25-SEP-2001; Project End 31-JUL-2004 Summary: (provided by applicant): The purpose of this International Research Scientist Development Award is to provide Dr. Elizabeth Stringer, Instructor in the Department of Obstetrics and Gynecology at the University of Alabama at Birmingham (UAB), with sufficient protected time to 1) develop a broad base of understanding in the theoretical aspects of clinical research; 2) gain practical experience in the conduct of methodologically-rigorous clinical research in the developing world, particularly in the area of contraception; and 3) develop expertise in decision analysis and outcomes research. These skills will be obtained in a systematic fashion, as outlined in this research career award application. Dr. Stringer will undertake Master's level coursework in the UAB School of Public Health, with a special emphasis on epidemiology, clinical trials design, and outcomes research. Under the direction of her mentors, Drs. Sten Vermund and Moses Sinkala, the candidate will conduct a randomized clinical trial of the intrauterine contraceptive device (IUD) versus "user-chosen" hormonal
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contraception among HIV-infected women in Lusaka, Zambia. The trial will be linked to the ongoing collaborative research activities of her mentors. The candidate will be primarily responsible for all aspects of the randomized trial, including protocol development, training, implementation, daily management, and analysis. This experience will provide her with valuable field expertise in the conduct of clinical research in the developing world. In the latter part of the award, under the direction of UAB faculty member Dr. Dwight Rouse, the candidate will develop a decision analysis model to describe the health effects and costs of the IUD and other contraceptive strategies in the developing world. Data collected from the randomized trial will be used to inform the model. The cumulative effect of this award will be to enable Dr. Stringer to compete successfully for NIH individual investigator funding, with an ultimate goal of helping to advance the health and status of women and their infants in the developing world. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CDB-2914 /PROGESTERONE RECEPTOR MODULATOR /VAGINAL RING Principal Investigator & Institution: Tsong, Yun-Yen; Population Council 1 Dag Hammarskjold Plaza New York, Ny 10017 Timing: Fiscal Year 2002; Project Start 30-AUG-2002; Project End 28-FEB-2007 Summary: (provided by applicant): A new progesterone receptor modulator, CDB-29 14, with potent antiovulatory properties will be investigated for its potential as a contraceptive for women when delivered through a sustained-released system such as a contraceptive vaginal ring. The molecule has been synthesized and developed by the National Institute of Child Health and Human Development (NICHD) for emergency contraception. Toxicology studies conducted at the NICHD indicate that the compound is safe, and the Food and Drug Administration (FDA) has approved an Investigational New Drug for clinical study. CDB-2914 binds to the progesterone receptor (PR) with high affinity and is a potent progesterone antgonist (PA). It exhibits potent antiovulatory properties in animal models. These properties of CDB-2914 make it attractive as a potential contraceptive, and preliminary studies suggest the possibility of delivering CDB-2914 continuously at low doses via a silastic vaginal ring. The research project described in this proposal will include the following studies: 1) The mechanism of action at the ovarian level will be explored. 2) CDB-2914 will be formulated into vaginal gel and rings and will involve assessment of in vitro release and stability studies. The extensive experience of The Population Council in laboratory scale manufacture of contraceptive rings (CRs) and in evaluation of their clinical performance provides a firm base for completing the development of the CDB-2914 device. 3) A radioimmunoassay will be set up for CDB-2914 and validated for kinetic studies to be conducted in animals and in women. 4) The potential proliferative action of CDB-2914 on human breast cells will be investigated as well for safety purposes, in anticipation of eventual long-term contraceptive efficacy studies in women. Parallel studies in women and monkeys, which relate to the above studies but for which funding has been obtained or will be requested from other sources, will be described separately. Ultimately, this new estrogen-free method should be associated with fewer side effects than estrogen-containing contraceptives and will likely induce endometrial changes resulting in amenorrhea, a condition highly acceptable to women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CELLULOSE ACETATE PHTHALATE SPERMICIDE ACTION Principal Investigator & Institution: Mahony, Mary C.; New York Blood Center 310 E 67Th St New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-JUL-2005 Description (provided by applicant): Spermicidal agents exert an anti-fertility effect upon spermatozoa as they pass through the female reproductive tract. They must act either to kill or immobilize sperm or render them incapable fertilization. These agents may act on a number of sperm functions; therefore, it is important to examine potential spermicidal actions with a battery of physiological, cellular and biochemical assays to secure a clear understanding of contraceptive efficacy. The spermicidal agent, nonoxynol-9, acts on the sperm plasma membrane to result in solubilization and cell death. Cellulose acetate phthalate (CAP) offers promise as a safe and effective broadspectrum microbicidal agent. While nonoxynol-9 disrupts sperm cellular integrity by its detergent nature, the phthalic acid residues of CAP, essential for its antiviral activity, are expected to exert spermicidal activity by providing low pH buffering and hydrophobicity. The objective of this proposal is to examine its potential spermicidal actions. From the aforementioned observations, the hypothesis is: CAP possesses spermicidal activity and will act to disrupt sperm functions by a number of different physical and biochemical actions. The specific aims are: (1) determine the effects of soluble CAP at neutral pH on sperm functional capacity; (2) determine the binding potential of soluble CAP at neutral pH to human sperm; (3) characterize the effects of a topical cream containing micronized CAP and a CAP sponge on sperm functional capacity and cervical mucus receptivity; and, test the in vivo contraceptive activity of CAP formulations in a rabbit model. Information gleaned for these studies will provide essential information on the spermicidal activity of CAP formulations. With a clear understanding of the spermicidal actions of CAP, the applicant will have identified a broad-spectrum microbicide with spermicidal activity that acts without detergent-like toxicity which will provide a woman-managed method of contraception and prevention of STD, including HIV-1 transmission. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CHANGING SOCIAL CONTEXTS AND FAMILY FORMATION Principal Investigator & Institution: Axinn, William G.; Professor; Population Studies Center; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-SEP-1994; Project End 31-AUG-2004 Summary: This is a continuation proposal to use new detailed dynamic measures of change over time in neighborhoods to dramatically advance our understanding of the impact of social context on behavior in several new directions. Our plan is to take advantage of a unique social setting in Nepal to investigate the social and economic factors which alter family formation processes and cause fertility decline. The aim of this research is to find empirical answers to five specific questions regarding the beginning of a transition from high fertility and no use of birth control to low fertility and the widespread use of birth control. These questions are: 1) To what extent do changes in the social and economic context influence family formation processes, particularly marriage, the timing of the first birth and contraception to terminate childbearing? 2) How do qualitative dimensions of these contextual changes, such as the quality of new schools or health services, shape family formation processes? 3) Do changes in the family organization of individual life courses transmit these contextual effects? 4) Does
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15
the family organization of neighbors life courses transmit these contextual effects? and 5) Do variations in attitudes and beliefs, or neighbors attitudes and beliefs, explain these consequences of community-level changes? Although our preliminary research demonstrates significant effects of community-level social and economic change on the adoption of birth control, we still know little about the extent to which these same changes influence other dimensions of family formation or the mechanisms through which these influences are transmitted. The large number of unanswered theoretical questions regarding the causes of fertility decline, along with the high priority policy makers place on reducing fertility in South Asia, make this research particularly timely. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHARACTERIZATION OF FLAGELLAR PROTEINS INVOLVED IN SPER* Principal Investigator & Institution: Sapiro, Rossana; University of the Republic 1824 Av 18 De Julio Montevideo, Timing: Fiscal Year 2002; Project Start 18-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant) Sperm must have purposeful forward motion following deposition in the female reproductive tract in order to fertilize ovulated eggs. The factors that control the sperm flagellar power stroke and waveform are poorly understood. Spag6, a protein containing eight armadillo repeats, a protein interaction motife, is the murine orthologue of Chlamydomonas PF16, a central apparatus protein required for algae flagellar function. Mice lacking Spag6 are infertile due to a severe sperm motility defect, resulting in part from disruption of the flagellar axoneme architecture. This model will be used to identify proteins that interact with Spag6 and thus expand the catalogue of the mammalian axonemal proteins that are essential for flagellar structure and function. Using two dimensional gel electrophoresis and surfaceenhanced laser desorption/ionization mass spectrometry, the proteome of Spag6deficient sperm will be characterized and compared with wild-type mouse sperm to identify missing proteins. The missing proteins will be characterized and their cDNAs cloned for further documentation of interaction with Spag6 using yeast two-hybrid and pull-down assays and immunocytochemical co-localization. The domains of Spag6 that mediate protein-protein interactions will be defined using yeast two-hybrid and other assays. The proteome of human sperm with motility and ultrastructural defects that mirror those of the Spag6-deficient mouse will be examined to screen for humans with SPAG6 deficiency. The knowledge gained from this research will provide a molecular framework for understanding sperm motility defects that cause male infertility and possibly offer new avenues for contraception through the disruption of purposeful sperm motion. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COLLABORATIVE STUDY OF GENETICS OF DIZYGOTIC TWINNING Principal Investigator & Institution: Montgomery, Grant W.; Queensland Institute of Medical Research Bramston Terr, Herston Brisbane, Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Infertility is a major public health problem that affects 10-15% of couples (2.5 million) in the US. The goal of this program is to locate genes that make substantial contributions to variation in natural dizygotic (DZ) twinning to understand critical pathways controlling female fertility. This will have
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Contraception
practical application in treatment of infertility and may provide new approaches to contraception. The proposed study extends our previous studies of the endocrinology, epidemiology, and molecular genetics of twinning in humans and in large animal models. We have ascertained 342 families with sister pairs who have both given birth to spontaneous DZ twins and a further 386 families with case-two parent triads and have collected DNA samples from the sisters' parents and other siblings. We shall use information from our twin studies and the Australian and Netherlands Twin Registries to collect an additional 240 affected sister pair families from Australia and New Zealand and 418 families from the Netherlands. DNA samples from these families will be used to complete a 10cM genome scan in 1000 families. We will use sib pair linkage analysis to locate QTLs for twinning. Our candidate positional cloning in animal models recently identified mutations in two genes (BMP15 and BMPRIB) from intra-ovarian signaling pathways that increase twinning frequency, and cause infertility in homozygous carriers of the BMP15 mutations. One important question is whether natural variation in human twinning is controlled by these emerging mechanisms or through other pathways. We will use available samples to immediately begin candidate gene studies by mutational screening and typing SNP markers in genes from this pathway (BMP15, GDF9, BMPR1B) using a matched case-control design with cases from our existing families and matched control samples. Significant associations will be tested in additional cases and their parents using the transmission disequilibrium test. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMPUTER-AIDED PREGNANCY/STDS
COUNSELING
TO
PREVENT
Principal Investigator & Institution: Gold, Melanie A.; Children's Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 15213
TEEN Hosp
Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 30-MAR-2007 Summary: (provided by investigator): Adolescent unintended pregnancy and STDs remain at epidemic levels in the United States. Healthy People 2010 Objectives set a goal to increase to 90 percent the proportion of sexually active adolescents who use contraception that both effectively prevents pregnancy and provides barrier protection against disease. How to effectively counsel adolescents to reach this goal is unclear. Counseling and feedback based on the Transtheoretical Model (TTM) have demonstrated greater success than standard, action-oriented advice in several domains of behavior change. The effectiveness of this type of counseling to alter female adolescents' sexual and contraceptive behaviors has not been rigorously evaluated. We propose recruiting 660 female adolescents, ages 13 to 21 years, from an inner-city, hospital-based clinic and randomizing them to either an innovative Computer-Assisted Motivational Intervention (CAMI) or a Didactic Educational Control (DEC). The CAM! group will receive three, 30-minute sessions of one-on-one counseling with a counselor that is guided by computer-generated personalized feedback. The CAMI is based on the principles of the TTM and on Motivational Interviewing. The DEC provides three 30minute sessions of one-on-one didactic information on contraception, STD prevention, and abstinence. The two interventions are identical in length and timing but vary in educational content, counseling style, and the provision of personalized feedback. We will track the two groups of female adolescents in this study through a 6-month intervention phase and a 12-month follow-up phase to assess differences in sexual and contraceptive behaviors by group. The primary specific aim for the study is to evaluate the efficacy of the CAMI as compared to the DEC in reducing sexual behaviors that increase the risks of both unintended pregnancy and STDs. We will examine protective
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sexual behaviors in three ways: 1) behaviors that protect against pregnancy; 2) behaviors that protect against STDs; and 3) behaviors that protect against both pregnancy and STDs. Our primary hypothesis is that the CAMI will decrease the proportion of subjects who engage in any intercourse that is poorly protected against pregnancy and against STDs. We also predict that among sexually active subjects, the CAMI will increase the percentage of episodes of intercourse that are well protected by the use of both condoms plus another contraceptive. Finally, we also predict that the CAMI will increase the prevalence of abstinence among the entire sample. If proven effective, computer-assisted personalized motivational counseling could be broadly implemented as a method to decrease the incidence of unintended pregnancy and STDs among female adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTRACEPTION BY AFFECTING TESTIS CELL JUNCTION DYNAMICS Principal Investigator & Institution: Cheng, C Y.; Population Council 1 Dag Hammarskjold Plaza New York, Ny 10017 Timing: Fiscal Year 2002; Project Start 30-AUG-2002; Project End 28-FEB-2007 Summary: (provided by applicant): Throughout spermatogenesis, developing germ cells must remain attached to the seminiferous epithelium via testis-specific adherens junctions (AJ) between Sertoli and germ cells, such as ectoplasmic specializations and tubulobulbar complexes. The long-term objective of the PL's laboratory is to prepare male contraceptives that would perturb the functionality of these AJs thereby inducing the loss of cell adhesiveness, which in turn causes germ cells to deplete prematurely from the epithelium making them incapable of fertilizing the egg. Studies from this laboratory in the past decade have permitted the synthesis and identification of two potential male contraceptives: l-(2,4-dichlorobenzyl)-indazole-3-carbohydrazide (AF2364) and 1 -(2,4,- dichlorobenzyl)-indazole-3-acrylic acid (AF-2785), having the effects of disrupting the adhesion of spermatids and spermatocytes onto the epithelium. Both AF-2364 and AF-2785 are effective to induce reversible male fertility in rats. They are neither nephrotoxic, hepatotoxic, nor affecting the hypothalamus-pituitary-testicular axis. Furthermore, recently completed acute toxicity studies and standard mutagenicity studies, which were performed by licensed toxicologists according to the FDA guidelines, have shown that both compounds are safe for further development. However, the mechanism(s) of action of these compounds at the cellular and molecular level is not known. We hereby propose two hypotheses to be tested by performing two series of mechanistic studies. First, AF-2364 exerts its effects exclusively on testis-specific AJs without affecting the blood-testis barrier (BTB) in the testis and AJs in other epithelia (Specific Aim 1). Second, AF-2364 and AF-2785 exert their effects by compromising the functionality of AJ-proteins (Specific Aim 2). Aim 1 will largely be in vivo studies investigating the effects of AF-2364 on the kinetics of spermatogenesis and AJ functionality using the techniques of histology, immunohistochemistry, micropuncture, and assays to assess the status and/or function of tight junctions (TJs) and AJs. Aim 2 will largely be in vitro studies to examine if these compounds exert their effects via the RhoB GTPase pathway, integrins, and other AJ-signaling molecules. These studies not only will unfold the site of action of either compound in the testis at the cellular and molecular levels; they will provide a framework to understand the biology and regulation of AJ dynamics in the testis. As such, additional targets, such as a specific signal transduction pathway pertinent to maintain the AJ functionality in the testis, will be identified to perturb germ cell attachment onto the epithelium. We also
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Contraception
seek support to expand ongoing toxicity studies by performing 2 longterm toxicity studies in rats & dogs in anticipation of Phase I clinical Trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTRACEPTION WITH MINI DOSE ANTIPROGESTIN IN MACAQUES Principal Investigator & Institution: Zelinski-Wooten, Mary B.; Affiliate Assistant Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-JUN-1995; Project End 30-JUN-2002 Summary: Continual administration of low doses of the antiprogestin, ZK 137 316, to female rhesus monkeys permits ovarian/menstrual cyclicity, but sufficiently alters the function(s) of the reproductive tract to inhibit fertility. Studies with pair-housed male and female monkeys demonstrated the contraceptive efficacy of minidose antiprogestin over six consecutive cycles of treatment. A pilot experiment suggests that normal pregnancies and live offspring can occur after cessation of the six-month regimen, but restoration of fertility following withdrawal of antiprogestin after longer treatment intervals needs rigorous testing. Studies are proposed to test the hypothesis that chronic, low dose ZK 137 316 during sustained ovarian/menstrual cyclicity acts at multiple sites in the reproductive tract to provide protection from pregnancy. Using the female rhesus monkey, the specific aims of this proposal are to determine whether this novel antiprogestin regimen: 1) is reversible with respect to restoration of fertility after one year of treatment; 2) impairs oocyte nuclear maturation, fertilization or early embryonic development; 3) disrupts gamete/embryo transport through the oviduct; and 4) prevents uterine receptivity/implantation. Females will receive vehicle or minidose antiprogestin for one year, followed by pairing with males to assess pregnancy as an endpoint of the reversibility of antiprogestin treatment. Resumption of oocyte meiosis, fertilization after insemination in vitro and development of resultant embryos of blastocysts during in vitro coculture with somatic cells will be evaluated after follicular stimulation of macaques in vivo with human gonadotropins alone or in combination with antiprogestin treatment. Pregnancy rates and histological analyses of the reproductive tract after oviductal and intrauterine transfer of untreated embryos to antiprogestin-treated recipients will delineate the oviductal and endometrial capacity for timely embryo transport and to support implantation, respectively. The ability of embryos exposed to antiprogestin in vivo to be transported and implant will be tested following oviductal and intrauterine transfer to untreated recipients. Oviductal fluid collected via indwelling catheter will be examined for sperm following artificial insemination and for changes in oviductal secretory protein. Restoration of fertility and identification of potential sites of contraceptive action within the reproductive tract following continual, minidose treatment with ZK 137 316 will support further investigation of biochemical mechanisms that prevent pregnancy, and support development of this regimen as a new mode of contraception for women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CONTRACEPTIVE PHARMACIES
PRACTICE
/DELIVERY
--
COMMUNITY
Principal Investigator & Institution: Gardner, Jacqueline S.; Associate Professor of Pharmacy; Pharmacy; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2006
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Summary: We wish to assess the feasibility of community pharmacists directly initiating and managing hormonal contraceptive methods for women through use of collaborative drug therapy agreements (CDTA) in a pilot study, and then to expand the demonstration to measure its effectiveness with a larger number of women in more pharmacies on the basis of the pilot data. Despite the fact that 93% of women at risk of pregnancy in the United States use some form of contraception, unintended pregnancies nonetheless represented nearly half of all pregnancies occurring to American women in 1995. Recommendations of the Committee on Unintended Pregnancy writing for the Institute of Medicine urged increasing access to contraception through broadening the range of health professionals that provide birth control. Emergency contraceptive pills (ECP) are efficiently provided by community pharmacists and women report satisfaction with the direct access. However, ongoing effective contraception currently requires a clinic visit and many women purchasing less effective over-the-counter (OTC) methods could benefit from increased choices, such as hormonal methods. If women will accept and effectively use hormonal contraceptives obtained from a community pharmacist, and if pharmacists can provide appropriate hormonal contraceptive screening and monitoring as sustainable, reimbursable activities within their practices, women could gain a new choice or venue to prevent unintended pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTRACEPTIVE USE PATTERNS AMONG TEENS AND YOUNG ADULTS Principal Investigator & Institution: Manlove, Jennifer S.; Child Trends, Inc. 4301 Connecticut Ave, Ste 100 Washington, Dc 20008 Timing: Fiscal Year 2001; Project Start 08-AUG-2001; Project End 31-JUL-2005 Summary: The specific aim of the proposed project is to enhance our understanding of how to sustain recent improvements in contraceptive use at first sex so that teens and young adults can become more consistent contraceptive users. The proposed project will examine patterns of contraceptive use and consistency across sexual relationships, within current cohorts of teens and young adults. Our premise is that contraceptive use must be negotiated and sustained within each new sexual relationship. Understanding why teens and young adults use contraception consistently, as well as understanding patterns of inconsistent use, will help inform strategies to prevent unintended pregnancy and STIs. Analyses by race/ethnicity will help address disparities in reproductive health among racial and ethnic minorities. Additional sub-population analyses will include comparisons of teens and young adults, and males and females. The proposed project will incorporate an ecological framework, which posits that behaviors among teens and young adults will be influenced by factors from multiple domains of their lives. We will incorporate multi-level and multi-process models to examine how contraceptive use patterns are shaped by individual knowledge and motivations, characteristics of each sexual relationship (including partner characteristics and sexual activity), peer environments and family background, including parent-child communication. We will also examine the influence of school, community, and policy variables, such as sex education programs and the presence of economic opportunities. The project will analyze month-by-month histories of contraceptive use and sexual relationships within two cycles of the National Survey of Family Growth (1995, 2001) and information on sexual relationships and contraceptive use patterns within three waves of the National Longitudinal Study of Adolescent Health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CO-OCCURING HIV RISK BEHAVIORS IN COMMUNITY CONTEXT Principal Investigator & Institution: Browning, Christopher R.; Sociology; Ohio State University 1800 Cannon Dr, Rm 1210 Columbus, Oh 43210 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: (adapted from applicant's abstract): While researchers have acknowledged the spatial concentration of HIV risk behaviors, few systematic investigations of the relationship between community characteristics and these behaviors have been undertaken. Rooted in social disorganization theory, the proposed analyses assess the hypothesis that urban poverty and residential instability inhibit the development of socially organized and cohesive communities capable of collectively managing individual level behavior relevant to HIV/STD transmission. Using the 1992 National Health and Social Life Survey and two data sets describing the city of Chicago-the 1994 Project on Human Development in Chicago Neighborhoods Community Survey and the 1995-97 Chicago Health and Social Life Survey-this research will address the following questions: 1. What is the joint distribution of key HIV risk behaviors-specifically, anal sex, ineffective contraception, and alcohol use during sex, and illicit drug use during sex-in the U.S. adult population and the population of a large urban center? Do these activities cluster within the same individuals, partnerships, and sexual events? 2. Are structural features of urban communities-including concentrated disadvantage and residential stability-associated with the individual level likelihood of co-occurring HIV risk behaviors? To what extent does dimensions of community social organization including the capacity of local residents to intervene collectively to achieve shared goals (informal social control) - mediate the relationship between structural disadvantage and the prevalence of HIV risk behaviors at the individual level? 3. To what extent are neighborhood levels and egocentric social network characteristics relevant to participation in HIV risk behavior? Are neighborhood level social networks differentially consequential for the prevalence of HTV risk behaviors at the individual level depending on the degree of informal social control characterizing the neighborhood? Is neighborhood level social network density differentially consequential for the manifestation of HIV risk behavior depending on the social characteristics of network members or their relationships? For instance, are dense networks among kin differentially consequential for HIV risk behavior when compared with friendship density? The proposed analyses will employ sophisticated statistical techniques and high quality data sources to investigate the distribution and etiology of co-occurring HIV risk behaviors. The combination of data sources on Chicago will offer a rare opportunity to investigate the individual level organization of risk behaviors in neighborhood context. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COOPERATIVE CONTRACEPTIVE RESEARCH CENTER Principal Investigator & Institution: Sitruk-Ware, Regine L.; Executive Director Contraceptive Develop; Population Council 1 Dag Hammarskjold Plaza New York, Ny 10017 Timing: Fiscal Year 2002; Project Start 30-SEP-1992; Project End 28-FEB-2007 Summary: (provided by applicant): The U54 Cooperative Contraceptive Development Research Center Grant described in this proposal is comprised of four research and development projects and one Core facility. The goals are to identify new leads that can be developed into safe and effective contraceptive methods: (I) A new progesterone receptor modulator CDB-2914, with potent anti-ovulatory effect, will be investigated in
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four aims: a) The molecular mechanism of action and the gene pathways involved at the ovarian level will be explored; b) CDB-2914 will be tested and formulated into vaginal gel and rings for contraceptive use in women; c) A radioimmunoassay will be established and validated for measuring serum levels of CDB-2914 for pharmacokinetic studies in women; d) The effects of CDB-2914 on human breast cells will be evaluated. Parallel studies investigating the effects of CDB-2914 on the primate endometrium and on ovarian function in women, for which funding will be requested from other sources, are also described in this document. (II) A vaginal gel containing both the microbicide Carraguard and the contraceptive steroid levonorgestrel (CARRA/LNG) will be tested for dual-protection against sexually transmitted infections and conception. Two mechanisms will be targeted for contraception in women having regular sex who will use this progestin microbicide daily: ovulation inhibition and thickening of the cervical mucus, which inhibits sperm penetration. Given the proven efficacy of LNG in emergency contraception, another goal is to test the product for use "on demand" before intercourse in women having occasional sex. (III) New compounds have been identified that are able to induce reversible germ cell depletion from the testis. The prime target of these compounds is the adherence junction (AJ) between Sertoli and germ cells in the testis. This project will focus on disruption in the AJs to induce germ cell loss without affecting hormonal pituitary-gonadal function. (IV) In a final project, sperm-supplied protein will be isolated from mammalian testes by recombinant DNA technology and will be investigated for its functional role in the development of early embryos from fertilized eggs. Antisense manipulation will be used to suppress the production of this novel sperm protein as a new method of fertility control. The Cell Culture Core facility will ensure the highest quality control standards, as well as priority access and services for Projects I, III, and IV. The Cell Culture Core Director will advise Core users concerning the latest technologies for facilitating their culture-based protocols. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COOPERATIVE MULTICENTER REPRODUCTIVE MEDICINE NETWORK Principal Investigator & Institution: Carr, Bruce R.; Dir, Div of Reproductive Endocrinology; Obstetrics and Gynecology; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001; Project Start 30-JUN-2000; Project End 31-MAR-2005 Summary: This research proposal describes the qualifications and experience of the Division of Reproductive Endocrinology faculty and research team at the University of Texas Southwestern Medical Center at Dallas, the facilities, and patient population available to them for carrying out clinical protocols to be designed by the NICHD Reproductive Medicine Unit (RMU) Network. The UT Southwestern Division of Reproductive Endocrinology includes 6 clinicians, 4 of whom are board certified in Reproductive Endocrinology. Within the division is the Women's Research Center which includes 3 research nurses led by a research nurse coordinator with 20 years experience in protocol development and implementation are available for participation in RMU network protocols. This research team has successfully completed an extensive number of randomized trials, some of which were supported by NIH grant support as well as multi-center randomized trials supported by pharmaceutical companies. These investigations included infertility, andrology, endometriosis, uterine leiomyomata, androgen excess, contraception, and menopause. In order to develop an interdisciplinary approach to the study of reproductive disorders we have brought to the RMU network support of UT Southwestern's NIH General Clinical Research Center,
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Contraception
Department of Urology, Psychiatry, Radiology, and Internal Medicine. A concept protocol is included which proposes to investigate pain relief in women suffering from endometriosis. This trial compares the effect of the medical treatment standard with gonadotropin releasing-hormone agonist versus continuous low-dose combined oral contraceptive pills. It is proposed that if continuous oral contraceptive pills are close in efficacy of relieving pain in women with endometriosis as are gonadotropin releasing hormone agonists, this mode of treatment would benefit a significant number of women wishing to save their reproductive organs for later reproduction. In summary, the reproductive endocrinology research team is experienced in multi- center clinical trials and is committed to collaborative participation consistent with the goals of the RMU network. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COUPLE DECISIONS ABOUT CONTRACEPTION Principal Investigator & Institution: Grady, William R.; Battelle Centers/Pub Hlth Res & Evaluatn Health Research & Evaluation Seattle, Wa 98105 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-JAN-2006 Summary: (provided by applicant): Most of what we know about the nature of the contraceptive decision-making process in which couples engage was obtained by analyzing reports from women about their fertility-related beliefs, attitudes, preferences and experiences. However, the growth of the AIDS epidemic has increased awareness that men have an important role in influencing the reproductive health of heterosexual couples. Despite this awareness, there is very little research on the contraceptive choices of couples that is based on data from both partners. In the proposed study, we will address this large research gap. We will accomplish this goal by conducting an inperson survey of approximately 1,200 married and cohabiting couples where the female partner is aged 20-35, where neither partner is sterile and where the couple is not currently pregnant or attempting to conceive. This survey, in which we will obtain separate, parallel reports from both partners, will provide unique and detailed data on the power relations, birth desires, and method-related expectancies, values, perceptions, preferences, and behaviors of men and women making contraceptive choices within the context of an intimate heterosexual relationship. Most importantly, the proposed analysis of these data, together with the data obtained in a one-year telephone follow-up survey, will allow us to gain new insights into the nature of the contraceptive decisionmaking process in which couples engage. In particular, it will inform us about how men are involved in that process and how their involvement is related to both the types of methods that couples choose and the effectiveness with which they use them. Such information will help family planning service providers determine when and how to include male partners in the method selection process as a way of helping couples achieve their separate and joint reproductive goals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CSHL CONFERENCE ON GERM CELLS Principal Investigator & Institution: Grodzicker, Terri I.; Assistant Director for Academic Affairs; Cold Spring Harbor Laboratory 1 Bungtown Road Cold Spring Harbor, Ny 11724 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2003 Summary: (provided by applicant): Germ cells are set aside from other lineages early in development, later differentiating into functioning gametes. To understand the nature
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and differentiation of germ cells would be a major achievement in biology, providing important insights into infertility, contraception, human congenital diseases, germ cell tumors, and preservation of endangered species. The molecular basis of germ cell differentiation is beginning to be understood, due to major intellectual and technical advances. General mechanisms of germ cell fate and behavior are emerging from studies in both vertebrates and invertebrates. This meeting, to be held October 10 -13, 2002, 2004 and 2006, will provide a public forum for discussion of all aspects of germ cell research, from the primordial germ cell to the functioning gamete, in diverse model organisms. We expect to attract about 250 participants from all over the world. There are no competing meetings that are so wide in scope. Seven topics have been chosen for platform presentations: Germ Cell Origins, The Embryonic Germ Line, Germ Line Stem Cells, Germ Line/Soma Interactions and Sex Determination, Spermatogenesis, Oogenesis, and Gamete Success and Evolution. Each session will be organized and cochaired by two experts in the topic, who will invite half the speakers and select the other half from submitted abstracts. We will encourage platform presentations from young scientists. The meeting will facilitate interactions between scientists who study different model systems and different aspects of germ cell biology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CYCLODEXTRIN AS NOVEL SPERMICIDE AND MICROBICIDE Principal Investigator & Institution: Hildreth, James Ek.; Professor; Pharmacol & Molecular Sciences; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 27-APR-2001; Project End 31-MAR-2004 Summary: (provided by applicant): Locally applied biomedical barriers and microbicides have proven ineffectual in preventing sexual transmission of HIV. We have recently found that HIV requires intact lipid rafts, highly specialized subregions in cell membranes, for entry into cells and for budding of fully infectious particles. Betacyclodextrin (beta-CD), a cyclic heptasaccharide that removes cholesterol from cell membranes and disperses lipid rafts, has been shown to block HIV infection and drastically reduce the infectivity of budding HIV particles. Cholesterol is also required by other pathogens some of which are associated with STDs. Beta-cyclodextrin is nontoxic and currently in human use as a carrier for polar drugs. Thus properly formulated, this molecule may be an effective microbicide with activity against HIV and other pathogens. Cholesterol has been shown to play a role in regulating sperm cell acrosomal reaction and depletion of sperm cell cholesterol by beta-CD induces capacitation and premature acrosomal reaction. The latter has been associated with low rates of fertilization. Thus beta-CD, by depleting sperm cell cholesterol, may prevent fertilization in vivo by inducing premature acrosomal reactions and reducing fusion efficiency. The central hypothesis of this proposal is that because it rapidly and efficiently depletes cholesterol from lipid membranes beta-CD has great potential as a combination microbicide-spermicide with low host cell toxicity. The goal of this project is to use in vitro and in vivo animal models to test the potential of beta-CD as a microbicide, particularly against HIV, and spermicide and to determine the mechanisms by which beta-CD inactivates H1V. The specific aims are: 1. To characterize and optimize the inhibitory effect of Beta-cyclodextrin on HIV-1 infection. 2. To determine the mechanisms by which Beta-cyclodextrin inactivates cell-free HIV-1 particles. 3. To determine the mechanisms by which Beta-cyclodextrin inactivates cell-associated HIV-1. 4. To determine the effects of Beta-cyclodextrin on sperm function in a rabbit contraception model. 5. To determine the effect of Beta-cyclodextrin in vitro on bacterial pathogens and vaginal flora. 6. To determine the anti-HIV microbicide potential of Beta-
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Contraception
cyclodextrin in a Hu-PBL-SCID mouse vaginal challenge model. 7. To determine the microbicide potential of Beta-cyclodextrin against HSV, papillomavirus, and chlamydia trachomatis in animal models. This project takes advantage of the shared importance of cholesterol in the biology of sperm and HIV and other pathogens to develop a novel microbicide/contraceptive approach. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPO ADOLESCENTS
PROVERA
AND
BONE
MINERAL
DENSITY
IN
Principal Investigator & Institution: Cromer, Barbara A.; Frederick C. Robbins Professor of Child; Pediatrics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: (Adapted from Investigator's Abstract) The United States has one of the highest adolescent pregnancy rates among industrialized nations. One of the major contributing factors is inadequate contraception. A very effective contraceptive method is depot-medroxyprogesterone acetate (DMPA) which has become increasingly popular in this age group. Recent research in adults has suggested a negative effect of DMPA on bone mineral density (BMD). With decreased BMD, one's risk increases later for osteoporosis, a major public health problem affecting millions of postmenopausal women every year. Compromised BMD would appear to be a particular concern in adolescents, as they normally accrue up to 40% of their total bone mineral content during this period. In preliminary work, the investigators demonstrated a 3.0% decrease in BMD in adolescent DMPA users over 2 years, compared with a 9.0% increase in untreated controls (p<0.0001). A prospective cohort study of the effects of DMPA on adolescent BMD, which will also include a double-blinded randomized prevention component, is proposed. Bone density in 400 adolescent DMPA initiators will be compared to their baseline values and to that of 300 and 120, oral and barrier contraceptive initiators, respectively, frequency matched on age and race. Bone density will be measured every six months for a maximum of two years. Bone density will also be measured at the time of discontinuation of contraceptive method. To evaluate the protective effects of estrogen on bone density, females in the DMPA treatment arm will be randomly assigned to DMPA with estradiol (n=200) and DMPA without estradiol (n=200). To examine the question of whether age modifies the effect of DMPA on bone density, the investigators will evaluate the age-treatment interaction between DMPA use and bone density among females of varying gynecologic ages. Finally, sex hormone levels and indices of calcium metabolism will be compared among the treatment groups in order to explore the biologic mechanisms underlying BMD changes. The statistical analysis will estimate the effect of DMPA on bone density while taking account of constant treatment discontinuation throughout the study period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPO-PROVERA AND BONE DENSITY IN PREMENOPAUSAL WOMEN Principal Investigator & Institution: Clark, M Kathleen.; Associate Professor; None; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: (Adapted from abstract): Registered nurses (RNs) and advanced practice nurses (APNs) play an important role in providing contraceptive services to women of
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reproductive age. Education and counseling regarding use, risks, and benefits of contraceptive choices are long-standing nursing interventions. With prescriptive authority, APNs are additionally responsible for providing safe, effective pharmacological interventions for preventing pregnancy. DMPA is a progestin only injectable contraception, approved for use in the US in 1992. Of concern is a potential adverse effect of DMPA on bone mineral density. Because DMPA disrupts the hypothalamic-pituitary-ovarian-axis (HPO), it theoretically will suppress estrogen production causing a relative estrogen deficiency, and corresponding loss of bone mineral density. The overall goals of this study are to determine the effect of DMPA on bone mineral density in women aged 18 to 30 years and to determine whether the effect can be modified by calcium intake or predicted by, baseline estradiol levels, irregular vaginal bleeding or weight gain. A two-year prospective longitudinal study of 275 women, 160 who are receiving their first DMPA injection, and 115 control subjects who are not using any hormonal method of contraception, will be completed. All participants will receive a baseline evaluation, and follow-up evaluations every three months for two years. At baseline, participants will have their bone mineral density of the femoral neck, lumbar spine and total body measured using dual energy x-ray densitometry (DEXA). Blood will be drawn for estradiol levels and other physical measurements completed. Participants will complete nutritional and physical activity assessments, as well as a comprehensive interview detailing demographic, medical reproductive and lifestyle behaviors that may influence bone mineral density. All participants will be given one 90-day menstrual calendar for the daily recording of vaginal bleeding. At each follow-up evaluation bone mineral density and body composition will be measured, nutrition and physical activity reassessed and components of the interview updated. The menstrual calendar will be collected, reviewed and new calendars provided. Random coefficient regression (RCR) analysis will be the major analytic strategy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT AND DIFFERENTIATION IN REPRODUCTIVE AXIS Principal Investigator & Institution: Mann, David R.; Professor; Physiology; Morehouse School of Medicine Atlanta, Ga 30310 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The mission of the proposed Cooperative Reproductive Science Research Center (CRSRC) at Morehouse School of Medicine (MSM) is to develop a rich intellectual environment that will promote and strengthen the research capabilities of the MSM investigators in the reproductive sciences. The applicant's ultimate goal is to become a research and training Center of excellence for minority investigators. To achieve this goal, the applicant proposes to develop a partnership between the CRSRC at the MSM and the Specialized Cooperative Center Program of Reproduction Research (SCCPRR) at the University of Pittsburgh. The CRSRC at the MSM will be composed of four Research Projects and an Administrative Core. The central theme of the proposal focuses on Development and Differentiation within the Reproductive Axis with emphasis on non-human primate paradigms. The proposed studies will integrate molecular, cellular and organismic approaches for elucidating physiological mechanisms that govern sexual development, follicular maturation, luteolysis and spermatogenesis. Each Research Project is led by a MSM Principal Investigator who works closely with at least one SCCPRR investigator at Pittsburgh. The experience and expertise of the SCCPRR Director and his colleagues will
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Contraception
be employed to assure the successful operation of the CRSRC. The CRSRC will utilize extensively the research resources made available via the partnership. Three Research Projects (I, II, and III) will be subserved by both the Primate and Assay Cores of the Pittsburgh SCCPRR, and three (II, III, and IV) will use the Cell-Imaging Core. The Pittsburgh SCCPRR will benefit from the scientific interaction with individuals at the MSM with similar interests, and from the association with a minority institution that will serve as a conduit for the recruitment of minority students, fellows and residents to Pittsburgh training programs. The partnership will also substantially increase use of the Core facilities at Pittsburgh by projects relevant to the mission of the Reproductive Sciences Branch, NICHD. The proposed research will lead to a better understanding of the causes of disorders of human reproduction and may ultimately result in improved therapeutic approaches to infertility and to development of novel strategies for contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DOXYCYCLINE CONTRACEPTORS
FOR
BLEEDING
IN
PROGESTIN
ONLY
Principal Investigator & Institution: Archer, David F.; Director, Clinical Research Center; Obstetrics and Gynecology; Eastern Virginia Medical School Norfolk, Va 23507 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Clinically, a high percentage of women using progestin-only contraception experience breakthrough bleeding spotting that causes impaired lifestyle and results in decreased compliance with this contraceptive method. There is a need for an effective, low-cost, easily adapted treatment to reduce the bleeding and spotting in progestin only contraceptives. The molecular environment of the endometrium of women with breakthrough bleeding [BTB] and spotting, like many other inflammatory disorders, contains abnormally high levels of pro-inflammatory cytokines (TNF-alpha and IL-1beta)and abnormally high levels of proteases (matrix metalloproteinases [MMPs] and neutrophil elastase), which prevent normal tissue repair. Doxycycline [DOX] is an inexpensive, FDA approved antibiotic that inhibits MMPs, TACE activity, and reduces NO synthesis. The therapeutic benefit of DOX in animal models and clinical studies of periodontal and ulcerative diseases is due to its inhibition of MMPs, not to its antibiotic effect. We do not anticipate any reduction in contraceptive efficacy with the use of DOX. We propose to clinically evaluate DOX treatment of progestin-only contraceptive induced BTB and spotting, and to biochemically characterize the endometrial molecular biologic changes that occur in DOX treated patients. If successful, DOX treatment could become an important adjuvant for treatment of this and possibly other inflammatory disorders effecting reproductive tract tissues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DUAL METHODS OF PROTECTION FROM PREGNANCIES AND STDS/HIV Principal Investigator & Institution: Roye, Carol F.; School of Nursing; Hunter College 695 Park Ave New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 31-MAR-2004 Summary: (adapted from the applicant's abstract): Effective use of contraception to prevent STIs/HIV and pregnancy requires that a young woman who uses a hormonal method of contraception has a male partner(s) who uses condoms consistently,
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regardless of the nature of the relationship between the two young people, e.g. longterm or casual. The target population of the proposed project is inner-city minority adolescent women who use hormonal contraceptives. The proposed project builds on the results of the applicant's preliminary studies of contraceptive use with male and female inner-city teens and on programs reported in the literature which have been successful at increasing condom use by subjects at risk for sexually acquired HIV and other STIs. The programs that will be replicated in this study are the brief counseling arm of Project RESPECT and the video-based patient education intervention implemented and evaluated by the Educational Development Center (EDC). The video to be used in the proposed study will be tailor-made and will reflect the needs of the target population, as determined by selected theories and the findings of prior qualitative and quantitative studies with members of this population. Subjects will be randomized into one of the four treatment conditions: Arm 1- brief patient counseling and video-education; arm 2- brief education counseling only, arm 3-video education only, arm 4- usual care. The research question to be answered is. What is the enhanced efficacy of the combination of a brief patient counseling intervention (an adaptation of Arm 2 of Project RESPECT) and video-based patient education? The main outcome variable is self-reported condom use. Other outcome measures include incidence of other risk behaviors including number of occasional partners and number of new partners during the follow up interval. Incidence of Chlamydia (the most prevalent STI in the target population) during the follow-up period will be tracked using the ligase chain reaction (LCR) assay to detect C. trachmatis. The project will be implemented in Planned Parenthood clinics in New York City Young women will be recruited on-site. Those who consent will be given a pre-test questionnaire addressing their sexual behaviors. They will also be given a urine Chlamydia test. They will then be randomized into one of the 4 research arms, and will participate in the intervention at that visit. Three months after participation the young women will be given a post-test questionnaire to access for behavior change and a second Chlamydia test will be analyzed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY NATURAL HISTORY OF ARTERIOSCLEROSIS Principal Investigator & Institution: Berenson, Gerald S.; Professor and Director; Sociology and Anthropology; Tulane University of Louisiana New Orleans, La 70118 Timing: Fiscal Year 2001; Project Start 01-MAR-1992; Project End 31-JUL-2003 Summary: The Bogalusa Heart Study is a long-term, epidemiologic program concerned with the early natural history of arteriosclerosis (atherosclerosis and essential hypertension) in a total biracial (black- white)childhood population, now reaching 20-41 years of age. The proposed research focuses on physiologic, genetic and lifestyle factors that contribute to cardiovascular (C-V)disease. The specific aims of the proposal are to study: 1) the impact of genetic factors on the evolution from childhood C-V risk factors to subclinical (C- V structural and functional characteristics) and clinical morbidity in adult population followed over a long period of time; and 2) the association of risk factor phenotypes to anatomic changes in the C- V system as seen by necropsy. The population for genotype- phenotype studies include approximately 1,400 siblings (sibships greater than 2) derived from 17 longitudinal birth cohorts. The C- V phenotypes include obesity measures, blood pressures, lipids, lipoproteins and apoproteins, homocysteine, glucose-insulin, fibrinogen, plasminogen activator inhibitor1 and von Willebrand factor. The environmental risk factors consist of sociodemographic characteristics, tobacco and alcohol use, oral contraception, physical
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Contraception
activity and diet. Subclinical morbidity will include echo-Doppler measurements of cardiac-carotid structure and function. Using robust sibling pair linkage methods, a genome-wide searching involving 391 markers with spacing of 10cM will be conducted for genes which influence quantitative traits. This will be supplemented with 41 highly polymorphic markers located in or near candidate genes likely to be related to obesity, lipoprotein metabolism, blood pressure levels, insulin resistance, diabetes, atherogenesis and thrombosis. Emphasis will be placed on longitudinal changes of clustering of correlated traits, i.e., insulin- resistant syndrome, Syndrome X. Analyses will be conducted to assess whether the same genes exert significant effects in both blacks and whites. Autopsy studies will address relationship of antemortem risk factors with the development of anatomic atherosclerotic and hypertensive lesions. The proposed studies will enable development of rational prevention programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY TEEN PREGNANCY PREVENTION--A PARENT/CHILD PROGRAM Principal Investigator & Institution: Lederman, Regina P.; Professor; None; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2000; Project Start 01-SEP-1997; Project End 31-JUL-2004 Summary: The proposed project has a two-fold purpose: 1) to conduct an annual schoolwide survey for three successive years to determine the antecedents (beliefs, intentions, school performance, home environment) of sexual behavior (initiation of sex, frequency of sex, number of partners, unprotected sex) and risk avoidant behaviors in middle school youth; and 2) to implement a new joint parent-teen education program for the prevention of sexual risk behaviors and pregnancy. The sample for survey testing will be recruited from youth in grades 6, 7, and 8 in three middle schools. Each school enrolls 700-725 students (N=2100- 2175), and has a high proportion of minority and economically disadvantaged youth. School approved motivational measures are used to obtain a representative survey sample of 70-90 percent student participation (N=14701970). In the first year, data from two survey pretests will be collected prior to the intervention to control for self- selection bias, to determine growth rate changes prior to the intervention, and to modify and tailor the planned curriculum to meet the needs of the study population. The educational program designed for parent-teen dyads focuses on strengthening family communication about sexual issues and behaviors. Content is included on reproduction, sexually transmitted diseases (STDs)/AIDS, contraception, sex risks and safe sex behaviors. The course utilizes social learning and cognitive behavioral concepts. Role- play and practice exercises are provided to enhance the learning of decision-making and refusal and resistance skills. Four 2 hour sessions are offered over a four-week period: two each are for parents and teens separately and two are combined. Subjects are recruited through school distribution of information flyers and consent forms, home mailings, parent-teacher meetings, neighborhood housing distribution to families, and neighborhood resident meetings. Using recruitment and incentive measures, it is estimated that 50 parent-child dyads can be obtained per school, for a total of 150: 75 experimental group pairs and 75 control group pairs. A randomized treatment/control group design will be used to assign 25 parent-teen dyads each to the experimental education and the attention-control groups in all three schools. Booster classes will be offered every six months at times prior to known teen peak conception periods. Pre and post-tests have been developed to determine betweengroup differences and within-group changes at course completion, and at 6, 12, and 20 months. The pre/post-test questionnaires assess group differences and changes in
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parent involvement and communication; sexual knowledge, attitudes, intentions, and behaviors; and the incidence of pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ECTOPY, HORMONAL CONTRACEPTION AND STD'S IN ADOLESCENTS Principal Investigator & Institution: Peralta, Ligia; Director of Adolescent Medicine; Pediatrics; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 20-SEP-2000; Project End 30-JUN-2005 Summary: Adolescents are at high risk for sexually transmitted diseases (STDs), which can have serious consequences for their future health and fertility, and which can increase their vulnerability to HIV infection. Cervical ectopy and use of oral contraceptives (OC), both common in adolescence, are risk factors for chlamydia, the most common inflammatory STD. Standardized, reliable measurements of ectopy have not been employed across studies. The independent risk of OC use stratified by ectopy has not been well studied. The association among Depot Medroxy Progesterone Acetate (DMPA), a contraceptive widely used among adolescents, ectopy and STD acquisition has not been reported. The aims of this proposal are to study prospectively: 1) the natural history of cervical ectopy and the transformation zone (T zone) in sexually active adolescents, 2) the impact of DMPA and a combined estrogen-progestins (OC) over time on cervical ectopy/T zone; 3) the relation between the size of the area of ectopy/T zone and STD acquisition, including chlamydia, gonorrhea, trichomonas and HPV; and 4) the risk of STDs in OC users compared to DMPA users stratified by the extent of cervical ectopy/T zone. Design: This is a 5 year prospective study on 500 inner-city sexually active nonparous females aged 12-18, some of whom will initiate DMPA or OC. They will be recruited consecutively from the Adolescent, Pediatric and community-based OB/Gyn Clinics of the University of Maryland, Baltimore, where the study will be conducted. Participants will be seen every 6 months for medical/sexual history, complete physical and pelvic examinations, and specimen collection of STDs. Cervicography will be used to determine the areas of ectopy and T zone, measured by computerized planimetry. This is an innovative reliable, sensitive and standardized method of measurement. Behavioral data will be collected anonymously by audio assisted computer interview (A-CASI). Interim follow up visits (every 3 months) will include behavioral risk by ACASI, medical history and incidence of STDs by urine screening and from the City STD registry. Summary. This proposal will 1) use a standardized measure of ectopy in young nonparous adolescents before and during hormonal contraceptive use; 2) address the relation between STDs and OCs, especially those OCs containing new progestins; 3) be one of the few studies to examine the association among DMPA, STDs and ectopy in adolescents; 4) recruit a difficult cohort with one of the highest rates of STDs, especially chlamydia infection. The team of researchers has expertise on STDs, adolescent health, and cervical anatomy. They have collaborated on the preliminary study and have experience in planning, implementing and managing successful longitudinal studies on high-risk youth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECT CONTRACEPTION
OF
CONTINUOUS
VS.
SEQUENTIAL
ORAL
Principal Investigator & Institution: Legro, Richard S.; Associate Professor; ObstetricsGynecology; Pennsylvania State Univ Hershey Med Ctr 500 University Dr Hershey, Pa 17033
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Contraception
Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2005 Summary: (provided by applicant): Withdrawal bleeding that occurs during the placebo period of the traditional OCP regimen is unnecessary and unwanted, and contributes to substantial method discontinuation rates. In U.S. women this contributes to one of the highest unwanted pregnancy rates in the world. In this proposal we will test the hypothesis that a long-term (6 month) continuous combined oral contraceptive pill (CCOCP) regimen (20 mug ethinyl estradiol/1 mg norethindrone acetate) will result in more profound endometrial and ovarian suppression than a traditional 21 day active pill/7 day placebo OCP regimen (21/70CP) with a randomized double blind trial. Currently CCOCP is commonly used by clinicians for a variety of indications, with little data of its safety and efficacy. As the clinical marker of endometrial and ovarian activity, we will be using number of bleeding days as the primary outcome in this study. We will secondarily monitor endometrial thickness and ovarian follicle formation by ultrasound, endometrial histology by biopsy, ovarian steroid production by monthly serum and daily urinary measurements, and patient satisfaction by questionnaire. We believe that a reduction in days of bleeding that will occur on a CCOCP regimen will improve patient satisfaction and compliance with this contraceptive regimen. We theorize that a tongterm CCOCP regimen may more effectively suppress ovarian follicular development and endometrial growth, because there are fewer rebounds in hormone levels due to loss of suppression during placebo periods. This regimen may therefore provide both effective contraception (with greater leeway for skipped pills) as well as more effective treatment of multiple gynecological conditions such as dysmenorrhea, dysfunctional uterine bleeding, endometriosis, and peripheral androgen disorders such as acne and hirsutism, as well as a greater reduction in risk for endometrial and ovarian cancer. Therefore, the risks and benefits of a CCOCP regimen are an important women's health issue that warrant investigation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECT OF HORMONAL CONTRACEPTION ON BONE MINERAL DENSITY Principal Investigator & Institution: Berenson, Abbey B.; Obstetrics and Gynecology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2001; Project Start 11-SEP-2001; Project End 31-AUG-2006 Summary: Recent studies have suggested that use of depot medroxyprogesterone acetate (DMPA) may have an adverse effect on bone mineral density (BMD). In contrast, use of oral contraceptives has been reported to have a beneficial effect or no effect. In a preliminary study, we observed a decrease of 3.0 percent in BMD among users of DMPA as compared with an increase of 0.1 percent-2.9 percent among users of 30-35 mug pills. Questions regarding the specific relationship between BMD and DMPA, however, have not been fully addressed. Furthermore, almost no data are available on the effects of the recently marketed pills containing only 20 mug of estradiol. Considering that over 11 million women in the US use hormonal contraception each year, it seems imperative to obtain accurate information on the effects of these medications on skeletal health. To address this important question, we propose to conduct a prospective clinical trial comparing changes in BMD over a 2-year interval experienced by women using DMPA or oral contraceptives containing 20 mug estradiol as compared with women not using hormonal contraception. Each cohort will be comprised of 229 women aged 16 to 33 years of white, black, or Hispanic race/ethnicity. The primary outcomes (ie, BMD and biomarkers of bone metabolism) will be analyzed to assess changes from baseline within each contraceptive group at 6, 12, 18, and 24
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31
months as compared to changes observed among controls. Furthermore, we will be able to assess the reversibility of potential adverse effects of hormonal contraception on BMD among those who discontinue their method by conducting a bone scan and measuring biomarkers at the point of discontinuation and at 6-month intervals from this point. This study will be among the first to investigate the role of race/ethnicity and age in contraceptive-related BMD changes while accounting for behavioral correlates (eg, prior contraceptive use, nutritional intake, exercise habits, alcohol use, smoking) in a multivariate fashion. Ultimately, this study will determine which women, if any, are placed at increased risk of osteopenia or osteoporosis as a result of using these hormonal contraceptives during their reproductive years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISPENSING
EFFECTIVENESS
OF
NURSE
HOME
CONTRACEPTIVE
Principal Investigator & Institution: Melnick, Alan L.; Assistant Professor; Family Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 30-JUN-2005 Summary: (provided by the applicant): The purpose of our study is to determine whether an innovative way of providing contraception, in the home, could reduce the incidence of unintended pregnancy for low income and minority women who have already had one birth. Women with a first-borne infant found to be at high risk for medical and social problems through a community-based screening program who are interested in delaying a subsequent pregnancy will be randomized into two groups. The first group will receive a home visit by a community health nurse, who will provide contraceptive counseling, including a referral to publicly funded family planning clinic. The second group will receive the same services, but will also receive either a threemonth supply of oral contraceptives or a depo-medroxyprogesterone injection. The study has two objectives: to determine whether this practice reduces subsequent unintended pregnancies in this population and whether this practice encourages or discourages utilization of clinic-based preventive services, such as sexually transmitted disease and cervical cancer screening. The results of our study have important implications for public health. Most local public health departments throughout the United States already use community health nurses to deliver many services at home, including case management for families with infants at risk for medical and social problems. If delivery of contraceptives at home is effective in reducing subsequent unintended pregnancies for these families, local health departments across the country could add this service for very little added cost. To the extent that home contraceptive delivery model proves successful at widening the interval between births for lowincome and minority women, and increases the likelihood that subsequent pregnancies are intended, it will increase the likelihood of having babies born healthier. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENDOCRINE REGULATION OF GERM CELL APOPTOSIS IN THE MALE Principal Investigator & Institution: Sinha Hikim, Amiya P.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 90502 Timing: Fiscal Year 2001; Project Start 06-APR-2001; Project End 31-MAR-2006 Summary: (Scanned from the applicant's abstract) Recent studies have demonstrated that apoptosis is the underlying mechanism of germ cell death during normal
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Contraception
spermatogenesis, and can be triggered by various physiological and pathological stimuli. The mechanisms by which these proapoptotic stimuli activate germ cell apoptosis are not well understood. The principal intracellular effectors of apoptosis are a family of cysteine proteases called caspases. These enzymes participate in a cascade involving initiator and executioner caspases that is triggered in response to proapoptotic signals. Active executioner caspases are then involved in the cleavage of key cellular proteins, resulting in eventual cell death. Four specific aims are proposed. Specific Aim 1 will focus on the characterization of the key molecular components of the intrinsic and extrinsic death pathways leading to caspase activation and increased germ cell apoptosis triggered by deprivation of the gonadotropic support or by mildly increased scrotal temperature. In Specific Aim 2, we will determine whether inhibition of germ cell apoptosis by replacement therapy of human FSH and/or LH, in the hormone deprivation model, will reverse the apoptosis related changes in the gene expression. Specific Aim 3 of this proposal will address the role of in vivo pre-treatments of rats with a broad-spectrum caspase inhibitor or a selective inhibitor of caspase 3 like proteases in preventing or attenuating the increased germ cell apoptosis induced by the hormonal and non-hormonal regulatory stimuli. Specific Aim 4 will focus on further characterization of the role of some of the key upstream modulators (p53, Bcl-2, Fas, and Fas L) of caspase activation in directing germ cell fate using mice harboring null mutation of either p53 or Bcl-2, or mice lacking functional Fas (lpr[cg]) or Fas L (gld). Results of these studies will provide insight into the basic control mechanisms of spermatogenesis in normal and pathological states and will be applicable to the assessment and management of male factor infertility as well as more targeted approaches to male contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EPIDIDYMAL MATURATION OF SPERM SIGNALING PATHWAYS Principal Investigator & Institution: Kopf, Gregory S.; Professor; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-JUL-2003 Summary: The long-term goals of the Principal Investigator and the Foreign Collaborator are to understand the molecular basis of sperm fertilization competence. The PI has focused in his research on the signal transduction mechanisms underlying sperm capacitation, which requires a maturation process that occurs during their transit through the epididymis. The foreign investigator has studied the biochemistry and cell biology of epididymal maturation. Together, these investigators have demonstrated an apparent maturation of the signal transduction mechanisms in parallel with epididymal maturation. The aims of this proposal are to 1) determine whether sperm epididymal transit is associated with alteration of cholesterol efflux in response to serum albumin and beta cyclodextrins, agents that bind cholesterol in vitro, 2) determine the mechanisms by which epididymal maturation regulates the response of the sperm to dbcAMP leading to protein tyrosine phosphorylation, and 3) determine whether the oxidation state of the epididymal environment can influence the maturation of the signal transduction machinery that regulates sperm capacitation. The results of these experiments may aid in the understanding of epididymal maturation and its role in fertilization competence, which may relevant to both male infertility and contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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•
33
Project Title: EPIDIDYMIS-SPECIFIC PROTEINS FOR MALE CONTRACEPTION Principal Investigator & Institution: French, Frank S.; Professor; Pediatrics; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 14-DEC-2001; Project End 30-NOV-2004 Summary: (provided by applicant) This research will be performed primarily at the Shanghai Institute of Biochemistry in China as an extension of NIH grant #R37 HD04466, the parent grant for this project. The Principal and Co-Investigators of this parent grant are Frank S. French, M.D. and Susan H. Hall, PhD., the Laboratories for Reproductive Biology of the University of North Carolina at Chapel Hill. The long-term objective is to identify human epididymal targets for male contraception by investigating epididymis-specific proteins involved in sperm maturation and fertilization. The study is part of a larger contraceptive development project involving a collaboration of the Laboratories for Reproductive Biology with Professor AJ Rao at the Indian Institute of Sciences for evaluation of lead proteins in monkeys and Dr. Catherine VandeVoort at University of California, Davis Primate Center, to test the effects of immunization against epididymis secretory proteins on sperm function in monkeys. Specific Aim 1 Define expression of the human proteins corresponding to monkey Clones ESC46I-ribonuclease A and ESC615-carboxylesterase B, Specific Aim 2 Determine the functions of the human ESC461 protein Specific Aim 3 Determine the functions of ESC615 protein Specific Aim 4 Evaluate additional epididymis-specific clones for potential as male contraceptives From a macaque epididymis-specific cDNA library containing novel cDNAs related to known gene families, two are selected for in depth study. One, ESC461 is related to the eosinophil ribonucleases A2 and A3 which have antimicrobial activity. The other, SC615 is related to the carboxylesterases which may have roles in modification of sperm surface proteins. To investigate where the proteins are expressed and localized in the human epididymis and whether they bind sperm, human clones will be obtained and recombinant protein produced and used to raise antibodies in rabbits. Recombinant proteins produced in bacteria or in eukaryotes will be used to determine the ability of ESC46I to bind and hydrolyze RNA and to inhibit the growth of bacteria. The ability of SC615-carboxylesterase to catalyze the hydrolysis of a range of substrates will be determined. If time permits, studies will be initiated on 2 other clones from this library encoding lipocalin-like proteins. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: FAMILY PLANNING PROMOTION IN HIV INFECTED ZAMBIANS Principal Investigator & Institution: Allen, Susan A.; Associate Professor; Epidemiology & Interntl Health; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: Eighty percent of the world's HIV infections are in sub-Saharan Africa. In Lusaka, the capital of Zambia, 85% of pregnant women are married and 47% are in. couples with at least one HIV+ partner (26% concordant positive, 21% discordant). It will be years before short course antivirals are widely implemented and many children who escape infection will be left orphaned. There are 360,000 AIDS orphans in Zambia, a country of 9 million, and 35, 000 HIV+ women deliver each year. Prevention of unplanned pregnancy in couples with HIV can reduce pediatric AIDS, HIV orphans, and the family consequences of parental illness and death. We have previously HIV tested and counseled 10,000 couples from Lusaka for our ongoing NIH funded studies of heterosexual HIV transmission. In a pilot randomized controlled trial of family
34
Contraception
planning promotion with 251 couples, we observed a marked increase in injectable and oral hormonal contraceptive uptake. The attrition rate was high, however, and compliance with oral contraception was poor. Although incident pregnancy was lower with the intervention, the magnitude of the impact was far less than anticipated. Effective, user-- independent methods such as the IUD and Norplant had lower attrition rates but they are unfamiliar to providers and clients and few women elected to use them. In this study, we will enroll 5000 concordant HIV+ and discordant couples in a randomized factorial trial of two interventions to reduce unplanned pregnancies. The first intervention will promote more effective contraception by placing user independent methods first in the educational message hierarchy and employing positive message framing. The second intervention will help couples plan for the consequences of their illness and death. This will include assisting husband and wife to work together and prepare a will, choose a guardian, and make a financial plan. By focusing on the cost of educating existing children and on the need to plan for their future care, we will encourage couples to reflect on the implications of future childbearing. We hypothesize that this will result in a decision to limit fertility. A standard family planning service will be compared with either or both interventions with respect to impact on incident pregnancy, contraceptive choice and pattern of use, psychosocial and behavioral variables, and future planning actions. Cost- effectiveness will be determined with methods developed jointly by experts in the fields of HIV therapy in Africa and contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FSH RECEPTOR ANTISENSE STRATEGY FOR CONTRACEPTION Principal Investigator & Institution: Leyda, James P.; Emerging Concepts, Inc. 3130 Highland Ave, Ste 3115 Cincinnati, Oh 45219 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAR-2002 Summary: (Scanned from the applicant's description): A new form of chemical contraceptive that has greater ease of use, more prolonged actions and a different profile of side effects than existing steroidal contraceptives would be welcomed by many women. A compound that specifically and reversibly inhibits development of ovarian follicles would be an ideal and radically different contraceptive. A specific inhibitor of follicle-stimulating hormone receptor (FSHR) synthesis is expected to be such a compound. The FSHR protein is required for ovarian follicular development and is present in ovarian follicular granulosa cells but not in non-reproductive tissues. The collaborator's laboratory has demonstrated that this compound inhibits synthesis of the FSHR in vitro. The goal of this six-month Phase I feasibility project is to determine if a phosphorothioated 18-mer antisense oligodeoxynucleotide (ODN) reversibly and specifically blocks follicular development in a mammalian species (rat) in a dosedependent manner. The goal of the Phase II project will be to establish and refine the pharmaceutical and toxicological properties of the ODN in a primate species using a biodegradable, sustained-release, long acting, and injectable microsphere formulation of the compound. The long-term objective is to develop an FSHR antisense ODN as a contraceptive that would transiently block ovarian follicular development in humans. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: FUNCTIONAL STUDIES OF THE CDY GENE FAMILY Principal Investigator & Institution: Lahn, Bruce T.; Human Genetics; University of Chicago 5801 S Ellis Ave Chicago, Il 60637
Studies
35
Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: (provided by applicant): The long-term goal of this proposal is to determine the function of a newly discovered gene family known as the CDY family in mammalian spermatogenesis. Founding members of this family are the human Y chromosomal genes CDY1 and CDY2 (together referred to as CDY). The CDY genes are linked to spermatogenic failure, as CDY1 maps to a region of the Y chromosome frequently deleted in infertile men. The role of CDY in spermatogenesis is further supported by its testis-specific expression. Other members of the CDY family are autosomal, and have expression patterns consistent with roles in both spermatogenesis and somatic development. This family of genes is shown by biochemical studies to encode a novel class of histone acetyltransferase enzymes, and are thus implicated in chromatin modification. The primary objective of this proposal is to test the hypothesis that the spermatogenic function of the CDY family is to promote chromatin condensation during spennarid maturation. Our specific aims are: 1) To determine the precise expression profile and protein localization of this gene family during spermatogenesis. 2) To biochemically characterize the CDY family, focusing on identifying factors that engage in protein-protein interactions with members of the family, and on characterizing the enzymatic properties of these histone acetyltransferase enzymes. 3) To construct knockout and transgenic mice involving members of the CDY family, and to use these mouse models for assessing the in vivo functions of these genes. Collectively, these developmental, biochemical and genetic studies should shed light on the organismal function of the CDY family. Specifically, they will aid in evaluating the hypothetical role of this gene family in promoting chromatin condensation during spermatid maturation. Results will also have implications for understanding the molecular etiology of male infertility, and for developing drug-based male contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENOMICS APPROACHES IN COMPARATIVE MEDICINE Principal Investigator & Institution: Piedrahita, Jorge A.; Professor; Molecular Biomedical Sciences; North Carolina State University Raleigh 2230 Stinson Drive Raleigh, Nc 27695 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2004 Summary: (provided by applicant): The nonhuman primate (NHP) is a valuable model for studying human health with direct implications to biomedical investigations of infertility and contraception, infectious diseases and vaccine development, drug and alcohol addiction, brain disorders, gene and stem cell based therapy and transplant biology. There are significant needs for populations of specific pathogen-free (SPF) animals with unique genotypes that can't be satisfied by the importation of animals from the wild or by the identification and propagation of founder animals by selective breeding. SPF, Indian-origin, rhesus macaques carrying specific MHC alleles is but one example. The assisted reproductive technologies (ARTs) have been practiced extensively in humans over the last 20 years and their applications in NHPs, while potentially very useful, have yet to be realized on a scale adequate to impact the needs described above. This application seeks support for a workshop that will identify and discuss integrative approaches to exploit the ARTs in NHPs thereby maximizing their contribution to ongoing and future research efforts. The overall topic of the workshop is based on the concept that research using NHPs can be improved significantly both in quality and quantity by increased availability of animals of desired genotypes, of genetically identical animals and of SPF animals. The aims of the workshop are to: 1) Review the current state of reproductive research employing the ARTs in NHPs including both
36
Contraception
basic concepts and specific applications; 2) Enhance interactions and collaborative efforts within and between NPRCs and academic institutions concerning reproductive research including infertility and contraceptive development studies that are clinically important but can't be accomplished in humans; and 3) Identify strategies that effectively expand NPRCs abilities to develop and practice the ARTs in NHPs. The proposed workshop will be held as a satellite meeting immediately prior to the annual meeting of the International Embryo Transfer Society. This arrangement will permit attendees to attend both meetings and should encourage participation by research trainees and fellows. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HCO3 AND NA+ TRANSPORT IN HUMAN & PIG VAS DEFERENS Principal Investigator & Institution: Schultz, Bruce D.; Assistant Professor; Anatomy and Physiology; Kansas State University 2 Fairchild Hall Manhattan, Ks 665061103 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 31-MAY-2005 Summary: (provided by applicant): The long-term goal for this project is to determine the epithelial ion transport pathways and the associated regulatory mechanisms within the distal male genital tract in order to provide a basis for better understanding reproductive dysfunction. Ion transport processes within the distal ductus deferens (dDD) have not been clearly identified although errant ion transport within the duct is clearly associated with asthenozoospermia, oligozoospermia, non-obstructive azoospermia, and obstructive azoospermia. Recent observations point to a novel constellation of Na+-dependent ion transport pathways within the dDD. The cellular and molecular basis of these observations remains to be determined. We hypothesize that specific cells in dDD epithelium are capable of regulated Na+-dependent HCO3secretion and/or Na + absorption. These processes may occur independently in separate cell populations or may be simultaneously expressed in a single cell population. The epithelial model that is proposed represents a paradigm shift from currently held views regarding dDD function. This new epithelial model provides for neurotransmitterdependent mechanisms to acutely alkalinize the lumen for sperm activation just prior to ejaculation and provides a basis to account for male factor infertility that is currently diagnosed as 'idiopathic.' Modem electrophysiological, biochemical, cytochemical, and molecular techniques will be employed to study native epithelium along with primary cell cultures to delineate the mechanisms and signaling pathways that contribute to epithelial function with the ultimate goal of modulating male fertility. The hypotheses will be tested by addressing the following specific aims. Aim 1. To identify key mechanisms that contribute to HC03 transport across distal ductus deferens pithelia. Aim 2. To identify key mechanisms that contribute to Na vtransport across distal ductus deferens epithelia. Results from these studies will lead to an increased understanding of male reproductive tract function along with a more complete understanding of Nav and HCO3 transport mechanisms in general. The proposed studies will ultimately benefit the medical community by providing rational bases for therapeutic interventions both to treat male infertility and to modulate male fertility (i.e., male contraception). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HIV PREVENTION TRIALS UNIT-THAILAND Principal Investigator & Institution: Celentano, David D.; Professor; Epidemiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2004
Studies
37
Summary: The Johns Hopkins University and its partners, Research Institute for Health Sciences [RIHES] and Faculty of Medicine, Chiang Mai University of Public Health Region 10; HIVNET 021 for participating medical centers; Northern Drug Dependence Treatment Center seek to be a Prevention Trial Network (PTN) Unit for Thailand. The purpose of our PTN Unit is to conduct state-of-the-art preventative interventions to slow the acquisition and transmission of HIV infection in this region. We propose to participate in HIV prevention trials in multi-site or single-site investigations in the following areas: (1) To continue our HIVNET sponsored investigation, "Hormonal Contraception and the Risk of HIV Acquisition (HIVNET 021)," which is a consortium of 7 clinical sites in Thailand and a Coordinating Center at RIHES. We are recruiting 2,600 women in 4 regions of Thailand over a 15-month period and following them at 3month intervals for an average of 24 months with incident HIV and STDs as study endpoints. PTN support for the period June 2000 to July 2002 is requested in this application. (2) To conduct a Phase I safety and acceptability trial of an anorectal microbicidal for men who have sex with men (MSM) in Chiang Mai. Possible products include Nonoxynol-9, other spermicides, BufferGel or other promising compounds, along with promotion of the use of the female condom during anal intercourse. (3) To evaluate the following substance use related interventions: (a) a feasibility study of promoting drug treatment entry among HIV-1 infected drug users who have relapsed to drug use following inpatient drug detoxification at the NDTC in Mae Rim. (4) To conduct a Phase I trial for antenatal/intrapartum prevention of maternal to child transmission (MCT) of HIV-1 infection using ZT monotherapy vs. PETRA (AZT/ETC); PMPA, an investigational new drug that has been demonstrated in the laboratory to have intriguing anti-retroviral effects; a combination of proven anti-retrovirals (e.g. nevirapine and AZT) or other promising compounds, as recommended by the PTN's Perinatal Working Group. Under HIVNET, we received approval for the conduct of a Phase I safety and toxicity study of PMPA in 25 mother/infant pairs in Thailand; due to unexpected complications from the company, we have not yet been able to field this study but anticipate doing so this coming year. Our team has the capacity to rapidly respond to new opportunities in HIV prevention, as might occur within the PTN structure. Our partners have demonstrated over the past 9 years that we have the necessary infrastructure, trained manpower, scientific capability and expertise to both expand our efforts to meet the needs for large population efficacy trials, and to be able to recruit and retain very large, diverse cohorts which might be needed as trials are ready for Phase III implementation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HORMONAL REGULATION OF SERTOLI CELL MATURATION Principal Investigator & Institution: Griswold, Michael D.; Professor; Biochemistry and Biophysics; Washington State University 423 Neill Hall Pullman, Wa 99164 Timing: Fiscal Year 2001; Project Start 01-AUG-1977; Project End 31-MAR-2002 Summary: Sertoli cells are the epithelial "nurse" cells of the testis which along with the germ cells comprise the seminiferous tubules. The Sertoli cells clearly play important although incompletely defined roles in the process of spermatogenesis. The long term goals of this project are to understand the different roles of the Sertoli cells in spermatogenesis. These goals relate directly to human health problems dealing with reproductive infertility and may lead to new approaches to contraception. In the past grant periods this project has focused on the characterization of Sertoli cell secretion products and their specific roles in spermatogenesis. In the next grant period we propose logical and focused extensions of our previous studies, and, in addition,
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Contraception
propose some new approaches to understanding how Sertoli cells products influence germ cells. The specific aims for the next grant period include: 1. The identification and characterization of regulatory elements on the FSH receptor (FSHR) gene promoter. 2. Identification of agents which regulate the expression of the FSH receptor in Sertoli cells in culture and in vivo. 3. Successful direction of transgenes into the Sertoli cells of transgenic mice. We hope that this last aim will lead to ways to specifically alter the expression of genes in Sertoli cells in vivo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IDENTIFYING CONTRACEPTIVE U*
SERVICES
CHANGES
TO
IMPROVE
Principal Investigator & Institution: Frost, Jennifer J.; Alan Guttmacher Institute 120 Wall St, 21St Fl New York, Ny 10005 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2006 Summary: This project aims to improve contraceptive use and reduce unintended pregnancy in the United States by expanding the knowledge base needed to move from basic research to effective program and policy change. Specifically, our goals are to provide a comprehensive, national frame of reference or "map" of key factors contributing to poor contraceptive use from women's perspectives and to match this map with information on contraceptive service delivery practices in order to identify changes that have the greatest potential for reducing unintended pregnancy. To accomplish these goals, we propose to carry out three interrelated activities: (1) We will undertake a broad, comprehensive mapping of the difficulties women at risk of unintended pregnancy in the U.S. face in successfully using contraception and assess their priority for attention based on their contribution to national levels of unintended pregnancy. To accomplish this, we will collect data that do not now exist from a national sample of sexually active women at risk for unintended pregnancy. (2) We will ascertain the extent to which contraceptive service providers are aware of the problems hindering successful method use and are able to provide services that address factors leading to contraceptive failure and nonuse. We will obtain this information from surveys of national samples of publicly funded family planning clinics and of private physicians. (3) We will combine this information, findings from others' research, and advice from researchers and service delivery experts to identify policy and program limitations and make recommendations for next steps in service delivery and research that will help reduce markedly unintended pregnancy in the U.S. We expect that this project will identify factors hindering effective contraceptive use that are amenable to impact through service delivery (and those that are not, at least in the short run), and that it will result in greater consensus on what changes and new undertakings in contraceptive care are needed, which types of changes offer the largest potential reduction in unintended pregnancy levels, and what steps are needed to effect those changes. By identifying gaps in knowledge and effective intervention models, it will also stimulate new research and intervention development and evaluation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INCREASED ACCESS TO EMERGENCY CONTRACEPTIVE PILLS Principal Investigator & Institution: Raymond, Elizabeth G.; Family Health International Box 13950 Research Triangle Park, Nc 27709 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2005
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39
Summary: (provided by applicant): Emergency contraceptive pills (ECPs) can substantially reduce the chance of unintended pregnancy after unprotected intercourse. However, over the longer term, broad availability of this method could affect women's use of other contraceptive methods, which could in turn have either beneficial or adverse consequences on the risk of pregnancy and sexually transmitted infections (STIs). Data on this issue are needed to inform policies and practices regarding provision of ECPs to women. The primary purpose of the proposed randomized trial is to evaluate the impact of maximally increased access to ECPs on pregnancy and STI rates. Secondary research aims are (1) to determine what contraceptive or STIprevention behaviors ore influenced by ready access to ECPs. and (2) to examine determinants of these behaviors. The trial will be conducted in young, primarily minority women, a population with a disproportionately high risk of these two outcomes. Sexually active women who are using barrier methods of contraception, oral contraceptive pills, or no contraception will be enrolled at two clinics in Indiana and California. Each woman will be randomly assigned to one of two groups. In the standard care group, women will be counseled about ECPs and invited to come to the clinic to obtain them (at usual clinic charges) when necessary. In the advance provision group, women will be given a supply of ECPs free of charge to keep at home in case of need. The two groups will be monitored over the following year. The primary analysis will compare the two groups for: 1. the 12-month incidence of pregnancy, and 2. the combined 12-month incidence of three STIs: cervical gonorrhea infection, cervical chlamydia infection and vaginal trichomoniasis. In addition, we will also compare behaviors in the two groups, specifically use of condoms, other contraceptive methods, and ECPs, and also motivating or deterrent determinants of these behaviors using a modified Health Behavior framework. These secondary analyses should help explain the primary biologic outcomes and should be useful in the development of counseling messages and service protocols in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MALE CONTRACEPTION RESEARCH CENTER GRANT Principal Investigator & Institution: Bremner, William J.; Chief; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 11-SEP-2002; Project End 28-FEB-2007 Summary: (provided by applicant): World population continues to increase at a frightening rate, particularly in developing countries. At the 1990 fertility rate (approximately 4 children per woman world-wide) there would be over 75 billion people on earth in the year 2100, compared to 6 billion at the present time. Even at the very optimistic projection of 2.5 children per woman, global population will grow to 19 billion by the year 2100. In addition, approximately one-quarter of all pregnancies are unwanted, leading to millions of abortions (1.5 million surgical or medical abortions annually in the United States) and approximately 100,000 deaths worldwide per year of otherwise healthy young women due to the complications of abortion. It is well established that men will use contraceptives (approximately 30% of all contraception in the U.S. now is accomplished with male methods). Therefore, the development of new, effective, safe, reversible male contraceptives is an extremely important societal goal. The work proposed in this application is designed to increase our basic and clinical knowledge of reproductive processes in the male with particular relevance to contraception. We are committed to excellence across the spectrum of studies proposed, from basic molecular biology and biochemistry through human physiology with direct application to contraceptive development. We have four research projects: 1) hormonal
40
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contraceptive studies in men (Dr. W. Bremner, PI), 2) genetic studies of the control of spermatogenesis in mice (Dr. R. Braun, PL), 3) studies of the roles of phosphodiesterases and their inhibitors in the testis (Dr. J. Beavo, PL), and 4) the cell-specific patterns of gene expression and their control in the testis (Dr. M. Griswold, PL). We also propose a Program for Fellows and New Investigators in Male Contraception and an Administration Core Unit. Our proposal incorporates the talents of outstanding investigators of varied backgrounds and professional training into an interactive research program in reproductive biology. We have structured this Center to meld superb science with the practical goal of applying new basic knowledge as quickly as possible to studies in human beings. We hope that, in this way, our work will address critical needs of society. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MATERNAL-FETAL HLA SHARING AND RISK OF PREECLAMPSIA Principal Investigator & Institution: Saftlas, Audrey Frieda.; Associate Professor; Epidemiology; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-SEP-1995; Project End 31-MAR-2005 Summary: An accumulating body of epidemiological evidence points coherently toward an immune-based etiology for preeclampsia. Several recent studies, as well as a collection of other studies conducted over the past 25 years, suggest that exposure to paternal, fetal; or foreign antigens is protective against subsequent risk preeclampsia; and that paternal/fetal factors may be as important as maternal factors in the etiology of preeclampsia. Consistent this evidence, HLA-sharing between mother and fetus has been positively associated with risk of preeclampsia. We hypothesize that histocompatibility between mother and fetus may have a detrimental effect on pregnancy by impairing maternal recognition of the fetal allograft as a gestation, thereby compromising development of maternal immune tolerance and effective implantation of the placenta. To evaluate this hypothesis, we propose to conduct a case-control study to determine if nulliparous women who develop preeclampsia are more likely to share HLA antigens with their infants than women who have normotensive gestations. Specifically, we will examine sharing at each of five HLA loci (A, B, C, DR, and DQ), as well as generalized sharing across loci. In addition, we will evaluate selected epidemiologic factors indicative of exposure to paternal/fetal antigens (e.g., duration of sexual cohabitation, coital frequency, and use of barrier contraception with baby's father prior to conception). We will also test for the presence of gene-environment interactions to determine if effects of maternal-fetal HLA sharing are modified by the primary epidemiologic exposures under study. The study population (N=250 cases; N=250 controls), identified from Iowa and Connecticut live birth files, will include residents of four Iowa and two Connecticut counties who deliver between November l, 2001 and October 31, 2003. All participants will be asked to provide buccal cell samples from their babies and themselves for HLA genotyping (N=1,000 samples), and to respond to a 25 minute telephone interview. Medical chart abstractions will be conducted to validate case definition and control criteria. The study was powered to detect a two-fold increased risk of preeclampsia associated with the presence of only one maternal- fetal HLA mismatch across the three loci (HLA-A, B, and DRbeta1) loci, with at least 80 percent power, and an alpha of.05. The proposed study may be the first to examine the effects of maternal-fetal HLA sharing in an adequately powered epidemiological framework. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: METHODS FOR ANALYSIS OF LONGITUDINAL AND FAMILIAL DATA Principal Investigator & Institution: Fitzmaurice, Garrett M.; Associate Professor; Biostatistics; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 01-SEP-1981; Project End 30-NOV-2002 Summary: This project will develop statistical methods for the joint analysis of time-toevent and repeated measures data collected serially in longitudinal studies. Such data are increasingly common in many settings in medicine and public health, including clinical trials designed to evaluate palliative, maintenance, or preventative therapies, in evaluation of prevention interventions, and in population studies of the effects of risk factors on the development of disease. Our methodology will be applied to clinical trial data for AIDS, schizophrenia, and contraception therapies, and to a longitudinal epidemiological study of obesity in childhood. There are two main components to the project, both of them involving the joint analysis of repeated measures and time-toevent data. The first component will focus on the case where primary interest is in describing trends in a categorical outcome over time in the presence of non-ignorable dropout. This is common in clinical trials where removal from treatment may be related to the outcome of interest and causes follow-up to cease. A new feature of this work will be the use of a mixture model to incorporate information on dropout. Mixture models offer two important advantages: they can be easily implemented and it is straightforward to characterize model assumptions. We will develop methods based on Generalized Estimating Equations (GEE) for the case where any intermediate missingness prior to dropout is Missing Completely at Random, and extend the method to del with arbitrary patterns of non-ignorable non-response. We will also develop maximum likelihood approaches using both marginal and Markov models for the case where intermediate missingness is Missing at Random. Second, we will focus on the case where the primary interest is survival and where the repeated measures are used to gain efficiency in the presence of censoring. This component will extend previous work on this problem by using mixture models for categorical repeated measures, by including covariates for the survival model with the proportional hazards assumption, and by using maximum likelihood to estimate the joint distribution of survival and repeated measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MIGRATION, CONTRACEPTION, AND SOCIAL NETWORKS Principal Investigator & Institution: Entwisle, Barbara; Professor; Epidemiology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 20-AUG-1999; Project End 31-JUL-2004 Summary: The proposed research explores interrelationships between migration, contraceptive choice, and social networks using a unique set of social surveys collected in Nang Rong, Thailand. Social networks- i.e., sets of relations between individuals, households, and communities -are key to the dissemination of information and diffusion processes more generally. They are also fundamental to an understanding of norms, normative pressure, and conformity. The proposed research will shed light on these mechanisms by investigating: (a) social networks in the place of origin and the likelihood of finding and successfully interviewing out-migrants; (b) the implications of social networks at the origin and connections between the origin and destination for the
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amount, composition, and directionality of remittance flows; (c) the effect of social network position on contraceptive choice. Comparisons of kin-based networks with networks based on economic assistance and exchange, and of networks at multiple levels of analysis will make it possible to draw some inferences about the relative importance of normative pressure and information flow in accounting for effects. Further, in contrast to literatures preoccupied with migration and fertility as outcomes, the proposed research will also consider them as potential determinants of social network position and the overall structure of social networks. The proposed research will use data collected in 1984, 1994 and 1995 as part of the Nang Rong CEP and CEPCPC Surveys. Innovative elements of the data include the prospective panel design; 100 percent samples of households and individuals within study villages; the follow-up of out-migrants from a subset of villages and the ability to link them to origin households; and complete social network data at multiple levels and for multiple relations. The last will be used to develop quantitative measures of network position(centrality, path length, component membership) and structure (density, average path length, prevalence of isolates, number of components) which will be featured in regression-based statistical models of the likelihood of finding out-migrants; the composition, amount and directionality of remittance flows between them and the origin households; and contraceptive choices made by migrants, return migrants, and non-migrants. Measures of network position will be the focus of models investigating the effects of household size and change for the ties with other households in villages. Prosposed statistical techniques take account of selectivity and patterns of clustering Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR AND CELLULAR TRANSPORT IN MUCUS Principal Investigator & Institution: Saltzman, William M.; Bp Amoco/H. Laurence Fuller Professor; Chemical and Biomedical Engineering; Cornell University Ithaca Office of Sponsored Programs Ithaca, Ny 14853 Timing: Fiscal Year 2001; Project Start 01-APR-1990; Project End 30-NOV-2002 Summary: Mucus epithelia in the intestine, lung, mouth, eye, and vagina provide an effective and essential barrier against the entry of pathogens and toxins. Since these epithelia are readily accessible from outside the body, they also represent valuable sites for drug delivery. Here, the investigators propose to continue their bioengineering studies of the ability of molecules and cells to function in and penetrate the mucus layer that protects these tissues. In previous work, they demonstrated that the controlled delivery of antibodies (Ab) could provide passive immune protection against viral infection and contraception. Their present goal is to extend their findings to design methods for the controlled delivery of vaccinogens (Vg) directly to a mucus epithelium. Specifically, biocompatible polymeric controlled release devices will be designed to continuously deliver macromolecules to mucus layers over an extended period. The present studies will focus on 1) measuring the distribution and bioavailability of Vg following release from a polymer into the mucus secretions of the reproductive and intestinal tracts, and 2) determining the ability of Vg molecules to stimulate active immunity in the mucus secretions. By synthesizing Vg with a range of molecular characteristics, they will test the hypothesis that active mucosal immunity can be enhanced by local delivery of Vg with optimal physiochemical properties. Since macrophages and other phagocytic cells can transport pathogens and molecules across mucus layers, the ability of phagocytic cells to crawl in mucus will be studied, as well as the ability of mucus and external agents to interfere with phagocyte migration and adhesion to epithelial tissues. Mathematical methods will be used to correlate their
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results, to enhance the value of in vitro methods for optimizing devices for use in vivo. All of the information collected from these basic studies will be used to design improved controlled release polymers for the localized and extended delivery of proteins to the mucus secretions of mice and monkeys. Finally, these polymeric systems will be used to test the efficacy of delivery for sustained protection against unwanted pregnancy (immunocontraception). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MUCOSAL IMMUNE RESPONSES TO HIV-1 IN SEX WORKERS Principal Investigator & Institution: Plummer, Francis A.; Professor, Scientific Director; University of Manitoba Winnipeg R3t 2N2, Canada Winnipeg, Timing: Fiscal Year 2001; Project Start 15-SEP-2000; Project End 31-AUG-2003 Summary: There is mounting evidence that some individuals are protected against HIV1 infection. In a sex worker cohort from Nairobi, Kenya a subgroup of women show epidemiologic evidence for resistance to HIV-1 infection. In this cohort HIV-1 resistance correlates with T helper cell recognition of HIV-1 antigens, CTL to HIV-1, neutralizing HIV-1 specific mucosal IgA and HLA alleles, suggesting that resistance may be mediated by immune mechanisms. The potential role of the mucosal immune response to HIV-1 in protection against infection has been poorly studied. In this project, studies of mucosal immune mechanisms potentially mediating HIV-1 resistance will be expanded. There are two broad specific aims of these studies. The first is to understand what HIV-1 specific mucosal immune mechanisms occur in HIV-1 resistant women and the second is to understand why these responses develop. To examine what specific mucosal immune mechanisms occur in HIV-1 resistant women, the frequency and epitope specificity of HIV-1 specific IgA and HIV-1 specific CTL in the genital tract of resistant women will be determined. Studies will also address how HIV-1 specific responses in the genital tract change over time and with concomitant infections and with hormonal contraception in HIV-1 uninfected and resistant sex workers. To understand why mucosal immune responses develop in HIV-1 resistant women, studies to characterize the T helper cell response to HIV-1 in the genital tract will be carried out. The project will also examine immunogenetic influences on the development of mucosal immune responses by correlating immune effector responses to genetic factors linked to HIV-1 resistance. Finally HIV-1 specific antibody and CTL, T helper cell, dendritic cell response and immunoregulatory factors in the genital tract will be correlated with protection against HIV-1 infection and epidemiologic, reproductive and behavioral variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NA,K-ATPASE ALPHA4 ISOFORM IN MALE GERM CELL PHYSIOLOGY Principal Investigator & Institution: Blanco, V Gustavo.; Molecular & Integrative Phys; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The Na,K-ATPase comprises a group of isozymes responsible for maintaining the Na+ and K+ gradients across the plasma membrane of most cells. Isozyme diversity for the Na,K-ATPase results from the association of different molecular forms of the catalytic alpha, alpha1, alpha2, alpha3 and alpha4 and glycosylated beta (beta1,beta2 and beta3) subunits that constitute the enzyme. The various Na,K-ATPase isozymes are expressed in a highly regulated manner, depending
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on cell type, developmental stage, hormonal stimulation and pathological state of the tissue. In addition, Na,K-ATPase isoforms have enzymatic properties that are unique. The a4 isoform exhibits the most restricted pattern of expression, and it is selectively expressed in rat testes, where it is abundant in germ cells. Its function comprises approximately two thirds of the total Na,K-ATPase activity of spermatozoa, the rest corresponding to the ubiquitously expressed ctl isoform. Functionally, the alpha4 polypeptide has enzymatic properties different from those of the other Na,K-ATPase isoforms. This suggests a physiological role for the isoform, and (4 may be adapted to fulfill the ionic requirements of the male germ cells. It is well known that the Na+ and K+ gradients are key factors for sperm motility. Also, for spermatozoa capacitation and acrosomal reaction, which are required steps for the biogenesis of fertile spermatozoa. At present, the precise role of (4 in these processes remains unknown. The main objective of the present proposal is to elucidate the biological importance of the Na,KATPase alpha4 isoform in male germ cell function and its relevance to male fertility. Specifically the aims are: 1) to investigate expression and cell localization of the Na,KATPase (4 polypeptide in male germ cells during development, and in Sertoli cells, 2) to study the function of (4 in male germ cells during gametogenesis, epididymal maturation and acrosomal reaction, 3) to study the role of the Na,K-ATPase (4 isoform in sperm physiology, and 4) to determine the enzymatic properties and function of Na,K-ATPase (4 isoform from humans. This study will be important to understand the biological relevance of the testes specific isoform of the Na,K-ATPase in male fertility and contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NATIONAL CHIMPANZEE BREEDING AND RESEARCH PROGRAM Principal Investigator & Institution: Keeling, Michale E.; Asst Veterinarian and Asst Professor; Veterinary Science; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 1999; Project Start 30-SEP-1986; Project End 31-AUG-2004 Summary: This continuing cooperative agreement will set aside for breeding a demographically balanced population of 109 physically and behaviorally healthy chimpanzees. This self-sustaining complement of chimpanzees can contribute significantly to providing a stable supply of serologically pathogen free offspring for investigative use that are behaviorally equipped to contribute to continued successful propagation in captivity after reaching adulthood. None of these animals are compromised by previous poor behavioral management or transmissible asymptomatic infectious disease research. To complement the health and behavioral management programs, we will continue to collaborate with Trinity University to maintain a comprehensive genetic management program using DNA probes and other techniques to establish positive paternity, determine population heterozygosity and identify genetic correlates of infertility or disease. We will continue our collaborations with the International Species Inventory System (ISIS) program documenting demographic data for the national program. The proposed plan and facilities have a 16 year track record to substantiate the success of the breeding program and the cost-effective delivery of highquality husbandry and care. The progressively designed physical facilities insure a balance between an enriched and protected habitat. To complement the facilities, sufficient numbers of dedicated and experienced professional and technical personnel are available to assure a successful program. We offer a professional staff with a combined 47 years of experience in chimpanzee care and management and a technical and animal care cadre with a combined 50 years of experience. The animal care
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personnel to animal ratio (1:24) provides the ideal balance of quality care and efficiency. Because the facility design complements the social and physical health needs of the chimpanzee in all stages of development, this quality care and enriched environment can be provided cost- effectively. This dedicated colony will continue to provide a core resource to support relevant clinical investigations designed to complement the breeding program by improving chimpanzee health, well-being and productivity. Clinical investigations of positive reinforcement training, behavioral enrichment, reversible contraception, clinical leprosy and obesity will continue. We will also support a companion behavioral research grant for continuing applied studies to improve the care and well-being of captive chimpanzees. This program has been very productive during the last two award periods by supplying objective behavioral data on which to base our behavioral management decisions. New areas of investigation include continued documentation of relevant positive reinforcement training, behavioral interventions to address obesity, computer-assisted enrichment to challenge the chimpanzees' cognitive abilities, examination of predictability of animal care routines and animal control over environmental stimuli with regard to well-being. On-going studies comparing behavioral development and enclosure design will be completed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NATURAL HISTORY OF CIN2 IN ADOLESCENTS Principal Investigator & Institution: Moscicki, Anna-Barbara B.; Professor; Pediatrics; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: This is a 5 year prospective study designed to: 1) examine the natural history of CIN-2 (cervical intra-epithelial lesions) subset of high grade squamous intra-epithelial lesions (HSIL) among adolescents, and 2) identify immunologic and behavioral factors associated with regression of CIN 2 lesions. The study of immunologic and behavioral factors that may influence CIN 2 regression will include: sustained local (cervical) Th-1 like cytokine response, systemic cytotoxic T lymphocyte (CTL) responses to HPV (for HPV 16 positive women only), size of lesion at diagnosis, amount of cervical immaturity (ectopy) at diagnosis, and hormonal contraception. Other factors that will be monitored for possible effects include high risk sexual behavior and outcomes (multiple partners, substance use, pregnancy, sexually transmitted infections, and bacterial vaginosis). Last, this study proposes to compare local immunologic responses among women who at baseline visit are diagnosed with CIN-1, CIN-2 and normal histology on biopsy. Approximately 40,000 young women 19 years or younger are expected to undergo cervical cytology screening within the Northern California Kaiser Permanente clinics over a 24 month period. Adolescents aged 13-19 years with abnormal cytology (estimated N=2680) will be recruited. Baseline examination will include interview and cervical samples for HPV DNA testing and quantitative cytokine studies using reverse transcriptase polymerase chain reaction techniques. Colpophotographs will be obtained to determine lesion size. All samples will be obtained prior to biopsy. Those with biopsy-confirmed CIN 2 (N=416) will be followed every 3 months using interview, colposcopy, HPV DNA testing, and cytology and undergo immune studies (cervical cell cytokine analysis using real-time RT-PCR and peripheral blood CTL assays on women with HPV 16 infection) until the end of the study. Women with CIN-3 are exited for standard therapy. Those with biopsied confirmed low grade (L) SIL or less will exited. Understanding of the natural history of CIN 2 will be critical in efforts to construct costeffective strategies for cancer screening in adolescents. In addition, defining immunologic factors associated with CIN 2 regression will have important implications
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for vaccine and therapeutic strategies and defining clinical (including repeated HPV DNA testing) and behavioral risks will have important implications for triage and counseling strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHYSIOLOGICAL ISOFORMS OF SAC IN MALE GERM CELLS Principal Investigator & Institution: Buck, Jochen; Pharmacology; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: (Scanned from the applicant's abstract) Recently, this laboratory biochemically purified and molecularly isolated a unique, cytosolic form of mammalian adenylyl cyclase, the soluble Adenylyl Cyclase (sAC). sAC and the more widely studied, G protein responsive, transmembrane adenylyl cyclases (tmACs) define distinct cAMP signaling pathways within eukaryotic cells. While tmACs are modulated by heterotrimeric G proteins in response to extracellular signals which act through seventransmembrane spanning receptors, sAC is directly regulated by bicarbonate ions suggesting it functions as the physiological CO2 chemosensor. sAC is most abundantly expressed in male germ cells, and likely mediates a number of the bicarbonate-induced, cAMP-mediated changes sperm must undergo prior to fertilization; such as capacitation, hyperactivated motility, and the acrosome reaction. During maturation from pachytene spermatocytes to spermatozoa, full-length sAC protein (187 kD) seems to be proteolytically processed via 150 kD intermediates to three distinct mature isoforms of 120 kD, 48 kD and 45 kD. The molecular details of these sAC isoforms are unknown. Individual sAC isoforms seem to be targeted to distinct subcellular compartments suggesting they generate second messenger directly and independently at the various subcellular sites of cAMP action. Additionally, proteolysis represents a mechanism for activating sAC. The specific activity of full-length sAC protein is at least 20 times lower than the enzymatic activity of a C-terminal truncation consisting of the amino terminal 53 kD. These data suggest the presence of an autoinhibitory domain Cterminal to the catalytic region. With the help of this grant, we plan to molecularly identify and structurally and biochemically characterize the physiological sAC isoforms in male germ cells. These studies will ultimately lead to an understanding of their specific biological roles. A long-term objective of this work is development of highly specific pharmacological reagents targeting individual isoforms as a novel method of contraception or to treat infertility. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREIMPLANTATION EMBRYO BLASTOMERE FRAGMENTATION Principal Investigator & Institution: Latham, Keith E.; Associate Professor; Fels Institute for Cancer Research; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2002; Project Start 23-AUG-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The interactions between oocyte and sperm or between ooplasm and the paternal genome that support early development remain poorly understood. We have discovered an interaction between oocyte and sperm that affects cellular integrity in the 2-cell mouse embryo. Cellular fragmentation and apoptosis during the preimplantation period of development have been observed in a variety of species, including human, mouse, and bovine, but this process is poorly understood. Blastomere fragmentation and apoptosis diminish fertility and may negatively affect the success rates of in vitro methods for treating infertility in humans.
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We have shown that the genotypes of both the mother and the father affect the incidence of fragmentation. Moreover, a significant parental origin effect is observed for reciprocal F1 hybrid mothers. This may reflect a strain difference in mitochondria or the involvement of at least one imprinted gene in controlling early blastomere fragmentation. Our data also reveal that the magnitude of the effect exerted by both maternal and paternal genotype are each dependent upon the genotype of the other. These observations establish a novel experimental system with which to examine the fundamental biological mechanisms that operate in embryos to maintain cellular integrity. Our findings also have important implications for human reproductive medicine, because they indicate that parameters of gamete fitness, particularly oocyte quality, or genetic factors affecting early development, cannot necessarily be evaluated independently of the genotype of the opposite parent. We propose to (a) determine whether maternal and paternal genotypes affect fragmentation through cytoplasmic constituents of the gametes or through allelic differences in genes expressed in the early embryo, (b) determine whether blastomere fragmentation at the 2-cell stage reflects activation of apoptotic processes or is the result of other aberrant cellular events, and (c) determine the long-term effects of partial blastomere fragmentation on embryo developmental competence. The proposed studies, when completed, should provide essential and valuable new information about the basic biology of the early embryo, oocyte-sperm interactions and their consequences, the roles of gamete-derived factors in controlling early embryo viability, and useful information for improving assisted reproduction techniques or for devising novel approaches to contraception. They should also provide the necessary cellular information with which to design biochemical, or genetic approaches to the identification of molecules involved in fragmentation. Last, because studies such as those proposed cannot be conducted in the human, the proposed studies will provide unprecedented data regarding the relationship between fragmentation and viability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROGESTERONE RECEPTOR AND BREAST CANCER Principal Investigator & Institution: Lydon, John P.; Cell Biology; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: Breast cancer is recognized as the most prevalent malignancy among women in North America with a life time risk currently estimated to be one in eight. Most importantly, reproductive history or more specifically steroid hormonal status has been shown to be an important risk factor. Recently, I generated a progesterone receptor (PR) knockout (PRKO) mouse that has demonstrated that progesterone (P), and its receptor, the PR, are absolutely required for normal mammary gland proliferation and differentiation. The involvement of P in mammary tumorigenesis has been a matter of controversy for several years mainly because P can protentiate or inhibit mammary tumorigenesis. To clarify the complex temporal relationship between P and mammary tumorigenesis, the PRKO mouse will be utilized to determine whether the P induedproliferative signal has a role to play in breast cancer by investigating the effects of removing PR function on mammary tumor progression. The specific aims of this proposal are to: 1) evaluate whether removal of PR function alters murine susceptibility to carcinogen-induced mammary tumorigenesis at the morphological, histological, and molecular level; 2) determine whether PR function has a role in the development of hormone dependent mammary tumors exhibited by the Grunder mouse and define whether the PR has an involvement in the progression of these tumors to a hormone
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independent phenotype; and 3) to define the distinct effects of mammary epithelial and stromal derived PR populations on mammary development and tumorigenesis by using reciprocal mammary gland transplantation technology. Apart from advancing our current understanding of P's contribution to mammary tumorigenesis, information from these studies will aid in the design of effective strategies for breast cancer prevention and treatment as well as prompting a reevaluation of the current use of progestins in contraception and postmenopausal hormonal replacement therapies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROGRAM FOR FELLOWS AND NEW INVESTIGATORS Principal Investigator & Institution: Braun, Robert E.; Associate Professor; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 11-SEP-2002; Project End 28-FEB-2007 Summary: (provided by applicant): We intend to create a program to attract new fellows (M.D. and Ph.D.) for research and training in basic and clinical reproductive biology and to provide research support to outstanding investigators outside the area of contraception development to entice them into working on contraception. We believe there is currently a shortage in the number of new investigators entering the field of reproduction research, especially as it relates to contraceptive research and development. We hope to attract three types of individuals to our Center. The first are outstanding Ph.D. trained fellows who have achieved significant accomplishments in research areas within and outside of mammalian reproduction. The goal is to attract creative young scientists with original ideas. In some cases, these fellows will have been trained as graduate students in reproduction research. However, we especially want to attract fellows who have received graduate training in research areas outside of reproduction. We believe these fellows will bring fresh outlooks and will have a high chance of success in making the transition to independent investigators. Our second group of fellows will be those trained as medical doctors or as physician scientists. Medical fellows will be recruited from residency and fellowship programs in obstetrics and gynecology, reproductive endocrinology, medicine and urology. We believe it is important to attract medical fellows to the Center, as they should be better trained in the practical considerations related to translating research in contraceptive development from basic research to studies in humans and eventually into the practice of medicine. Fellows will be recruited both locally and nationally. Lastly, we will provide research funds for 1-2 year pilot projects to new investigators in reproduction research. New investigators are defined as researchers at any stage in their career that are new to the field of reproduction and who are proposing research related to contraception. This includes new Assistant Professors just starting their labs and established Full Professors who have not previously worked in the field of contraception but who are interested in initiating new studies in this field. We fully expect that these pilot projects will translate into preliminary data for new R01 proposals from these individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RCT OF A NOVEL ORAL CONTRACEPTIVE INITIATION METHOD Principal Investigator & Institution: Westhoff, Carolyn L.; Associate Professor; Obstetrics and Gynecology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 29-AUG-2002; Project End 30-JUN-2005 Description (provided by applicant): Pregnancy rates are high among acceptors of oral contraceptives despite the effectiveness of the method. These pregnancies occur due to
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incorrect use and due to premature discontinuation of oral contraceptives. Failure to begin one contraceptives after receiving a prescription is a large subcategory. Up to 25% of adolescents who seek oral contraceptives from family planning clinics never take the first pill. Failure to begin oral contraceptives may occur due to ambivalence, confusion about starting instructions, or due to intervening pregnancy. Conventional starting instructions for oral contraceptives require waiting until the next menstrual period, which may leave the client at high risk of pregnancy. Novel approaches to initiation may improve continuation and decrease pregnancy rates among young women seeking oral contraceptives. In order to increase initiation rates we developed a quick start approach in which the client swallows the first pill during the clinic visit under direct observation and then continues daily pill use without waiting for her next menses. Pregnancy tests emergency contraception are used as clinically indicated. In a pilot study of 250 women, those who swallowed the first pill in the clinic were more likely to continue to their second pack of pills than women who received conventional starting instructions (adjusted CR 2.74, 2.74, 95% C.I. 1.1-6.8). We also carried out a randomized trial comparing 90-day bleeding patterns in 113 women who were randomized to quick start or conventional start of a monophasic 35ug EE OC. 104 women completed the study. Bleeding patterns were identical in the quick start and conventional start groups with excellent power to rule out clinically important differences. To further evaluate the usefulness of quick start we propose a multi-enter randomized clinical trial in which we will enroll 2l00 women aged less than 25 years. Subjects will be recruited from 3 publicly funded clinics that primarily serve Hispanic and African-American urban populations of low socio-economic status. They will complete a baseline, 3 month and 6 month questionnaire. The primary aim of the trial is to assess oral contraceptive continuation rates and pregnancy rates. We anticipate 75% low up at 6 months. The major secondary aim is to evaluate the predictive power of the Transtheoretical Model constructs relevant to adoption of and adherence to oral contraceptives. We will also assess dual method use for STD prevention in the study to adoption of and adherence to oral contraceptives. We will also assess dual method use for STD prevention in the study population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION SPERMATOGENESIS
OF
GENE
EXPRESSION
DURING
Principal Investigator & Institution: Petrusz, Peter; Cell and Developmental Biology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): Androgens are indispensable for normal spermatogenesis; however, the mechanism by which androgens exert their effect on this complex process is poorly understood. Androgens act on their target cells by binding to and activating the androgen receptor (AR) present in Sertoli cells, peritubular cells, and Leydig cells but not in germ cells. It is assumed that androgens' actions on spermatogenesis are mediated by paracrine signals resulting from changes in gene expression in Sertoli and peritubular cells. In spite of an intensive research effort for several decades, traditional methods have failed to pinpoint key androgen-regulated genes whose activation is critical for spermatogenesis. We have studied a transgenic mouse model that overexpresses androgen-binding protein (ABP), a secretory product of Sertoli cells. These transgenic animals develop a progressive impairment of spermatogenesis and become gradually infertile. The results of our morphological, immunocytochemical, and flow cytometric analyses of the testes indicate that the most
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likely cause of this impairment is the reduction in the concentration of bioavailable androgens in the peritubular compartment and the seminiferous tubules. DNA microarray technology offers a novel and powerful means to analyze gene expression in a comprehensive, yet efficient, way. The Specific Aim of this pilot project is to test the hypothesis that the chronic reduction of bioavailable androgens within the seminiferous tubules of the ABP-transgenic mice is manifested in ordered changes in gene expression detectable by DNA microarray analysis. Murine genome oligonucleotide arrays will be probed by cRNAs prepared from testes of wild type and transgenic mice of 30 days of age. As additional controls, a set of the transgenic animals will be treated with human chorionic gonadotropin. This treatment is known to increase intratesticular androgen concentration and should reverse the changes caused specifically by androgen depletion. Results will be analyzed in terms of expression levels, expression profiles (dendrograms) and functional relationships. Cellular localization of altered gene expression will be determined by in situ hybridization and immunocytochemistry. This strategy is likely to provide, for the first time, a comprehensive view of androgendependent genes in the mammalian testis, offering a rich source of information for further studies, new clues for understanding and treating certain cases of human male infertility, and new potential molecular targets for male contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF MAMMALIAN OOCYTE MATURATION Principal Investigator & Institution: Downs, Stephen M.; Biology; Marquette University P.O. Box 1881 Milwaukee, Wi 532011881 Timing: Fiscal Year 2003; Project Start 02-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): A major goal of my research program is to identify molecules and metabolic pathways that participate in the control of oocyte maturation in mammals. In our model for meiotic induction, gonadotropin triggers an increase in cAMP phosphodiesterase (PDE) that induces meiotic resumption by both a loss of cAMP-dependent protein kinase activity and an increase in AMP-activated protein kinase (AMPK) activity. The oocyte-cumulus cell complex, isolated from mice 48 h after hormonal priming, will be used as the principal model system, but oocytes induced to mature in vivo by hCG injection will also be examined. Isoform-specific PDE inhibitors will be used to manipulate meiosis according to the cellular target site, and PDE activity will be measured to test for a cause-and-effect relationship with maturation-promoting factor (MPF; measured as histone H1 kinase activity) and germinal vesicle breakdown (GVB). Western analysis of AMPK (beta, gamma subunits) in complexes will be completed, and the temporal relationship between AMPK activation, MPF activation and GVB during spontaneous maturation or maturation induced by adenosine analogs or hormones will be tested. Oocyte microinjection will determine if active AMPK induces GVB and if antibodies to alpha subunits antagonize meiotic induction. Antisera to alpha subunits of AMPK as well as an anti-phosphoantibody to active AMPK will be employed to localize the enzyme in oocytes by indirect immunofluorescence during meiotic resumption. We will also investigate the potential role of ERK1/2 and p38 mitogen-activated protein kinases in mediating the meiosis-inducing action of AMPK. These results will help delineate specific metabolic pathways involved in meiotic maturation and will have important implications for both fertility and contraception, since each is affected by the ability of the oocyte to successfully initiate and complete meiotic maturation. They may also help in preventing or minimizing erroneous meiotic control that can give rise to aneuploidy and its disastrous consequences. Furthermore,
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these studies will benefit the development of in vitro systems where either meiotic arrest or completion of meiotic maturation is the desired endpoint. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF MEIOTIC ARREST IN OOCYTES BY G-PROTEINS Principal Investigator & Institution: Mehlmann, Lisa M.; Physiology; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2005 Summary: (provided by applicant): Mammalian oocytes grow and mature within ovarian follicles. They are arrested at prophase I of meiosis until they reach their full size, and in response to a preovulatory surge of luteinizing hormone (LH), they are stimulated to resume meiosis. The presence of the follicle cells around the oocyte is necessary to maintain meiotic arrest, and the arrest appears to be mediated by elevation of cAMP in the oocyte. However, the signaling pathways between the follicle and the oocyte are not well understood. Rece nt evidence points to a role for the Gs G-protein, which stimulates adenylyl cyclase, in maintaining meiotic arrest. However, it is not yet known how Gs activity is maintained in the oocyte, or how LH action on the follicle cells initiates the resumption of meiosis. The specific aims of this proposal are: 1) to identify Gs-coupled receptor proteins in the oocyte that may be responsible for stimulating Gs; 2) to test the function of any Gs-linked receptors that are found in the mouse oocyte; and 3) to examine whether LH might trigger oocyte maturation by stimulating a Gi G-protein in the oocyte, thus turning off the production of cAMP. Understanding how the oocyte cell cycle is regulated within the follicle may find applications to practical problems including assisted reproductive techniques, contraception, and infertility. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REGULATION OF TESTIS GENE EXPRESSION BY CAMP AND CREB Principal Investigator & Institution: Walker, William H.; Cell Biology and Physiology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: (Adapted from applicant's abstract) The overall goal of this proposed project is to define how the CREB transcription factor relays hormonal and environmental signals in the mammalian testis to genes within Sertoli and germ cells during spermatogenesis. The specific hypothesis to be tested is that alterations in the relative concentrations of activator and repressor CREB isoforms in the seminiferous tubules regulate the expression of cAMP-inducible genes required for the expansion and differentiation of male germ cells. One objective is to define the mechanisms responsible for the stage-specific expression of various CREB isoforms during the maturation of germs cells. The role of NF-kB and Spl activator proteins as well as CREB and CREM repressor isoforms in regulating CREB gene transcription will be investigated. Transient transfection studies will be performed using primary rat Sertoli cells to determine if the proposed regulator proteins modulate CREB promoter activity through previously identified binding motifs. The cell types and spermatogenic stages in which the regulatory proteins act will be determined using in situ histochemical and immunocytochemistry protocols. Also nuclear extracts from isolated seminiferous tubule segments representing various spermatogenic stages will be used to quantitate regulator protein levels using western immunoblot and DNA-protein binding studies. Protein-protein interactions involving CREB will be studied using coimmunoprecipitation and protein binding to column immobilized CREB-GST fusion
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proteins. A second objective of this study is to identify "target" genes expressed in Sertoli cells that are regulated by the cAMP signaling pathway and the CREB transcription factor. A focused differential display protocol employing primary Sertoli cells infected with adenovirus vectors expressing a dominant negative CREB mutant will be used to identify and clone genes that are up-regulated through CREB after FSH stimulation. In summary, this study seeks to characterize the factors that modulate expression of the CREB gene in the testis and identify genes critical for progression of spermatogenesis that are regulated by cAMP and the CREB family of transcription factors. The results of this work may then lead to infor-mation needed to provide therapies for infertility and solutions for male contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RENOVATION OF FOURTH FLOOR OF FASER HALL Principal Investigator & Institution: Wells, Barbara G.; Professor and Dean; None; University of Mississippi P.O. Box 907 University, Ms 386770907 Timing: Fiscal Year 1999; Project Start 30-SEP-1999; Project End 29-SEP-2004 Summary: The specific aim of this project is on the renovation of the fourth floor of Faser Hall and 5000 gross square feet of new laboratory space on the third and fourth floors of Faser Hall in order to improve the capability of The University of Mississippi to support a burgeoning, cutting-edge biomedical research program. At the foundation of this program are a number of PHS-funded research projects to discover, design, and synthesize new drugs for unmet therapeutic needs in human health, an important national priority. The School of Pharmacy Building named Faser Hall was completed and occupied in May, 1969. Faser Hall has been the location of the research endeavors of the Pharmaceutical Sciences for nearly thirty years. While some renovation and repairs have occurred over this time, the current structure and infrastructure is quite antiquated for conducting contemporary, state-of-the-art biomedical research. Expansive research growth has occurred during this period making the laboratories more crowded. The University of Mississippi School of Pharmacy has undertaken a long-term and comprehensive plan to totally renovate Faser Hall. This will result in increased research space, more efficient use of research space, and an enhancement of the laboratories to meet contemporary safety standards. The State of Mississippi and the University have provided $2,000,000 for the development of a comprehensive planning strategy for the replacement of the roof and significant infrastructure changes including the renovation of the fourth floor and for new construction of 5000 gross square of new laboratory space designated as "swing space" which will become permanent research facilities for the third and fourth floors. Current projects and personnel will be moved into this swing space while renovation occurs in Faser Hall, thus greatly minimizing disruption to active biomedical research. This request is for $1.0 million of total funds from NIH to match with State funds to achieve complete renovation of the research laboratories on the entire fourth floor of Faser Hall and construction of additional research space on the third and fourth floors. The fourth floor currently houses the Drug Discovery, Design and Synthesis Research Program which as significant current and pending NIH grants. This unit encompasses a number of important therapeutic areas (including AIDS and associated opportunistic infections, cancer, malaria, contraception, cardiovascular disease, treatment of cocaine and heroin addiction, immune-mediated diseases). The current laboratories are small and crowded, and contain relatively few hoods, most of which are small and marginally functional; a research environment which is less than ideal for the quality research being conducted. Completion of the renovation as planned for the fourth floor and the construction of laboratories extended from the third and
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fourth floors will greatly increase the usable space and provide contemporary and safer laboratories for conducting biomedical research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REPRODUCTIVE BIOLOGY RESEARCH TRAINING FOR LATIN AMERICA Principal Investigator & Institution: Strauss, Jerome F.; Professor; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1995; Project End 30-APR-2005 Summary: This application requests continuation of an international post-doctoral research training program in advanced techniques in reproductive biology. The training focuses on Latin America through a network of institutions in Argentina, Brazil, Chile and Mexico which have established that compliment the investigative strengths of the University of Pennsylvania. The goals of the program are: 1) to provide outstanding Latin American scholars holding the Ph.D., M.D., V.M.D. or equivalent degrees with advanced training under the guidance of an experienced mentor and in doing so augment the research capacity of Latin American research centers, and 2) to enhance ongoing NIH-sponsored research through collaboration with Latin American colleagues. Training activities will be under the auspice of the Center for Research on Reproduction and women's Health, a multi-disciplinary research enterprise with a faculty drawn from multiple academic units. Four research themes are emphasized: molecular endocrinology; gametogenesis and fertilization; early embryo development and implantation; and translational research in contraception and microbicide development. An academic enrichment program including seminars, journal clubs and optional advanced coursework is offered. Scholars are selected on the basis of e3xcellence in their prior training/research experience, a commitment to a career in research and the commitment of the applicant's home institution to support his/her investigative career upon completion of training. Training opportunities are available for junior scholars as well as more established investigators. Scholars select faculty advisor in their area of interest. A coherent research plan is developed that meets the scholar's goals and those of his/her home institution. The faculty evaluates activities of trainees at six month intervals: growth in the areas of independence, in experimental design and data interpretation, mastery of new technical skills, productivity, clarity of oral presentations and scientific writing are considered in assessing trainee progress. At the end of the experience, scholars should be well prepared to pursue high quality research on a relevant topic in the reproductive sciences at their homer institutions. The re-entry of foreign scholars is facilitated by a small grant award. Senior foreign scholars are encouraged to collaborate with their Penn colleagues through Fogarty International Collaborative Research Awards. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REPRODUCTIVE/CONTRACEPTIVE ENDOMETRIOSIS
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Principal Investigator & Institution: Holt, Victoria L.; Professor; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2001; Project Start 01-MAY-1997; Project End 30-APR-2003 Summary: Endometriosis affects up to 10% of women of reproductive age in the U.S. with chronic pelvic pain, dysmenorrhea, and probable increased risk of infertility. Although the disease has been identified as a top research priority by the National
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Institutes of Health, the etiology is still uncertain, and few modifiable risk factors have been identified. Past epidemiologic research has been inconclusive about the impact of reproductive or contraceptive history on the development of endometriosis. Most studies of these risk factors have been limited by using cases identified at infertility surgery, as these women may be atypical of all endometriosis cases in terms of reproductive and contraceptive history. We propose a population-based case-control study of endometriosis among the entire population of reproductive-age women enrolled in an HMO in western Washington State to test the hypothesis that spontaneous abortion and induced abortion may increase risk of endometriosis, taking into account possible hormonal and immunological influences. The associations between endometriosis and delayed childbearing and various types of contraception will be investigated as well. All 18-44 year old enrollees of Group Health Cooperative of Puget Sound (GHC) diagnosed with endometriosis by surgery, and a portion of those diagnosed by physical examination or ultrasound examination alone between August l, 1996 and April 30, 2001 will be identified and invited to participate (approximately 750 women of all races). Cases will be selected using computerized records, and eligibility verified by medical records. Controls randomly selected from computerized enrollment files will be frequency matched to cases on age and primary care clinic region. Data will be obtained from cases and controls by in-person interview, and anthropometric measurement; and linked with the GHC computerized pharmacy database. Subjects will be interviewed regarding their reproductive and contraceptive histories; including spontaneous and induced abortions, stillbirths, livebirths, use of hormonal contraceptives, intrauterine devices, and sterilization procedures; menstrual history; infertility history; and other risk factors for endometriosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RES FACIL CONST: INTRAVAGINAL CONTRACEPTION Principal Investigator & Institution: Sundberg, Richard J.; Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2003 Summary: (provided by applicant): The long-term objective of this application is to enhance the biomedical research capabilities in molecular and cellular biology in the Department of Biology and the UVA. Specific aims are to renovate on the ground floor of Gilmer Hall to provide the following: 1) three modern molecular and cellular biology research laboratories; 2) support areas and conference rooms for use of these and other cell and molecular biology laboratories; and 3) research and support space to consolidate at one site the currently dispersed personnel and equipment of an existing research laboratory. Morphogenesis was identified in an internal and external review of the Department of Biology as the major initiative for emphasis. The Biology Department is strong in developmental genetics, developmental biology, and imaging technology, especially in light of complementing strengths in the School of Medicine nearby, and morphogenesis is an area of exciting progress with the advent of the genome projects, development of new imaging and biophysical methods, and new possibilities for medical applications in stem cell research. To enhance existing strengths and take advantage of these new developments, the Department of Biology must strengthen its cell biological approaches to morphogenesis, specifically in such areas as the cytoskeleton, molecular motors, cell adhesion, cell polarity, transport and localization of RNA and proteins, cell adhesion, and cell migration. The proposed renovations will include new laboratory space for two new research faculties in these areas and provide
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support areas for these and existing laboratories throughout Gilmer Hall, thus enhancing biomedical research programs in Biology and elsewhere at the University. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH TRAINING IN REPRODUCTION FOR ASIAN FELLOWS Principal Investigator & Institution: Herr, John C.; Professor; Cell Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 30-SEP-1995; Project End 30-APR-2005 Summary: This competing continuation application requests support to train six PhD scientists or postresident physicians [MD or PhD/MD] educated at institutions in India or China for investigative careers in reproductive research. Emphasis will be placed on training in cell and molecular biology of reproduction with translational components aimed at infertility and the discovery of new leads for contraceptives. The global need for new options in contraception is highlighted by the fact that one in every two pregnancies is unwanted. Deployment of known contraceptives as well as advancement of new contraceptive options is a highest priority. This training program develops biomedical scientist who can meet the challenges of contraceptive discovery by equipping them with the tools to uncover the fundamental mechanisms governing reproductive processes and to recognize the opportunities afforded by such basic knowledge to identify and test new contraceptive strategies. Research and didactic experiences are tailored to accommodate trainees from diverse professional and academic backgrounds. Supplemental instruction is offered including courses in biostatistics, recombinant DNA technology, bioethics, and scientific English as a second language, to improve writing and communication skills. Interdisciplinary research training is achieved through interactions with preceptors who hold appointments in basic and clinical departments, through programs that evaluate leads and establish proof of principle of contraceptive action, and through collaboration with industrial advisors. All mentors hold faculty appointments in the School of Medicine or the College of Arts and Sciences and direct at least one active research grant. The institutional environment fosters interaction and exchange through a rich mix of seminars, visiting professors, conferences, and specialized research cores. The broad basic themes of faculty research programs include: the molecular analysis of sperm-egg fusion., signal transduction mechanisms between membrane receptors, capacitation and the acrosome reaction, protein transcription, nuclear transcription factors, molecular physiology of ion channels, neuroendocrine control of mechanisms in reproduction, molecular control of spermatogenesis and oogenesis, immune mechanisms of tolerance and autoimmunity to sperm and egg antigens, sperm maturation in the epididymis and mathematical modeling of hormone secretion. Applied themes of this research include male contraceptives targeted to transcription factors acting n the testis and epididymis, spermicides, infertility diagnostics, and contraceptive vaccines based on sperm and egg antigens. Continued training of young basic scientists as well as internists, urologist, and obstetricians in cellular and molecular approaches to reproductive processes is consistent with the tradition and commitment to foster a close link between basic and clinical investigators at US institutions and their counterparts in India and China and facilitate international cooperation and understanding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STAGE MATCHED INTERVENTION TO INCREASE DUAL METHOD USE Principal Investigator & Institution: Peipert, Jeffrey F.; Director; Women and Infants Hospital-Rhode Island 101 Dudley St Providence, Ri 02905 Timing: Fiscal Year 2001; Project Start 16-SEP-1998; Project End 31-JUL-2003 Summary: Protection from both sexually transmitted infections (STIs), human immunodeficiency virus (HIV), and unintended pregnancy can be achieved with the use of dual methods of contraception. This proposal is designed to develop, implement, and evaluate the impact of an innovative, computer-assisted stage-based individualized interactive intervention (Individualized Intervention) based on the transtheoretical model compared to enhanced standard care counseling on the use of dual methods of contraception. This randomized clinical trial of 400 high- risk women will assess behavioral and biological primary outcomes. Women will be followed at 6 month intervals for 24 months with follow-up interviews to determine reported use of dual methods of contraception (behavioral outcome). Clinical examinations at 12 and 24 months and with new onset of symptoms will assess biological outcomes including incident or recurrent cases of STI and unintended pregnancy. Secondary outcomes will include intermediate outcomes variables such as changes in stage of change, processes of change, decisional balance, and self- efficacy. The primary hypotheses of this study are: 1. the Individualized Intervention will result in increased dual contraceptive use; 2. the Individualized Intervention will result in protection against new cases of STIs, reinfection with sexually transmitted organisms, and unplanned pregnancies; and 3. the Individualized Intervention will lead to the greatest changes in secondary outcome measures. Comparisons among the primary outcomes will be made according to the intention-to-treat principle using time to event (survival) curve analysis with the Kaplan-Meier nonparametric estimator and the log rank statistic. If found to be effective, the stage-matched intervention has potential for widespread dissemination in schools, clinics, offices, and community centers to prevent STIs/HIV and unintended pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SUPPRESSION OF BREAKTHROUGH BLEEDING IN LNG-IUS USERS Principal Investigator & Institution: Brenner, Robert M.; Senior Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The Mirena(c) (Leiras, OY, Finland) is an intrauterine system (IUS) that releases levonorgestrel (LNG) and provides women with highly effective contraception for 5 years. However, serious breakthrough bleeding (BTB) can occur that leads many patients to discontinue treatment. In women using subcutaneous Norplant contraception, BTB can be suppressed by intermittent antiprogestin therapy with mifepristone. NICHD has a new antiprogestin, CDB-2914, that is more potent than mifepristone. The goal of this proposal is to determine whether CDB-2914 can suppress the BTB associated with the LNG-IUS. Preclinical studies will be done first in rhesus macaques fitted with an LNG-IUS and the information gained will be transmitted to Professor Hilary Critchley, University of Edinburgh, who will select a test population of 150 women from a pool of over 400 who are being fitted annually with an LNG-IUS for contraception. The bleeding-suppressive dose and schedule of CDB-2914 that works well in macaques will be adapted for use in women. The work consists of two major aims: Aim 1: to establish an effective, bleeding-suppressive dose
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schedule of CDB 2914 in macaques, and to assess spatio-temporal expression of bleeding-associated factors in the endometrium. Aim 2: to conduct a randomized, placebo controlled trial to evaluate CDB-2914 suppression of BTB in women being fitted with the LNG-IUS; and for added value, to develop a questionnaire to assess acceptability of the proposed treatment to women. This proposal involves translation of the information gained from basic research with macaques into clinical practice in women within the time frame of the grant. It is essential to conduct the clinical work at the University of Edinburgh, Scotland, UK, because no clinic in the USA has such a large patient population of women being fitted with the LNG-IUS for contraception. The macaque model provides excellent predictability for human studies, and Drs. Brenner and Critchley have published collaboratively on data from macaques and women in several recent papers. The proposal brings basic scientists and clinicians together for a "bench to bedside" approach that will advance women's health and improve contraceptive technology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ARTS IN ACTION IN NONHUMAN PRIMATES Principal Investigator & Institution: Wolf, Don P.; Senior Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2004 Summary: (provided by applicant): The nonhuman primate (NHP) is a valuable model for studying human health with direct implications to biomedical investigations of infertility and contraception, infectious diseases and vaccine development, drug and alcohol addiction, brain disorders, gene and stem cell based therapy and transplant biology. There are significant needs for populations of specific pathogen-free (SPF) animals with unique genotypes that cannot be satisfied by the importation of animals from the wild or by the identification and propagation of founder animals by selective breeding. SPF, Indian-origin, rhesus macaques carrying specific MHC alleles is but one example. The (ARTs) have been practiced extensively in humans over the last 20 years and their applications in NHPs, while potentially very useful, have yet to be realized on a scale adequate to impact the needs described above. This application seeks support for a workshop that will identify and discuss integrative approaches to exploit the ARTs in NHPs thereby maximizing their contribution to ongoing and future research efforts. The overall topic of the workshop is based on the concept that research using NHPs can be improved significantly both in quality and quantity by increased availability of animals of desired genotypes, of genetically identical animals and of SPF animals. The aims of the workshop are to: 1) Review the current state of reproductive research employing the ARTs in NHPs including both basic concepts and specific applications; 2) Enhance interactions and collaborative efforts within and between NPRCs and academic institutions concerning reproductive research including infertility and contraceptive development studies that are clinically important but can't be accomplished in humans; and 3) Identify strategies that effectively expand NPRCs abilities to develop and practice the ARTs in NHPs. The proposed workshop will be held as a satellite meeting immediately prior to the annual meeting of the International Embryo Transfer Society. This arrangement will permit attendees to attend both meetings and should encourage participation by research trainees and fellows. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE HOPKINS POPULATION CENTER Principal Investigator & Institution: Hill, Kenneth H.; Professor; Division of Biophysics; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-MAR-1978; Project End 30-JUN-2003 Summary: The Hopkins Population Center (HPC) requests a five-year renewal, for years 24 to 28, of its NICHD P30 Population Research Center Core Grant. The HPC has a long and distinguished record as a research center focusing on both domestic and international population issues. Population research at Hopkins, dating back to the 1930s, has always had a distinctive public health perspective, linking biological science to behavioral science, and taking results from the laboratory onto the street. Today, the HPC supports research throughout the University on population-related topics as diverse as the impact of welfare reform on families, the effects of needle-sharing networks on the spread of sexually-transmitted disease (STDs), development of a barrier method of female contraception that would also protect against STDs, and the manner in which cells in the mammalian testis communicate with each other. The HPC is administratively located in the Johns Hopkins School of Hygiene and Public Health, among the preeminent centers for public health research and teaching in the world. The School of Hygiene and Public Health provides a behavioral and biological science link between the Medical School and the social science departments in the School of Arts and Sciences. The HPC facilitates and fosters research connections within and between these divisions of the University through the provision of essential research infrastructure. Continuation of P30 support for the Center for the period 1997-2002 will allow us to maintain the existing infrastructure offered to Center associates, to expand the range of services offered and to accommodate the expected increase in numbers of associates over the next five years. This proposal requests support for seven Cores: (1) Administration; (2) Computing; (3) Information Services; 94) Quantitative Sciences; (5) Sexually Transmitted Disease Diagnostics; (6) Morphology; and (7) Radioimmunoassay. Over the grant period, the HPC proposes to take advantage of rapidly-evolving technology and recent faculty appointments to expand and improve the Center's cores, and to increase integration and communication among them. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE ZIMBABWE-SAN FRANCISCO HIV PREVENTION TRIALS UNIT Principal Investigator & Institution: Chipato, Tsungai; Ob, Gyn and Reproductive Scis; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: This proposal represents a collaboration between the University of Zimbabwe-UCSF Women's Health Programme in Harare, Zimbabwe (led by Dr. Nancy Padian at UCSF), and the Zimbabwe AIDS Prevention Program (ZAPP, led by Dr. Yvonne Maldinado), and the HIV/AIDS Research Group at the San Francisco Departrnent of Public Health (led by Dr. Susan Buchbinder). Dr. Tsungai Chipato from the University of Zimbabwe will be Principal Investigator for the overall program. Together, we bring to the new HPTN two strong research sites (one international [consisting of both the UZ-UCSF Program and ZAPP] and one domestic) and substantial expertise in epidemiology, clinical trials design, clinical medicine, behavioral science, biostatistics, virology and data management. We have strong ties with HIV-infected and at-risk populations in Zimbabwe and San Francisco, and can ensure active community involvement in the planning and implementation of trials. Even more than the fruitful
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collaboration between separate HPTN sites, a combined site will foster synergy and communication between investigators representing a wide range of expertise. It will be cost effective by funding investigators and staff at the combined site to work on multiple projects. The science arising from such combined sites also benefit from the broad focus brought to prevention research by the need to integrate domestic and international concerns, and develop prevention strategies for different modes of sexual transmission. Integration of the two community advisory boards will deepen understanding, disseminate complementary skills, and ultimately enhance the contribution of affected communities to the research agenda. In this proposal, we will continue four existing HIVNET studies: HIVNET 016, an international Phase III clinical trial of the microbicidal effects of N-9 gel on STDs and HIV; HIVNET 021, an international observational study to determine the effect of hormonal contraception on the acquisition of STDs and HIV; HIVNET 015, a domestic Phase III behavioral trial comparing an intensive individualized behavioral intervention with standard counseling and testing among high-risk MSM; and HIVNET 023, an international safety and dosing study of nevirapine for post-natal prevention of HIV transmission. In addition, we also propose new domestic Phase I trials both for antiretroviral therapy (ART) and rectal and vaginal microbicides. Thus we propose four specific aims: l) To provide scientific expertise and leadership to the network specifically in the areas of: a) rectal and vaginal microbicide and barrier contraceptive research; b) identification and implementation of interventions to reduce high-risk sexual behavior; c) use of anti-retroviral therapy to prevent transmission; d) research on prevention of perinatal transmission; 2) to conduct and participate in Phase I, II and/or III prevention intervention clinical trials domestically and internationally; 3) to convene and maintain community advisory boards in San Francisco and in Zimbabwe and to link them; 4) to demonstrate our ability to expand to multiple prevention efficacy trials in new populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSCRIPTIONAL REGULATION DURING SPERMIOGENESIS Principal Investigator & Institution: Reddi, P Prabhakara.; Assistant Professor of Research; Cell Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 08-DEC-1998; Project End 30-NOV-2003 Summary: Transcriptional regulatory mechanisms determine cellular phenotypes by directing precise patterns of temporal gene expression. The central hypothesis underlying this proposal is that one or more key testis- specific transcription factors mediate the signal for terminal differentiation of male germ cells by activation of spermatid-specific genes. The goal of this research program is to isolate and characterize testicular transcription factor(s) involved in postmeiotic gene regulation. The study focuses on a testis-specific gene encoding the acrosomal protein SP-10, a model gene for studying regulation of post- meiotic, testis-specific gene expression. This gene 1) Exhibits a temporal pattern of gene expression, being restricted to the golgi and cap phases of spermiogenesis; 2) Is well characterized in both human and mouse; and 3) Is expressed uniquely in round spermatids, and is present as a single copy gene. Evidence indicates that SP-10 is not under the transcriptional control of CREM, the only well characterized transcription factor in testis. The current proposal utilizes the SP-10 gene promoter to capture novel testis-specific transcription factors and to test the hypotheses that such factors arise in a stage-specific manner during spermatogenesis to bring about coordinate expression of spermatid-specific genes. To identify and characterize the transcription factors which regulate SP-10 gene expression; transgenic mice will be
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generated using SP-10 promoter +GFP reporter constructs, and gel shift assays and Dnase I footprinting will be performed to identify the cis-acting elements. To determine the functional role of the putative transcription factor(s) in SP-10 gene expression, in vitro transcription assay will be developed using testicular nuclear extracts and SP-10 promoter driven G-less cassette. 3) To test the hypothesis that SP-10 transcription factor(s) appear in a developmental-stage specific manner in the testis, in situ hybridization of testis sections, Northern analysis and RT-PCR of testicular RNA obtained from prepuberal as well as adult mice will be performed. Identification of the transcription factor(s) governing SP-10 gene expression will pave the way for future studies concerning the role of these factor(s) in coordinate gene regulation during spermiogenesis. Achievement of these aims will add significantly to the knowledge of male germ cell differentiation at the molecular level. The proposed studies are clinically relevant because meiotic arrest in spermatogenesis is a documented cause of infertility in men. The factors governing gene regulation of spermiogenesis may provide new approaches to male contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSDERMAL CONTRACEPTION
LEVONORGESTREL
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EMERGENCY
Principal Investigator & Institution: Nichols, L D.; Biotek, Inc. 21-C Olympia Ave Woburn, Ma 01801 Timing: Fiscal Year 2001; Project Start 28-SEP-1999; Project End 30-APR-2003 Summary: (Scanned from the applicant's description): This program seeks to develop a transdermal system capable of delivering 1,500 ug of levonorgestrel over the course of 24 hours through two 30 cm2 patches. Such a system should be as effective for emergency contraception as the currently approved oral method, while offering greater convenience and fewer side effects. Although the required transdermal dose is high for a drug as insoluble as levonorgestrel, BIOTEK's past experience suggested that it could be achieved. Phase I began with an in vitro study on human skin to confirm and optimize high levonorgestrel fluxes, continued with a study of irritation and bioavailability in rabbits, and concluded with an evaluation of materials for use in comfortable patches capable of maintaining good skin contact over a large area. These tasks were successfully completed. The Phase II work proposed here will complete patch design work, prepare and characterize GMP patches, submit an IND, and conclude with a 10-subject human clinical dose ranging study of safety, follicular response, and levonorgestrel pharmacokinetics at the Jones Institute of the Eastern Virginia Medical School. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: UNINTENDED EFFECTIVENESS
PREGNANCY
AND
CONTRACEPTIVE
Principal Investigator & Institution: Darroch, Jacqueline E.; Alan Guttmacher Institute 120 Wall St, 21St Fl New York, Ny 10005 Timing: Fiscal Year 2001; Project Start 05-APR-2001; Project End 31-MAR-2005 Summary: The issue of pregnancy intetention and contraepective failure continue to cause substantial social concern in the United States. An important aspect of this concern is the persistence of large differences among socioeconomic subgroups in levels of unintended pregnancy, abortion and contractive failure. New survey data have begun
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to reveal the complexities underlying what has been traditionally considered simply "unintended pregnancy." however, the traditional or core measures continue to be needed to provide consistent monitoring of trends. The proposed project would use new National Survey of Family Growth (NSF) data, as well as data from a new Abortion Provider Survey and a new Abortion Patient Survey, to study in detail pregnancy intention and the interrelationships between planning status, bit want and contraceptive failure, in addition to estimating core measures of unintended pregnancy and conteacrptive failure and discontinuation. We would estimate total and subgroupspecific levels of pregnancy and unintended pregnancy and analyze components of change over time. We will also estimate two indicator of success or difficulty among American couples using contraceptives- the proportions of method users who become accidentally pregnant while using a method and the proportions who discontinue method use for other reasons- as well as to which these indicators differ across methods and across subgroups. We would investigate changes from the mid- 1980's to 2000 in use-failure and discontinuation rates. If unintended pregnancies ending in abortion are highly underrepoted in the 2001 NSF, as they have been in all prior NSFGs, we would use procedures developed under a prior NICHE grant to correct NSF data for abortion under reporting and to calculate more accurate measures of contraceptive use-failure and discontinuation rates and of national pregnancy and unintended pregnancy levels than would be possible from the NSF alone. Findings from this project would contribute to the morning of the Healthy People 2010 adjectives and help to direct their achievement; they would also assist health professionals counseling clients on choice of contraception, and individuals choosing a method; and they would provide assistance to other researchers using NSF data for analysis of pregnancy outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VANADOCENES AS A NEW CLASS OF SPERMICIDAL DRUGS Principal Investigator & Institution: D'cruz, Osmond J.; Paradigm Pharmaceuticals, Llc 2685 Patton Rd St. Paul, Mn 55113 Timing: Fiscal Year 2003; Project Start 25-MAR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): Detergent-based spermicides are the most popular forms of reversible contraception in the United States the active ingredient in these spermicides is nonoxynol-9 (N-9), a non-ionic surfactant, which has been available in various forms for over 30 years. Surfactant spermicides have high contraceptive failure rate and interfere with natural and protective vaginal mechanisms thereby enhancing the risk of transmission and infection by a sexually transmitted disease. It would be desirable, therefore, to provide improved vaginal spermicides without toxicity. In a systematic search effort to identify non-toxic spermicides potentially capable of performing better and without the drawback of detergent-type spermicides, we have rationally designed and synthesized several disubstituted metallocene derivatives, where bis(cyclopentadienyl) moieties are positioned in a tetrahedral symmetry and in a bent conformation with respect to the central transition metal atoms. We discovered bis (cyclopentadienyl) complexes of vanadium(IV) or vanadocenes to have rapid, potent, and selective spermicidal activity. They work by targeting the motility-apparatus of sperm Vanadocenes lack membrane toxicity and hence have the potential to perform better, than those available today. We have synthesized a series of vanadocenes and studied how chemical modification of simple inorganic vanadium salt alters the properties of vanadium as potent spermicides. Unlike N-9, vanadocenes are spermicidal at nanomolar to micromolar ranges without cytotoxicity to human female genital tract epithelial cells and lack mucosal, systemic, and reproductive toxicity in animal models.
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Vanadocenes, because of their potent spermicidal activity and lack of inflammatory and toxic effects, may be useful as a new class of vaginal contraceptives for women. Results of our in vitro and in vivo studies indicated that the lead vanadocene complex, vanadocene dithiocatbamate (VDDTC), would be an attractive candidate to further explore as a vaginal spermicide. Therefore, preclinical studies will be performed to test the in vivo contraceptive efficacy in the relevant animal model. The porcine model was found to be a suitable animal model for investigating the in vivo contraceptive efficacy of spermicidal vanadocenes. Using the minipig model, we will test our hypothesis that vaginally delivered gel-microemulsion formulation of VDDTC prior to artificial insemination will prevent the conception without side effects. We will test the dose and duration of vaginally applied gel formulation of VDDTC on fertility rates in artificially inseminated and hormonally primed gilts. The development of a mechanism-based spermicide aimed at mild contraception will be a potentially paradigm shifting area in contraception research. The preclinical data on the in vivo efficacy of gel formulation of VDDTC will be essential to further explore the utility of VDDTC as an intravaginal spermicide in Phase II. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WELFARE REFORM, FERTILITY AND REPRODUCTIVE BEHAVIOR Principal Investigator & Institution: Kaestner, Robert; Professor; National Bureau of Economic Research Cambridge, Ma 02138 Timing: Fiscal Year 2001; Project Start 25-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): It is widely held that an out-of-wedlock birth hinders a woman's ability to achieve financial security and to raise children in a healthy and secure environment. In recent years, beginning first with state governments and culminating in the federal legislation embodied in the Personal and Work Opportunity Reconciliation Act of 1996 (PRWORA), welfare policies have been dramatically altered so as to discourage out-of-wedlock birth. Thus, the primary objective of this project is to examine whether key provisions of recent welfare reform policies such as benefit time limits and family cap provisions affected rates of out-of-wedlock birth, abortion and pregnancy among women between the ages of 19 and 35. Importantly, our proposed research will provide evidence as to the effect of welfare reform on abortion, which is of interest not only because it is a significant public health outcome, but also because it is a possible link in the causal chain connecting welfare reform to rates of nonmarital pregnancy and birth. In addition, we will investigate whether recent welfare reform has affected contraception and sexual activity, two other causal links between welfare reform and non-marital pregnancy for which there is no current information. A secondary objective of the proposal will be to collect, under the direction of Dr. Stanley Henshaw, in collaboration with the Alan Guttmacher Institute, individual induced termination records from as many of the 45 states and vital registries that maintain such data. This is a unique and important contribution of our proposal for it represents the first attempt to collect individual data on induced terminations since the National Center for Health Statistics discontinued its effort in 14 states almost a decade ago. These micro-level data on abortions permit a more refined analysis of the effect of public policies on abortion than is possible with abortion data provided by the Centers for Disease Control and Prevention (CDC) or the Alan Guttmacher Institute (AGI). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: WOMEN IN PRISON: DECREASING UNPLANNED PREGNANCIES & STDS Principal Investigator & Institution: Clarke, Jennifer G.; Rhode Island Hospital (Providence, Ri) Providence, Ri 02903 Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): This application is a revised submission for a Mentored-Patient Oriented Research Career Development Award (K23) from the National Institute of Health. My goal is to gain the tools required to become a leader in women?s health research as an independent clinical investigator with a focus on incarcerated women. Building on my strong training in women?s health I propose to develop additional skills through: 1)coursework and seminars to strengthen my understanding of statistics and research methods and to obtain an MPH; 2) interaction with a multidisciplinary team of mentors; and 3) a focused supervised research project. My research and career objectives involve impacting the health of impoverished communities through investigations of public health interventions addressing the needs of incarcerated women. I plan to work closely with Dr. Jeffrey Peipert (primary mentor) who is an accomplished researcher with expertise in prevention of sexually transmitted infections (STIs) and unplanned pregnancies. I will also work with Drs. Mike Stein and Timothy Flanigan who have expertise in infectious diseases, substance abuse, and research involving incarcerated women. The research proposed in this application examines the effects of a computer-based educational intervention targeting behaviors to decrease STIs and unplanned pregnancies. The specific aim is to evaluate a computer based feedback program that is individualized to a woman?s readiness to change a behavior (Individualized Intervention) versus a standard computer educational program. Primary outcomes are behavioral (reporting use of dual methods of contraception) and biological (incident or recurrent STIs or unplanned pregnancies.) Women will be randomized to either the Individualized Intervention or enhanced standard of care while in prison and will be followed every six months for 12 months. My primary mentor, Dr. Peipert has extensive experience with the Individualized Intervention and was instrumental in its development. Funded by the NICHD, he is the PI evaluating this system in two primary care settings. He will provide me with advanced training in survey research methodology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “contraception” (or synonyms) into the search box. This search gives you access to
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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full-text articles. The following is a sample of items found for contraception in the PubMed Central database: •
Apparent interaction between warfarin and levonorgestrel used for emergency contraception. by Ellison J, Thomson AJ, Greer IA, Walker ID.; 2000 Dec 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27541
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Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study. by Churchill D, Allen J, Pringle M, HippisleyCox J, Ebdon D, Macpherson M, Bradley S.; 2000 Aug 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27465
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Effect of educational leaflets and questions on knowledge of contraception in women taking the combined contraceptive pill: randomised controlled trial. by Little P, Griffin S, Kelly J, Dickson N, Sadler C.; 1998 Jun 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28594
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Emergency contraception. by Cole M.; 2000 Aug 8; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80282
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Emergency contraception: a matter of dedication and access. by Weir E.; 2001 Oct 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=81562
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Improving teenagers' knowledge of emergency contraception: cluster randomised controlled trial of a teacher led intervention. by Graham A, Moore L, Sharp D, Diamond I.; 2002 May 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=111106
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Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. by Beral V, Hermon C, Kay C, Hannaford P, Darby S, Reeves G.; 1999 Jan 9; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27684
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Over-the-counter emergency contraception available soon across country? by Sibbald B.; 2001 Mar 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80890
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Questionnaire study of use of emergency contraception among teenagers. by Kosunen E, Vikat A, Rimpela M, Rimpela A, Huhtala H.; 1999 Jul 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28157
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Value of family history in identifying women at risk of venous thromboembolism during oral contraception: observational study. by Cosmi B, Legnani C, Bernardi F, Coccheri S, Palareti G.; 2001 Apr 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=31038
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Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study. by Free C, Lee RM, Ogden J.; 2002 Dec 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=138517
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 6
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction
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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with contraception, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “contraception” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for contraception (hyperlinks lead to article summaries): •
A group practice disagrees about offering contraception. Author(s): Chervenak FA, McCullough L. Source: American Family Physician. 2002 March 15; 65(6): 1230, 1233. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925099&dopt=Abstract
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A male genital tract-specific carbohydrate epitope on human CD52: implications for immunocontraception. Author(s): Norton EJ, Diekman AB, Westbrook VA, Mullins DW, Klotz KL, Gilmer LL, Thomas TS, Wright DC, Brisker J, Engelhard VH, Flickinger CJ, Herr JC. Source: Tissue Antigens. 2002 November; 60(5): 354-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492811&dopt=Abstract
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A qualitative study of the views of women aged 18-29 on over-the-counter availability of hormonal emergency contraception. Author(s): Folkes L, Graham A, Weiss M. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 189-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457465&dopt=Abstract
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A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception. Author(s): Ashok PW, Stalder C, Wagaarachchi PT, Flett GM, Melvin L, Templeton A. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 May; 109(5): 553-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12066946&dopt=Abstract
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A randomized comparative study on mifepristone alone and in combination with tamoxifen for emergency contraception. Author(s): Changhai H, Youlun G, Jie Y, Bingshun W, Exiang Z, Ersheng G, Mauck C. Source: Contraception. 2002 October; 66(4): 221-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413615&dopt=Abstract
with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A randomized controlled educational intervention on emergency contraception among drugstore personnel in southern Thailand. Author(s): Ratanajamit C, Chongsuvivatwong V, Geater AF. Source: J Am Med Womens Assoc. 2002 Fall; 57(4): 196-9, 207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405236&dopt=Abstract
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A randomized double-blind comparison of two single doses of mifepristone for emergency contraception. Author(s): Xiao BL, Von Hertzen H, Zhao H, Piaggio G. Source: Human Reproduction (Oxford, England). 2002 December; 17(12): 3084-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456607&dopt=Abstract
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A right for family planning: the benefits of contraception for women's health and social status. Author(s): Charlafti I. Source: Embo Reports. 2002 March; 3(3): 211-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11882538&dopt=Abstract
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A study on the knowledge and practice of contraception among men in the United Arab Emirates. Author(s): Ghazal-Aswad S, Zaib-Un-Nisa S, Rizk DE, Badrinath P, Shaheen H, Osman N. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 October; 28(4): 196-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419060&dopt=Abstract
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Abnormal uterine bleeding associated with hormonal contraception. Author(s): Schrager S. Source: American Family Physician. 2002 May 15; 65(10): 2073-80. Review. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046776&dopt=Abstract
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Abnormal uterine bleeding during progestin-only contraception may result from free radical-induced alterations in angiopoietin expression. Author(s): Krikun G, Critchley H, Schatz F, Wan L, Caze R, Baergen RN, Lockwood CJ. Source: American Journal of Pathology. 2002 September; 161(3): 979-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213726&dopt=Abstract
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Acceptability of personal hormone monitoring for contraception: longitudinal and contextual variables. Author(s): Severy LJ, Klein CT, McNulty J. Source: The Journal of Social Psychology. 2002 February; 142(1): 87-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11915857&dopt=Abstract
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Acceptability of the levonorgestrel-releasing intrauterine system after discontinuation of previous contraception: results of a French clinical study in women aged 35 to 45 years. Author(s): Dubuisson JB, Mugnier E. Source: Contraception. 2002 August; 66(2): 121-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204786&dopt=Abstract
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ACOG practice bulletin. Emergency oral contraception. Number 25, March 2001. (Replace Practice Pattern Number 3, December 1996). American College of Obstetricians and Gynecologists. Author(s): American College of Obstetricians and Gynecologists. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2002 August; 78(2): 191-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360907&dopt=Abstract
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ACOG Practice Bulletin. The use of hormonal contraception in women with coexisting medical conditions. Number 18, July 2000. Author(s): ACOG Committee on Practice Bulletins-Gynecology. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 October; 75(1): 93-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732484&dopt=Abstract
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Adolescent access to emergency contraception in A and E departments: reviewing the literature from a feminist perspective. Author(s): Fallon D. Source: Journal of Clinical Nursing. 2003 January; 12(1): 4-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519243&dopt=Abstract
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Adolescent dual use of condoms and hormonal contraception: trends and correlates 1991-2001. Author(s): Anderson JE, Santelli J, Gilbert BC. Source: Sexually Transmitted Diseases. 2003 September; 30(9): 719-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12972796&dopt=Abstract
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Adolescent emergency contraception: attitudes and practices of certified nursemidwives. Author(s): Kettyle EP, Klima C. Source: Journal of Midwifery & Women's Health. 2002 March-April; 47(2): 68-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019988&dopt=Abstract
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Adolescents accessing emergency contraception in the A&E department - a feminist analysis of the nursing experience. Author(s): Fallon D. Source: Accident and Emergency Nursing. 2003 April; 11(2): 75-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633623&dopt=Abstract
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Adolescents and emergency contraception. Author(s): Roye CF, Johnsen JR. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 2002 January-February; 16(1): 3-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11802114&dopt=Abstract
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Adolescents' use of emergency contraception provided by Washington State pharmacists. Author(s): Sucato GS, Gardner JS, Koepsell TD. Source: Journal of Pediatric and Adolescent Gynecology. 2001 November; 14(4): 163-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748011&dopt=Abstract
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Advance supply of emergency contraception. effect on use and usual contraception--a randomized trial. Author(s): Jackson RA, Bimla Schwarz E, Freedman L, Darney P. Source: Obstetrics and Gynecology. 2003 July; 102(1): 8-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850599&dopt=Abstract
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Advances in male contraception. Author(s): Brady BM, Anderson RA. Source: Expert Opinion on Investigational Drugs. 2002 March; 11(3): 333-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11866663&dopt=Abstract
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Advances in male hormonal contraception. Author(s): Anawalt BD, Amory JK. Source: Annals of Medicine. 2001 December; 33(9): 587-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817653&dopt=Abstract
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Amenorrhea associated with contraception-an international study on acceptability. Author(s): Glasier AF, Smith KB, van der Spuy ZM, Ho PC, Cheng L, Dada K, Wellings K, Baird DT. Source: Contraception. 2003 January; 67(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521650&dopt=Abstract
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Angie Pham offers controversial advice to practitioners regarding emergency contraception. Author(s): Kinn MC. Source: J Okla State Med Assoc. 2002 July; 95(7): 505. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145919&dopt=Abstract
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Angioedema and oral contraception. Author(s): Bouillet L, Ponard D, Drouet C, Jullien D, Massot C. Source: Dermatology (Basel, Switzerland). 2003; 206(2): 106-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12592075&dopt=Abstract
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Antiandrogens in hormonal contraception limit muscle strength gain in strength training: comparison study. Author(s): Ruzic L, Matkovic BR, Leko G. Source: Croatian Medical Journal. 2003 February; 44(1): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590431&dopt=Abstract
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Antigestogens: the holy grail of contraception. Author(s): Baird DT. Source: Reproduction, Fertility, and Development. 2001; 13(7-8): 723-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999326&dopt=Abstract
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Avoiding unwanted pregnancy--the role of communication, information and knowledge in the use of contraception among young Norwegian women. Author(s): Sundby J, Svanemyr J, Maehre T. Source: Patient Education and Counseling. 1999 September; 38(1): 11-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528567&dopt=Abstract
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Belgium to subsidise costs of contraception to teenagers. Author(s): Watson R. Source: Bmj (Clinical Research Ed.). 2003 October 25; 327(7421): 945. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14576223&dopt=Abstract
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Beyond the pill. Four new devices aim to make contraception easier. Author(s): Brink S. Source: U.S. News & World Report. 2002 September 23; 133(11): 54, 56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360832&dopt=Abstract
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Biphasic versus monophasic oral contraceptives for contraception. Author(s): Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF. Source: Cochrane Database Syst Rev. 2003; (2): Cd002032. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804421&dopt=Abstract
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Biphasic versus monophasic oral contraceptives for contraception. Author(s): Van Vliet H, Grimes D, Helmerhorst F, Schulz K. Source: Cochrane Database Syst Rev. 2001; (4): Cd002032. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11687135&dopt=Abstract
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Biphasic versus monophasic oral contraceptives for contraception. Author(s): Van Vliet H, Grimes DA, Helmerhorst F, Schulz K. Source: Cochrane Database Syst Rev. 2001; (2): Cd002032. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11406026&dopt=Abstract
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Biphasic versus monophasic oral contraceptives for contraception: a Cochrane review. Author(s): Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF. Source: Human Reproduction (Oxford, England). 2002 April; 17(4): 870-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925375&dopt=Abstract
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Biphasic versus triphasic oral contraceptives for contraception. Author(s): Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF. Source: Cochrane Database Syst Rev. 2003; (2): Cd003283. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804457&dopt=Abstract
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Biphasic versus triphasic oral contraceptives for contraception. Author(s): van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF. Source: Contraception. 2002 May; 65(5): 321-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12057781&dopt=Abstract
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Biphasic versus triphasic oral contraceptives for contraception. Author(s): Van Vliet H, Grimes D, Helmerhorst F, Schulz K. Source: Cochrane Database Syst Rev. 2001; (4): Cd003283. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11687185&dopt=Abstract
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Bleeding problems and progestogen-only contraception. Author(s): Porter C, Rees MC. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 October; 28(4): 178-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419054&dopt=Abstract
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Bone mineral density at various anatomic bone sites in women receiving combined oral contraceptives and depot-medroxyprogesterone acetate for contraception. Author(s): Wanichsetakul P, Kamudhamas A, Watanaruangkovit P, Siripakarn Y, Visutakul P. Source: Contraception. 2002 June; 65(6): 407-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12127638&dopt=Abstract
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Brain infarction after postcoital contraception in a migraine patient. Author(s): Sanchez-Guerra M, Valle N, Blanco LA, Combarros O, Pascual J. Source: Journal of Neurology. 2002 June; 249(6): 774. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173575&dopt=Abstract
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Breast-feeding and contraception in Peru. Author(s): Rice S, Coombs D, Fish L, Leeper J. Source: J Health Popul Nutr. 2002 March; 20(1): 51-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12022160&dopt=Abstract
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Bringing emergency contraception to American women: the history and remaining challenges. Author(s): Coeytaux F, Pillsbury B. Source: Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health. 2001 March-April; 11(2): 80-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11275510&dopt=Abstract
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CAG repeat length in the androgen receptor gene and gonadotrophin suppression influence the effectiveness of hormonal male contraception. Author(s): Eckardstein SV, Schmidt A, Kamischke A, Simoni M, Gromoll J, Nieschlag E. Source: Clinical Endocrinology. 2002 November; 57(5): 647-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390340&dopt=Abstract
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Can secular patients survive Catholic hospitals?: merger trends threaten abortion, contraception, living wills. Author(s): Flynn T. Source: Free Inq. 2000 Winter; 21(1): 32-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528746&dopt=Abstract
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Canadian physicians' role in contraception from the 19th century to now. Author(s): Liu KE, Fisher WA. Source: J Obstet Gynaecol Can. 2002 March; 24(3): 239-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12196874&dopt=Abstract
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Cervical cap versus diaphragm for contraception. Author(s): Gallo MF, Grimes DA, Schulz KF. Source: Cochrane Database Syst Rev. 2002; (4): Cd003551. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519602&dopt=Abstract
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Chromosomes after oral contraception. Author(s): Hetherington RJ. Source: Lancet. 1967 October 21; 2(7521): 896-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12389574&dopt=Abstract
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Chronically homeless women's perceived deterrents to contraception. Author(s): Gelberg L, Leake B, Lu MC, Andersen R, Nyamathi AM, Morgenstern H, Browner C. Source: Perspectives on Sexual and Reproductive Health. 2002 November-December; 34(6): 278-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558090&dopt=Abstract
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Clinical practice. Emergency contraception. Author(s): Westhoff C. Source: The New England Journal of Medicine. 2003 November 6; 349(19): 1830-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14602882&dopt=Abstract
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Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Author(s): Truitt ST, Fraser AB, Grimes DA, Gallo MF, Schulz KF. Source: Cochrane Database Syst Rev. 2003; (2): Cd003988. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804497&dopt=Abstract
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Comment: postfertilization effect of hormonal emergency contraception. Author(s): Mikolajczyk R. Source: The Annals of Pharmacotherapy. 2002 October; 36(10): 1649. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243619&dopt=Abstract
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Commentary on repeat emergency contraception. Author(s): Rowlands S. Source: Contraception. 2003 May; 67(5): 421; Author Reply 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742568&dopt=Abstract
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Commentary: Judicial review of the pharmacy provision of emergency contraception in the UK. Author(s): Weyman A. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 April; 28(2): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422882&dopt=Abstract
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Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians. Author(s): Arowojolu AO, Okewole IA, Adekunle AO. Source: Contraception. 2002 October; 66(4): 269-73. Erratum In: Contraception. 2003 February; 67(2): 165. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413624&dopt=Abstract
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Contraception among young women attending high school in rural Nova Scotia. Author(s): Langille DB, Hughes J, Murphy GT, Rigby JA. Source: Canadian Journal of Public Health. Revue Canadienne De Sante Publique. 2002 November-December; 93(6): 461-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448872&dopt=Abstract
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Contraception and abortion attitudes and practices of Western Ukraine women. Author(s): Muscato L, Kidd RS. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2003 June; 8(2): 80-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831605&dopt=Abstract
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Contraception and induced abortion in rural Ghana. Author(s): Geelhoed DW, Nayembil D, Asare K, van Leeuwen JH, van Roosmalen J. Source: Tropical Medicine & International Health : Tm & Ih. 2002 August; 7(8): 708-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167098&dopt=Abstract
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Contraception and men attending a genitourinary medicine clinic. Author(s): Wallace SV, Carlin EM. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 217-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457471&dopt=Abstract
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Contraception and pregnancy in women affected by glycogen storage diseases. Author(s): Mairovitz V, Labrune P, Fernandez H, Audibert F, Frydman R. Source: European Journal of Pediatrics. 2002 October; 161 Suppl 1: S97-101. Epub 2002 September 04. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12373581&dopt=Abstract
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Contraception and sexuality among the youth in Kisumu, Kenya. Author(s): Oindo ML. Source: Afr Health Sci. 2002 April; 2(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789113&dopt=Abstract
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Contraception and society. Author(s): Diczfalusy E. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 December; 7(4): 199-209. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648291&dopt=Abstract
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Contraception and treatment in the perimenopause with a novel “frameless” intrauterine levonorgestrel-releasing drug delivery system: an extended pilot study. Author(s): Wildemeersch D, Schacht E, Wildemeersch P. Source: Contraception. 2002 August; 66(2): 93-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204781&dopt=Abstract
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Contraception failure and wrongful birth claims. Author(s): Bird S. Source: Aust Fam Physician. 2002 October; 31(10): 935-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404832&dopt=Abstract
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Contraception in perimenopause. Author(s): Taneepanichskul S, Dusitsin N. Source: J Med Assoc Thai. 2003 June; 86 Suppl 2: S140-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12929981&dopt=Abstract
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Contraception use, family planning, and unprotected sex: few differences among HIV-infected and uninfected postpartum women in four US states. Author(s): Wilson TE, Koenig L, Ickovics J, Walter E, Suss A, Fernandez MI; Perinatal Guidelines Evaluation Project. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2003 August 15; 33(5): 608-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902806&dopt=Abstract
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Contraception. Playing a responsible game. Author(s): Hastings-Asatourian B. Source: Pract Midwife. 2002 October; 5(9): 32-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400415&dopt=Abstract
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Contraception. We've come a long way. Author(s): Calabresi L. Source: Aust Fam Physician. 2002 October; 31(10): 885. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404821&dopt=Abstract
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Contraception--past and future. Author(s): Glasie A. Source: Nature Cell Biology. 2002 October; 4 Suppl: S3-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479606&dopt=Abstract
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Controversies in adolescent hormonal contraception. Author(s): Davis AR, Teal SB. Source: Obstetrics and Gynecology Clinics of North America. 2003 June; 30(2): 391-406, Vii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12836727&dopt=Abstract
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Counseling the adolescent about contraception. Author(s): Rimsza ME. Source: Pediatrics in Review / American Academy of Pediatrics. 2003 May; 24(5): 16270. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728189&dopt=Abstract
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Current opinion: consensus statement on intrauterine contraception. Author(s): Rivera R, Best K. Source: Contraception. 2002 June; 65(6): 385-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12127634&dopt=Abstract
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Current perspectives on emergency contraception. Author(s): Lo SS. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2002 December; 8(6): 435-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12459600&dopt=Abstract
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Depression and hormonal contraception. Author(s): Freeman MP. Source: Jama : the Journal of the American Medical Association. 2001 August 8; 286(6): 671-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11495612&dopt=Abstract
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Determinants for non-use of contraception at first intercourse; a study of 10841 young Danish women from the general population. Author(s): Svare EI, Kjaer SK, Thomsen BL, Bock JE. Source: Contraception. 2002 November; 66(5): 345-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443965&dopt=Abstract
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Determinants of current use of contraception and children ever born in Nepal. Author(s): Satyavada A, Adamchak DJ. Source: Soc Biol. 2000 Spring-Summer; 47(1-2): 51-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11521456&dopt=Abstract
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Development of a miniature, low-dose, frameless intrauterine levonorgestrelreleasing system for contraception and treatment: a review of initial clinical experience. Author(s): Wildemeersch D, Schacht E, Wildemeersch P, Janssens D, Thiery M. Source: Reproductive Biomedicine Online. 2002 January-February; 4(1): 71-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12470357&dopt=Abstract
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Development of methods of male contraception: impact of the World Health Organization Task Force. Author(s): Waites GM. Source: Fertility and Sterility. 2003 July; 80(1): 1-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849793&dopt=Abstract
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Diabetes and depot medroxyprogesterone contraception in Navajo women. Author(s): Kim C, Seidel KW, Begier EA, Kwok YS. Source: Archives of Internal Medicine. 2001 July 23; 161(14): 1766-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11485510&dopt=Abstract
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Diaphragm versus diaphragm with spermicides for contraception. Author(s): Cook L, Nanda K, Grimes D. Source: Cochrane Database Syst Rev. 2002; (3): Cd002031. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12137639&dopt=Abstract
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Diaphragm versus diaphragm with spermicides for contraception. Author(s): Cook L, Nanda K, Grimes D. Source: Cochrane Database Syst Rev. 2003; (1): Cd002031. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535422&dopt=Abstract
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Diaphragm versus diaphragm with spermicides for contraception. Author(s): Cochrane Database Syst Rev. 2001;(4):CD002032 Source: Cochrane Database Syst Rev. 2001; (2): Cd002031. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687135
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Differences between emergency contraception users in the United States and the United Kingdom. Author(s): Blanchard K, Haskell S, Ferden S, Johnstone K, Spears A, Evans M, Leadbetter C, Carlson S, Meehan A, Abuabara K, Ellertson C. Source: J Am Med Womens Assoc. 2002 Fall; 57(4): 200-3, 214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405237&dopt=Abstract
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Does former use of hormonal contraception predispose women to accept hormone replacement therapy? Author(s): Maamari R. Source: Medgenmed [electronic Resource] : Medscape General Medicine. 2001 November 9; 3(6): 3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11965198&dopt=Abstract
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Ectopic pregnancies following emergency levonorgestrel contraception. Author(s): Sheffer-Mimouni G, Pauzner D, Maslovitch S, Lessing JB, Gamzu R. Source: Contraception. 2003 April; 67(4): 267-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684145&dopt=Abstract
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Effectiveness of the Yuzpe regimen of emergency contraception by cycle day of intercourse: implications for mechanism of action. Author(s): Trussell J, Ellertson C, Dorflinger L. Source: Contraception. 2003 March; 67(3): 167-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618250&dopt=Abstract
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Emergency contraception and risk of ectopic pregnancy: is there need for extra vigilance? Author(s): Vinson DR. Source: Annals of Emergency Medicine. 2003 August; 42(2): 306-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12899155&dopt=Abstract
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Emergency contraception and stroke. Author(s): Hamandi K, Scolding J. Source: Journal of Neurology. 2003 May; 250(5): 615-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12814110&dopt=Abstract
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Emergency contraception for prevention of adolescent pregnancy. Author(s): Lindberg CE. Source: Mcn. the American Journal of Maternal Child Nursing. 2003 May-June; 28(3): 199-204. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771699&dopt=Abstract
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Emergency contraception given via a patient group direction. Author(s): Walsh S. Source: Nurs Times. 2003 August 26-September 1; 99(34): 34-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515566&dopt=Abstract
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Emergency contraception pills (ECPs): current trends in United States college health centers. Author(s): Brening RK, Dalve-Endres AM, Patrick K. Source: Contraception. 2003 June; 67(6): 449-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12814813&dopt=Abstract
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Emergency contraception provision: a survey of emergency department practitioners. Author(s): Keshavarz R, Merchant RC, McGreal J. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2002 January; 9(1): 69-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772673&dopt=Abstract
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Emergency contraception. Author(s): Grimes DA, Raymond EG. Source: Annals of Internal Medicine. 2002 August 6; 137(3): 180-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12160366&dopt=Abstract
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Emergency contraception. Author(s): Dunn S, Guilbert E, Lefebvre G, Allaire C, Arneja J, Birch C, Fortier M, Jeffrey J, Vilos G, Wagner MS, Grant L, Beaudoin F, Cherniak D, Pellizzari R, Sadownik L, Saraf-Dhar R, Turnbull V; Clinical Practice Gyneacology and Social Sexual Issues Committees, Society of Obstetricians and Gyneacologists of Canada (SOGC). Source: J Obstet Gynaecol Can. 2003 August; 25(8): 673-9, 680-7; Quiz 688-90. English, French. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12908020&dopt=Abstract
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Emergency contraception. Author(s): Webb AM. Source: Bmj (Clinical Research Ed.). 2003 April 12; 326(7393): 775-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689951&dopt=Abstract
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Emergency contraception. the right questions? Author(s): Raine T. Source: Obstetrics and Gynecology. 2003 July; 102(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850595&dopt=Abstract
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Emergency contraception: a pilot study by school nurses. Author(s): Smith G. Source: Nurs Times. 2003 March 25-31; 99(12): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12710244&dopt=Abstract
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Emergency contraception: knowledge, attitude, and practices among health care providers in North India. Author(s): Tripathi R, Rathore AM, Sachdeva J. Source: The Journal of Obstetrics and Gynaecology Research. 2003 June; 29(3): 142-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841696&dopt=Abstract
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Emergency contraception: lessons learned from the UK. Author(s): Schenk KD. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):35-40. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681036&dopt=Abstract
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Emergency contraception: models to increase accessibility. Author(s): Cohen MM, Dunn S, Cockerill R, Brown TE. Source: J Obstet Gynaecol Can. 2003 June; 25(6): 499-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806451&dopt=Abstract
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Emergency contraception: the journey so far. Author(s): Haggai DN. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 April; 110(4): 339-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699793&dopt=Abstract
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Enhancing resident training in abortion and contraception through hospitalcommunity partnership. Author(s): Sankey HZ, Lewis RS, O'shea D, Paul M. Source: American Journal of Obstetrics and Gynecology. 2003 September; 189(3): 644-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14526283&dopt=Abstract
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Estimating the efficacy of emergency contraception--how reliable are the data? Author(s): Stirling A, Glasier A. Source: Contraception. 2002 July; 66(1): 19-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12169376&dopt=Abstract
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Evaluating the safety of medicines, with particular reference to contraception. Author(s): Skegg DC. Source: Statistics in Medicine. 2001 December 15; 20(23): 3557-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11746337&dopt=Abstract
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Evaluation of a mass media campaign on contraception in France. Author(s): Moreau C, Bajos N, Bouyer J. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 June; 7(2): 105-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201322&dopt=Abstract
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Evaluation of a media campaign to increase knowledge about emergency contraception. Author(s): Trussell J, Koenig J, Vaughan B, Stewart F. Source: Contraception. 2001 February; 63(2): 81-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11292472&dopt=Abstract
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Evaluation of an emergency contraception advance provision service. Author(s): Blanchard K, Bungay H, Furedi A, Sanders L. Source: Contraception. 2003 May; 67(5): 343-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742555&dopt=Abstract
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Evaluation of immunocontraception as a publicly acceptable form of vertebrate pest species control: the introduced grey squirrel in Britain as an example. Author(s): Lurz PW, Shirley MD, Shirley MD, Rushton SP. Source: Environmental Management. 2002 September; 30(3): 342-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148069&dopt=Abstract
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Expanding access to emergency contraception: the case of Brazil and Colombia. Author(s): Heimburger A, Gras C, Guedes A. Source: Reproductive Health Matters. 2003 May; 11(21): 150-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800712&dopt=Abstract
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Exposure to emergency contraception in an undergraduate medical curriculum. Author(s): Khan Y, Sbrocca N, Stanojevic S, Penava D. Source: J Obstet Gynaecol Can. 2003 May; 25(5): 391-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738980&dopt=Abstract
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Extending the time limit for starting the Yuzpe regimen of emergency contraception to 120 hours. Author(s): Ellertson C, Evans M, Ferden S, Leadbetter C, Spears A, Johnstone K, Trussell J. Source: Obstetrics and Gynecology. 2003 June; 101(6): 1168-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798519&dopt=Abstract
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Factors influencing women's satisfaction with birth control methods. Author(s): den Tonkelaar D, Oddens BJ. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2001 September; 6(3): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763979&dopt=Abstract
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False risk attribution results in misleading assessment of the relationship between suppression of ovulation and the effectiveness of the Yuzpe regimen for emergency contraception. Author(s): Mikolajczyk RT, Stanford JB. Source: Contraception. 2003 April; 67(4): 333-5; Author Reply 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684157&dopt=Abstract
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Family history and risk of venous thromboembolism with oral contraception. Family history is important tool. Author(s): Vandenbroucke JP, van der M eer FJ, Helmerhorst FM, Rosendaal FR. Source: Bmj (Clinical Research Ed.). 2001 September 29; 323(7315): 752. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11675729&dopt=Abstract
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FFPRHC Guidance: emergency contraception (April 2003). Author(s): Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):9-16. No Abstract Available. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159`. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681030&dopt=Abstract
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Flutamide-metformin therapy to reduce fat mass in hyperinsulinemic ovarian hyperandrogenism: effects in adolescents and in women on third-generation oral contraception. Author(s): Ibanez L, De Zegher F. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 October; 88(10): 4720-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557446&dopt=Abstract
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Formulation and evaluation of metronidazole acid gel for vaginal contraception. Author(s): El-Gizawy SA, Aglan NI. Source: The Journal of Pharmacy and Pharmacology. 2003 July; 55(7): 903-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12906747&dopt=Abstract
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Forty years of combined oral contraception: the evolution of a revolution. Author(s): Fraser IS. Source: The Medical Journal of Australia. 2000 November 20; 173(10): 541-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11194739&dopt=Abstract
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Frameless versus classical intrauterine device for contraception. Author(s): Cochrane Database Syst Rev. 2003;(2):CD003283 Source: Cochrane Database Syst Rev. 2001; (4): Cd003282. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804457
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Gender factors affect fatty acids-induced insulin resistance in nonobese humans: effects of oral steroidal contraception. Author(s): Perseghin G, Scifo P, Pagliato E, Battezzati A, Benedini S, Soldini L, Testolin G, Del Maschio A, Luzi L. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 July; 86(7): 3188-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11443187&dopt=Abstract
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High-risk teen compliance with prescription contraception: an analysis of Ohio Medicaid claims. Author(s): Zink TM, Shireman TI, Ho M, Buchanan T. Source: Journal of Pediatric and Adolescent Gynecology. 2002 February; 15(1): 15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888805&dopt=Abstract
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HIV infection in women: impact on contraception. Author(s): Magalhaes J, Amaral E, Giraldo PC, Simoes JA. Source: Contraception. 2002 August; 66(2): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204780&dopt=Abstract
Studies
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Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study. Author(s): Ness RB, Soper DE, Holley RL, Peipert J, Randall H, Sweet RL, Sondheimer SJ, Hendrix SL, Amortegui A, Trucco G, Bass DC, Kelsey SF; PID Evaluation and Clinical Health (PEACH) Study Investigators. Source: American Journal of Obstetrics and Gynecology. 2001 July; 185(1): 121-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11483915&dopt=Abstract
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Hormonal and barrier methods of contraception, oncogenic human papillomaviruses, and cervical squamous intraepithelial lesion development. Author(s): Coker AL, Sanders LC, Bond SM, Gerasimova T, Pirisi L. Source: Journal of Women's Health & Gender-Based Medicine. 2001 June; 10(5): 441-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11445043&dopt=Abstract
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Hormonal contraception and cervical cancer. Author(s): Epstein RJ. Source: Lancet. 2003 May 31; 361(9372): 1915. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788614&dopt=Abstract
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Hormonal contraception and migraine. Author(s): MacGregor EA. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 January; 27(1): 49-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457550&dopt=Abstract
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Hormonal contraception and risk of sexually transmitted disease acquisition: results from a prospective study. Author(s): Baeten JM, Nyange PM, Richardson BA, Lavreys L, Chohan B, Martin HL Jr, Mandaliya K, Ndinya-Achola JO, Bwayo JJ, Kreiss JK. Source: American Journal of Obstetrics and Gynecology. 2001 August; 185(2): 380-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518896&dopt=Abstract
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Hormonal contraception can suppress natural antimicrobial gene transcription in human endometrium. Author(s): Fleming DC, King AE, Williams AR, Critchley HO, Kelly RW. Source: Fertility and Sterility. 2003 April; 79(4): 856-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749421&dopt=Abstract
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Hormonal contraception for human males: prospects. Author(s): Reddy PR. Source: Asian Journal of Andrology. 2000 March; 2(1): 46-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228937&dopt=Abstract
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Hormonal contraception in the male. Author(s): Anderson RA. Source: British Medical Bulletin. 2000; 56(3): 717-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255556&dopt=Abstract
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Hormonal emergency contraception. Author(s): Wanner MS, Couchenour RL. Source: Pharmacotherapy. 2002 January; 22(1): 43-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11794429&dopt=Abstract
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How can pharmacies improve access to emergency contraception? Author(s): Boggess JE. Source: Perspectives on Sexual and Reproductive Health. 2002 May-June; 34(3): 162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12137130&dopt=Abstract
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How safe is emergency contraception? Author(s): Norris Turner A, Ellertson C. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2002; 25(10): 695-706. Erratum In: Drug Saf 2002; 25(11): 758. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167065&dopt=Abstract
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Human sperm-specific peptide vaccine that causes long-term reversible contraception. Author(s): Naz RK, Chauhan SC. Source: Biology of Reproduction. 2002 August; 67(2): 674-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135913&dopt=Abstract
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Immediate postabortal contraception with the levonorgestrel intrauterine device, Norplant, and traditional methods. Author(s): Ortayli N, Bulut A, Sahin T, Sivin I. Source: Contraception. 2001 June; 63(6): 309-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11672552&dopt=Abstract
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Implant contraception. Author(s): Meckstroth KR, Darney PD. Source: Seminars in Reproductive Medicine. 2001 December; 19(4): 339-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727176&dopt=Abstract
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Improve adolescents' access to emergency contraception. Author(s): Pollack JS, Daley AM. Source: The Nurse Practitioner. 2003 August; 28(8): 11-23; Quiz 24-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902937&dopt=Abstract
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Improving compliance in oral contraception: 'the reminder card'. Author(s): Lachowsky M, Levy-Toledano R. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 December; 7(4): 210-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648292&dopt=Abstract
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Improving teenagers' knowledge of emergency contraception: cluster randomised controlled trial of a teacher led intervention. Author(s): Graham A, Moore L, Sharp D, Diamond I. Source: Bmj (Clinical Research Ed.). 2002 May 18; 324(7347): 1179. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12016180&dopt=Abstract
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Improving young people's access to emergency contraception. Author(s): Flowerdew C. Source: Nurs Times. 2003 August 19-25; 99(33): 24-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12953644&dopt=Abstract
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In search of appropriate contraception: horses for courses. Author(s): Edouard L. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):43-4. No Abstract Available. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681038&dopt=Abstract
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Indazole carboxylic acids in male contraception. Author(s): Cheng CY, Mo M, Grima J, Saso L, Tita B, Mruk D, Silvestrini B. Source: Contraception. 2002 April; 65(4): 265-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12020774&dopt=Abstract
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Influence of low-dose oral contraception on peripheral blood lymphocyte subsets at particular phases of the hormonal cycle. Author(s): Auerbach L, Hafner T, Huber JC, Panzer S. Source: Fertility and Sterility. 2002 July; 78(1): 83-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12095495&dopt=Abstract
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Information campaign and advocacy efforts to promote access to emergency contraception in Mexico. Author(s): Ellertson C, Heimburger A, Acevedo-Garcia D, Schiavon R, Mejia G, Corona G, del Castillo E, Langer A. Source: Contraception. 2002 November; 66(5): 331-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443963&dopt=Abstract
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Initiating contraception in sexually transmitted disease clinic setting: a randomized trial. Author(s): Shlay JC, Mayhugh B, Foster M, Maravi ME, Baron AE, Douglas JM Jr. Source: American Journal of Obstetrics and Gynecology. 2003 August; 189(2): 473-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14520221&dopt=Abstract
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Injectable contraception. Author(s): Mishell DR Jr. Source: J Reprod Med. 2002 September; 47(9 Suppl): 777-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12380405&dopt=Abstract
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Injectable hormone contraception and bone density: results from a prospective study. Author(s): Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM. Source: Epidemiology (Cambridge, Mass.). 2002 September; 13(5): 581-7. Erratum In: Epidemiology. 2002 November; 13(6): 749. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12192229&dopt=Abstract
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Insurance coverage for reversible contraception. A legal battle for women and NPs. Author(s): Judy-Kerr NR. Source: Adv Nurse Pract. 2003 September; 11(9): 80, 83-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14521113&dopt=Abstract
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Interactions between antiepileptic drugs and hormonal contraception. Author(s): Crawford P. Source: Cns Drugs. 2002; 16(4): 263-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11945109&dopt=Abstract
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Intrauterine contraception: a look at devices and systems. Author(s): Wickham H. Source: Community Nurse. 2000 October; 6(9): 41-2, 45. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11982146&dopt=Abstract
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Intra-vas deferens injection of styrene maleic anhydride gel for male contraception: is it safe? Author(s): Singh AK. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 October; 28(4): 208-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419065&dopt=Abstract
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Investigation of hormonal male contraception in African men: suppression of spermatogenesis by oral desogestrel with depot testosterone. Author(s): Anderson RA, Van Der Spuy ZM, Dada OA, Tregoning SK, Zinn PM, Adeniji OA, Fakoya TA, Smith KB, Baird DT. Source: Human Reproduction (Oxford, England). 2002 November; 17(11): 2869-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407041&dopt=Abstract
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Is “abortion culture” fading in the former Soviet Union? Views about abortion and contraception in Kazakhstan. Author(s): Agadjanian V. Source: Stud Fam Plann. 2002 September; 33(3): 237-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12385085&dopt=Abstract
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Is breast-feeding a substitute for contraception in family planning? Author(s): Rous JJ. Source: Demography. 2001 November; 38(4): 497-512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11723947&dopt=Abstract
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Knowledge about contraception in women undergoing repeat voluntary abortions, and means of prevention. Author(s): Alouini S, Uzan M, Meningaud JP, Herve C. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2002 August 5; 104(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12128261&dopt=Abstract
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Knowledge and attitudes about the differences between emergency contraception and medical abortion among middle-class women and men of reproductive age in Mexico City. Author(s): Gould H, Ellertson C, Corona G. Source: Contraception. 2002 December; 66(6): 417-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12499034&dopt=Abstract
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Knowledge and perception of emergency contraception among female Nigerian undergraduates. Author(s): Aziken ME, Okonta PI, Ande AB. Source: International Family Planning Perspectives. 2003 June; 29(2): 84-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783772&dopt=Abstract
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Knowledge and practice of contraception in United Arab Emirates women. Author(s): Ghazal-Aswad S, Rizk DE, Al-Khoori SM, Shaheen H, Thomas L. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 212-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457470&dopt=Abstract
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Knowledge and use of emergency contraception in a tertiary referral unit in a developing country. Author(s): Siebert I, Steyn PS. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 September; 7(3): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428932&dopt=Abstract
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Knowledge of emergency contraception among pharmacists and doctors in Durban, South Africa. Author(s): Hariparsad N. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2001 March; 6(1): 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11334472&dopt=Abstract
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Knowledge of the risks and benefits associated with oral contraception in a university-aged sample of users and non-users. Author(s): Bryden PJ, Fletcher P. Source: Contraception. 2001 April; 63(4): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11376650&dopt=Abstract
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Levonorgestrel implants (Norplant II) for male contraception clinical trials: combination with transdermal and injectable testosterone. Author(s): Gonzalo IT, Swerdloff RS, Nelson AL, Clevenger B, Garcia R, Berman N, Wang C. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 August; 87(8): 3562-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161475&dopt=Abstract
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Levonorgestrel-only emergency contraception: real-world tolerance and efficacy. Author(s): Gainer E, Mery C, Ulmann A. Source: Contraception. 2001 July; 64(1): 17-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535208&dopt=Abstract
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Low dose gossypol for male contraception. Author(s): Gu ZP, Mao BY, Wang YX, Zhang RA, Tan YZ, Chen ZX, Cao L, You GD, Segal SJ. Source: Asian Journal of Andrology. 2000 December; 2(4): 283-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11202417&dopt=Abstract
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Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomised trial. Author(s): von Hertzen H, Piaggio G, Ding J, Chen J, Song S, Bartfai G, Ng E, GemzellDanielsson K, Oyunbileg A, Wu S, Cheng W, Ludicke F, Pretnar-Darovec A, Kirkman R, Mittal S, Khomassuridze A, Apter D, Peregoudov A; WHO Research Group on Postovulatory Methods of Fertility Regulation. Source: Lancet. 2002 December 7; 360(9348): 1803-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480356&dopt=Abstract
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Magnitude and variability of sequential estradiol and progesterone concentrations in women using depot medroxyprogesterone acetate for contraception. Author(s): Clark MK, Sowers M, Levy BT, Tenhundfeld P. Source: Fertility and Sterility. 2001 May; 75(5): 871-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11334896&dopt=Abstract
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Male contraception, IV: hypotonic-like effect from Echeveria gibbiflora on human sperm. Author(s): Reyes R, Merchant-Larios H, Ortega-Hernandez A, Delgado NM. Source: Archives of Andrology. 2002 November-December; 48(6): 443-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12425761&dopt=Abstract
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Male contraception. Author(s): Jensen JT. Source: Curr Womens Health Rep. 2002 October; 2(5): 338-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215306&dopt=Abstract
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Male contraception. Author(s): Anderson RA, Baird DT. Source: Endocrine Reviews. 2002 December; 23(6): 735-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466187&dopt=Abstract
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Male contraception. Author(s): Wang C, Swerdloff RS. Source: Best Practice & Research. Clinical Obstetrics & Gynaecology. 2002 April; 16(2): 193-203. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12041962&dopt=Abstract
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Male contraception: prospects for the new millennium. Author(s): Hair WM, Wu FC. Source: Asian Journal of Andrology. 2000 March; 2(1): 3-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228934&dopt=Abstract
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Male contraception: views to the 21st century, Bethesda, MD, USA, 9-10 September 1999. Author(s): DePaolo LV, Hinton BT, Braun RE. Source: Trends in Endocrinology and Metabolism: Tem. 2000 March; 11(2): 66-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228881&dopt=Abstract
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Markers of platelet activation, thrombin generation and fibrinolysis in women with sickle cell disease: effects of differing forms of hormonal contraception. Author(s): Yoong WC, Tuck SM, Pasi KJ, Owens D, Perry DJ. Source: European Journal of Haematology. 2003 May; 70(5): 310-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694167&dopt=Abstract
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Married women's satisfaction with their choice of contraception. Author(s): Hsiao YC, Sung SH. Source: The Journal of Nursing Research : Jnr. 2003 June; 11(2): 119-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12820075&dopt=Abstract
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Mechanism of action of hormonal preparations used for emergency contraception: a review of the literature. Author(s): Croxatto HB, Devoto L, Durand M, Ezcurra E, Larrea F, Nagle C, Ortiz ME, Vantman D, Vega M, von Hertzen H. Source: Contraception. 2001 March; 63(3): 111-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11368982&dopt=Abstract
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Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception. Author(s): Cundy T, Cornish J, Roberts H, Reid IR. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5): 978-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12015524&dopt=Abstract
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Mobilizing demand for contraception in rural Gambia. Author(s): Luck M, Jarju E, Nell MD, George MO. Source: Stud Fam Plann. 2000 December; 31(4): 325-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198069&dopt=Abstract
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Mock family planning clinics: community-based teaching on contraception for medical students. Author(s): Baraitser P, Herns M. Source: Medical Education. 2001 November; 35(11): 1082-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11715971&dopt=Abstract
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Modeling the cost and outcomes of pharmacist-prescribed emergency contraception. Author(s): Marciante KD, Gardner JS, Veenstra DL, Sullivan SD. Source: American Journal of Public Health. 2001 September; 91(9): 1443-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11527778&dopt=Abstract
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Modifying the Yuzpe regimen of emergency contraception: a multicenter randomized controlled trial. Author(s): Ellertson C, Webb A, Blanchard K, Bigrigg A, Haskell S, Shochet T, Trussell J. Source: Obstetrics and Gynecology. 2003 June; 101(6): 1160-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798518&dopt=Abstract
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Mood changes in adolescents using depot-medroxyprogesterone acetate for contraception: a prospective study. Author(s): Gupta N, O'Brien R, Jacobsen LJ, Davis A, Zuckerman A, Supran S, Kulig J. Source: Journal of Pediatric and Adolescent Gynecology. 2001 May; 14(2): 71-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11479103&dopt=Abstract
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Natural contraception using the Billings ovulation method. Author(s): Attar E, Gokdemirel S, Serdaroglu H, Coskun A. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 June; 7(2): 96-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201328&dopt=Abstract
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New aspects of injectable contraception. Author(s): Phillips OP. Source: Int J Fertil Womens Med. 2001 January-February; 46(1): 31-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294618&dopt=Abstract
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New contraception options. Author(s): Kacmar JE. Source: Medicine and Health, Rhode Island. 2003 January; 86(1): 6-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633013&dopt=Abstract
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New developments in contraception. Author(s): Keder LM. Source: Journal of Pediatric and Adolescent Gynecology. 2002 June; 15(3): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12106759&dopt=Abstract
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New developments in contraception: what's happening. Author(s): Cody MM. Source: Clin Excell Nurse Pract. 1998 May; 2(3): 146-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12675083&dopt=Abstract
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New methods of hormonal contraception. Author(s): Murphy PA. Source: The Nurse Practitioner. 2003 February; 28(2): 11-21; Quiz 21-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584452&dopt=Abstract
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New options in contraception for adolescents. Author(s): Sucato G, Gold MA. Source: Curr Womens Health Rep. 2001 October; 1(2): 116-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112958&dopt=Abstract
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Noncompliance among a group of women using a novel method of contraception. Author(s): Hapangama DK, Glasier AF, Baird DT. Source: Fertility and Sterility. 2001 December; 76(6): 1196-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11730750&dopt=Abstract
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Non-hormonal contraception and the risk of ovarian cancer. Author(s): Weiss NS, Rossing MA. Source: Epidemiology (Cambridge, Mass.). 2001 May; 12(3): 300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11337602&dopt=Abstract
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Non-latex versus latex male condoms for contraception. Author(s): Gallo MF, Grimes DA, Schulz KF. Source: Cochrane Database Syst Rev. 2003; (2): Cd003550. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804475&dopt=Abstract
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Novel delivery systems in contraception. Author(s): Lahteenmaki P, Jukarainen H. Source: British Medical Bulletin. 2000; 56(3): 739-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255558&dopt=Abstract
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Nuptiality, fertility, use of contraception, and family policies in Uzbekistan. Author(s): Barbieri M, Blum A, Dolkigh E, Ergashev A. Source: Population Studies. 1996 March; 50(1): 69-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11609137&dopt=Abstract
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Of interception, postcoital contraception and the morning after. Author(s): Edouard L. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 April; 28(2): 105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396786&dopt=Abstract
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On the mechanisms of action of short-term levonorgestrel administration in emergency contraception. Author(s): Durand M, del Carmen Cravioto M, Raymond EG, Duran-Sanchez O, De la Luz Cruz-Hinojosa M, Castell-Rodriguez A, Schiavon R, Larrea F. Source: Contraception. 2001 October; 64(4): 227-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747872&dopt=Abstract
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Oral contraception and ear disease: findings in a large cohort study. Author(s): Vessey M, Painter R. Source: Contraception. 2001 February; 63(2): 61-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11292468&dopt=Abstract
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Oral contraception and epilepsy: findings in a large cohort study. Author(s): Vessey M, Painter R, Yeates D. Source: Contraception. 2002 August; 66(2): 77-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204778&dopt=Abstract
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Oral contraception and the risk of thromboembolism: what does it mean to clinicians and their patients? Author(s): Drife J. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2002; 25(13): 893-902. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381211&dopt=Abstract
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Oral contraception and the treatment of acne: where are we? Author(s): Belisle S. Source: J Obstet Gynaecol Can. 2002 July; 24(7): 550-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365395&dopt=Abstract
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Oral contraception: patterns of non-compliance. The Coraliance study. Author(s): Aubeny E, Buhler M, Colau JC, Vicaut E, Zadikian M, Childs M. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 September; 7(3): 155-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428935&dopt=Abstract
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Oral contraception: trends over time. Author(s): Yuzpe AA. Source: J Reprod Med. 2002 November; 47(11 Suppl): 967-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12497670&dopt=Abstract
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Oral contraceptives, other methods of contraception, and risk reduction for ovarian cancer. Author(s): Ness RB, Grisso JA, Vergona R, Klapper J, Morgan M, Wheeler JE; Study of Health and Reproduction (SHARE) Study Group. Source: Epidemiology (Cambridge, Mass.). 2001 May; 12(3): 307-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11337604&dopt=Abstract
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OTC emergency contraception? Author(s): Weiss B. Source: Rn. 2001 May; 64(5): Suppl 3-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12033024&dopt=Abstract
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Ovarian and endometrial function during hormonal contraception. Author(s): ESHRE Capri Workshop Group. Source: Human Reproduction (Oxford, England). 2001 July; 16(7): 1527-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11425842&dopt=Abstract
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Overview of advances in contraception. Author(s): Baird DT. Source: British Medical Bulletin. 2000; 56(3): 704-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255555&dopt=Abstract
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Pain and subsequent mortality and cancer among women in the Royal College of General Practitioners Oral Contraception Study. Author(s): Smith BH, Elliott AM, Hannaford PC. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 January; 53(486): 45-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12564277&dopt=Abstract
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Patient communication and counseling on contraception and hormone replacement therapy. Author(s): Ruggiero RJ. Source: Am J Manag Care. 2001 November; 7(18 Suppl): S580-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727397&dopt=Abstract
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Perception of university students in Ghana about emergency contraception. Author(s): Baiden F, Awini E, Clerk C. Source: Contraception. 2002 July; 66(1): 23-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12169377&dopt=Abstract
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Performance and acceptability of intrauterine release of levonorgestrel with a miniature delivery system for hormonal substitution therapy, contraception and treatment in peri and postmenopausal women. Author(s): Wildemeersch D, Schacht E, Wildemeersch P. Source: Maturitas. 2003 March 28; 44(3): 237-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648887&dopt=Abstract
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Pharmaceutical care in emergency contraception. Author(s): Downing D. Source: Journal of the American Pharmaceutical Association (Washington,D.C. : 1996). 2002 September-October; 42(5 Suppl 1): S38-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296548&dopt=Abstract
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Pharmacist's perceptions of nurse prescribing of emergency contraception. Author(s): Cooper N, Blackwell D, Taylor G, Holden K. Source: British Journal of Community Nursing. 2000 March; 5(3): 126-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589241&dopt=Abstract
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Pharmacokinetic study of different dosing regimens of levonorgestrel for emergency contraception in healthy women. Author(s): Johansson E, Brache V, Alvarez F, Faundes A, Cochon L, Ranta S, Lovern M, Kumar N. Source: Human Reproduction (Oxford, England). 2002 June; 17(6): 1472-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12042264&dopt=Abstract
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Pharmacologic characteristics of progestins used for contraception and hormone replacement therapy, including new transdermal technologies. Author(s): Burkman RT. Source: Am J Manag Care. 2001 November; 7(18 Suppl): S571-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727395&dopt=Abstract
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Pharmacy access to emergency contraception in Europe. Author(s): Ulmann A, Gainer E. Source: Perspectives on Sexual and Reproductive Health. 2002 September-October; 34(5): 271; Author Reply 271. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392220&dopt=Abstract
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Policy climate, scholarship, and provision of emergency contraception at affiliates of the International Planned Parenthood Federation in Latin America and the Caribbean. Author(s): Diaz-Olavarrieta C, Turner AN, Ellertson C, Helzner JF, Ezcurra E. Source: Contraception. 2002 February; 65(2): 143-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927117&dopt=Abstract
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Postcoital contraception in Turkey. Author(s): Sogukpinar N, Turkistanli EC, Saydam BK. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 February; 80(2): 159-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566189&dopt=Abstract
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Postfertilization effect of hormonal emergency contraception. Author(s): Kahlenborn C, Stanford JB, Larimore WL. Source: The Annals of Pharmacotherapy. 2002 March; 36(3): 465-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11895061&dopt=Abstract
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Progestin implants for female contraception. Author(s): Croxatt HB. Source: Contraception. 2002 January; 65(1): 15-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11861051&dopt=Abstract
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Progestogen-only emergency contraception and ectopic pregnancy. Author(s): Harrison-Woolrych M, Woolley J. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2003 January; 29(1): 5-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626168&dopt=Abstract
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Progestogen-only emergency contraception. Author(s): Gainer E, Mery C, Ulmann A. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):60. No Abstract Available. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681051&dopt=Abstract
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Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Author(s): Farrow A, Hull MG, Northstone K, Taylor H, Ford WC, Golding J. Source: Human Reproduction (Oxford, England). 2002 October; 17(10): 2754-61. Erratum In: Hum Reprod. 2002 November; 17(11): 3009. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12351558&dopt=Abstract
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Prospect for immunocontraception using the NH2-terminal recombinant peptide of human zona pellucida protein (hZPA). Author(s): Koyama K, Hasegawa A, Gupta SK. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 2002 May; 47(5): 303-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148546&dopt=Abstract
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Protection of RU-486 as contraception, emergency contraception and as an abortifacient under the law of contraception. Author(s): Wyser-Pratte RC. Source: Oregon Law Rev. 2000 Winter; 79(4): 1121-56. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452141&dopt=Abstract
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Provision of Chlamydia trachomatis screening in family planning clinics and emergency contraception in genitourinary medicine clinics: a collaborative crossspeciality survey. Author(s): Dale AW, Wilkinson C, Forster GE, Daniels D, Brook MG. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2002 October; 28(4): 185-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419057&dopt=Abstract
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Provision of emergency contraception in general practice and confidentiality for the under 16's: results of a postal survey by general practitioners in Avon. Author(s): Graham A, Moore L, Sharp D. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457466&dopt=Abstract
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Randomised controlled trial assessing the acceptability of GyneFix versus GyneT380S for emergency contraception. Author(s): D'Souza RE, Masters T, Bounds W, Guillebaud J. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):23-9. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681033&dopt=Abstract
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Randomized controlled trials in “Contraception”: the need for “CONSORT” guidelines. Author(s): Grimes DA, Schulz KF. Source: Contraception. 2001 September; 64(3): 139-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11704090&dopt=Abstract
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Re “Three new methods for male contraception”. Author(s): Handelsman DJ, Wu FC. Source: Asian Journal of Andrology. 2000 March; 2(1): 78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228943&dopt=Abstract
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Recent advances in hormonal male contraception. Author(s): Meriggiola MC, Costantino A, Cerpolini S. Source: Contraception. 2002 April; 65(4): 269-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12020775&dopt=Abstract
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Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception. Author(s): Johnson BR, Ndhlovu S, Farr SL, Chipato T. Source: Stud Fam Plann. 2002 June; 33(2): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132639&dopt=Abstract
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Relationships between contraception and abortion: a review of the evidence. Author(s): Marston C, Cleland J. Source: International Family Planning Perspectives. 2003 March; 29(1): 6-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709307&dopt=Abstract
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Release of progestin-only emergency contraception. Author(s): Schwartz JL. Source: Curr Womens Health Rep. 2001 December; 1(3): 191-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112969&dopt=Abstract
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Repeat emergency contraception: facing our fears. Author(s): Shelton JD. Source: Contraception. 2002 July; 66(1): 15-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12169375&dopt=Abstract
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Repeat use of emergency contraception: How frequent is it? Author(s): Roizen J, Garside R, Barnett L. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 197-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457467&dopt=Abstract
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Reproductive ability for sale, do I hear $200?: private cash-for-contraception agreements as an alternative to maternal substance abuse. Author(s): Johnson JM. Source: Ariz Law Rev. 2001 Spring; 43(1): 205-43. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12449978&dopt=Abstract
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Research on contraception still in the doldrums. Author(s): Holden C. Source: Science. 2002 June 21; 296(5576): 2172-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12077399&dopt=Abstract
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Residual ovarian activity during oral steroid contraception. Author(s): van Heusden AM, Fauser BC. Source: Human Reproduction Update. 2002 July-August; 8(4): 345-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206469&dopt=Abstract
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Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception. Author(s): Doll H, Vessey M, Painter R. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2001 March; 108(3): 304-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11281473&dopt=Abstract
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Role of education in the use of contraception. Author(s): Waiz NK. Source: Lancet. 2000 December; 356 Suppl: S51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191510&dopt=Abstract
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Role of family history in identifying women with thrombophilia and higher risk of venous thromboembolism during oral contraception. Author(s): Cosmi B, Legnani C, Bernardi F, Coccheri S, Palareti G. Source: Archives of Internal Medicine. 2003 May 12; 163(9): 1105-9. Erratum In: Arch Intern Med. 2003 August 11-25; 163(15): 1778. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742811&dopt=Abstract
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Routine provision of emergency contraception to teens and subsequent condom use: a preliminary study. Author(s): Roye CF, Johnsen JR. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2001 March; 28(3): 165-6. Erratum In: J Adolesc Health 2001 May; 28(5): 432. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11291636&dopt=Abstract
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Rural and urban Midwestern United States contraception practices. Author(s): Hartlage SA, Breaux C, Gehlert S, Fogg L. Source: Contraception. 2001 June; 63(6): 319-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11672554&dopt=Abstract
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Rural men and their attitude towards vasectomy as means of contraception in Ethiopia. Author(s): Dibaba A. Source: Trop Doct. 2001 April; 31(2): 100-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321254&dopt=Abstract
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Savings/credit group formation and change in contraception. Author(s): Steele F, Amin S, Naved RT. Source: Demography. 2001 May; 38(2): 267-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11392912&dopt=Abstract
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Scanning electron microscopic (SEM) changes of the endometrium in women taking high doses of levonorgestrel as emergency postcoital contraception. Author(s): Ugocsai G, Rozsa M, Ugocsai P. Source: Contraception. 2002 December; 66(6): 433-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12499036&dopt=Abstract
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School nurses and contraception. Author(s): Day P. Source: Nurs Times. 2000 August 3-9; 96(31): 39-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11962856&dopt=Abstract
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Screening for Chlamydia trachomatis infection is indicated for women under 30 using emergency contraception. Author(s): Kettle H, Cay S, Brown A, Glasier A. Source: Contraception. 2002 October; 66(4): 251-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413621&dopt=Abstract
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Sensitive LH and FSH assays for monitoring low serum levels in men undergoing steroidal contraception. Author(s): Robertson DM, Pruysers E, Stephenson T, Pettersson K, Morton S, McLachlan RI. Source: Clinical Endocrinology. 2001 September; 55(3): 331-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589676&dopt=Abstract
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Sex discrimination and insurance for contraception. Author(s): Law SA. Source: Wash Law Rev. 1998 April; 73(2): 363-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465638&dopt=Abstract
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Sexuality and contraception among never married high school students in Butajira, Ethiopia. Author(s): Versnel M, Berhane Y, Wendte JF. Source: Ethiop Med J. 2002 January; 40(1): 41-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240566&dopt=Abstract
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Sexuality, reproduction, contraception, and abortion: a review of recent literature. Author(s): Mohr JC. Source: Journal of Women's History. 1996 Spring; 8(1): 172-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11623408&dopt=Abstract
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Should emergency contraception pills be available “over the counter”? Author(s): Devine KS, Barron ML. Source: Mcn. the American Journal of Maternal Child Nursing. 2001 NovemberDecember; 26(6): 294-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11725400&dopt=Abstract
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Should school nurses be dispensing emergency contraception? Author(s): Reid P, Jackson P. Source: Nurs Times. 2001 January 18-24; 97(3): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11954142&dopt=Abstract
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Skin patch and vaginal ring versus combined oral contraceptives for contraception. Author(s): Gallo MF, Grimes DA, Schulz KF. Source: Cochrane Database Syst Rev. 2003; (1): Cd003552. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535478&dopt=Abstract
102 Contraception
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Sponge versus diaphragm for contraception. Author(s): Kuyoh MA, Toroitich-Ruto C, Grimes DA, Schulz KF, Gallo MG. Source: Cochrane Database Syst Rev. 2002; (3): Cd003172. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12137678&dopt=Abstract
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Sponge versus diaphragm for contraception: a Cochrane review. Author(s): Kuyoh MA, Toroitich-Ruto C, Grimes DA, Schulz KF, Gallo MF. Source: Contraception. 2003 January; 67(1): 15-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521652&dopt=Abstract
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Steroidal contraception for men. Author(s): Sarkar NN. Source: Int J Clin Pract. 2000 November; 54(9): 594-603. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220988&dopt=Abstract
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Suppression of spermatogenesis by etonogestrel implants with depot testosterone: potential for long-acting male contraception. Author(s): Anderson RA, Kinniburgh D, Baird DT. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 August; 87(8): 3640-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161488&dopt=Abstract
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Surfing on the morning after: analysis of an emergency contraception website. Author(s): Gainer E, Sollet C, Ulmann M, Levy D, Ulmann A. Source: Contraception. 2003 March; 67(3): 195-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618253&dopt=Abstract
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Switching emergency contraception to over-the-counter status. Author(s): Grimes DA. Source: The New England Journal of Medicine. 2002 September 12; 347(11): 846-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12226159&dopt=Abstract
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Switching emergency contraception to over-the-counter status. Author(s): Rothschild TJ. Source: The New England Journal of Medicine. 2003 January 2; 348(1): 82-3; Author Reply 82-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510052&dopt=Abstract
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The checkered history and bright future of intrauterine contraception in the United States. Author(s): Hubacher D. Source: Perspectives on Sexual and Reproductive Health. 2002 March-April; 34(2): 98103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043715&dopt=Abstract
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The diaphragm with and without spermicide for contraception: a Cochrane review. Author(s): Cook L, Nanda K, Grimes D. Source: Human Reproduction (Oxford, England). 2002 April; 17(4): 867-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925374&dopt=Abstract
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The 'frameless' intrauterine system for long-term, reversible contraception: a review of 15 years of clinical experience. Author(s): Wildemeersch D, Batar I, Affandi B, Andrade A, Shangchun W, Jing H, Xiaoming C. Source: The Journal of Obstetrics and Gynaecology Research. 2003 June; 29(3): 164-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841701&dopt=Abstract
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The legal status of emergency contraception. Author(s): Cook RJ, Dickens BM, Ngwena C, Plata MI. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 November; 75(2): 185-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11684114&dopt=Abstract
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The levonorgestrel two-rod implant for long-acting contraception: 10 years of clinical experience. Author(s): Wan LS, Stiber A, Lam LY. Source: Obstetrics and Gynecology. 2003 July; 102(1): 24-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850601&dopt=Abstract
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The next step for emergency contraception: over-the-counter availability. Author(s): O'Callaghan MA, Andrist LC. Source: Clin Excell Nurse Pract. 2001 March; 5(2): 73-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11329553&dopt=Abstract
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The prevalent use of contraception among teenagers in Denmark and the corresponding low pregnancy rate. Author(s): Wielandt H, Boldsen J, Knudsen LB. Source: Journal of Biosocial Science. 2002 January; 34(1): 1-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11814208&dopt=Abstract
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The process of preventing pregnancy: women's experiences and emergency contraception use. Author(s): Esacove AW, Andringa KR. Source: Qualitative Health Research. 2002 November; 12(9): 1235-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448669&dopt=Abstract
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The relationship between attitudes toward pregnancy and contraception use among drug users. Author(s): Gutierres SE, Barr A. Source: Journal of Substance Abuse Treatment. 2003 January; 24(1): 19-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646327&dopt=Abstract
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The role of surgical techniques in the treatment of menstrual problems and as contraception in adolescents with disabilities. Author(s): Zurawin RK, Paransky OI. Source: Journal of Pediatric and Adolescent Gynecology. 2003 February; 16(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604149&dopt=Abstract
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The role of the pharmacist in emergency contraception. Author(s): Taylor B. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2003 April; 29(2): 7. Erratum In: J Fam Plann Reprod Health Care. 2003 July; 29(3): 159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681053&dopt=Abstract
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The transdermal contraceptive patch: a new approach to hormonal contraception. Author(s): Burkman RT. Source: Int J Fertil Womens Med. 2002 March-April; 47(2): 69-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991433&dopt=Abstract
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Thromboembolic disease and present oral contraception. Author(s): Belicova M, Lukac B, Dvorsky J, Peter G, Mokan M, Kubisz P. Source: Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2003 January; 9(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643323&dopt=Abstract
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Timing of emergency contraception. Author(s): Raymond E, Taylor D. Source: American Journal of Obstetrics and Gynecology. 2002 January; 186(1): 167-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11810104&dopt=Abstract
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Toward optimal health: the experts discuss oral contraception. Author(s): Meisler JG. Source: Journal of Women's Health & Gender-Based Medicine. 2001 December; 10(10): 921-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11788103&dopt=Abstract
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Training and supporting pharmacists to supply progestogen-only emergency contraception. Author(s): Bacon L, Savage I, Cook S, Taylor B. Source: J Fam Plann Reprod Health Care. 2003 April;29(2):17-22. Erratum In: J Fam Plann Reprod Health Care. 2003 July;29(3):159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681032&dopt=Abstract
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Transdermal contraception. Author(s): Creasy GW, Abrams LS, Fisher AC. Source: Seminars in Reproductive Medicine. 2001 December; 19(4): 373-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727179&dopt=Abstract
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Transdermal contraception: evaluation of three transdermal norelgestromin/ethinyl estradiol doses in a randomized, multicenter, dose-response study. Author(s): Dittrich R, Parker L, Rosen JB, Shangold G, Creasy GW, Fisher AC; Ortho Evra/Evra 001 Study Group. Source: American Journal of Obstetrics and Gynecology. 2002 January; 186(1): 15-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11810078&dopt=Abstract
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Transvaginal ultrasonography in women receiving emergency contraception. Author(s): Severi FM, Bocchi C, Florio P, Cobellis L, Ignacchiti E, Petraglia F. Source: Fertility and Sterility. 2003 May; 79(5): 1074-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738498&dopt=Abstract
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Two generations. Family planning nurses have provided support to decades of young women in need of contraception and advice. Author(s): Pearce L. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2001 February 14-20; 15(22): 14-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211940&dopt=Abstract
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U.S. policy can reduce cost barriers to contraception. Author(s): Dailard C. Source: Issues Brief (Alan Guttmacher Inst). 1999; (2): 1-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12134877&dopt=Abstract
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Undiagnosed HIV in women attending a sexual health clinic for non-barrier methods of contraception. Two case studies. Author(s): Jones M. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2003 January; 29(1): 31-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626178&dopt=Abstract
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Unwanted pregnancy on self-medication with St John's wort despite hormonal contraception. Author(s): Schwarz UI, Buschel B, Kirch W. Source: British Journal of Clinical Pharmacology. 2003 January; 55(1): 112-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534648&dopt=Abstract
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Update on Contraception Awareness Project. Author(s): Reid R. Source: Can Fam Physician. 2002 June; 48: 1090-1, 1097-8. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113196&dopt=Abstract
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Update on contraception. Author(s): Tumolo J. Source: Adv Nurse Pract. 2000 August; 8(8): 74, 79-80. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11761529&dopt=Abstract
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Update on contraception: benefits and risks of the new formulations. Author(s): Batur P, Elder J, Mayer M. Source: Cleve Clin J Med. 2003 August; 70(8): 681-2, 685-6, 668-90 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959393&dopt=Abstract
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US judge condemns health plan for not covering contraception. Author(s): Josefson D. Source: Bmj (Clinical Research Ed.). 2001 June 23; 322(7301): 1507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11420265&dopt=Abstract
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Use of hormonal emergency contraception at a university health centre over a 6 year period. Author(s): Porter JH. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 January; 27(1): 47-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457549&dopt=Abstract
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Vaginal ring hormone delivery systems in contraception and menopause. Author(s): Ballagh SA. Source: Clinical Obstetrics and Gynecology. 2001 March; 44(1): 106-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11219238&dopt=Abstract
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Value of family history in identifying women at risk of venous thromboembolism during oral contraception: observational study. Author(s): Cosmi B, Legnani C, Bernardi F, Coccheri S, Palareti G. Source: Bmj (Clinical Research Ed.). 2001 April 28; 322(7293): 1024-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11325765&dopt=Abstract
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Vas deferens, a site of male contraception: an overview. Author(s): Cochrane Database Syst Rev. 2002;(3):CD002031 Source: Asian Journal of Andrology. 2001 June; 3(2): 87-95. Review. /entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12137639
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Views of Chinese parents on the provision of contraception to unmarried youth. Author(s): Cui N, Li M, Gao E. Source: Reproductive Health Matters. 2001 May; 9(17): 137-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11468829&dopt=Abstract
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What do women want? Counselling in contraception. Author(s): Webb A. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2002 September; 7(3): 150-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428934&dopt=Abstract
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Will Australian men use male hormonal contraception? A survey of a postpartum population. Author(s): Weston GC, Schlipalius ML, Bhuinneain MN, Vollenhoven BJ. Source: The Medical Journal of Australia. 2002 March 4; 176(5): 208-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999235&dopt=Abstract
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Women's knowledge and sources of information on the risks and benefits of oral contraception. Author(s): Picardo CM, Nichols M, Edelman A, Jensen JT. Source: J Am Med Womens Assoc. 2003 Spring; 58(2): 112-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744425&dopt=Abstract
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Women's use of contraception in rural India: a village-level study. Author(s): Chacko E. Source: Health & Place. 2001 September; 7(3): 197-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11439255&dopt=Abstract
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Young people's contraception and sexual health: report of a local needs assessment in Staveley, North Derbyshire. Author(s): Smith A. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 January; 27(1): 29-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457544&dopt=Abstract
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Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies. Author(s): Falk G, Falk L, Hanson U, Milsom I. Source: Contraception. 2001 July; 64(1): 23-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535209&dopt=Abstract
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CHAPTER 2. NUTRITION AND CONTRACEPTION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and contraception.
Finding Nutrition Studies on Contraception The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “contraception” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “contraception” (or a synonym): •
Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: a nationwide case-control study. Author(s): Department of Statistics, Chair of Medical Statistics and Epidemiology, University of Milan, Milan (Italy) Source: Corrao, G. Tragnone, A. Caprilli, R. Trallori, G. Papi, C. Andreoli, A. Paolo, M. di Riegler, G. Rigo, G.P. Ferrau, O. Mansi, C. Ingrosso, M. Valpiani, D. InternationalJournal-of-Epidemiology (United Kingdom). (1998). volume 27(3) page 397-404.
Additional physician-oriented references include: •
A 35-year-old woman with progesterone implant contraception and multiple liver masses. Author(s): Department of Pathology, Saint Louis University School of Medicine, 2625 Vista Avenue, St. Louis, MO 63110, USA. Source: Suarez, A A Brunt, E M Di Bisceglie, A M Semin-Liver-Dis. 2001 August; 21(3): 453-9 0272-8087
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A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception. Author(s): Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, UK. Source: Ashok, Premila W Stalder, Catriona Wagaarachchi, Prabhath T Flett, Gillian M Melvin, Louise Templeton, Allan BJOG. 2002 May; 109(5): 553-60 1470-0328
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Adolescent contraception. Source: Kreutner, A K Prim-Care. 1987 March; 14(1): 121-38 0095-4543
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Antifertility effects of neem (Azadirachta indica) oil by single intrauterine administration: a novel method for contraception. Author(s): National Institute of Immunology, New Delhi, India. Source: Upadhyay, S N Kaushic, C Talwar, G P Proc-R-Soc-Lond-B-Biol-Sci. 1990 December 22; 242(1305): 175-9 0080-4649
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Approaches to post-testicular contraception. Author(s): Institute of Reproductive Medicine of the University, Munster, Germany.
[email protected] Source: Cooper, T G Yeung, C H Asian-J-Androl. 1999 June; 1(1-2): 29-36
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Bleeding problems and progestogen-only contraception. Author(s): Victoria Clinic, Nottingham, UK. Source: Porter, C Rees, M C J-Fam-Plann-Reprod-Health-Care. 2002 October; 28(4): 17881 1471-1893
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Contraception 2000: lunelle, an injectable combination contraceptive option. Author(s): Department of Obstetrics and Gynecology, Division of Reproductive Genetics, University of Illinois at Chicago, Chicago, Illinois 60612-7313, USA. Source: Shulman, L P J-Womens-Health-Gend-Based-Med. 2000 September; 9(7): 725-9 1524-6094
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Contraception and culture: the use of yuyos in Paraguay. Author(s): Denver Public Health, Colorado 80204, USA. Source: Bull, S S Melian, M Health-Care-Women-Int. 1998 Jan-February; 19(1): 49-60 0739-9332
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Contraception for american women 40 and over. Source: Fortney, J A Fam-Plann-Perspect. 1987 Jan-February; 19(1): 32-4 0014-7354
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Contraception in lactating women. Author(s): Instituto Chileno de Medicina Reproductiva, Consultorio de Planificacion Familiar, Santiago. Source: Diaz, S Croxatto, H B Curr-Opin-Obstet-Gynecol. 1993 December; 5(6): 815-22 1040-872X
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Contraception in men: efficacy and immediate toxicity. A study of 18 cases. Source: Lobel, B Olivo, J F Guille, F Le Lannou, D Acta-Urol-Belg. 1989; 57(1): 117-24 0001-7183
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Contraception. Author(s): Pennsylvania Hospital, Philadelphia. Source: Beck, W W Curr-Opin-Obstet-Gynecol. 1989 December; 1(2): 195-8 1040-872X
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Current options for injectable contraception in the United States. Author(s): Department of Obstetrics and Gynecology, University of Florida Health Science Center/Jacksonville, Jacksonville, Florida, USA. Source: Kaunitz, A M Semin-Reprod-Med. 2001 December; 19(4): 331-7 1526-8004
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Emergency contraception. Author(s): Department of Human Reproduction, Hospital of the University of Pennsylvania, Philadelphia. Source: Barnhart, K T Sondheimer, S J Curr-Opin-Obstet-Gynecol. 1994 December; 6(6): 559-63 1040-872X
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GnRH agonist for postpartum contraception: biochemical, hormonal and endometrial effects. Author(s): Department of Reproductive Biology, School of Medicine, University of Coahuila, C.P., Mexico. Source: Vega, R R Barraza Vazquez, A Vega, M G Fernandez Gonzalez, E M Mayagoitia, S B Adv-Contracept. 1996 March; 12(1): 15-25 0267-4874
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Historical role of herbs in contraception. Source: Riddle, J.M. Phytochemicals and health proceedings, tenth annual Penn State Symposium in Plant Physiology, May 18-20, 1995 / Penn State Symposium in Plant Physiology. Rockville, Md. : American Society of Plant Physiologists, c1995. page 105111. ISBN: 0943088321
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Hormonal contraception and replacement and the use of androgens in the antiphospholipid syndrome. Author(s): The New York Medical College, New York, NY, USA. Source: Lahita, R G J-Autoimmun. 2000 September; 15(2): 213-6 0896-8411
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Hormonal male contraception: progress and prospects for the 21st century. Author(s): Andrology Unit, Royal Prince Alfred Hospital, Sydney, NSW. Source: Handelsman, D J Aust-N-Z-J-Med. 1995 December; 25(6): 808-16 0004-8291
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Immuno-contraception undergoing promising trials. Source: Koshy, L M Indian-Med-Trib. 1994 August 15; 2(13): 7 0971-488X
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Interactions with hormonal contraception. Source: Elliman, A Br-J-Fam-Plann. 2000 April; 26(2): 109-11, quiz 111,122 0144-8625
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Intranasal LHRH agonist combined periodically with a progestogen for contraception. Author(s): Hopital St-Francois d'Assise, Departement d'obstetrique-gynecologie, Universite Laval, Quebec, Canada. Source: Lemay, A Adv-Contracept. 1989 December; 5(4): 253-62 0267-4874
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Intra-vas deferens injection of styrene maleic anhydride gel for male contraception: is it safe? Author(s): School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India.
[email protected] Source: Singh, A K J-Fam-Plann-Reprod-Health-Care. 2002 October; 28(4): 208-9 14711893
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I've heard that scientists are looking at testosterone injections as a form of male contraception. How does adding testosterone make a man infertile? Source: Atkinson, H G Health-News. 2000 September; 6(9): 10 1081-5880
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Low dose gossypol for male contraception. Author(s): Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 200031, China.
[email protected] Source: Gu, Z P Mao, B Y Wang, Y X Zhang, R A Tan, Y Z Chen, Z X Cao, L You, G D Segal, S J Asian-J-Androl. 2000 December; 2(4): 283-7
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Low-dose progestogen contraception and the nursing mother. Author(s): Metabolic Unit, Institute for Research in Reproduction, Parel, Bombay, India. Source: Toddywalla, V S Patel, S B Betrabet, S S Saxena, B N Adv-Contracept. 1995 December; 11(4): 285-94 0267-4874
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Luteinizing hormone releasing hormone agonist for postpartum contraception. Author(s): Department of Reproductive Biology, School of Medicine, University of Coahuila, C.P., Mexico. Source: Mayagoitia, S B Hernandez Morales, C Macias, A M Vega, R R Adv-Contracept. 1996 March; 12(1): 27-41 0267-4874
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Male contraception. Author(s): Department of Obstetrics and Gynecology and Division of Reproductive Sciences, Oregon Regional Primate Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098, USA.
[email protected] Source: Jensen, J T Curr-Womens-Health-Repage 2002 October; 2(5): 338-45 1534-5874
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Menstrual bleeding patterns in untreated women and with long-acting methods of contraception. Task Force on Long-Acting Systemic Agents for Fertility Regulation. Author(s): Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland. Source: Belsey, E M Adv-Contracept. 1991 Jun-September; 7(2-3): 257-70 0267-4874
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New developments in contraception. Author(s): College of Medicine, Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, USA.
[email protected] Source: Keder, L M J-Pediatr-Adolesc-Gynecol. 2002 June; 15(3): 179-81 1083-3188
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New options in contraception for adolescents. Author(s): Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, G437, 3705 Fifth Avenue, Pittsburgh, PA 15213-2583, USA.
[email protected]
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Source: Sucato, G Gold, M A Curr-Womens-Health-Repage 2001 October; 1(2): 116-23 1534-5874 •
Novel delivery systems in contraception. Source: Lahteenmaki, P Jukarainen, H Br-Med-Bull. 2000; 56(3): 739-48 0007-1420
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Oral contraception in Bangladesh: social marketing and the importance of husbands. Source: Davies, J Mitra, S N Schellstede, W P Stud-Fam-Plann. 1987 May-June; 18(3): 157-68 0039-3665
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Pharmacologic characteristics of progestins used for contraception and hormone replacement therapy, including new transdermal technologies. Source: Burkman, R T Am-J-Manag-Care. 2001 November; 7(18 Suppl): S571-4 1096-1860
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Plant immunomodulators for termination of unwanted pregnancy and for contraception and reproductive health. Author(s): Reproductive Health and Vaccinology Division, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, India. Source: Talwar, G P Raghuvanshi, P Misra, R Mukherjee, S Shah, S Immunol-Cell-Biol. 1997 April; 75(2): 190-2 0818-9641
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Prescribing and managing oral contraceptive pills and emergency contraception for adolescents. Author(s): Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, School of Medicine, Pennsylvania, USA.
[email protected] Source: Gold, M A Pediatr-Clin-North-Am. 1999 August; 46(4): 695-718 0031-3955
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Present status of hormonal contraception (COCs). Author(s): Palatine Centre, University of Manchester, UK. Source: Elstein, M Adv-Contracept. 1996 September; 12(3): 155-66 0267-4874
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Recent biochemical approaches to post-testicular, epididymal contraception. Author(s): Institute of Reproductive Medicine of the University, Munster, Germany.
[email protected] Source: Cooper, T G Yeung, C H Hum-Reprod-Update. 1999 Mar-April; 5(2): 141-52 1355-4786
•
Release of progestin-only emergency contraception. Author(s): Department of Obstetrics/Gynecology, Magee-Women's Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.
[email protected] Source: Schwartz, J L Curr-Womens-Health-Repage 2001 December; 1(3): 191-5 15345874
•
Review on copper in male reproduction and contraception. Author(s): Department of physiology, M.P. Shah Medical College, Jamnagar, India. Source: Skandhan, K P Rev-Fr-Gynecol-Obstet. 1992 December; 87(12): 594-8 0035-290X
•
The use of traditional methods of contraception among Turkish couples. Author(s): Behavioral Epidemiology and Demographic Research Branch, Center for Disease Control and Prevention, Atlanta, GA 30341-3724. Source: Goldberg, H I Toros, A Stud-Fam-Plann. 1994 Mar-April; 25(2): 122-8 0039-3665
•
Three new methods for male contraception. Author(s): Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt.
[email protected] Source: Shafik, A Asian-J-Androl. 1999 December; 1(4): 161-7
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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
•
The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMDHealth: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to contraception; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Ascorbic Acid Source: Integrative Medicine Communications; www.drkoop.com Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Folic Acid Alternative names: Vitamin B9 (Folic Acid) Source: Integrative Medicine Communications; www.drkoop.com Niacin Source: Integrative Medicine Communications; www.drkoop.com Pyridoxine Alternative names: Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com Riboflavin Alternative names: Vitamin B2 (Riboflavin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin a Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10066,00.html Vitamin B2 (riboflavin) Alternative names: Riboflavin Source: Integrative Medicine Communications; www.drkoop.com Vitamin B3 (niacin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 (pyridoxine) Alternative names: Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin B9 (folic Acid) Alternative names: Folate Source: Integrative Medicine Communications; www.drkoop.com Vitamin C (ascorbic Acid) Alternative names: Ascorbic Acid Source: Integrative Medicine Communications; www.drkoop.com
116 Contraception
Vitamin E Alternative names: Alpha-Tocopherol, Beta-Tocopherol, D-Alpha-Tocopherol, Delta-Tocopherol, Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com •
Minerals Alpha-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Beta-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Copper Source: Integrative Medicine Communications; www.drkoop.com D-alpha-tocopherol Alternative names: Vitamin E Source: Integrative Medicine Communications; www.drkoop.com Delta-tocopherol Alternative names: Vitamin E Source: Integrative Medicine Communications; www.drkoop.com Folate Alternative names: Vitamin B9 (Folic Acid) Source: Integrative Medicine Communications; www.drkoop.com Folate Source: Prima Communications, Inc.www.personalhealthzone.com Gamma-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Iron Alternative names: Ferrous Sulfate Source: Integrative Medicine Communications; www.drkoop.com Retinol Alternative names: Vitamin A (Retinol) Source: Integrative Medicine Communications; www.drkoop.com Vitamin A (Retinol) Alternative names: Retinol Source: Integrative Medicine Communications; www.drkoop.com
•
Food and Diet Diabetes Source: Healthnotes, Inc.; www.healthnotes.com
Nutrition
Ferrous Sulfate Alternative names: Iron Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. CONTRACEPTION
ALTERNATIVE
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to contraception. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to contraception and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “contraception” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to contraception: •
“Spoiling the womb”: definitions, aetiologies and responses to infertility in north west province, Cameroon. Author(s): Richards SC. Source: Afr J Reprod Health. 2002 April; 6(1): 84-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476732&dopt=Abstract
•
A study of knowledge and attitudes towards contraception among health care staff in Kelantan (Malaysia). Author(s): Suhaimi H, Monga D, Siva A. Source: Singapore Med J. 1996 February; 37(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8783914&dopt=Abstract
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•
Abortion and contraception in Poland. Author(s): Okolski M. Source: Stud Fam Plann. 1983 November; 14(11): 263-74. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6648995&dopt=Abstract
•
Age-old methods of contraception. Author(s): Guerrero AM. Source: Initiatives Popul. 1977 March; 3(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12309378&dopt=Abstract
•
Antifertility effects of neem (Azadirachta indica) oil by single intrauterine administration: a novel method for contraception. Author(s): Upadhyay SN, Kaushic C, Talwar GP. Source: Proceedings of the Royal Society of London. Series B. Biological Sciences. 1990 December 22; 242(1305): 175-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1983033&dopt=Abstract
•
Appeal to increase religious tolerance for contraception. Author(s): Verkuyl DA. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1992 December; 82(6): 480-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1465704&dopt=Abstract
•
Attitudes of Chinese women towards sexuality and birth control. Author(s): Ellis D, Ho MS. Source: Can Nurse. 1982 March; 78(3): 28-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6916612&dopt=Abstract
•
Avicenna's recipe for contraception. Author(s): Nathan B, Mikhail M. Source: British Journal of Obstetrics and Gynaecology. 1991 December; 98(12): 1303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1777469&dopt=Abstract
•
Awareness and practice of contraception among female students at the Institute of Management and Technology (IMT), Enugu. Author(s): Ozumba BC, Amaechi FN. Source: Public Health. 1992 November; 106(6): 457-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1475337&dopt=Abstract
•
Birth control techniques in China. Author(s): Xiao B, Wang M.
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Source: China Popul Newsl. 1983 December; 1(2): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12312957&dopt=Abstract •
Breastfeeding as a means of contraception. Author(s): Diaz CA. Source: Initiatives Popul. 1983; 7(3): 16-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12339840&dopt=Abstract
•
Conception and birth control use: Cambodian refugee women's beliefs and practices. Author(s): Kulig JC. Source: Journal of Community Health Nursing. 1988; 5(4): 235-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3204423&dopt=Abstract
•
Contraception and culture: the use of yuyos in Paraguay. Author(s): Bull SS, Melian M. Source: Health Care for Women International. 1998 January-February; 19(1): 49-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9479094&dopt=Abstract
•
Contraception in Jordan: a cultural and religious perspective. Author(s): Kridli SA, Libbus K. Source: International Nursing Review. 2001 September; 48(3): 144-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11558689&dopt=Abstract
•
Contraception with progestogens and progesterone during lactation. Author(s): Shaaban MM. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1991; 40(4-6): 70510. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1835650&dopt=Abstract
•
Contraception. Playing a responsible game. Author(s): Hastings-Asatourian B. Source: Pract Midwife. 2002 October; 5(9): 32-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400415&dopt=Abstract
•
Control of physiological phenomena via hypnosis with special reference to contraception. Author(s): Perry BJ. Source: Aust J Clin Hypnother. 1980 September; 1(2): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12339307&dopt=Abstract
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Cultural perspectives on contraception: a literature review. Author(s): Noone J.
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Source: Clin Excell Nurse Pract. 2000 November; 4(6): 336-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858315&dopt=Abstract •
Developments in male contraception. Author(s): Bialy G, Alexander NJ. Source: Health Sex. 1992 Fall; 3(2): 10-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12286189&dopt=Abstract
•
Elizabethan birth control and Puritan attitudes. Author(s): Schnucker RV. Source: J Interdiscip Hist. 1975; 5(4): 655-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11619425&dopt=Abstract
•
Emergency contraception and sexual assault. Assessing the moral approaches in Catholic teaching. Author(s): Hamel RP, Panicola MR. Source: Health Progress (Saint Louis, Mo.). 2002 September-October; 83(5): 12-9, 51; Discussion 14-5, 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12239894&dopt=Abstract
•
Emergency contraception: a review. Author(s): Haspels AA. Source: Contraception. 1994 August; 50(2): 101-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7956209&dopt=Abstract
•
Folklore information from Assam for family planning and birth control. Author(s): Tiwari KC, Majumder R, Bhattacharjee S. Source: Int J Crude Drug Res. 1982 November; 20(3): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12266264&dopt=Abstract
•
Hypnocontraception effectivity tested. Author(s): Cepicky P, Pecena M, Cepicka B, Jarolimek M, Ferenc R. Source: Homeost Health Dis. 1991 October; 33(3): 119-23; Discussion 123-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1818665&dopt=Abstract
•
Immunological approaches to contraception in dogs. Author(s): Gonzalez A, Allen AF, Post K, Mapletoft RJ, Murphy BD. Source: J Reprod Fertil Suppl. 1989; 39: 189-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2695637&dopt=Abstract
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Informed consent for emergency contraception: variability in hospital care of rape victims. Author(s): Smugar SS, Spina BJ, Merz JF. Source: American Journal of Public Health. 2000 September; 90(9): 1372-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10983186&dopt=Abstract
•
Interference with epididymal physiology as possible site of male contraception. Author(s): Reyes A, Chavarria ME. Source: Archives of Andrology. 1981 September; 7(2): 159-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6456706&dopt=Abstract
•
Intravasal contraception with styrene maleic anhydride and its noninvasive reversal in langur monkeys (Presbytis entellus entellus). Author(s): Lohiya NK, Manivannan B, Mishra PK, Pathak N, Balasubramanian SP. Source: Contraception. 1998 August; 58(2): 119-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9773267&dopt=Abstract
•
Islam and birth control in Muslim minority areas of China. Author(s): Winters CA. Source: Asian Thought Soc. 1985; 10(30): 179-85. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11616647&dopt=Abstract
•
Male contraception, IV: hypotonic-like effect from Echeveria gibbiflora on human sperm. Author(s): Reyes R, Merchant-Larios H, Ortega-Hernandez A, Delgado NM. Source: Archives of Andrology. 2002 November-December; 48(6): 443-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12425761&dopt=Abstract
•
Medicinal plants: conception / contraception. Author(s): Chaing HS, Merino-chavez G, Yang LL, Wang FN, Hafez ES. Source: Adv Contracept Deliv Syst. 1994; 10(3-4): 355-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12287843&dopt=Abstract
•
New IPPF statement on breast feeding, fertility and post-partum contraception. Author(s): International Planned Parenthood Federation IPPF. International Medical Advisory Panel IMAP. Source: Ippf Med Bull. 1990 April; 24(2): 2-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12316284&dopt=Abstract
•
Oral contraception in Bangladesh: social marketing and the importance of husbands. Author(s): Davies J, Mitra SN, Schellstede WP.
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Source: Stud Fam Plann. 1987 May-June; 18(3): 157-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3617122&dopt=Abstract •
Plants used as means of abortion, contraception, sterilization and fecundation by Paraguayan indigenous people. Author(s): Arenas P, Moreno Azorero R. Source: Econ Bot. 1977 July-September; 31(3): 302-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12335641&dopt=Abstract
•
Repeated vas occlusion and non-invasive reversal with styrene maleic anhydride for male contraception in langur monkeys. Author(s): Lohiya NK, Manivannan B, Mishra PK. Source: International Journal of Andrology. 2000 February; 23(1): 36-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10632760&dopt=Abstract
•
Reversible contraception like activity of embelin in male dogs (Canis indicus Linn). Author(s): Dixit VP, Bhargava SK. Source: Andrologia. 1983 September-October; 15(5): 486-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6316811&dopt=Abstract
•
Statement on breast feeding, fertility and contraception. Author(s): International Planned Parenthood Federation IPPF. International Medical Advisory Panel IMAP. Source: Ippf Med Bull. 1987 December; 21(6): 5-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12268854&dopt=Abstract
•
The behavior of Italian family physicians regarding the health problems of women and, in particular, family planning (both contraception and NFP). Author(s): Girotto S, Del Zotti F, Baruchello M, Gottardi G, Valente M, Battaggia A, Rosa B, Fedrizzi P, Campanella M, Zumerle M, Bressan F. Source: Advances in Contraception : the Official Journal of the Society for the Advancement of Contraception. 1997 June-September; 13(2-3): 283-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9288347&dopt=Abstract
•
The position of Islamic tradition on contraception. Author(s): Atighetchi D. Source: Med Law. 1994; 13(7-8): 717-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7731352&dopt=Abstract
•
The role of the midwife in permanent contraception. Author(s): Gall JK, Schima ME.
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Source: Journal of Nurse-Midwifery. 1983 July-August; 28(4): 13-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6554309&dopt=Abstract •
The Subanen of Zamboanga del Sur. Said to be the first tribe to practise birth control. Author(s): Daligang H. Source: Popul Forum. 1981; 7(4): 9-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12338244&dopt=Abstract
•
The use of traditional methods of contraception among Turkish couples. Author(s): Goldberg HI, Toros A. Source: Stud Fam Plann. 1994 March-April; 25(2): 122-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8059445&dopt=Abstract
•
Through the patient's eyes: strategies toward more successful contraception. Author(s): Delbanco TL, Daley J. Source: Obstetrics and Gynecology. 1996 September; 88(3 Suppl): 41S-47S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8752227&dopt=Abstract
•
Unwanted pregnancy on self-medication with St John's wort despite hormonal contraception. Author(s): Schwarz UI, Buschel B, Kirch W. Source: British Journal of Clinical Pharmacology. 2003 January; 55(1): 112-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534648&dopt=Abstract
•
Users of traditional methods of contraception in Bangladesh: 1981-91. Author(s): Rahman MM, Islam MN, Islam MM. Source: Journal of Biosocial Science. 1996 July; 28(3): 257-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8698706&dopt=Abstract
•
Vaginal contraception with gossypol: a clinical study. Author(s): Ratsula K, Haukkamaa M, Wichmann K, Luukkainen T. Source: Contraception. 1983 June; 27(6): 571-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6684533&dopt=Abstract
•
Why Islam permitted birth control. Author(s): Musallam BF. Source: Arab Stud Q. 1981; 3(2): 181-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11614208&dopt=Abstract
•
Women's choice between indigenous and Western contraception in urban Mozambique. Author(s): Agadjanian V.
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Source: Women & Health. 1998; 28(2): 1-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10067803&dopt=Abstract •
Yoruba traditional healers' knowledge of contraception, abortion and infertility. Author(s): Oyebola DD. Source: East Afr Med J. 1981 October; 58(10): 777-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7343313&dopt=Abstract
•
Young people's contraception and sexual health: report of a local needs assessment in Staveley, North Derbyshire. Author(s): Smith A. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 January; 27(1): 29-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457544&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMDHealth: http://my.webmd.com/drugs_and_herbs
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
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The following is a specific Web list relating to contraception; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Abnormal Pap Smear Source: Healthnotes, Inc.; www.healthnotes.com Acne Source: Integrative Medicine Communications; www.drkoop.com Acne Vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Amenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Candida/yeast Hypersensitivity Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Cervical Dysplasia Source: Integrative Medicine Communications; www.drkoop.com Colds and Flus Source: Prima Communications, Inc.www.personalhealthzone.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Endometriosis Source: Healthnotes, Inc.; www.healthnotes.com Fibrocystic Breast Disease Source: Healthnotes, Inc.; www.healthnotes.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Hirsuitism Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com Male Infertility Source: Healthnotes, Inc.; www.healthnotes.com Menorrhagia Source: Healthnotes, Inc.; www.healthnotes.com
128 Contraception
Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Pelvic Inflammatory Disease Source: Integrative Medicine Communications; www.drkoop.com Pms Alternative names: Premenstrual Stress Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Premenstrual Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Prostatitis Source: Healthnotes, Inc.; www.healthnotes.com Raynaud's Disease Source: Healthnotes, Inc.; www.healthnotes.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Urinary Tract Infection in Women Source: Integrative Medicine Communications; www.drkoop.com Uti Source: Integrative Medicine Communications; www.drkoop.com Vaginal Inflammation Source: Integrative Medicine Communications; www.drkoop.com Vaginitis Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Cosmo-biological Birth Control Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Kulkarni Naturopathy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/k.html
•
Herbs and Supplements Aloe Alternative names: Aloe vera, Aloe barbadensis, Aloe ferox , Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com
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Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Andrographis Source: Prima Communications, Inc.www.personalhealthzone.com Black Cohosh Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10009,00.html Cat’s Claw Alternative names: Uncaria tomentosa Source: Healthnotes, Inc.; www.healthnotes.com Chaste Tree Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Chasteberry Source: Prima Communications, Inc.www.personalhealthzone.com Dioscorea Villosa Source: Integrative Medicine Communications; www.drkoop.com Estradiol Source: Healthnotes, Inc.; www.healthnotes.com Estrogens (combined) Source: Healthnotes, Inc.; www.healthnotes.com Glycyrrhiza Glabra Alternative names: Licorice Source: Integrative Medicine Communications; www.drkoop.com Hypericum Perforatum Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Klamathweed Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Licorice Alternative names: Glycyrrhiza glabra Source: Integrative Medicine Communications; www.drkoop.com Medroxyprogesterone Source: Healthnotes, Inc.; www.healthnotes.com Oral Contraceptives Source: Healthnotes, Inc.; www.healthnotes.com
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Oral Contraceptives Source: Prima Communications, Inc.www.personalhealthzone.com Red Clover Source: Integrative Medicine Communications; www.drkoop.com Spanish Licorice Alternative names: Licorice Source: Integrative Medicine Communications; www.drkoop.com St. John's Wort Alternative names: Hypericum perforatum Source: Integrative Medicine Communications; www.drkoop.com Wild Yam Alternative names: Dioscorea villosa Source: Integrative Medicine Communications; www.drkoop.com Wild Yam Source: Prima Communications, Inc.www.personalhealthzone.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON CONTRACEPTION Overview In this chapter, we will give you a bibliography on recent dissertations relating to contraception. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “contraception” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on contraception, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Contraception ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to contraception. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparison of Ever-pregnant and Never-pregnant Adolescents on Manifest Needs and Field-dependence - Independence (contraception, Black Females) by Harper, Charlyn Alaine, Phd from Georgia State University, 1986, 199 pages http://wwwlib.umi.com/dissertations/fullcit/8616277
•
A Discernment Model for the Ethics of Birth Control: an Application of a Narrative Method with Critical Observations by Mccarthy, Jeremiah Joseph, Phd from Graduate Theological Union, 1985, 271 pages http://wwwlib.umi.com/dissertations/fullcit/8529994
•
A Method for the Content Analysis of Cartoons: the Case of Attitudes toward Contraception and Population Growth by Halliwell, Betty Mary, Phd from University of California, Los Angeles, 1972, 265 pages http://wwwlib.umi.com/dissertations/fullcit/7220444
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•
A Study of Adolescent Attitudes toward Sexuality, Contraception and Pregnancy by O'leary, James Joseph, Phd from United States International University, 1980, 142 pages http://wwwlib.umi.com/dissertations/fullcit/8104793
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Abortion before Birth Control: the Politics of Reproduction in Postwar Japan by Norgren, Christiana A. E., Phd from Columbia University, 1998, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9838995
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Acceptance or Rejection of Sex-role Stereotypes As a Factor in Adolescent Female Sexual Behavior and Use of Contraception. by Garblik, Pauline Barbara, Edd from University of Cincinnati, 1978, 154 pages http://wwwlib.umi.com/dissertations/fullcit/7904781
•
Adolescents and Birth Control: a Study of Oral Contraceptive Use by Balassone, Mary Lou, Dsw from University of California, Berkeley, 1987, 240 pages http://wwwlib.umi.com/dissertations/fullcit/8726121
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An Analysis of the Relationship between Female Employment and Family Contraception by Reed, Fred Warren, Phd from The University of North Carolina at Chapel Hill, 1972, 79 pages http://wwwlib.umi.com/dissertations/fullcit/7224836
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An Economic Model of Fertility, Sex and Contraception by Brunborg, Helge, Phd from The University of Michigan, 1983, 367 pages http://wwwlib.umi.com/dissertations/fullcit/8324145
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An Evaluation of a Program to Investigate Four Views of Birth Control (contraception Education) by Hornok, Richard John, Dmin from Dallas Theological Seminary, 1993, 171 pages http://wwwlib.umi.com/dissertations/fullcit/9322321
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Analysis of a Peer Contraception Education Program Based on the Health Belief Model by Jorgensen, Cheryl Marie, Phd from The Pennsylvania State University, 1982, 127 pages http://wwwlib.umi.com/dissertations/fullcit/8305656
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Attitudes of Educated Women toward the Use of Oral Contraception by Miller, Grace Gregory, Edd from The University of Tulsa, 1970, 112 pages http://wwwlib.umi.com/dissertations/fullcit/7019959
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Birth Control and the American Imagination: Textual Con(tra)ceptions, 1914--1944 by Capo, Beth Widmaier; Phd from The Pennsylvania State University, 2001, 310 pages http://wwwlib.umi.com/dissertations/fullcit/3036012
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Birth Control Policy, Practice and Prohibition in the 1930s: the Maternal Health Association of Cleveland, Ohio by Meyer, Jimmy Elaine Wilkinson, Phd from Case Western Reserve University, 1993, 277 pages http://wwwlib.umi.com/dissertations/fullcit/9406249
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Breastfeeding and Contraception As Substitute Family Planning Strategies by Rous, Jeffrey Joseph, Phd from The University of North Carolina at Chapel Hill, 1996, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9708171
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Communication, Coorientation, and Contraception: Family Planning among Couples in Rural Bangladesh by Pathak, Shubha, Phd from The Johns Hopkins University, 1998, 283 pages http://wwwlib.umi.com/dissertations/fullcit/9821182
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Conjugal Role Structure, Joint Action, and Contraception Adoption by Maultsby, Don Mize, Phd from Tulane University, 1971, 294 pages http://wwwlib.umi.com/dissertations/fullcit/7203897
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Contraception in Costa Rica: a Sociocultural Study of Three Communities. by Thein, Tin Myaing, Phd from Columbia University, 1975, 296 pages http://wwwlib.umi.com/dissertations/fullcit/7525734
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Contraception, Future, and Individuation (teenage Pregnancy) by Sharpe-taylor, Linda, Phd from University of Missouri - Saint Louis, 1995, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9509039
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Contraception: the Secular Controversy, 1830-1937. by Goodart, Margaret Metcalf, Phd from University of California, Davis, 1975, 304 pages http://wwwlib.umi.com/dissertations/fullcit/7522847
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Coping with Contraception: a Cognitive-behavioral Approach to Prevention of Unwanted Teenage Pregnancy by Gilchrist, Lewayne Dorman, Phd from University of Washington, 1981, 132 pages http://wwwlib.umi.com/dissertations/fullcit/8113441
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Couples' Health Beliefs Regarding Postpartum Contraception: Congruence or Disparity? by Chisolm, Stephanie Marie; Phd from The University of Alabama at Birmingham, 2000, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9982647
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Cultivation Effects and Contraception, Pregnancy, and Negative Consequences of Sexual Behaviors in Daytime Soap Operas: a Content Analysis and Survey (cultivation Hypothesis) by Olson, Beth Marie, Phd from Indiana University, 1992, 210 pages http://wwwlib.umi.com/dissertations/fullcit/9231616
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Dirty Discourse: Birth Control Advertising in the 1920s and 1930s (american Medical Association) by Sarch, Amy, Phd from University of Pennsylvania, 1994, 297 pages http://wwwlib.umi.com/dissertations/fullcit/9427611
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Education As an Indicator of Women's Status and It's Impact on Fertility and Contraception in Pakistan: a Multivariate Analysis by Rathnam, Padma Sukumar, Phd from The University of Texas at Austin, 1995, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9617328
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Emergence of the Reproductive Research Enterprise: a Sociology of Biological, Medical and Agricultural Science in the United States, 1910-1940 (contraception) by Clarke, Adele E., Phd from University of California, San Francisco, 1985, 498 pages http://wwwlib.umi.com/dissertations/fullcit/8608572
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Emergency Contraception and Reducing Unplanned Pregnancy: the Search for Sound Policy by Delbanco, Suzanne Frances, Phd from University of California, Berkeley, 1999, 295 pages http://wwwlib.umi.com/dissertations/fullcit/9931225
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Emergency Contraception and Rural Health Care Providers in Idaho by Cuvala, Peggy L.; Ms from California State University, Long Beach, 2002, 63 pages http://wwwlib.umi.com/dissertations/fullcit/1413247
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Emergency Contraception: Knowledge and Practices of Military Health Care Providers by Baykan, Beth Mary; Msn from University of South Alabama, 2003, 87 pages http://wwwlib.umi.com/dissertations/fullcit/1412869
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Essays on Developed Nation Mortality and Kenyan Contraception by White, Kevin Mcarthur; Phd from University of Pennsylvania, 1999, 122 pages http://wwwlib.umi.com/dissertations/fullcit/9953617
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Factors Affecting the Adoption of Oral Contraception. by Melching, Dolores Elizabeth, Phd from Bryn Mawr College, 1977, 328 pages http://wwwlib.umi.com/dissertations/fullcit/7802586
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Female Work Participation and Work-motivated Contraception. by Sastry, Kappalamodugu Ramachandra, Phd from The University of North Carolina at Chapel Hill, 1973, 160 pages http://wwwlib.umi.com/dissertations/fullcit/7405970
•
Fertile Fields: a History of the Ideological Origins and Institutionalisation of the International Birth Control Movement, 1870--1940 by Burnett, Genevieve; Phd from University of New South Wales (australia), 1999 http://wwwlib.umi.com/dissertations/fullcit/f2138217
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Fertility, Gender and War: the 'culture of Contraception' in Zimbabwe, 1957-1980 by Kaler, Amy Kathleen, Phd from University of Minnesota, 1998, 347 pages http://wwwlib.umi.com/dissertations/fullcit/9903350
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Finality and Marriage (contraception) by Hogan, Margaret Monahan, Phd from Marquette University, 1991, 205 pages http://wwwlib.umi.com/dissertations/fullcit/9226219
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French Women and Politics; the Involvement of Women in the Fight for Contraception Reform, 1953-1968. by Webster, Ann Adams, Phd from Princeton University, 1974, 846 pages http://wwwlib.umi.com/dissertations/fullcit/7506688
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Human Action and Thomistic Natural Law: Application to the Morality of Contraception (saint Thomas Aquinas) by Maclean-tollefsen, Laurie A., Phd from Emory University, 1995, 228 pages http://wwwlib.umi.com/dissertations/fullcit/9605435
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Implications of Treatment on Sex Knowledge, Sex Attitudes, and Contraception of Sexual Liberal/conservative Males by Haverstock, Lynda M; Phd from The University of Saskatchewan (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NL20752
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Implications of Treatment on Sex Knowledge, Sex Attitudes, and Contraception of Sexual Liberal/conservative Males by Haverstock, Lynda Maureen, Phd from The University of Saskatchewan (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/f2125557
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John Cuthbert Ford, S.j.: His Contribution to Twentieth Century Catholic Moral Theology on the Issue of Contraception by Menius, Margaret Kelly, Phd from Saint Louis University, 1998, 386 pages http://wwwlib.umi.com/dissertations/fullcit/9911966
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•
Knowledge of Contraception and Use of Contraceptive Methods among College Students in a Major Southeastern Public University by Palmer, Nancy Sigrest, Edd from The University of Alabama, 1984, 180 pages http://wwwlib.umi.com/dissertations/fullcit/8413154
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Knowledge of Reproduction, Attitudes toward Contraception, and Self-esteem of Teenage Pregnant Girls in Southeastern Michigan by Emodi, Sylva Obiajulum Ralph, Phd from The University of Michigan, 1981, 389 pages http://wwwlib.umi.com/dissertations/fullcit/8204642
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Locus of Control of Increasing Specificity, Reinforcement Value and Contraceptive Use among Sexually Experienced College Females, Who Are Knowledgeable about Contraception by Albano, Santo Joseph, Phd from New York University, 1981, 83 pages http://wwwlib.umi.com/dissertations/fullcit/8210902
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Managing Menses for Reproductive Health and Pregnancy Avoidance in Guinea: Beyond Contraception and Abortion by Levin, Elise Claire; Phd from Northwestern University, 2003, 276 pages http://wwwlib.umi.com/dissertations/fullcit/3087938
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Margaret Sanger Vs. the Catholic Church: the Early Debate on Contraception by Mulloy, Clement A.; Phd from University of Arkansas, 2000, 240 pages http://wwwlib.umi.com/dissertations/fullcit/9987246
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Marriage, Sexuality, and Contraception in the British Middle Class, 1918-1939: the Correspondence of Marie Stopes by Holtzman, Ellen Martha, Phd from Rutgers the State University of New Jersey - New Brunswick, 1982, 175 pages http://wwwlib.umi.com/dissertations/fullcit/8305748
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Natality, Contraception and Family Patterns in a Caracas Barrio. by Gamble, George Raymond, Phd from The University of North Carolina at Chapel Hill, 1978, 158 pages http://wwwlib.umi.com/dissertations/fullcit/7914349
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Natural Law and Artificial Contraception: a Critical Comparison of the Views of Three Recent Popes, Paul Ramsey and Charles Curran by Martin, Mariano Merino, Thd from Boston University School of Theology, 1981, 102 pages http://wwwlib.umi.com/dissertations/fullcit/8127126
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Orthodoxy? Anomie? Or Pluralism? An Empirical Sociological Analysis of Attitudes of the Catholic Laity in the Archdiocese of Boston toward Contraception. by Scanlon, Wilfred John, Phd from Boston University Graduate School, 1975, 295 pages http://wwwlib.umi.com/dissertations/fullcit/7521012
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Political Encounters in Benevolence: Canada, Contraception, and Women Having Babies Abroad by Roy, Kalapi; Ma from Carleton University (canada), 2002, 158 pages http://wwwlib.umi.com/dissertations/fullcit/MQ72058
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Population and Power: the Religious Debate over Contraception, 1916-1936. (volumes I and Ii) by Tobin-schlesinger, Kathleen, Phd from The University of Chicago, 1994, 340 pages http://wwwlib.umi.com/dissertations/fullcit/9501554
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Prophylactic Practices: Contraception and the Construction of Female Desire from Eliza Haywood to George Eliot by Silverman, Debra Beth, Phd from University of Southern California, 1995, 296 pages http://wwwlib.umi.com/dissertations/fullcit/9614071
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Reproductive Choice in Romania: Cultural Models of Abortion and Contraception by Leibowitz, Jami Leah; Phd from The University of Connecticut, 2003, 232 pages http://wwwlib.umi.com/dissertations/fullcit/3089748
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Sexual Decision-making among Unmarried Female Undergraduates (contraception) by Devine, Lise Diamond, Dsw from Tulane University, School of Social Work, 1987, 217 pages http://wwwlib.umi.com/dissertations/fullcit/8715885
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Sources of Health Information Regarding Contraception and Stds among Family Planning Clinic Clients by Krishnan, Satya P., Phd from Texas Woman's University, 1994, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9506565
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Teaching Contraception Through Programmed Learning Modules. by Stevens, Ella Marie, Phd from The University of Michigan, 1978, 86 pages http://wwwlib.umi.com/dissertations/fullcit/7907176
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The Afro-american Community and the Birth Control Movement, 1918-1942 by Rodrique, Jessie May, Phd from University of Massachusetts, 1991, 242 pages http://wwwlib.umi.com/dissertations/fullcit/9132903
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The Birds and the Bees and Decision Trees: Couples Talk about Their Birth Control and Family Decisions by Finch, Susan Chloe; Phd from University of Southern California, 2000, 262 pages http://wwwlib.umi.com/dissertations/fullcit/3054868
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The Diffusion of Birth Control in Germany, 1871 - 1933 by Woycke, James Edward, Phd from University of Toronto (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/f2283221
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The Dynamics of the Diffusion of Information and Adoption of Contraception in Costa Rica (family Planning) by Knight, Rodney Jospeh, Phd from Brown University, 1995, 263 pages http://wwwlib.umi.com/dissertations/fullcit/9540782
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The Effects of Formal Sex Education on Adolescent Intercourse, Contraception and Pregnancy in the United States by Dawson, Deborah Anne, Phd from The Johns Hopkins University, 1986, 104 pages http://wwwlib.umi.com/dissertations/fullcit/8615963
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The Initiation of Contraception in Taiwan. by Siddiqui, Mohammad Khalid, Phd from The University of Michigan, 1979, 260 pages http://wwwlib.umi.com/dissertations/fullcit/7916817
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The New Woman, the New Family and the Rationalization of Sexuality: the Sex Reform Movement in Germany 1928 to 1933 (abortion, Birth Control, Sterilization) by Grossmann, Atina, Phd from Rutgers the State University of New Jersey - New Brunswick, 1984, 726 pages http://wwwlib.umi.com/dissertations/fullcit/8424110
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The Press and the Beginning of the Birth Control Movement in the United States (law, History) by Goldstein, Cynthia, Phd from The Pennsylvania State University, 1985, 294 pages http://wwwlib.umi.com/dissertations/fullcit/8516028
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The Relationship of Age, Ethnicity, and Feminism to Attitudes about Maternity, Contraception, and Abortion in Undergraduate Women in an Urban Community College by Van Felix, Norma, Edd from New York University, 1989, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9004333
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The Role of Communication in Family Planning: the Case of the Philippines (birth Control, Mass Media) by Yehya, Riad Melhem, Phd from Bowling Green State University, 1992, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9237699
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The Sociocultural Context of Teenage Childbearing among Hispanic Adolescents in Los Angeles (adolescent Pregnancy, California, Contraception) by Erickson, Pamela Irene, Phd from State University of New York at Buffalo, 1993, 273 pages http://wwwlib.umi.com/dissertations/fullcit/9330069
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The Unmet Need and Demand for Modern Contraception in the Philippines (birth Control) by Mortezo, Linda Verra, Phd from Bowling Green State University, 1995, 128 pages http://wwwlib.umi.com/dissertations/fullcit/9628817
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The Use of Contraception for Delaying and Spacing Births in Colombia, Costa Rica, and Korea by Grigsby, Jill Spencer, Phd from Princeton University, 1983, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8316797
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The Value of Children and the Costs of Contraception: Predictors of Reproductive Ideals and Contraceptive Practice in Egypt by Vernon-carter, Ricardo, Phd from The University of Chicago, 1982 http://wwwlib.umi.com/dissertations/fullcit/T-28327
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Unmet Need for Contraception in Brazil by Wheeler, Sarah Marie; Phd from University of Pittsburgh, 2001, 144 pages http://wwwlib.umi.com/dissertations/fullcit/3038297
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Use of Induced Abortion and Contraception in Taiwan: a Multivariate Analysis. by Koo, Helen Ping-ching, Drph from The University of Michigan, School of Public Health, 1973, 301 pages http://wwwlib.umi.com/dissertations/fullcit/7411216
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Value Orientations, Adoption of Contraception, and Fertility: a Social Demographic Study by Brown, Louie Anderson, Phd from University of Kentucky, 1970, 178 pages http://wwwlib.umi.com/dissertations/fullcit/7119357
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Women's Attitudes towards Selected Health Issues: Implications for Nursing Education (abortion, Euthanasia, Sexuality, Contraception, Substance Abuse) by Thompson, Jacqueline K., Phd from State University of New York at Buffalo, 1986, 374 pages http://wwwlib.umi.com/dissertations/fullcit/8629119
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND CONTRACEPTION Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning contraception.
Recent Trials on Contraception The following is a list of recent trials dedicated to contraception.8 Further information on a trial is available at the Web site indicated. •
Providing Birth Control Through Home Health Visits Condition(s): Pregnancy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: This study will evaluate a program that provides birth control to low income and minority women through home visits by a community health nurse. The goal of the program is to reduce unwanted pregnancies. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00065078
•
Quick Start Approach to Birth Control Pills Condition(s): Pregnancy; Contraception Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: Women who choose to take birth control pills are currently instructed to begin taking the pills at the end of a menstrual cycle. This creates a window of time between when the woman is given the pills and when she begins taking
8
These are listed at www.ClinicalTrials.gov.
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them. Some women fail to begin taking the pills, placing them at increased risk of pregnancy. This study will evaluate a new approach to beginning birth control pills. Women will take the first pill in the doctor's office rather than waiting until the next menstrual cycle. Phase(s): Phase IV; MEDLINEplus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068848 •
The Direct Access Study: Access to Hormonal Birth Control Through Community Pharmacies Condition(s): Contraception Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: Hormonal birth control methods include birth control pills, patches, and vaginal rings; they are normally available only with a doctor's prescription. This study will evaluate a program designed to increase the availability of birth control by allowing pharmacists to give women hormonal birth control without a doctor's prescription. Under this program, pharmacists will evaluate women who want to use birth control according to specific guidelines created by doctors. If a woman meets the criteria in the guidelines, a pharmacist could then give her the appropriate form of hormonal birth control. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00065871
•
A Study to Evaluate the Effects of Different Methods of Birth Control on the Drug Actions of Zidovudine (an Anti-HIV Drug) in HIV-Positive Women and to Compare Zidovudine Metabolism in Men and Women Condition(s): HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to look at the effects of different methods of birth control (oral and injectable) on how the body absorbs, makes available, and removes zidovudine (ZDV). This study will also evaluate the differences in men and women in how the body absorbs, makes available, and removes ZDV. Past research has shown that the effectiveness of ZDV as an anti-HIV drug might be decreased in individuals who use certain methods of birth control. ZDV may also have different effects in men compared to women. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000897
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•
Effects of hypericum perforatum on effectiveness of oral contraceptives Condition(s): Contraception Study Status: This study is no longer recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to evaluate the effects of a common herbal remedy, St. John's Wort, on the effectiveness of birth control pills. St. John's Wort has recently been shown to increase metabolism of some drugs. If it could increase metabolism of oral contraceptives as well, it may increase the risk of contraceptive failure and unintended pregnancy. Study participants will be evaluated for risk of ovulation on oral contraceptives before and during simultaneous therapy with St. John's Wort. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00026013
•
Hormonal Birth Control and the Risk of Acquiring HIV Condition(s): HIV Infections; HIV Seronegativity Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD); National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to find out whether hormonal birth control increases, decreases, or does not change the risk of women becoming infected with HIV. Sexual intercourse between men and women is the main way HIV is transmitted. About 90 percent of HIV infections in women are caused by sexual intercourse. Also, hormonal birth controls are widely used. This study hopes to find out whether hormonal birth control changes the risk of women becoming infected with HIV. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006324
•
Safety of Estrogens in Lupus: Birth Control Pills Condition(s): Systemic Lupus Erythematosus Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Office of Research on Women's Health (ORWH) Purpose - Excerpt: Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill. Phase(s): Phase III Study Type: Interventional
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000420 •
Emergency Contraception (ECP): Reducing Unintended Pregnancies Condition(s): Contraception; Pregnancy Study Status: This study is completed. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: Emergency contraception is a method of birth control that can be used up to three days after sexual intercourse. Emergency contraceptive pills (ECPs) can be given to a woman before she needs them (advance provision) or when she needs them (emergency provision). This study will compare these two methods of providing ECPs. Phase(s): Phase IV; MEDLINEplus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067509
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “contraception” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON CONTRACEPTION Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “contraception” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on contraception, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Contraception By performing a patent search focusing on contraception, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on contraception: •
Buccal drug administration in the treatment of female sexual dysfunction Inventor(s): Place; Virgil A. (P.O. Box 44555 -10 Ala Kahua, Kawaihae, HI 96743) Assignee(s): none reported Patent Number: 6,284,263 Date filed: July 27, 2000 Abstract: A buccal dosage unit is provided for administering a combination of steroidal active agents to a female individual. The novel buccal drug delivery systems may be used in female hormone replacement therapy, in female contraception, to treat female sexual dysfunction, and to treat or prevent a variety of conditions and disorders which are responsive to the active agents discussed herein. The buccal dosage unit comprises a progestin, an estrogen and optionally an androgenic agent, as well as a polymeric carrier that bioerodes and provides for delivery of the active agents throughout a predetermined drug delivery period. Excerpt(s): This invention relates generally to pharmaceutical compositions and methods for administering pharmacologically active agents. More particularly, the invention relates to buccal drug delivery, and to a buccal dosage unit and method for administering a combination of steroidal active agents, e.g., for female hormone replacement therapy, female contraception, treatment of female sexual dysfunction, and the like. Androgens are the hormones that cause most of the masculinizing changes that occur in males during puberty. Harrison's Principles of Internal Medicine, 12th Edition (New York, N.Y.: McGrawHill, Inc., 1991). However, low levels of androgens are also present in normal females. Testosterone and other androgens are secreted by the ovary and the adrenal cortex. See, e g., Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition (New York, N.Y.: McGraw Hill, Inc., 1996). Dehydroepiandrosterone (DHEA) and androstenedione are also synthesized by both the adrenal gland and the ovary and can be converted to testosterone or estrogen in peripheral tissues. The daily rate of production of testosterone in women is on the order of 0.25 mg, about half of which is derived from the metabolic conversion of androstenedione to testosterone at extraglandular sites. The plasma concentration of testosterone in women alters with the menstrual cycle and ranges from 15 to 65 nanogam/deciliter (ng/dl). As with estrogen, testosterone levels peak at the preovulatory and luteal phases of the cycle. At menopause, plasma androgen and estrogen levels are reduced but not completely absent in women. Alteration in the hormone profile is believed to be an underlying cause of menopausal symptoms in women, including vasomotor instability ("hot flash"), atrophy of the urogenital epithelium and skin, decreased size of the breasts and osteoporosis. See, e.g., Harrison's Principles of Internal Medicine, supra. Alteration in normal hormonal levels can also cause sexual dysfunction. For example, estrogen deficiency, causing vaginal atrophy and dyspareunia, is a common cause of sexual dysfunction. Dyspareunia is thought to affect approximately 40% of women; it has been estimated that over 40 million female individuals will suffer dyspareunia at some time in their lives. On the order of twentyfive million women will experience dyspareunia in the peri- and postmenopausal periods (Kelly (1992) Clinical Practice and Sexuality 8(8):2; and Sato et al. (1992) Clinical Practices in Sexuality 8(5):1. Web site: http://www.delphion.com/details?pn=US06284263__
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Composition and method for contraception and treatment of tumors of the mammary glands Inventor(s): Hesch; Rolf-Dieter (Alpsteinweg 8, D78464, Kosntanz, DE) Assignee(s): none reported Patent Number: 6,451,779 Date filed: April 10, 2000 Abstract: A composition with three hormone components is administered to a mammal to cause the suppression or cessation of the menstruation cycle. Alternatively, it can be administered for treatment of tumors of the mammary gland. The composition contains at least a synthetic estrogen, a biogenetic estrogen, and a gestagen. Alternatively, the composition can include hormones which upon ingestion are metabolized to the abovementioned hormones. Excerpt(s): The invention relates to a means for hormonal contraception with three components used especially for the treatment and/or prophylaxis of tumors of the mammary glands, as well as a process for the hormonal contraception and/or treatment and/or prophylaxis of tumors of the mammary glands. Since the beginning of the availability of hormonal contraceptives in the 1960s, a large number of hormonal components were developed with regard to their suitability in very different administration schemes. Basically, a division into combination and sequence preparations is possible. In known combination preparations, for example, in as far as the desired cycle period is 28 days, a combination of an estrogen and a gestagen preparation is administered for 21 days in a constant or changing, absolute or relative dosage, wherein the estrogen preparation can be, for example, natural estrogen or synthetic ethinylestradiol and a 7-day pause follows the ingestion of the abovementioned 21 daily units during which time a withdrawal bleeding occurs simulating the natural monthly bleeding. Web site: http://www.delphion.com/details?pn=US06451779__
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Compounds with progesterone-antagonistic and antiestrogenic action to be used together for female contraception Inventor(s): Chwalisz; Kristof (Berlin, DE), Stockemann; Klaus (Berlin, DE) Assignee(s): Schering Aktiengesellschaft (Berlin, DE) Patent Number: 6,362,237 Date filed: December 26, 1995 Abstract: This invention describes the use of at least one compound with a progesterone-antagonistic (PA) action and at least one compound with an antiestrogenic (AE) action, each in a non-ovulation-inhibiting dosage in a single dosage unit, for the production of pharmaceutical agents for female contraception. Excerpt(s): This invention relates to the use of at least one compound with progesteroneantagonistic (PA) activity and at least one compound with antiestrogenic (AE) activity, each in a non-ovulation-inhibiting dosage in a single dosage unit, for the production of pharmaceutical agents for female contraception. The pharmaceutical agents produced according to the invention exert their contraceptive action based on receptivity inhibition, by preventing nidation of a fertilized egg cell in the mucous membrane of the uterus, without ovulation or the cycle being disrupted. Already all over the world, the
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use of oral contraceptives has developed into a business factor that cannot be ignored. Especially in view of the fact that the world population is continuing to shoot upward, further development of the hitherto proven methods for birth control is absolutely necessary. Web site: http://www.delphion.com/details?pn=US06362237__ •
Ligand/lytic peptide compositions and methods of use Inventor(s): Elzer; Philip H. (Baton Rouge, LA), Enright; Frederick M. (Baton Rouge, LA), Foil; Lane D. (Baton Rouge, LA), Hansel; William (Baton Rouge, LA), Jaynes; Jesse M. (Baton Rouge, LA), Koonce; Kenneth L. (Baton Rouge, LA), McCann; Samuel M. (Baton Rouge, LA), Melrose; Patricia A. (Baton Rouge, LA), Yu; Wen H. (Baton Rouge, LA) Assignee(s): Board of Supervisors of Louisiana State University and Agricultural and (Baton Rouge, LA) Patent Number: 6,635,740 Date filed: September 24, 1999 Abstract: Amphipathic lytic peptides are ideally suited to use in a ligand/cytotoxin combination to specifically inhibit cells that are driven by or are dependent upon a specific ligand interaction; for example, to induce sterility or long-term contraception, or to attack tumor cells, or to selectively lyse virally-infected cells, or to attack lymphocytes responsible for autoimmune diseases. The peptides act directly on cell membranes, and need not be internalized. Administering a combination of gonadotropin-releasing hormone (GnRH) (or a GnRH agonist) and a membrane-active lytic peptide produces long-term contraception or sterilization in animals in vivo. Administering in vivo a combination of a ligand and a membrane-active lytic peptide kills cells with a receptor for the ligand. The compounds are relatively small, and are not antigenic. Lysis of gonadotropes has been observed to be very rapid (on the order of ten minutes.) Lysis of tumor cells is rapid. The two components--the ligand and the lytic peptide--may optionally be administered as a fusion peptide, or they may be administered separately, with the ligand administered slightly before the lytic peptide, to activate cells with receptors for the ligand, and thereby make those cells susceptible to lysis by the lytic peptide. The compounds may be used in gene therapy to treat malignant or nonmalignant tumors, and other diseases caused by clones or populations of "normal" host cells bearing specific receptors (such as lymphocytes), because genes encoding a lytic peptide or encoding a lytic peptide/peptide hormone fusion may readily be inserted into hematopoietic stem cells or myeloid precursor cells. Excerpt(s): This invention pertains to compositions and methods for specifically inhibiting cells that are driven by or are dependent on specific ligand interactions. Examples are compositions and methods for long-term contraception or sterilization; compositions and methods for inhibiting or killing malignant and non-malignant, hormone-dependent tumors; compositions and methods for selectively killing virally infected cells; and compositions and methods for selectively destroying lymphocytes responsible for autoimmune disorders. Compositions that have sometimes been used for long-term contraception include those based upon natural or synthetic steroidal hormones to "trick" the female reproductive tract into a "false pregnancy." These steroidal hormones must be administered repeatedly to prevent completion of the estrous cycle and conception. Steroids have side effects that can be potentially dangerous. P. Olson et al., "New Developments in Small Animal Population Control,"
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JAVMA, vol. 202, pp. 904-909 (1993) gives an overview of methods for preventing or terminating unwanted pregnancies in small animals. The following discussion appears at page 905: "Tissue-specific cytotoxins--Permanent contraception in females and males might be achieved by administration of a cytotoxin that is linked to gonadotropinreleasing hormone (GnRH) and that selectively destroys gonadotropin-secreting pituitary cells. Similarly, a cytotoxin linked to antibodies against gonadotropin receptors could be targeted to alter gonadal function. Toxins would need to be carefully targeted to specific cells, yet be safe for all other body tissues." (citation omitted). Web site: http://www.delphion.com/details?pn=US06635740__ •
Method and apparatus for stimulating ovulation in induced ovulation mammals as a mean of contraception Inventor(s): Drapeau; Richard (61 Rue Papillon, St-Alphonse-Rodriguez, CA) Assignee(s): none reported Patent Number: 6,287,589 Date filed: September 30, 1998 Abstract: A contraceptive method of inducing ovulation in induced ovulation mammals, in particular the female cat, by stimulating mainly the cervical region of the vagina to trigger a cascade of hormonal reactions to cause ovulation and pseudo-pregnancy to eliminate the unwanted behavior of female cats in heat. The treatment consists in the introduction of an ovulator inside the vaginal cavity of the animal. This apparatus is similar in shape and size to the penis of a cat, is made of a soft flexible material and is safe and easy to clean. The method imitates the sexual behavior of cats by causing a repeated number of brief stimulations at the peak of the estrus cycle. Excerpt(s): Motivated by the desire to find an alternative to spaying (ovariohysterectomy), which removes healthy organs for a healthy female cat, I explored different alternatives to prevent the unwanted behavior of female cats in heat and to prevent unwanted litters. I found that it was known by some veterinarians that when they collected cell samples from the vaginal cavity of female cats, that this procedure sometimes induced accidental ovulation. This ovulation in turn ends the unwanted behavior and frees unfertilized eggs, which will remain unfertilized because the female is no more responsive to males. Some cat breeders, who would not spay their queens, use sterile males to induce ovulation and relieve the females from the stress of their heat period. I invented an ovulator to substitute a sterile male or a veterinarian's instrument to use in precise conditions and following a detailed method to stimulate ovulation and cause the ovulation to initiate a pseudo-pregnancy, stop the hear behavior and prevent unwanted litters. Spaying is a mutilation of healthy organs on healthy animals. My ovulator and method offer an alternative to cat owners whom presently only have a choice between unwanted litters or enduring the disagreeable heat behavior and on the other side, a major operation on a healthy animal. The invention consists of an apparatus, hereafter called an ovulator, which is introduced in the vaginal cavity of a female cat in heat, to cause an ovulation by using the ovulator according to a method which prescribes when, how and how often to use the ovulator to stop the unwanted behavior. The embodiment of the ovulator can be modulated to fit domestic and professional uses and different mammals. The preferred embodiment is for an ovulator to be used by veterinarians on average size domestic cats. This ovulator is a generally cylindrical shape consisting of a tip analogous in shape and size to the penis of a cat and a handle shaped to prevent hurting the animal by limiting the depth of use. The
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ovulator is textured to hold therapeutic substances and serve as an applicator. It is generally made of a soft plastic material easy to clean. The principle and mode of operation of the ovulator is based on the fact that unlike humans, cats and camels amongst other mammals are induced ovulators. In humans, the female will spontaneously ovulate when her egg is mature. In camels, ovulation will only occur if the semen of the male is present in the vaginal cavity. In cats, ovulation will only occur if there is a physical contact with the vulvo-vaginal region, which is connected to the central nervous system. At the proximal part of the vagina there is a structure called the cervix which is especially sensitive to physical stimulation. Through a nerve system connected to the brain via the spinal cord, the mechanical stimulation is translated into nervous stimulus. Inside the brain, the hypothalamus, stimulated by this signal, releases gonadothropin hormone (GmRH) which acts on the pituitary gland, causing it to release (FSH) follicles stimulating hormone and (LH) luteinizing hormone. These hormones stimulate ovulation by acting on the follicles, and initiating the development of the corpus luteus. The corpus luteus produces progesterone which causes the female cat to go into pseudo-pregnancy for 4 to 6 weeks. One or 2 weeks after the pseudo-pregnancy a new heat period may follow. On average, almost two months will separate the onset of a heat period instead of two weeks if untreated. Web site: http://www.delphion.com/details?pn=US06287589__ •
Method of preparation and use for zona pellucida antigens and antibodies for sterilization and contraception Inventor(s): Dunbar; Bonita Sue (Houston, TX) Assignee(s): Zonagen, Inc. (The Woodlands, TX) Patent Number: 6,264,953 Date filed: October 9, 1998 Abstract: The invention relates to antigenic preparations useful for inducing the production of antibodies in an individual which will bind to epitopes on zona pellucida. Also disclosed are immunogenic compositions and methods for immunizing an individual to enable the production of antibodies to zona pellucida antigens. Also disclosed are the use of these recombinant molecules and monoclonal antibodies thereto for immunocontraception or sterilization. Excerpt(s): The present invention relates to the preparation and use of zona pellucida (ZP) antigens and monoclonal antibodies for contraception or sterilization in individuals. The present invention also relates to immunological contraception. More specifically, the present invention relates to immunological contraception utilizing zona pellucida antigens produced by recombinant DNA technology to actively immunize an individual against pregnancy, or monoclonal antibodies prepared against the zona pellucida antigens to passively immunize the individual. In addition, the present invention relates to the use of anti-idiotypic monoclonal antibodies which would mimic ZP antigens to actively immunize an individual against pregnancy. This invention also relates to monoclonal anti-zona pellucida antibody, to novel hybridoma cells which express such antibody, and to a method for producing such hybrid cells and anti-zona pellucida antibody. The zona pellucida is the complex extracellular glycoprotein matrix which surrounds the mammalian oocyte. This matrix is formed during the early stages of oocyte growth and follicular cell differentiation and serves to protect the oocyte and embryo until implantation in the uterine wall (Austin, et al., Reproduction in Mammals: Germ Cells and Fertilization, Cambridge Univ. Press, Cambridge, England (1982)). In
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addition, the zona pellucida plays an important role in the fertilization process since the sperm must first adhere to and penetrate the zona pellucida. After binding to the zona pellucida of an oocyte, the sperm must penetrate the zona pellucida. Sperm penetration of the zona pellucida is probably mediated by the limited hydrolysis of zona pellucida components by sperm enzymes such as acrosin (McRorie et al., Ann. Rev. Biochem. 43: 777 (1974); Dunbar et al., Biol. Reprod. 32:619 (1985), and Stambaugh, Gam. Res. 1:65, 1978). The zona pellucida remains intact after fertilization, to ensure proper embryonic development and perhaps to prevent embryo fusion in the oviduct (Mintz, Science 138:594, 1962). Web site: http://www.delphion.com/details?pn=US06264953__ •
Methods and compounds for treatment of abnormal uterine bleeding Inventor(s): Nowak; Romana A. (West Roxbury, MA), Stewart; Elizabeth A. (Cambridge, MA) Assignee(s): Brigham & Women's Hospital (Boston, MA) Patent Number: 6,440,445 Date filed: February 20, 1998 Abstract: The invention provides methods for treating abnormal uterine bleeding via application of compounds that block uterine stromal cell response to angiogenic growth factors by interfering with the growth factors themselves, by blocking receptors in the uterine epithelial or stromal cells to those growth factors, and/or by inhibiting other receptors to those growth factors. The compounds include interferons, particularly type I interferons, pirfenidone, heparin, heparin-like polyaromatic anionic compounds, heparin-sulfate-based compounds, secreted or soluble FGF receptors, and/or RGDpeptide. The angiogenic growth factors to which response is blocked include basic fibroblast growth factor (bFGF), FGF receptors (FGFR), acidic fibroblast growth factor (aFGF), transforming growth factor.beta. (TGF-.beta.), platelet-derived growth factor (PDGF), heparin binding epidermal growth factor (HBEGF), vascular endothelial growth factor (VEGF), parathyroid hormone-related protein (PTHrP) and/or prolactin. The methods contemplate introducing the aforementioned response-blocking compounds into the body of a patient either systemically, e.g., via injection or implant, or locally to the uterus, e.g., via medicated intrauterine devices, foams and the like. The invention also provides methods for female contraception comprising administering the aforementioned response-blocking compounds, along with progestin or a progestinonly contraceptive, to inhibit pregancy while reducing bleeding otherwise associated with such contraceptives. Excerpt(s): The invention pertains to medical methods, compounds and devices and, particularly, to the treatment of abnormal uterine bleeding and to improved female contraception. A common cause of abnormal uterine bleeding is the presence of leiomyomas, or fibroids, in the uterus. The mechanism by which these neoplasms cause abnormal bleeding is not known, but there are several hypotheses. One is that leiomyomas may increase the surface area of the endometrial cavity. Another is that these neoplasms cause changes in the venous structures in the endometrium and myometrium by compressing veins which results in venule ectasia. Abnormal uterine bleeding is also associated with the occurrence of endometrial polyps, adenomyosis, perimenopausal hormonal transition, as well as idiopathic bleeding (i.e., bleeding for which there is no obvious cause). Furthermore, abnormal uterine bleeding often results from the use of progestin-only contraceptives. Current non-surgical therapies for
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abnormal uterine bleeding focus on the manipulation of the steroid hormone environment, including, use of oral contraceptives, GnRH agonists and antagonists, and progestins. These therapies result in limited efficacy and/or a significant impact on other steroid hormone-dependent tissues, including breast or bone. Web site: http://www.delphion.com/details?pn=US06440445__ •
Methods for the treatment of hormone-dependent tumors with immunogens against gonadotropin releasing hormone Inventor(s): Grimes; Stephen (Davis, CA), Scibienski; Robert (Woodland, CA) Assignee(s): Aphton Corporation (Woodland, CA) Patent Number: 6,303,123 Date filed: June 7, 1995 Abstract: Immunogenic compositions capable of generating an immune response in mammals against GnRH are disclosed. The immunogenic compositions are effective in methods of treating gonadotropin and gonadal steroid hormone dependent diseases and immunological contraception of mammals. Excerpt(s): Gonadotropin Releasing Hormone ("GnRH", also known as Luteinizing Hormone Releasing Hormone, or "LHRH"), is of central importance to the regulation of fertility. Johnson M., Everitt B. Essential Reproduction, 3rd Edn. Blackwell Scientific Publications, 1988. In males and females, GnRH is released from the hypothalamus into the bloodstream and travels via the blood to the pituitary, where it induces the release of the gonadotropins, luteinizing hormone and follicle stimulating hormone, by gonadotrophs. These two gonadotropins, in turn, act upon the gonads, inducing steroidogenesis and gametogenesis. Steroids released from the gonads into the circulation subsequently act upon various tissues. The gonadotropin hormonal cascade can be halted by neutralization of the biological activity of GnRH. Fraser H. M. Physiological Effects of Antibody to Leutenizing Hormone Releasing Hormone. In: Physiological Effects of Immunity Against Reproductive Hormones, Edwards and Johnson, Eds. Cambridge University Press, 1976. As a consequence of GnRH neutralization, the gonadotropins and gonadal steroids are not released into the blood and their biological activities are thereby eliminated. By eliminating the biological activity of GnRH, the hormonal regulation of fertility is interrupted and gametogenesis ceases. GnRH neutralization halts the production of gametes. GnRH neutralization is thus an effective means of contraception. A number of important diseases are affected by gonadotropins and gonadal steroid hormones, particularly the gonadal steroids. Such diseases include breast cancer, uterine and other gynecological cancers, endometriosis, uterine fibroids, prostate cancer and benign prostatic hypertrophy, among others. Removal of the gonadal steroid hormonal stimuli for these diseases constitutes an important means of therapy. An effective method of accomplishing this is by neutralizing GnRH, the consequence of which is the elimination of gonadal steroids that induce and stimulate these diseases. McLachlan R. I., Healy D. L., Burger G. B. 1986. Clinical Aspects of LHRH Analogues in Gynaecology: a Review, British Journal of Obstetrics and Gynaecology, 93:431-454. Conn P. M., Crowley W. F. 1991. Gonadotropin-Releasing Hormone and Its Analogs, New England Journal of Medicine. 324:93-103. Filicori M., Flamigni C. 1988. GnRH Agonists and Antagonists, Current Clinical Status. Drugs. 35:63-82. Web site: http://www.delphion.com/details?pn=US06303123__
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Modulators of polysaccharides and uses thereof Inventor(s): Mohamadzadeh; Mansour (Plano, TX), Mummert; Mark E. (Dallas, TX), Takashima; Akira (Coppel, TX) Assignee(s): The University of Texas System (Austin, TX) Patent Number: 6,653,285 Date filed: March 22, 2000 Abstract: The present invention provides peptides with a specific affinity for glycosaminoglycan molecules. These peptides may have any number of functions, including but not limited to use as inhibitors of glycosaminoglycan-mediated processes, enhancers of glycosaminoglycan-mediated processes, and as molecular probes to identify the presence of a specific glycosaminoglycan. Peptides of the invention may be directed against any glycosaminoglycan, including hyaluronic acid, chondroitin sulfate A, chondroitin sulfate C, dermatan sulfate, heparin, keratan sulfate, keratosulfate, chitin, chitosan 1, and chitosan 2. These isolated peptides may have therapeutic uses in the treatment or prevention of diseases involving infection, inflammatory diseases, cancer, infections, etc. The peptides may also have other biological functions such as contraception. Excerpt(s): The invention relates to peptide inhibitors of glycosaminoglycans. This invention also relates to formulations, uses and methods of identifying such inhibitors. The extracellular matrix (ECM) is a dynamic assemblage of interacting molecules that regulate cell functions and interactions in response to stimulation. One class of extracellular matrix macromolecules, the glycosaminoglycans, are molecules known to be involved in a wide array of both normal and abnormal biological processes, including cell migration, differentiation, proliferation, immune response and cytoskeletal organization. The glycosaminoglycan hyaluronan (HA) is a repeating disaccharide of [GlcNAc.beta.1-4GlcUA.beta.1-3].sub.n that exists in vivo as a high molecular weight linear polysaccharide. HA is found in mammals predominantly in connective tissues, skin, cartilage, and in synovial fluid, and is also the main constituent of the vitreous of the eye. In connective tissue, the water of hydration associated with HA creates spaces between tissues, thus creating an environment conducive to cell movement and proliferation. HA plays a key role in biological phenomena associated with cell motility including rapid development, regeneration, repair, embryogenesis, embryological development, wound healing, angiogenesis, and tumorigenesis (Toole, Cell Biol. Extracell. Matrix, Hay (ed), Plenum Press, New York, 1384-1386 (1991); Bertrand et al. Int. J. Cancer 52:1-6 (1992); Knudson et al, FASEB J. 7:1233-1241 (1993)). HA levels have been shown to correlate with tumor aggressiveness (Ozello et al., Cancer Res. 20:600-604 (1960); Takeuchi et al., Cancer Res. 36:2133-2139 (1976); Kimata et al., Cancer Res. 43:1347-1354 (1983)), and can be indicative of the invasive properties of tumor cells. M. M. Knupfer et al., Anticancer Res 18:353-6 (1998). Web site: http://www.delphion.com/details?pn=US06653285__
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Nucleic acid sequences of genes encoding high mobility group proteins Inventor(s): Bullerdiek; Jorn (Weibdornpfad 14, D-28355 Bremen, DE) Assignee(s): none reported Patent Number: 6,323,329 Date filed: June 26, 1998
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Abstract: The invention relates to DNA-sequences, their use and the use of DNAsequences of the MAG gene or genes encoding the high mobility group proteins, agents for the treatment of various diseases including tumors, influencing the development of the vascular system, as well as for contraception and tissue regeneration, and appropriate kits and processes. The sequences, agents, uses, kits and processes enable the specific influencing of molecular mechanisms that jointly form the basis for various diseases, the development of the vascular system, the contraception and the regeneration of tissue. Thus, the disadvantages associated with other agents or processes are decreased. Excerpt(s): The present invention relates to the fields of molecular biology and biotechnology. More specifically, the invention relates to compositions and methods based on DNA sequences of MAG genes or of genes of the high mobility group proteins and substances for: (1) treatment of diseases; (2) contraception; and (3) tissue generation. Corresponding kits and methods also are disclosed. When studying the molecular basis of aberrant cell growth that accompanies the growth of benign and malignant tumors, so-called MAG genes (multiple-tumor aberration growth genes) were identified as belonging to the group to which high mobility group protein (HMG genes) genes belong. The genes of the high mobility group proteins, such as the HMGI-C gene located on the human chromosome 12 and the HMGI-Y gene on chromosome 6, which, among the known HMG genes, has the relative highest homologous degree compared to HMGI-C, usually have components that code for DNA-bonding protein parts and components that code for protein-bonding components. Web site: http://www.delphion.com/details?pn=US06323329__ •
Ovarian capsules and methods of surgical contraception by ovarian encapsulation Inventor(s): Yoon; InBae (2101 Highland Ridge Dr., Phoenix, MD 21131) Assignee(s): none reported Patent Number: 6,332,466 Date filed: July 7, 1998 Abstract: An ovarian capsule includes a capsule body enclosing an interior for receiving an ovary and defining a selectively openable, selectively closeable access. The access, when open, forms a gap, space or opening in the ovarian capsule through which an ovary is introduced in the interior. When the access is closed, withdrawal of the ovary from the interior is prevented whereby the ovary is encapsulated by the ovarian capsule to prevent fertilization of ova released by the encapsulated ovary. A method of encapsulating an ovary in the body of a patient includes the steps of introducing an ovarian capsule in the abdominal cavity of the patient, opening the ovarian capsule to provide access to the interior thereof, positioning an ovary of the patient within the interior of the capsule and closing the ovarian capsule to encapsulate the ovary and prevent withdrawal of the ovary from the ovarian capsule. Excerpt(s): The present invention relates to surgical contraception of the female and, more particularly, to ovarian capsules and methods of performing both permanent and temporary, reversible surgical contraception by ovarian encapsulation. Female contraception is widely practiced to prevent pregnancy, either permanently or temporarily. Various contraceptive methods and devices are used to prevent pregnancy in females including, for example, natural family planning methods such as the rhythm method and coitus interruptus, spermicides, barrier devices such as the diaphragm,
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sponge, cap and condom, chemical or hormonal treatments such as birth control pills, intrauterine devices (IUDs) and tubal occluding devices and methods such as plugs, adhesives and tubal ligation. Many of the contraceptive devices and methods currently in use are user dependent and, therefore, have relatively high rates of failure due to nonuse and/or improper use. In addition, some user dependent contraceptive methods and devices, such as rhythm and coitus interruptus, are inherently unreliable. User dependent methods and devices of female contraception have various drawbacks ranging from inconvenience to serious medical complications. Birth control pills, for instance, have been associated with adverse side effects including cardiovascular disease and, in particular, stroke. Although non-user dependent methods and devices of female contraception have lower rates of failure, they also have many drawbacks. The IUD, for example, has been associated with pelvic inflammatory disease and undesired sterility. Surgical contraception such as tubal ligation has the drawback of being difficult to reverse to allow for future pregnancy due to blockage or damage of the Fallopian tubes incurred as part of the tubal ligation procedure. On the other hand, surgical contraception presents the advantages of being highly effective in preventing pregnancy and of eliminating the need for user intervention. Furthermore, surgical advances have greatly increased the safety and efficacy of surgical female contraceptive procedures. However, the various advantages of surgical contraception may be outweighed by the disadvantage of permanence or irreversibility where permanent contraception is not desired. Web site: http://www.delphion.com/details?pn=US06332466__ •
Pharmaceutical combined preparation, kit and method for hormonal contraception Inventor(s): Klemann; Walter (Berlin, DE), Schmidt-Gollwitzer; Karin (Berlin, DE) Assignee(s): Schering Aktiengesellschaft (Berlin, DE) Patent Number: 6,312,722 Date filed: January 3, 2000 Abstract: The present invention describes a two-stage pharmaceutical combined preparation for hormonal contraception containing at least 30 daily unit doses, which preparation, in its first stage, comprises as hormonal active ingredient a combination of an oestrogen preparation and, in a dose that is at least sufficient to inhibit ovulation, a gestagen preparation, in single stage form and, in the second stage comprises as hormonal active ingredient an oestrogen preparation only, wherein the first stage comprises a minimum of 25 and a maximum of 77 daily discrete or continuous unit doses and the second stage comprises 5, 6 or 7 daily discrete or continuous unit doses, and wherein the total number of daily units is equal to the total number of days of the desired cycle of a minimum of 30 and a maximum of 84 days. This combined preparation, in the form of a monthly pack, which is used for female fertility control, permits as low as possible an oestrogen content in each individual unit dose and also has a low total hormone content per cycle of administration, with high contraceptive reliability, low incidence of follicle development, and satisfactory cycle control with reliable avoidance of intermediate bleeding as well as undesired side effects. Excerpt(s): The present invention relates to a two-stage pharmaceutical combined preparation for hormonal contraception containing at least 30 daily unit doses, which preparation, in its first stage, comprises as hormonal active ingredient a combination of an oestrogen preparation and, in a dose that is at least sufficient to inhibit ovulation, a gestagen preparation, in single stage form and, in the second stage comprises as
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hormonal active ingredient an oestrogen preparation only, wherein the first stage comprises a minimum of 25 and a maximum of 77 daily discrete or continuous unit doses and the second stage comprises 5, 6 or 7 daily discrete or continuous unit doses, and wherein the total number of daily units is equal to the total number of days of the desired cycle of a minimum of 30 and a maximum of 84 days, and relates also to a corresponding pack (contraceptive kit) containing that combined preparation, and to a contraceptive method that uses the above contraceptive preparation. Oral contraceptives in the form of combined preparations have been known since 1960 as so-called monophase preparations. Those preparations consist of 21 unit doses that comprise active ingredient and 7 tablets or dragees that are active ingredient-free. The daily unit dose is composed of an oestrogen and gestagen. In monophase preparations the dose of active ingredient to be administered daily is the same in each unit dose. If the dose that is to be administered daily of the active components in the individual unit doses is different in individual sections over the administration cycle, then the preparation is referred to as a so-called multi-phase preparation. Triquilar.RTM. may be mentioned as an especially well-known example (DE-AS 23 65 103). (3) a minimum of undesired side effects should be ensured. Web site: http://www.delphion.com/details?pn=US06312722__ •
Topical application of antibodies for contraception and for prophylaxis against sexually transmitted diseases Inventor(s): Cone; Richard A. (Baltimore, MD), Whaley; Kevin J. (Baltimore, MD) Assignee(s): Johns Hopkins University (Baltimore, MD) Patent Number: 6,355,235 Date filed: November 23, 1999 Abstract: Certain antibody molecules are so stable and so potent at immobilizing sperm as well as the pathogens for sexually transmitted diseases (STDs) that they make possible new prophylactic contraceptive methods: (a) for men, a skin lotion containing antibodies against sperm and against STD pathogens to be applied to the penis and external genitals during sexual activity, thereby delivering prophylactically effective doses of antibodies to virtually all areas of skin and epithelia across which most STDs, including AIDS, are usually transmitted, and, during vaginal intercourse, the penis will deliver a contraceptively reliable dose of the antibodies to the cervical region of the vagina; and (b) for women, intrauterine devices (IUDs) and intravaginal devices (IVDS) that release antibodies into the uterus or into the vagina to provide continuous protection against pregnancy and STDs for periods of months to years. Excerpt(s): This invention describes methods of contraception and prophylaxis against sexually transmitted diseases (STDs), including acquired immunodeficiency syndrome (AIDS), and compositions and devices for use in such methods. There is an urgent need, worldwide, for improved contraceptives, especially male contraceptives. There is also an urgent need, worldwide, for improved prophylactic methods for preventing the spread of STDs. Vaccines could be highly valuable for meeting these needs and substantial efforts are being made to develop vaccines that will stimulate the body to synthesize its own antibodies against sperm and against STD pathogens. However, no contraceptive vaccine is yet available, and for some STDs, including AIDS, there is considerable doubt that a vaccine can ever be developed--infected individuals develop high titers of anti-HIV antibodies but this immunity to HIV does not stop the fatal course of AIDS. In the absence of vaccines, the most effective methods now available for
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preventing both pregnancy and STDs are the condom, and the topical spermicidal contraceptives--foams, jellies, suppositories, and sponges. Condoms are both contraceptive and prophylactic since they create a mechanical barrier that prevents sperm as well as STD pathogens in the ejaculate from contacting the sexual partner. Many topical contraceptives are also both contraceptive and prophylactic since they use detergents for their active (spermicidal) ingredient, usually the nonionic detergent nonoxynol-9. Detergents not only kill (lyse) sperm, they also kill many pathogenic bacteria, protozoa, and viruses. Unfortunately, detergents also injure epithelial cells, and many people cannot use topical contraceptives because the detergents cause too much irritation, especially to the urethra. Also, detergents are only active for a short time after being applied to a mucus epithelium: contraceptive suppositories start to become unreliable about 45 minutes after being inserted in the vagina because detergents become inactive after solubilizing oily molecules. Detergents are also absorbed into the body through mucus epithelia. Web site: http://www.delphion.com/details?pn=US06355235__ •
Zona pellucida proteins for contraception Inventor(s): Habenicht; Ursula-Friederike (Berlin, DE), Lobbia; Alessandro (Glienicke, DE) Assignee(s): Schering Aktiengesellschaft (DE) Patent Number: 6,344,442 Date filed: May 3, 1999 Abstract: The present invention relates to the use of peptides which are derived from zona pellucida proteins and are used for contraception, and pharmaceutical formulations which contain the peptides without the peptides having an immunogenic effect. Excerpt(s): This invention relates to the use of peptides that are derived from zona pellucida proteins for contraception and for pharmaceutical formulations that contain these peptides, without these peptides having an immunizing action. With the increase in world population, the need for efficient methods of contraception is also growing. In addition to oral contraceptives and spermicides, mechanical contraceptives are also available here, such as, for example, IUDs (intrauterine devices), vaginal rings, and condoms. Another approach is based on preventing fertilization by blocking the eggsperm interaction. The sperm must penetrate the zona pellucida, an extracellular matrix that consists of glycoproteins and that surrounds the female gametes (the growing oocytes and the ovulated egg). This interaction takes place via a complex interplay of ligands, as well as sperm receptors on the part of the ovocyte or the sperm surface. The zona pellucida of the various mammalian species consists of three to four glycoproteins, which are normally referred to as ZP1, 2, and 3 or ZPA, B and C [Harris, J. et al.: Cloning and Characterization of Zona Pellucida Genes and cDNA's from Variety of Mammalian Species: The ZPA, ZPB and ZPC Gene Families. DNA Sequence: 4, 361-393, (1994)]. In mice, it has been described that the sperm bond first to ZP3 via O-bonded oligosaccharide chains, and the additional bond is probably mediated by ZP2. ZP3 seems to mediate not only the initial bond of the sperm to the zona pellucida, but also another decisive process for fertilization, the acrosome reaction [Dean, J.: Biology of Mammalian Fertilization. J. Clin. Invest.: 89, 1055-1059 (1992); Wassermann, P. M.: Regulation of Fertilization by Zona Pellucida Glycoproteins. J. Reprod. Suppl.: 42, 79-87, (1990)]. In view of the fact that the zona pellucida glycoproteins are unique in the ovary,
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exhibit antigenic properties, and are accessible to circulating antibodies during the intraovarian growth phase, the research has focused on the development of contraceptive vaccines on the basis of zona pellucida proteins [Naz, R. K. et al.: Development of Contraceptive Vaccines for Humans Using Antigen Derived from Gametes (Spermatozoa and Zona Pellucida) and Hormones (Human Chorionic Gonadotropin): Current Status. Human Reprod. Update: 1, 1-18, (1995); Millar, S. E. et al.: Vaccination with Zona Pellucida Peptides Produces Long-Term Contraception in Female Mice. Science: 246, 935-938, (1989)]. A phenomenon that was noted in almost all animals in the case of immunization with zona pellucida proteins is the induction of an oophoritis. Previously it was not possible to completely explain the reason for the occurrence of an oophoritis. In any case, the formation of an oophoritis makes the longer-term use of zona pellucida proteins or of peptides that are derived from these proteins appear problematical for contraceptive immunization. Web site: http://www.delphion.com/details?pn=US06344442__
Patent Applications on Contraception As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to contraception: •
21-SUBSTITUTED PROGESTERONE ANTIPROGESTATIONAL AGENTS
DERIVATIVES
AS
NEW
Inventor(s): ACOSTA, CARMIE K.; (SAN ANTONIO, TX), BLYE, RICHARD P.; (HIGHLAND, MD), CESSAC, JAMES W.; (SAN ANTONIO, TX), KIM, HYUN K.; (BETHESDA, MD), RAO, PEMMARAJU N.; (SAN ANTONIO, TX) Correspondence: Eugenia Garrett Wackowski; Townsend And Townsend And Crew; Two Embarcadero Center; 8th Floor; San Francisco; CA; 94111 Patent Application Number: 20020025951 Date filed: May 24, 1999 Abstract: A compound having the general formula: 1in which: R.sup.1 is a member selected from the group consisting of --OCH.sub.3, --SCH.sub.3, --N(CH.sub.3).sub.2,-NHCH.sub.3, --CHO, --COCH.sub.3 and --CHOHCH.sub.3; R.sup.2 is a member selected from the group consisting of halogen, alkyl, acyl, hydroxy, alkoxy, acyloxy, alkyl carbonate, cypionyloxy, S-alkyl and S-acyl; R.sup.3 is a member selected from the group consisting of alkyl, hydroxy, alkoxy and acyloxy; R.sup.4 is a member selected from the group consisting of hydrogen and alkyl; and X is a member selected from the group consisting of.sub.dbd.O and.sub.dbd.N--OR.sup.5 , wherein R.sup.5 is a member selected from the group consisting of hydrogen and alkyl.In addition to providing the compounds of Formula I, the present invention provides methods wherein the compounds of Formula I are advantageously used, inter alia, to antagonize endogenous progesterone; to induce menses; to treat endometriosis; to treat dysmenorrhea; to treat endocrine hormone-dependent tumors; to treat uterine fibroids; to inhibit uterine endometrial proliferation; to induce labor; and for contraception.
10
This has been a common practice outside the United States prior to December 2000.
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Excerpt(s): The present invention relates generally to the field of steroids and, in particular, to new 11.beta.-substituted-21-substituted-19-nor-pro- gesterone analogs which possess potent antiprogestational activity with minimal antiglucocorticoid activity. There have been numerous attempts over the past few decades to prepare steroids with antihormonal activity. These have been reasonably successful where antiestrogens and anti-androgens are concerned. However, the discovery of effective antiprogestational and antiglucocorticoid steroids has proved to be a formidable task for the steroid chemist. It has been generally recognized for some years, however, that antiprogestational steroids would find wide applicability in population control, while antiglucocorticoids would be extremely valuable in the treatment of, for example, Cushing's syndrome and other conditions characterized by excessive endogenous production of cortisone. In the last decade, largely through the efforts of Teutsch, et al. of the Roussel-Uclaf group in France, a new series of 19-nortestosterone derivatives has been synthesized with strong affinity for the progesterone and glucocorticoid receptors and with marked antiprogestational and antiglucocorticoid activity in vivo. This important discovery revealed the existence of a pocket in the progesterone/glucocorticoid receptors that is able to accommodate a large 11.beta.substituent on selected 19-nortestosterone derivatives. By suitable selection of such a substituent, steroids with antihormonal properties were obtained. The pioneering studies of Teutsch, et al. on the synthesis of antiprogestational and antiglucocorticoid steroids is summarized in a recent review article (G. Teutsch in Adrenal Steroid Antagonism. Ed. M. K. Agarwal, Walter de Gruyter and Co., Berlin, 1984. pp. 43-75) describing the work leading to the discovery of RU-38,486, the first steroid of this type selected for clinical development. RU-38,486 or mifepristone was found to be an effective antiprogestational/contragestat- ive agent when administered during the early stages of pregnancy (IPPF Medical Bulletin 20; No. 5, 1986). In addition to these antiprogestational properties, mifepristone has very significant antiglucocorticoid activity and was successfully used by Nieman, et al. (J. Clin. Endocrinology Metab. 61:536, 1985) in the treatment of Cushing's syndrome. In common with the vast majority of steroidal hormone analogs, mifepristone additionally exhibits a range of biological properties. Thus, for example, it exhibits growth-inhibitory properties towards estrogeninsensitive T47Dco human breast cancer cells (Horwitz, Endocrinology 116:2236, 1985). Experimental evidence suggests that the metabolic products derived from mifepristone contribute to its antiprogestational and antiglucocorticoid properties (Heikinheimo, et al., J. Steroid Biochem. 26:279, 1987). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
8Beta-substituted 11beta-aryl-estra-1,3,5,(10)-triene derivatives Inventor(s): Brauer, Nico; (Jena, DE), Hegele-Hartung, Christa; (Mulheim a.d Ruhr, DE), Hillisch, Alexander; (Jena, DE), Muhn, Peter; (Berlin, DE), Peters, Olaf; (Jena, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20030171345 Date filed: October 15, 2002 Abstract: This invention relates to 11.beta.-(para-substituted)phenyl-estra-1,3,5(10- )trienes with a straight-chin or branched-chain, optionally partially or completely halogenated alkyl radical or alkenyl radical in each case with up to 5 carbon atoms, an ethinyl radical or prop-1-inyl radical in 8.beta.-position.The new compounds can be
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used for contraception in men and women, without influencing other estrogen-sensitive organs, such as the uterus or the liver. They are also suitable for the treatment of benign or malignant proliferative diseases of the ovary, such as ovarian cancer and granulosa cell tumors. Excerpt(s): This application claims the benefit of the filing date of U.S. Provisional Application Serial No. 60/330,728 filed Oct. 29, 2001. This invention relates to new compounds as pharmaceutical active ingredients that have in vitro a higher affinity to estrogen receptor preparations from rat prostates than to estrogen receptor preparations from rat uteri and exert in vivo a contraceptive action by their preferential action on the ovary, their production, their therapeutic use and pharmaceutical dispensing forms that contain the new compounds. The chemical compounds are novel, steroidal, tissueselective estrogens. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
ANDROGEN AS A MALE CONTRACEPTIVE AND NON-CONTRACEPTIVE ANDROGEN REPLACEMENT Inventor(s): MOO-YOUNG, ALFRED J.; (HASTINGS-ON-HUDSON, NY) Correspondence: Lerner, David, Littenberg,; Krumholz & Mentlik; 600 South Avenue West; Westfield; NJ; 07090; US Patent Application Number: 20020193359 Date filed: September 16, 1998 Abstract: The present invention relates to methods of providing male contraception using a specified androgen without the need of a separate sterilizing agent. The invention also describes methods for non-contraceptive androgen replacement and devices useful for carrying out both processes. Excerpt(s): The present application claims benefit of U.S. Provisional Patent Application Nos. 60/059,300 and 60/062,962, filed Sep. 17, 1997, and Oct. 10, 1997, respectively, the disclosures of which are hereby incorporated by reference herein. The present invention relates to the fields of medicine and pharmaceutical science in providing androgen replacement methods of male contraception and devices useful in accordance with those methods. Male contraception has been enigmatic. Mechanical devices offer reduced sensation and inconvenience. While they may be effective in reducing the transmission of sexually transmitted diseases, they may also be a source of friction in a relationship. Moreover, such contraceptive methods are not without a significant incidence of failure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Anti-estrogen plus progestin containing oral contraceptives Inventor(s): Gast, Michael J.; (Phoenixville, PA), Miller, Christopher P.; (Wayne, PA) Correspondence: American Home Products Corporation; Five Giralda Farms; Patent Law; Madison; NJ; 07940; US Patent Application Number: 20020061875 Date filed: November 21, 2001
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Abstract: This invention provides a method of providing contraception which comprises administering to a female of child bearing age a combination of a nonuterotrophic anti-estrogen and a progestin for 28 days per 28-day menstrual cycle. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/093,051, which was converted from U.S. patent application Ser. No. 08/965,083, filed Nov. 6, 1997, pursuant to a petition filed under 37 C.F.R. 1.53(c)(2)(i) on Apr. 15, 1998. This invention relates to oral contraceptive regimens containing a nonuterotrophic antiestrogen (i.e., a tissue selective estrogen) and a progestin. The vast majority of oral contraceptives consist of a combination of a progestin and estrogen that are administered concurrently for 21 days followed either by a 7 day pill free interval or by the administration of a placebo for 7 days in each 28 day cycle. The most important aspects of a successful oral contraceptive product are effective contraception, good cycle control (absence of spotting and breakthrough bleeding and occurrence of withdrawal bleeding), and minimal side effects. Combination oral contraceptives have traditionally acted by suppression of gonadotropins. In addition, it appears that the progestin component is primarily responsible for contraceptive efficacy through inhibition of ovulation, and other peripheral effects which include changes in the cervical mucus (which increase the difficulty-of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation). The estrogenic component intensifies the anovulatory effect of the progestin, and is also important for maintaining cycle control. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Combination preparation for contraception based on naural estrogens Inventor(s): Dittgen, Michael; (Apolda, DE), Fricke, Sabine; (Jena, DE), Hoffmann, Herbert; (Jena, DE), Moore, Claudia; (Jena, DE), Oettel, Michael; (Jena, DE), Ostertag, Monika; (Gottingen, DE) Correspondence: Striker, Striker & Stenby; 103 East Neck Road; Huntington; NY; 11743; US Patent Application Number: 20020107229 Date filed: September 12, 2001 Abstract: The combination preparation for contraception includes from 2 to 4 first stage daily dosage portions each including an effective amount of at least one natural estrogen as sole active ingredient, from 16 to 22 second stage daily dosage portions each including an effective amount of a combination of at least one natural estrogen and at least one natural or synthetic gestogen as active ingredient; from 2 to 4 third stage daily dosage portions each including an effective amount of at least one natural estrogen as sole active ingredient; and from 2 to 4 final stage daily dosage portions containing a pharmaceutically acceptable placebo. The estrogen may be estradiol, an estradiol compound that is metabolized to estradiol when taken into the body, a conjugated equine estrogen or a phytoestrogen. The natural or synthetic gestogen can be natural progesterone or a synthetic gestogens, such as medroxyprogesterone acetate. Excerpt(s): The present invention relates to a multistage contraceptive preparation based on natural estrogens. Oral contraceptives were first marketed 60 years ago. By continuous research it has been possible to reduce the required dosages of hormones in a stepwise manner. Currently low dosage oral contraceptives exist which chiefly comprise an estrogen component and a gestogen component. The hormone dosage of these contraceptives is delivered in different combinations and dosages in the form of
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combination preparations (one-stage preparation) or multistage combination preparations (staged preparations) and sequenced preparations (two-stage preparations) over time periods of from 21 to 28 days. One-stage preparations (usually designated as combination preparations) are characterized by a constant dosage of certain estrogens and gestogens each day. Because of the uniform delivery of gestogen ingredients with estrogen components from the first application day, the combination preparation is a highly reliable contraceptive. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Contraception method using competitive progesterone antagonists and novel compounds useful therein Inventor(s): Chwalisz, Krzystof; (Berlin, DE), Elger, Walter; (Berlin, DE), Ottow, Eckhard; (Berlin, DE), Schmidt-Gollwitzer, Karin; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20020058649 Date filed: November 28, 2001 Abstract: Competitive progesterone antagonists, including two novel steroids, viz., 11.beta.,19-[4-(cyanophenyl)-o-phenylene]-17.beta.-hydroxy-17.alpha.-(3-h- ydroxyprop1(Z)-enyl)-4-androsten-3-one and 11.beta.,19-[4-(3-pyridinyl)-o- -phenylene]-17.beta.hydroxy-17.alpha.-(3-hydroxyprop-1(Z)-enyl)-4-androst- en-3-one, inhibit formation of endometrial glands at below their ovulation inhibiting dose and the abortive dose, and thus achieve oral contraception in females without adversely affecting the menstrual cycle and without risk of aborting a previous implanted fertilized egg or a fetus. Excerpt(s): This invention relates to a novel contraceptive method employing a competitive progesterone antagonist and to novel progesterone antagonists useful therein. By inhibiting the formation of endometrial glands and epithelium growth, the implantation of a fertilized egg in the uterus is rendered impossible (inhibition of the uterine receptivity). The employment of competitive progesterone antagonists according to the invention can thus be used for contraception in the female. RU 486 (11.beta.-[4N,N-(dimethylamino)phenyl]-17.beta.-hydroxy-17.- alpha.-propinyl-estra-4,9(10)-dien-3one; EP-A-0057115) and other 11.beta.-aryl or 11.beta.,19-arylene-substituted steroids are compounds which can displace progesterone and the glucocorticoids from their respective receptors. These substances are pharmacologically distinguished by strong progesterone- and glucocorticoid-antagonistic effects. These properties determine their previously practiced therapeutic uses. RU 486 is useful, e.g., as a progesterone antagonist for therapeutic termination of pregnancy and also as a glucocorticoid antagonist for treatment of Cushing's syndrome in the wake of a pathologically increased secretory activity of the suprarenal cortex. The abortive dose of RU 486 is 200600 mg in the female. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 163
•
CONTRACEPTIVE SYSTEM AND METHOD OF USE Inventor(s): CALLISTER, JEFFREY P; (MENLO PARK, CA), HARGES, DENISE S.; (SALT LAKE, UT), TREMULIS, WILLIAM S.; (REDWOOD CITY, CA) Correspondence: Edward J Lynch; Heller Ehrman White & Mcauliffe; 525 University Avenue; Palo Alto; CA; 943011900 Patent Application Number: 20020013589 Date filed: December 18, 1996 Abstract: A device and method of using the device for contraception or sterilization and particularly for reversible contraception by occluding a reproductive lumen to prevent the passage of reproductive cells through the lumen for a desired period of time until the patient wishes to become fertile again and then be reopened. The occluding member preferably comprises a tubular framework formed from a shape memory material configured to be implanted in a reproductive lumen. The occluding member is implanted within a body lumen, secured to the wall of the reproductive lumen and then collapsed to collapse the wall and occlude the lumen. Alternatively, the occluding member may be collapsed upon a solid plug. The closure of the reproductive lumen may be reversed by introducing a balloon catheter and by a series of inflations of the balloon reexpanding the collapsed occluding member or by removing the plug. The occluding member and the plug may be configured to facilitate endothelialization, to provoke an inflammatory responses or to deliver a drug. Excerpt(s): This invention relates to the field of contraceptive and sterilization devices and more particularly to reversible contraceptive devices and the methods of using such devices. Conventional contraceptive strategies generally fall within three categories: physical barriers, drugs and surgery. While each have certain advantages, they also suffer from various drawbacks. Barriers such as condoms and diaphragms are subject to failure due to breakage and displacement. Drug strategies, such as the pill and Norplant.TM., which rely on artificially controlling hormone levels, suffer from known and unknown side-effects from prolonged use. Finally, surgical procedures, such as tubal ligation and vasectomy, involve the costs and attendant risks of surgery, and are frequently not reversible. Thus, there remains a need for a safe, effective method of contraception, particularly a non-surgical method which is reversible. The present invention is directed to a contraceptive or sterilization system for occluding a reproductive tract or lumen to prevent the passage of reproductive cells through the tract or lumen. The invention includes an occluding member expandable within the body lumen from a first configuration suitable for introduction into the body lumen to a second larger configuration to facilitate securing the expanded occluding member to at least a portion of a wall which defines the reproductive body lumen. The invention also includes means to facilitate securing the expanded occluding member to the wall of the body lumen and means to contract the expanded occluding member and the wall portion secured to the occluding member to occlude the reproductive body lumen sufficiently to prevent the passage of reproductive cells therethrough. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Cyclodextrin-drospirenone inclusion complexes Inventor(s): Backensfeld, Thomas; (Berlin, DE), Heil, Wolfgang; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20020128229 Date filed: December 20, 2001 Abstract: Described are inclusion complexes formed between cyclodextrin and drospirenone. In a specific embodiment of the invention, the cyclodextrin is.beta.cyclodextrin. The invention further relates to methods of providing such an inclusion complex, and to the use of said inclusion complex for improving the solubility of drospirenone, for providing pharmaceutical compositions, for use as a medicament in the treatment of symptoms associated with menopause and in female contraception. Excerpt(s): This application claims priority to U.S. Provisional Application No. 60/256,483, filed Dec. 20, 2000. The present invention relates to an inclusion complex formed between cyclodextrin and drospirenone, to methods of providing such an inclusion complex, and to a method of increasing the water solubility of drospirenone by providing such an inclusion complex. Moreover, the present invention relates to the use of said inclusion complex in pharmaceutical compositions for use as a medicament in the treatment of symptoms associated with menopause and in female contraception. Drospirenone (6.beta.,7.beta.;15.beta.,16.beta.-dimethylene-3-oxo-1- 7.alpha.-pregn-4ene-21,17-carbolactone), which may be prepared substantially as described in e.g. U.S. Pat. No. 4,129,564 or WO 98/06738, is only sparingly soluble in aqueous media at various pH values. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Cyclothiocarbamate derivatives as progesterone receptor modulators Inventor(s): Collins, Mark A.; (Norristown, PA), Edwards, James P.; (San Diego, CA), Fensome, Andrew; (Wayne, PA), Jones, Todd K.; (Solana Beach, CA), Tegley, Christopher M.; (Thousand Oaks, CA), Terefenko, Eugene A.; (Quakertown, PA), Wrobel, Jay E.; (Lawrenceville, NJ), Zhang, Puwen; (Audubon, PA), Zhi, Lin; (San Diego, CA) Correspondence: Howson And Howson; One Spring House Corporation Center; Box 457; 321 Norristown Road; Spring House; PA; 19477; US Patent Application Number: 20030092711 Date filed: May 6, 2002 Abstract: Methods of using compounds which are progesterone receptor agonists for contraception and the treatment of progesterone-related maladies alone or in combination with an estrogen receptor agonist or progesterone receptor antagonist are provided. These compounds have the structure: 1wherein R.sub.1 and R.sub.2 are selected from the group of H, optionally substituted C.sub.1 to C.sub.6 alkyl, alkenyl, alkynyl, or alkynyl groups C.sub.3 to C.sub.8 cycloalkyl, aryl, substituted aryl, or heterocyclic groups, or COR.sup.A or NR.sup.BCOR.sup.A; or R.sup.1 and R.sup.2 are fused to form an optionally substituted ring structure as defined herein; R.sup.A and R.sup.B are as defined herein; R.sup.3 is H, OH, NH.sub.2, COR.sup.C, or optionally substituted C.sub.1 to C.sub.6 alkyl, C.sub.3 to C.sub.6 alkenyl, or alkynyl groups;
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R.sup.C is as defined herein; Q.sup.1 is S, NR.sup.7, or CR.sup.8R.sup.9; R.sup.5 is an optionally trisubstituted benzene ring or an optionally substituted five or six membered heterocyclic ring. Excerpt(s): This application is a continuation of U.S. patent application Ser. No. 09/552,354, filed Apr. 19, 2000, which claims the benefit of the priority of U.S. Patent Application No. 60/183,013, filed May 4, 1999, now abandoned. This invention relates to compounds which are agonists of the progesterone receptor, their preparation and utility. This invention also provides methods of using these compounds in the inducement of contraception and the treatment and/or prevention of dysfunctional bleeding, uterine leiomyomata, endometriosis, polycystic ovary syndrome, and carcinomas and adenocarcinomas of the endometrium, ovary, breast, colon, and prostate. Intracellular receptors (IR) form a class of structurally related gene regulators known as "ligand dependent transcription factors" (R. M. Evans, Science, 240, 889, 1988). The steroid receptor family is a subset of the IR family, including progesterone receptor (PR), estrogen receptor (ER), androgen receptor (AR), glucocorticoid receptor (GR), and mineralocorticoid receptor (MR). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Formulations comprising selective androgen receptor modulators Inventor(s): Dalton, James T.; (Columbus, OH), Miller, Duane D.; (Germantown, TN), Steiner, Mitchell S.; (Germantown, TN), Veverka, Karen A.; (Cordova, TN) Correspondence: Eitan, Pearl, Latzer & Cohen Zedek, LLP.; Suite 1001; 10 Rockefeller Plaza; New York; NY; 10020; US Patent Application Number: 20030162761 Date filed: October 15, 2002 Abstract: The present invention relates to pharmaceutical compositions and formulations comprising a novel class of androgen receptor targeting agents (ARTA) which demonstrate androgenic and anabolic activity of a nonsteroidal ligand for the androgen receptor. The agents define a new subclass of compounds which are selective androgen receptor modulators (SARM) which are useful for a) male contraception; b) treatment of a variety of hormone-related conditions, for example conditions associated with Androgen Decline in Aging Male (ADAM), such as fatigue, depression, decreased libido, sexual dysfunction, erectile dysfunction, hypogonadism, osteoporosis, hair loss, anemia, obesity, sarcopenia, osteopenia,osteoporosis, benign prostate hyperplasia, alterations in mood and cognition and prostate cancer; c) treatment of conditions associated with Androgen Decline in Female (ADIF), such as sexual dysfunction, decreased sexual libido, hypogonadism, sarcopenia, osteopenia, osteoporosis, alterations in cognition and mood, depression, anemia, hair loss, obesity, endometriosis, breast cancer, uterine cancer and ovarian cancer; d) treatment and/or prevention of chronic muscular wasting; and/or e) decreasing the incidence of, halting or causing a regression of prostate cancer. The present invention provides pharmaceutical compositions comprising the selective androgen receptor modulator compounds, together with pharmaceutically acceptable excipients. Excerpt(s): This Application is a Continuation-in-Part application of U.S. Ser. No. 09/935,044, filed Aug. 23, 2001 and of U.S. Ser. No. 09/935,045, filed Aug. 23, 2001, which are Continuation-in-Part applications of U.S. Ser. No. 09/644,970 filed Aug. 24, 2000; and claims priority of U.S. Serial No. 60/300,083, filed Jun. 25, 2001, which are
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hereby incorporated by reference. The present invention relates to pharmaceutical compositions and formulations comprising a novel class of androgen receptor targeting agents (ARTA), which demonstrate androgenic and anabolic activity of a nonsteroidal ligand for the androgen receptor. The agents define a new subclass of compounds, which are selective androgen receptor modulators (SARMs) useful for a) male contraception; b) treatment of a variety of hormone-related conditions, for example conditions associated with Androgen Decline in Aging Male (ADAM); c) treatment of conditions associated with Androgen Decline in Female (ADIF); d) treatment and/or prevention of chronic muscular wasting; and/or e) decreasing the incidence of, halting or causing a regression of prostate cancer. The androgen receptor ("AR") is a ligandactivated transcriptional regulatory protein that mediates induction of male sexual development and function through its activity with endogenous androgens. Androgens are generally known as the male sex hormones. The androgenic hormones are steroids which are produced in the body by the testes and the cortex of the adrenal gland or can be synthesized in the laboratory. Androgenic steroids play an important role in many physiologic processes, including the development and maintenance of male sexual characteristics such as muscle and bone mass, prostate growth, spermatogenesis, and the male hair pattern (Matsumoto, Endocrinol. Met. Clin. N. Am. 23:857-75 (1994)). The endogenous steroidal androgens include testosterone and dihydrotestosterone ("DHT"). Testosterone is the principal steroid secreted by the testes and is the primary circulating androgen found in the plasma of males. Testosterone is converted to DHT by the enzyme 5 alpha-reductase in many peripheral tissues. DHT is thus thought to serve as the intracellular mediator for most androgen actions (Zhou, et al., Molec. Endocrinol. 9:208-18 (1995)). Other steroidal androgens include esters of testosterone, such as the cypionate, propionate, phenylpropionate, cyclopentylpropionate, isocarporate, enanthate, and decanoate esters, and other synthetic androgens such as 7-MethylNortestosterone ("MENT") and its acetate ester (Sundaram et al., "7 Alpha-MethylNortestosterone(MENT): The Optimal Androgen For Male Contraception," Ann. Med., 25:199-205 (1993) ("Sundaram")). Because the AR is involved in male sexual development and function, the AR is a likely target for effecting male contraception or other forms of hormone replacement therapy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Full length human hcn1ih channel subunit and variants Inventor(s): Dunbar, Donald Robert; (Linlithgow, GB), Morrow, John Anthony; (Edinburgh, GB) Correspondence: William M Blackstone; Intervet Inc Patent Department; PO Box 318; Millsboro; DE; 19966; US Patent Application Number: 20030180753 Date filed: November 22, 2002 Abstract: This invention relates to a DNA sequence encoding a member of the hyperpolarised activated ion channel family (HCN) and variants thereof, and the use of said sequences in assays for the measurement of gene expression. It also relates to assays for screening of I.sub.h activators and blockers for clinical and therapeutic use in the management of human psychiatric and neurological dysfunction in the CNS, cardiovascular dysfunction of the heart, and reproductive dysfunction and/or contraception related to I.sub.h function in testes and spermatozoa. Further, antibodies
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against the expressed DNA sequences and other compounds reactive with the expressed DNA sequence are also part of the invention. Excerpt(s): Voltage-gated ion channels play a critical role in shaping of electrical activity of neuronal and muscle cells, and in controlling the secretion of neurotransmitters and hormones through the gating of calcium ion entry. Large families of voltage gated sodium (Na.sup.+), potassium (K.sup.+) and calcium (Ca.sup.2+) ion channels have been defined using electrophysiological, pharmacological and molecular techniques [1, 18]; they are named according to their selective permeability for a particular cation with reference to their voltage dependence, kinetic behaviour or molecular identity. The importance of membrane voltage and ion permeability in the control of cell function ensures that modulation of ion channels will invariably have important consequences for cells and tissues, and such modulation can often be turned to therapeutic advantage. Major indication for ion channel modulators already include cardiac arrhythmia, hypertension, anxiety, epilepsy, pain, chemotherapy-induced nausea and diabetes as well as a range of drugs in development for important new indications such as neuroprotection and psychiatry. A variety of bodily functions such as heart beat, sleepwake cycles, secretion of hormones and control of behavioural state depend on the action of pacemakers, specialised cells that are able to generate rhythmic, spontaneously firing action potentials. The archetypal organ displaying autonomic rhythmicity is the heart. Pacemaking in the heart is accomplished by the rhythmic discharge of the sino atrial node [8, 11, 12]. The firing rate of the sino atrial node is determined by the diastolic depolarisation phase of the action potential. During this phase the membrane potential is slowly depolarised to the threshold triggering the next action potential. The ionic conductance underlying the cardiac pacemaker depolarisation was identified in the late seventies and early eighties [10] and called I.sub.f (f for `funny`) or I.sub.h (h for hyperpolarisation activated). A similar current was subsequently discovered in neurones, first in photoreceptors, [2, 3, 6] and then in various central neurons eg hippocampal pyramidal cells [16] where is was called Iq (q for `queer`). This current was subsequently found in a wide variety of central and peripheral neurons [25]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Male contraceptive formulation comprising norethisterone Inventor(s): Kamischke, Axel; (Muenster, DE), Nieschlag, Eberhard; (Muenster, DE), Oettel, Michael; (Jena, DE), Ruebig, Alexander; (Berlin, DE), Schillinger, Ekkerhard; (Berlin, DE), Ursula-Friederike, Habenicht; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20020103176 Date filed: January 19, 2001 Abstract: A formulation for male contraception comprising a progestin possessing both estrogenic and androgenic properties is remarkably effective for spermatogenesis suppression in males. The progestin Norethisterone (NET), particularly its derivatives Norethisterone acetate and Norethisterone enanthate in sufficient doses induce oligozoospermia or azoospermia in males. Formulations further comprising an androgen, such as a testosterone derivative such as a testosterone ester, particularly testosterone undecanoate, are especially effective male contraceptive formulations.
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Excerpt(s): The invention relates to a formulation of a male contraceptive comprising a progestin as well as methods of male contraception utilising progestins. Moreover, the invention relates to formulation further comprising an androgen as well as to methods using formulations comprising a progestin and an androgen so as to suppress spermatogenesis. Contraceptive methods for men are considered an essential component of world-wide reproductive health (Nieschlag and Behre; Testosterone: action, deficiency, substitution, 1998, Springer, Berlin, p 514). Hormonal methods of male contraception offer the advantages of high-reversibility and efficacy. In hormonal male contraception, the suppression of spermatogenesis is sought through the suppression of the gonadotropins leuteinizing hormone (LH) and follicle stimulating hormone (FSH) to undetectable levels within the endocrine feedback mechanism operating between the pituitary gland and the hypothalamus. Disadvantageously, suppression of these gonadotropins also induces symptoms related to androgen deficiency (Nieschlag and Behre; 1998, pp 513-528). Male contraceptive methods seek to suppress FSH and LH, resulting in a depletion of intratesticular testosterone and cessation of spermatogenesis, whilst substituting peripheral testosterone with another androgen. This androgen has typically been testosterone itself and serves the endocrine androgenic role of testosterone such as to maintain libido, male sex characteristics, protein anabolism, hematopoesis and others. In short, the objective is to deplete the testes of testosterone whilst maintaining levels in the general circulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Mammalian SUV39H2 proteins and isolated DNA molecules encoding them Inventor(s): Jenuwein, Thomas; (Wien, AT), O'Carroll, Donal; (Greystones, IE), Rea, Stephen; (Headford, IE) Correspondence: Sterne, Kessler, Goldstein & Fox Pllc; 1100 New York Avenue, N.W., Suite 600; Washington; DC; 20005-3934; US Patent Application Number: 20020039776 Date filed: June 8, 2001 Abstract: Murine and human Suv39h2 polypeptide and DNA molecules encoding them. Suv39h2 is a novel member of the Suv3-9 gene family. Suv39h2 is a novel component of meiotic higher order chromatin. It has histone methyltransferase activity and is required, in combination with Suv39h1, for male gametogenesis. Suv39h2 can be used in screening methods to identify modulators of its methyltransferase activity, which are useful in cancer therapy and for male contraception. Excerpt(s): This application claims priority benefit of U.S. Provisional Application No. 60/224,220, filed Aug. 9, 2000, which is hereby incorporated by reference in its entirety. The invention relates to the isolation and functional characterisation of a novel mammalian Su(var)3-9 homologue, Suv39h2, and its use. In eukaryotes, control of gene expression and the functional organisation of chromosomes depends on higher-order chromatin (Paro and Harte, 1996; Karpen and Allshire, 1997). In addition to its role in somatic cells, higher-order chromatin is also involved in chromosomal dynamics during meiosis (Dernburg et al., 1996). Although condensation and pairing of meiotic chromosomes is evolutionarily highly conserved, meiosis in male mammals is exceptional because the heteromorphic X and Y chromosomes undergo facultative heterochromatinisation that is accompanied by transcriptional silencing (Handel and Hunt, 1992). This selective inactivation of the male sex chromosomes, which is cytologically defined by the appearance of the so-called XY body or sex vesicle (Solari,
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1974), has been proposed to restrict promiscuous pairing or recombination between nonhomologous chromosomes, thereby reducing the risk for aneuploidy (Handel and Hunt, 1992). In fact, failure to form this specialised chromatin structure in the XY body prevents successful spermatogenesis (Kot and Handel, 1990; Matsuda et al., 1991). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Means and method for hormonal contraception Inventor(s): Coelingh Bennink, Herman Jan Tijmen; (Driebergen, NL), Van Beek, Agatha Antonia Magdalena; (Uden, NL) Correspondence: Young & Thompson; 745 South 23rd Street 2nd Floor; Arlington; VA; 22202 Patent Application Number: 20020177580 Date filed: May 23, 2001 Abstract: A contraceptive method comprises the administration of a hormone composition in an amount effective to inhibit ovulation. More specifically the invention relates to the use of a hormone composition in the manufacture of a kit containing a plurality of dosage units for use in a contraceptive method, which method comprises administering a sequence of the dosage units to a female of childbearing capability so as to provide the hormone composition in an amount which is effective to inhibit ovulation, wherein the hormone composition is dydrogesterone component or a combination of estrogen and dydrogesterone component. Another embodiment concerns an oral contraceptive kit comprising from 20-35 daily oral dosage units, wherein 10-35 units contain a combination of estrogen in an amount equivalent to at least 2.mu.g ethinyl estradiol and dydrogesterone component in an amount equivalent to at least 2 mg dydrogesterone, 0-25 units contain estrogen in an amount equivalent to at lease 2.mu.g ethinyl estradiol and no progestogen, and 0-8 units contain no progestogen and no estrogen. Excerpt(s): The present invention is concerned with a contraceptive method, which method comprises administering to a female of childbearing capability one or more dosage units containing a hormone composition in a therapeutically effective amount to inhibit ovulation. The hormone composition used in accordance with the present invention contains a special progestogen (i.e. dydrogesterone) which is structurally and biologically closely related to progesterone and produces less undesirable side-effects than the synthetic progestogens commonly used in hormonal contraceptive regimens. Dydrogesterone (9.beta.,10.alpha.-pregna-4,6-diene-3,20-dione) is an orally active progestative hormone that has been commercially available since the early seventies. Dydrogesterone is mainly used in the treatment of endometriosis and in hormone replacement therapy. "Martindale" (Martindale, "The Complete Drug Reference", Micromedex Healthcare Series, Integrated Index 1974-2001) mentions a number of indications for which dydrogesterone may suitably be used. These include menstrual disorders, endometriosis, endometrial protection during menopausal hormone replacement therapy, threatened abortion, habitual abortion and infertility. Except for endometriosis all these applications have in common that they relate to progesterone deficiency in the body. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Means and method for hormonal contraception Inventor(s): Coelingh Bennink, Herman Jan Tijmen; (Driebergen, NL), Van Beek, Agatha Antonia Magdalena; (Uden, NL) Correspondence: Young & Thompson; 745 South 23rd Street 2nd Floor; Arlington; VA; 22202 Patent Application Number: 20020193356 Date filed: May 23, 2001 Abstract: The present invention is concerned with a kit containing a plurality of hormone units for use in a contraceptive method which consists of two alternating consecutive phases, sometimes referred to as a sequential method or sequential regimen. More particularly the present invention relates to a kit containing a plurality of daily hormone units for use in a contraceptive method which consists of two alternating consecutive phases--an estrogenic and a progestogenic phase--of administering a sequence of said hormone units to a female of childbearing capability, the plurality of daily hormone units consisting of:a) one or more daily hormone units, for use during the estrogenic phase, containing synthetic estrogen or a combination of synthetic estrogen and biogenic estrogen in a therapeutically effective amount to inhibit ovulation andb) at least 10 daily hormone units, for use during the progestogenic phase, containing a combination of biogenic estrogen and progestogen in a therapeutically effective amount to inhibit ovulation and to transform the endometrium from a proliferative into a secretory state. Excerpt(s): The present invention is concerned with a kit containing a plurality of hormone units for use in a contraceptive method which consists of two alternating consecutive phases, sometimes referred to as a sequential method or sequential regimen. This method comprises administering to a female of childbearing capability during one phase one or more hormone units containing estrogen in a therapeutically effective amount to inhibit ovulation and during the other phase one or more hormone units, containing a combination of estrogen and progestogen in a therapeutically effective amount to inhibit ovulation and to transform the endometrium from a proliferative into a secretory state. The method according to the invention, unlike virtually all methods used to date, does not include an interval of about 2-7 days during which a placebo or no daily units are units are administered. Kits for use in a sequential contraceptive method as described above are known in the art. EP-A 0 628 312 (Jenapharm) describes a method comprising one or more phases wherein one phase uses a combination of biogenic estrogen, synthetic estrogen and progestogen and the other phases may use a placebo, or a synthetic or biogenic progestogen, or a synthetic or biogenic estrogen, or a combination of biogenic estrogen, synthetic estrogen and progestogen, or a combination of synthetic estrogen and progestogen. An examples is given of a regimen which consists of 2 phases, one phase of 21 days using the combination of biogenic estrogen, synthetic estrogen and progestogen and another phase of 7 days using only a biogenic estrogen or no hormone at all. DE-A 42 24 534 (Ehrlich et al.) is concerned with a sequential contraceptive method that consists of one phase of 5-14 days during which an estrogen preparation is administered in an therapeutically effective amount to cause disturbance of the follicle stimulation and another phase of 14-23 days during which a combination of estrogen and progestogen preparation is administered in a therapeutically effective amount to inhibit ovulation and wherein the ethinyl estradiol concentration in the estrogen preparation, if used, is below 30.mu.g. In all the examples the same estrogen is used in both phases.
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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and device for vas occlusion Inventor(s): Burton, John; (Minnetonka, MN), Ferraro, Ricky James; (Crown Point, IN), Socha, Jerome; (Newport, MN), Townsend, Greg; (Plymouth, MN) Correspondence: Beck & Tysver, P.L.L.C.; Suite 100; 2900 Thomas Avenue S.; Minneapolis; MN; 55416; US Patent Application Number: 20020059936 Date filed: November 21, 2001 Abstract: A pair of removable soft pliant plugs is inserted in the Vas to impede the flow of sperm to provide reversible male contraception. Excerpt(s): The present invention relates generally to male contraception and more generally to devices and methods for reversibly occluding the vas deferens of a male. Sterilization is the most popular method of contraception in the United States among couples with children and no desire for more children. It is believed that the acceptance of male contraception would improve if the procedure were more likely to be reversible. At present the surgical reversal of a vasectomy is problematic and requires microsurgery. Various techniques have been applied to occlude the vas to achieve reversible contraception. For example, exterior clips have been used to "squeeze off" the lumen of the vas. However, it has been found that the pressure levels required for reliable occlusion promotes tissue necrosis. Injectable plugs have been used to "fill" the vas. However the delivery of the filler material is difficult and the curing time lengthens the procedure time. These "formed-in-place" plugs have also proved prone to migration which is undesirable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method for detecting or quantifying environmental hormones Inventor(s): Minegishi, Takashi; (Maebashi-shi, JP), Miyamoto, Kaoru; (Maebashi-shi, JP) Correspondence: Fitzpatrick Cella Harper & Scinto; 30 Rockefeller Plaza; New York; NY; 10112; US Patent Application Number: 20030003491 Date filed: July 11, 2002 Abstract: The present invention relates to a method for the detection or determination of environmental hormones, in particular, dioxins in a sample using granulosa cells, etc. In the present invention, the change in the amount of an expressed luteinizing hormone receptor induced by follicle-stimulating hormone, etc. in granulosa cells is employed as an indicator for the detection or determination of dioxins.The present invention also relates to a method for contraception comprising inhibiting the expression of luteinizing hormone receptor induced by follicle-stimulating hormone in granulosa cells, and to a contraceptive agent comprising, as an active ingredient, a substance which inhibits the expression of luteinizing hormone receptor. Excerpt(s): The present invention relates to a method for the detection or determination of environmental hormones, in particular, dioxins in a sample using granulosa cells, etc. In the present invention, the change in the amount of an expressed luteinizing hormone
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(hereinafter referred to as LH) receptor induced by follicle-stimulating hormone (hereinafter referred to as FSH), etc. in granulosa cells is employed as an indicator for the detection or determination of dioxins. Recently, environmental hormones which disturb the endocrine system, or endocrine disrupting chemicals, have attracted attention for their effect on the human body [Birnbaum, L. S., Toxicol. Lett., 82-83, 743750 (1995)]. Among them, dioxins have particularly high toxicity [DeVito, M. J. and Birnbaum, L. S., Toxicology, 102, 115-123 (1995)]. "Dioxins" is the collective name for polychlorodibenzo-p-dioxin (PCDD) and its analogous substance, polychlorodibenzofuran (PCDF). Dioxins are chemical substances secondarily formed in the processes of production of agricultural chemicals, incineration of wastes, paper bleaching, etc. There are 210 kinds of homologues and isomers of dioxins varying in the position and the number of chlorine atoms. In a method generally employed for the detection of dioxins, dioxins are extracted with an organic solvent such as methanol, purified by silica gel chromatography, followed by reconcentration, and then measured by gas chromatography-mass spectrometry (GC-MS) [Gendai Kagaku (Modern Chemistry), the January issue, 38-43 (1999)]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for evaluating and affecting male fertility Inventor(s): Klinefelter, Gary; (Research Triangle Park, NC) Correspondence: Browdy And Neimark, P.L.L.C.; 624 Ninth Street, NW; Suite 300; Washington; DC; 20001-5303; US Patent Application Number: 20020052011 Date filed: January 3, 2001 Abstract: A 22 kD sperm protein, SP22, correlates with fertility and predicts fertility in males. The protein can be assayed to detect decreases in fertility resulting from exposure to toxicants and pollutants which are known or suspected to decrease fertility. In an antibody is generated to this protein, the antibody recognition by sperm in an epididymal sperm sample or ejaculate would reflect the fertility of the sample. This antibody can be used as a contraceptive to inactivate sperm, screen for toxicity, select animals for artificial insemination, and select men for assisted reproductive technologies. The protein itself can be inactivated by gene knockout, which is another approach to contraception, or the protein can be added to sperm from infertile men to make fertility techniques more feasible. Excerpt(s): The present application is a continuation in part of application Ser. No. 09/123,492, filed Jul. 28, 1998, Ser. No. and PCTUS9701725 filed Jan. 29, 1998, which is a continuation in part of application Ser. No. 08/592,677, filed Jan. 29, 1996 and now abandoned, both of which are hereby incorporated by reference in the entirety. The present application is based on and claims priority from provisional application No. 60/082,753, filed Apr. 23, 1998. The present invention relates to a sperm protein which can be used for evaluating, inhibiting, and/or enhancing male fertility, as well as antibodies to the sperm protein. Sperm production in the testis of human males is far less efficient than sperm production in other mammals, such as rat, rabbit and monkey (Amann, 1970) due to an increased rate of germ cell atresia. Together with this is the fact that a high incidence of sperm in the ejaculate of a fertile man is morphologically abnormal (Wyrobek et al., 1982). Thus, there is a heightened awareness of the possibility that the quantity and quality of sperm in the ejaculates of men are declining because of environmental influences (Sharpe, 1993). A toxicant-induced alteration in the process of
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sperm maturation during sperm transit through the epididymis, the organ in which sperm acquire fertilizing ability, could render a man infertile. It has been hypothesized that specific proteins are added to sperm in the epididymis which confer fertility. Recently, Klinefelter et al., in Journal of Andrology 15(4), 318-327 (1994) demonstrated that an 18 kD epididymal sperm surface protein, presumably a plasma membrane protein, was well correlated with fertility, although it was not believed that this protein was predictive of fertility. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for identifying compounds altering higher-order chromatin-dependent chromosome stability Inventor(s): Eisenhaber, Frank; (Wien, AT), Jenuwein, Thomas; (Wien, AT), O'Carroll, Donal; (Greystones, IE), Rea, Stephen; (Headford, IE) Correspondence: Sterne, Kessler, Goldstein & Fox Pllc; 1100 New York Avenue, N.W., Suite 600; Washington; DC; 20005-3934; US Patent Application Number: 20020081638 Date filed: June 8, 2001 Abstract: A method for identifying compounds that alter higher order chromatin dependent chromosome stability is based on determining the compounds' ability to modify a methyltransferase with Suv39h-like methyltransferase activity. The identified compounds are useful in therapy, in particular the therapy of human cancer and for contraception. Excerpt(s): This application claims priority benefit of U.S. Provisional Application No. 60/224,220, filed Aug. 9, 2000, which is hereby incorporated by reference in its entirety. The invention relates to a method for identifying compounds influencing chromosome dynamics in eukaryotic cells. In particular, the invention relates to the treatment and prevention of human conditions by modulating higher order chromatin dependent chromosome stability during mitosis and meiosis. Higher-order chromatin is essential for epigenetic gene control and for the functional organisation of chromosomes. Differences in higher-order chromatin structure have been linked with distinct covalent modifications of histone tails which regulate transcriptional `on` or `off` states (Grunstein, 1998; Turner, 1998; Strahl and Allis, 2000) and influence chromosome condensation and segregation (Karpen and Allshire, 1997; Wei et al., 1999). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method of long-term reversible contraception for animals Inventor(s): Ramey, Jacques; (Omaha, NE) Correspondence: Mark Frederiksen; PO Box 938; Council Bluffs; IA; 51502-0938; US Patent Application Number: 20030108586 Date filed: December 11, 2001 Abstract: A method of preventing fertility in a non-human animal includes administering a GnRH antagonist to the animal in an amount sufficient to prevent fertility.
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Excerpt(s): The present invention relates generally to methods for preventing conception in animals, and more particularly to an improved method for contraception that is longterm and reversible. The standard method for controlling animal fertility currently used in the prior art is by surgical removal of the animal's reproductive organs. If pet owners want a safe and efficacious method of temporarily preventing reproductive capabilities, few options are currently available. Nonsurgical means of controlling reproduction that are currently available include the use of intravaginal devices and a few pharmacological agents (generally composed of steroids). Only two drugs are approved in the U.S.A. as a means of controlling small animal reproduction: (1) Ovaban.TM. (megestrol acetate; a product produced by Schering-Plough Animal, Union, N.J.), a synthetic progestin and Mibolerone.TM. (Cheque drops; a product produced by Pharmacia and Updon, Peapack, N.J.), a synthetic androgen (both of which are approved for reproductive suppression in female canines). These drugs are administered daily, usually by mixing them in the dog's food. The dosage is based on weight and the length of administration depends on when the drug is given in relation to the animal's reproductive cycle. An 8-32 day course of Ovaban.TM. is required to prevent fertility. This drug should not be administered for more than two consecutive treatment cycles. In contrast, Mibolerone.TM. is approved for daily administration for up to 2 years and must be instituted for at least 30 days to prevent pregnancy. This drug is not recommended for use in dogs that are to be used for future breeding. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method of using lectins for contraception, prophylaxis against diseases transmittable by sexual contact, and therapy of such diseases, and apparatus for administering lectins Inventor(s): Oldham, Michael J.; (Oxnard, CA), Rose, Bruce F.; (Ventura, CA) Correspondence: Thomas R. Boland; Vorys, Sater, Seymour And Pease Llp; Suite 1111; 1828 L Street, NW; Washington; DC; 20036-5104; US Patent Application Number: 20030060516 Date filed: September 30, 2002 Abstract: In order to prevent conception and/or the spread of sexually transmitted diseases (STD's) one or more lectins capable of binding sperm and/or the pathogenic microorganisms responsible for STD's are administered to the vagina prior to sexual intercourse. The lectins immobilize the sperm to render them incapable of fertilization and also bind to the microorganisms to render them non-pathogenic or to the cells to prevent infection by the microorganisms. Lectins can also be administered to treat sexually transmitted vaginal infections. The invention also encompasses a device for to be placed in the vault of the vagina which comprises a ring which surrounds the cervix and a membrane spanning the central aperture of the ring to prevent the direct contact of ejaculate with the cervical tissues. The device is impregnated or coated with lectins and releases them into the vaginal environment over a period of time. Excerpt(s): This invention relates generally to methods of contraception and prophylaxis against diseases transmittable by sexual contact and therapy of such diseases, and more particularly to a method using intravaginally administered lectins for contraception and to protect against the transmission of diseases that are transmissible by sexual contact and to treat such diseases. The invention also relates to devices for intravaginal administration of lectins. Sexually transmitted diseases (STD's) are epidemic in this country and worldwide. Furthermore, other diseases that have not
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traditionally been considered to be STD's have also been found to be transmitted by sexual contact, e.g., hepatitis B. The medical and public health problems associated with these epidemics have motivated a search for methods of controlling these diseases by limiting their transmission from person to person. Similarly, although many methods of contraception have been employed, no universally satisfactory method has been developed. Hitherto it has been generally agreed that barrier methods which prevent the contact of body fluids between individuals are the most effective means of preventing transmission of such diseases. Such barrier methods are also effective contraceptive procedures. However, such methods are somewhat inconvenient and require some cooperation between individuals. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods for modulation of oocyte activation Inventor(s): Baxter, Gregory; (Ithaca, NY), Epel, David; (Carmel, CA), Kuo, Richard; (Fremont, CA) Correspondence: Pamela J. Sherwood; Bozicevic, Field & Francis Llp; 200 Middlefield Road, Suite 200; Menlo Park; CA; 94025; US Patent Application Number: 20020106360 Date filed: December 8, 2000 Abstract: Nitric oxide synthase and nitric-oxide-related bioactivity are shown to be necessary and sufficient for activation of an oocyte during the process of fertilization. Methods are provided for the modulation of oocyte activation through modulation of nitric oxide levels. Oocyte activation is enhanced by the addition of nitric oxide synthase, nitric oxide synthase activators, nitric oxide donors, or other compounds that increase the nitric oxide levels of the oocyte during fertilization. The administration of NOS inhibitors is used to block oocyte activation, where contraception is desired. Excerpt(s): In mammals, life begins at fertilization when the sperm interacts with the oocyte to trigger a series of intracellular Ca.sup.2+ oscillations that persists for several hours. This prolonged period of repetitive Ca.sup.2+ pulses triggers the developmental program by stimulating the enzymatic machinery involved in the cell division cycle. Further changes in intracellular Ca.sup.2+ are not observed until the one cell embryo is ready to divide, when a spontaneous Ca.sup.2+ transient triggers cleavage to form two daughter cells. The early steps that lead to the rises in calcium and oocyte activation at fertilization were unknown but of great interest, particularly with the advent of in vitro fertilization techniques, and whole-animal cloning by nuclear transfer. This calcium rise is required for oocyte activation and the subsequent events of development in eggs or oocytes of all species. The meiotic division of mammalian oocytes begins with one primary germ cell (oocyte), which gives rise to only one mature ovum (egg). In normal mammalian development, oocytes become developmentally arrested in the ovaries at the germinal vesicle stage in prophase of the first meiotic division. Upon appropriate stimulation, meiosis resumes, the germinal vesicle breaks down, and the first meiotic division is completed with the extrusion of a diploid set of chromosomes into the first polar body, another diploid set of chromosomes remaining within the cytoplasm of the oocyte. The oocyte then becomes arrested at metaphase of the second meiosis ("Met II"). Met II oocytes (mature oocytes) can then be ovulated and fertilized. Once fertilized, the activated oocyte completes the second meiotic division with the extrusion of a haploid set of chromosomes into the second polar body, male and female pronuclei are formed, and DNA replication is initiated in the pronuclei. The male and female pronuclei then
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fuse together, allowing their chromosomes to mingle. Equal segregation of the genetic material occurs by mitosis and the zygote cleaves to form two daughter blastomeres. The embryo continues to develop by undergoing a series of mitotic divisions before differentiating into specific cells, resulting in the organization of tissues and organs. This developmental program ensures the successful transition from oocyte to offspring. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods of inhibiting fertility Inventor(s): Liu, Irwin K.M.; (Winters, CA), Morales-Levy, Maria; (Davis, CA) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20030181409 Date filed: December 6, 2002 Abstract: The present invention features compositions and methods for inhibiting fertility or inducing contraception in a mammal. The compositions comprise a nucleic acid molecule encoding all or part of a zona pellucida peptide. In preferred embodiments, the peptide is a zona pellucida subunit 3, especially 3a or 3b. In especially preferred embodiments, the peptide is a porcine zona pellucida. The nucleic acid can be incorporated into an expression vector. The methods for inhibiting fertility or inducing contraception in a mammal comprise the step of administering a nucleic acid molecule encoding all or part of a zona pellucida peptide. Excerpt(s): This invention relates to the field of DNA vaccines particularly for inhibiting fertility or inducing contraception. The prevention of infectious diseases through use of vaccines has been realized for more than two centuries. Vaccines can be live, attenuated viruses, bacteria, inactivated organisms, toxins or partially purified preparations of organisms, polysaccharides or recombinant proteins. Other types of vaccines in development include peptides, recombinant heterologous antigens expressed by viral or bacterial vectors and plasmid DNA. A vaccine must be effective, safe and inexpensive. Antigen presentation is critically important to the development of vaccines. Distinct immune responses are required for protection including elaboration of cytokines, neutralization by antibodies or cell-mediated immune responses. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Neuronal uses of BMP-11 Inventor(s): Celeste, Anthony J.; (Hudson, MA), Thies, R. Scott; (Andover, MA), Wozney, John M.; (Hudson, MA) Correspondence: Wyeth; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20030083252 Date filed: December 20, 2001 Abstract: Purified BMP-11 proteins and processes for producing them are disclosed. Recombinant DNA molecules encoding the BMP-11 proteins are also disclosed. The proteins may be useful in regulating follicle stimulating hormone, such as for contraception. In addition, the proteins may be useful for the induction and/or maintenance of bone, cartilage and/or other connective tissue, and/or neuronal tissue.
Patents 177
Excerpt(s): This application is a divisional of U.S. Ser. No. 09/414,234 filed Oct. 7, 1999, which is a continuation of application U.S. Ser. No. 08/966,297 filed Nov. 7, 1997; which is a continuation-in-part of application U.S. Ser. No. 08/9119,850 filed Aug. 28, 1997 and U.S. Ser. No. 08/452,772 filed May 30, 1995 and issued as U.S. Pat. No. 5,700,911 on Dec. 23, 1997; which is a divisional application of U.S. Ser. No. 08/247,907, filed May 20, 1994 and issued as U.S. Pat. No. 5,639,638 on Jun. 17, 1997; which is a continuation-in-part application of U.S. Ser. No. 08/061,464, filed on May 12, 1993, now abandoned. The present invention relates, inter alia, to a novel family of purified proteins designated BMP-11, DNA molecules encoding them, and processes for obtaining them. The inventors have previously designated the BMP-11 proteins as Activin WC. The BMP-11 proteins may be useful to induce bone and/or cartilage formation and in wound healing and tissue repair, or for augmenting the activity of other bone morphogenetic proteins. The BMP-11 proteins may also be useful to regulate the production of follicle stimulating hormone, for contraception, to promote neuronal cell survival, to stimulate hematopoiesis, and to suppress the development of gonadal tumors. U.S. Pat. No. 4,798,885 disclosed DNA encoding the prepro inhibin.alpha. and.beta. chains. U.S. Pat. No. 5,071,834 discloses pharmaceutical compositions of activin with two beta.sub.B chains formulated in a pharmaceutically acceptable carrier. U.S. Pat. No. 5,102,807 discloses a purified inhibin protein which suppresses production of FSH without suppressing production of luteinizing hormone. In addition, the BMP-11 proteins of the present invention are useful to modulate all aspects of neuronal cell development, particularly neuronal formation, growth, differentiation, proliferation, and especially neuronal maintenance. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Novel androgens Inventor(s): Bursi, Roberta Buma; (HT sHertogenbosch, NL), De Gooyer, Marcel Evert; (RC Meteren, NL), Leysen, Dirk; (Lommel, BE), Van der Louw, Jaap; (En Oss, NL) Correspondence: William M Blackstone; Akzo Nobel; Patent Department Intervet; 405 State Street; Millsboro; DE; 19966; US Patent Application Number: 20030100543 Date filed: September 11, 2002 Abstract: The disclosed invention relates to the unexpected finding of novel steroids which are characterized by a 14.beta.,15.beta.-cyclopropane ring and a 17.alpha. hydroxymethyl group. These steroids according to the invention are found to have in common an androgenic activity. They can be used for the preparation of an agent for male contraception, as well as for the preparation of a medicament for the treatment of androgen insufficiency. Excerpt(s): The present invention is in the field of steroid compounds having a cyclopropane ring, which ring includes carbon atoms 14 and 15 of the steroid skeleton. More particularly, the invention pertains to such steroid compounds as possess an androgenic activity. Steroids having the above-indicated cyclopropane ring have been disclosed in EP 768 316, which is in the field of female contraception and hormonetherapy against endometriosis or climacteric complaints. The steroids are described as having progestagenic activity, examples being 14.alpha.,15.alpha.-methylene estra-4,9diene-3-one-17.alpha.-ol and 3-oxo 14.beta.,15.beta.-methylene estra-4,9-diene-17.beta.-yl (N-phenyl)carbamate. Neither potency, nor any other receptor activities, of these progestagens can be derived from this disclosure. In a non-prepublished patent
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application PCT/DE99/01795 (published on Dec. 29, 1999 as WO 99/67276) a group of 14,15-cyclopropyl steroids has been described, among which are 17.beta.-hydroxy substituted ones. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Nucleic acid sequences of genes encoding high mobility group proteins and uses thereof Inventor(s): Bullerdiek, Jorn; (Bremen, DE) Correspondence: Knobbe Martens Olson & Bear Llp; 620 Newport Center Drive; Sixteenth Floor; Newport Beach; CA; 92660; US Patent Application Number: 20020120120 Date filed: September 10, 2001 Abstract: The invention relates to DNA-sequences, their use and the use of DNAsequences of the MAG gene or genes encoding the high mobility group proteins, agents for the treatment of various diseases including tumors, influencing the development of the vascular system, as well as for contraception and tissue regeneration, and appropriate kits and processes. The sequences, agents, uses, kits and processes enable the specific influencing of molecular mechanisms that jointly form the basis for various diseases, the development of the vascular system, the contraception and the regeneration of tissue. Thus, the disadvantages associated with other agents or processes are decreased. Excerpt(s): This application is a continuation of U.S. application Ser. No. 09/105,542, filed Jun. 26, 1998, which is a continuation-in-part of U.S. application Ser. No. 09/102,321, filed Jun. 22, 1998, which is a continuation of International Application PCT/DE96/02494, filed Dec. 20, 1996, which designates the United States and which claims priority to German application DE 195 48 122.4, filed Dec. 21, 1995. The present invention relates to the fields of molecular biology and biotechnology. More specifically, the invention relates to compositions and methods based on DNA sequences of MAG genes or of genes of the high mobility group proteins and substances for: (1) treatment of diseases; (2) contraception; and (3) tissue generation. Corresponding kits and methods also are disclosed. When studying the molecular basis of aberrant cell growth that accompanies the growth of benign and malignant tumors, so-called MAG genes (multiple-tumor aberration growth genes) were identified as belonging to the group to which high mobility group protein (HMG genes) genes belong. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Once-a-month injection as a depot contraceptive and for hormone replacement therapy for perimenopausal and premenopausal women Inventor(s): Aydinlik, Semiramis; (Berlin, DE), Lachnit-Fixson, Ursula; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20020193358 Date filed: February 5, 2002
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Abstract: This invention describes the use of a once-a-month injection (once-a-month injectable) that contains an estrogenic and gestagenic component as an active ingredient for the production of a pharmaceutical agent for contraception and simultaneous hormone replacement therapy for perimenopausal and premenopausal women.With this pharmaceutical agent, a more reliable contraceptive effect with a "natural" estrogen (without ethinylestradiol) with accompanying active therapy of the beginning estrogenloss symptoms, as well as prevention of osteoporosis, is achieved. Excerpt(s): This invention relates to the use of a once-a-month injection (once-a-month injectable composition) that contains an estrogenic and gestagenic component as an active ingredient for the production of a pharmaceutical agent for contraception and simultaneous hormone replacement therapy for perimenopausal and premenopausal women. A once-a-month injection as defined by this invention means a hormone preparation that is injected in women of child-bearing age once a month for contraception. In this hormone preparation, a gestagenic as well as an estrogenic component are contained as active substances, each with a sufficiently long action to achieve a contraceptive effect for a one-month period. So-called progestogen-only injectables are also available, which ensure longer-lasting contraceptive protection, but with poor cycle control. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Pharmaceutical preparations containing estra-1,3,5(10)-triene derivatives Inventor(s): Elger, Walter; (Berlin, DE), Reddersen, Gudrun; (Jena, DE), Schneider, Birgitt; (Jena, DE), Schwarz, Sigfrid; (Jena, DE), Siemann, Christel; (Jena, DE) Correspondence: Wood, Phillips, Vansanten,; Clark & Mortimer; Suite 3800; 500 West Madison Street; Chicago; IL; 60661; US Patent Application Number: 20020061868 Date filed: November 21, 2001 Abstract: The invention concerns pharmaceutical preparations containing estra-1,3,5(10)triene derivatives as active ingredients which carry a group of the general formulaR-SO.sub.2--O--at their C3 position whereinR is a R.sup.1R.sup.2N group whereinR.sup.1 and R.sup.2 are independent of each other and represent a hydrogen atom, a C.sub.1C.sub.5 alkyl radical or, together with the N atom, a polymethylene imino radical containing 4 to 6 C atoms, or a morpholino radical.The preparations according to the invention can be used for hormonal contraception and for hormon replacement therapy (HRT). They exhibit a low hepatic estrogenity. Excerpt(s): This invention relates to pharmaceutical preparations containing active ingredients that are estra-1,3,5(10)-triene derivatives having an R--SO.sub.2--O group at their C3 position. Estrogens play a major role in hormonal contraception, in menopausal hormone replacement therapy (HRT), and for treating gynecologic (e.g. mammary carcinoma) and andrologic (e.g. prostatic carcinoma) diseases. For HRT and contraception, estrogens are mainly used together with a gestagen, e.g. levornogestrel, desogestrel, gestodene, drospirorenone, norethisterone, cyproterone acetate, chlormadinone acetate, dienogest. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Process for preparing17alpha-acetoxy-11beta-[4-n,n(dimethylamino)phenyl]-2- 1methoxy-19-norpregna-4,9-diene -3,20-dione, intermediates useful in the process , and processes for preparing such intermediates Inventor(s): Cessac, James W; (San Antonio, TX), Kim, Hyun Koo; (Bethesda, MD), Rao, Pemmaraju N; (San Antonio, TX), Simmons, Anne Marie; (San Antonio, TX) Correspondence: Leydig Voit & Mayer, Ltd; 700 Thirteenth ST. NW; Suite 300; Washington; DC; 20005-3960; US Patent Application Number: 20030060646 Date filed: June 27, 2002 Abstract: A compound having general formula (I) in which R.sup.1 is a member selected from the group consisting of --OCH.sub.3, --SCH.sub.3, --N(CH.sub.3).sub.2, -NHCH.sub.3, --CHO, --COCH.sub.3 and --CHOHCH.sub.3; R.sup.2 is a member selected from the group consisting of halogen, alkyl, acyl, hydroxy, alkoxy, acyloxy, alkyl carbonate, cypionyloxy, S-alkyl and S-acyl; R.sup.3 is a member selected from the group consisting of alkyl, hydroxy, alkoxy and acyloxy; R.sup.4 is a member selected from the group consisting of hydrogen and alkyl; and X is a member selected from the group consisting of --O and --N--OR.sup.5, wherein R.sup.5 is a member selected from the group consisting of hydrogen and alkyl. In addition to providing the compounds of formula (I), the present invention provides methods wherein the compounds of formula (I) are advantageously used, inter alia. to antagonize endogenous progesterone; to induce menses; to treat endometriosis; to treat dysmenorrhea; to treat endocrine hormone-dependent tumors; to treat uterine fibroids; to inhibit uterine endometrial proliferation; to induce labor; and for contraception. 1 Excerpt(s): This application claims the benefit of U.S. provisional patent application No. 60/173,470, filed Dec. 29, 1999, the disclosure of which is incorporated by reference in its entirety. The present invention relates generally to steroids, and in particular to a process for preparing 17.alpha.-acetoxy-11.beta.-[4-N,N-(- dimethylamino)phenyl]-21methoxy-19-norpregna-4,9-diene-3,20-dione, intermediates useful in the process, and processes for preparing such intermediates. International patent application No. PCT/US 97/07373, filed Apr. 30, 1997, WO 97/41145, published Nov. 6, 1997, and U.S. provisional patent application No. 60/016,628, filed May 1, 1996, both assigned to the same assignee as the present application, disclose, inter alia, 17.alpha.-acetoxy-11.beta.[4-N,N-(dimethylamino)phenyl]-21-methoxy-19-no- rpregna-4,9-diene-3,20-dione as an antiprogestational agent. This compound also is useful in other treatments, e.g., to induce menses or labor, to treat diseases such as endometriosis, dysmenorrhea, and endocrine hormone-dependent tumors, uterine fibroids, and to inhibit uterine endometrial proliferation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Selective androgen receptor modulators and methods of use thereof Inventor(s): Dalton, James T.; (Columbus, OH), He, Yali; (Florence, SC), Miller, Duane D.; (Germantown, TN), Yin, Donghua; (St. Louis, MO) Correspondence: Eitan, Pearl, Latzer, & Cohen-zedek; One Crystal Park, Suite 210; 2011 Crystal Drive; Arlington; VA; 22202-3709; US Patent Application Number: 20020099096 Date filed: August 23, 2001
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Abstract: This invention provides a novel class of androgen receptor targeting agents (ARTA). The agents define a new subclass of compounds which are tissue-selective androgen receptor modulators (SARM), which are useful for oral testosterone replacement therapy, male contraception, maintaining sexual desire in women, treating prostate cancer and imaging prostate cancer. These agents have an unexpected in-vivo activity for an androgenic and anabolic activity of a nonsteroidal ligand for the androgen receptor. These agents may be active alone or in combination with progestins or estrogens. The invention further provides a novel class of non-steroidal agonist compounds. The invention further provides compositions containing the selective androgen modulator compounds or the non-steroidal agonist compounds and methods of binding an androgen receptor, modulating spermatogenesis, treating and imaging prostate cancer, and providing hormonal therapy for androgen-dependent conditions. Excerpt(s): This Application claims the benefit of U.S. Ser. No. 09/644,970, filed Aug. 24, 2000 and claims priority of U.S. Ser. No. 60/300,083, filed Jun. 25, 2001, which are hereby incorporated by reference. The present invention relates to a novel class of tissueselective androgen receptor targeting agents (ARTA) which demonstrate androgenic and anabolic activity of a nonsteroidal ligand for the androgen receptor. The agents define a new subclass of compounds which are tissue-selective androgen receptor modulators (SARM) which are useful for male hormone therapy such as oral testosterone replacement therapy, mate contraception, maintaining sexual desire in women, treating prostate cancer, and imaging prostate cancer. These agents are also administered to a subject for the treatment of sarcopenia, lack of sexual libido, osteoporosis, erythropoiesis, and fertility. The agents may be used alone or in combination with a progestin or estrogen. The androgen receptor ('AR'") is a ligandactivated transcriptional regulatory protein that mediates induction of male sexual development and function through its activity with endogenous androgens. Androgens are generally known as the male sex hormones. However, androgens also play a pivotal role in female physiology and reproduction. The androgenic hormones are steroids which are produced in the body by the testis and the cortex of the adrenal gland, or synthesized in the laboratory. Androgenic steroids play an important role in many physiologic processes, including the development and maintenance of male sexual characteristics such as muscle and bone mass, prostate growth, spermatogenesis, and the male hair pattern (Matsumoto, Endocrinol. Met. Clin. N. Am. 23:857-75 (1994). The endogenous steroidal androgens include testosterone and dihydrotestosterone ("DHT") Testosterone is the principal steroid secreted by the testes and is the primary circulatiag androgen found in the plasma of males. Testosterone is converted to DHT by the enzyme 5 alpha-reductase in many peripheral tissues. DHT is thus thought to serve as the intracellular mediator for most androgen actions (Zhou, et al., Molec. Endocrinol. 9:208-18 (1995)). Other steroidal androgens include esters of testosterone, such as the cypionate, propionate, phenylpropionate, cyclopentylpropionate, isocarporate, enanthate, and decanoate esters, and other synthetic androgens such as 7-MethylNortestosterone ("MENT'") and its acetate ester (Sundaram et al., "7 Alpha-MethylNortestosterone(MENT): The Optimal Androgen For Male Contraception," Ann. Med., 25:199-205 (1993) ("Sundaram")). Because the AR is involved in male sexual development and function, the AR is a likely target for effecting male contraception or other forms of hormone replacement therapy. The AR also regulates female sexual function (i.e., libido), bone formation, and erythropoiesis. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Transdermal administration of steroid drugs using hydroxide-releasing agents as permeation enhancers Inventor(s): Hsu, Tsung-Min; (San Diego, CA), Luo, Eric C.; (Plano, TX) Correspondence: Reed & Eberle Llp; 800 Menlo Avenue, Suite 210; Menlo Park; CA; 94025; US Patent Application Number: 20030157157 Date filed: February 20, 2003 Abstract: A method is provided for increasing the permeability of skin or mucosal tissue to transdermally administered steroid drugs. The method involves use of a specified amount of a hydroxide-releasing agent, the amount optimized to increase the flux of the drug through a body surface while minimizing the likelihood of skin damage, irritation or sensitization. Formulations and drug delivery systems for co-administering a hydroxide-releasing agent with a steroid drug are provided as well. Optimally, the steroid drugs are a combination of an estrogen and progestin that may be administered in female hormone replacement therapy, to provide female contraception, and the like Excerpt(s): This is a divisional application of U.S. Ser. No. 09/737,833, filed Dec. 14, 2000; which is a continuation-in-part of U.S. Ser. No. 09/569,889, filed May 11, 2000, now abandoned; which is a continuation-in part of U.S. Ser. No. 09/465,098, filed Dec. 16, 1999, now abandoned; the disclosures of which are incorporated by reference. This invention relates generally to transdermal administration of pharmacologically active agents, and more particularly relates to methods and compositions for transdermally administering steroid drugs, particularly progestins and estrogens. The delivery of drugs through the skin provides many advantages; primarily, such a means of delivery is a comfortable, convenient and noninvasive way of administering drugs. The variable rates of absorption and metabolism encountered in oral treatment are avoided, and other inherent inconveniences , e.g., gastrointestinal irritation and the like, are eliminated as well. Transdermal drug delivery also makes possible a high degree of control over blood concentrations of any particular drug. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Ultra low dose oral contraceptives with sustained efficacy and induced amenorrhea Inventor(s): Anderson, Freedolph D.; (Virginia Beach, VA), Hodgen, Gary D.; (Virginia Beach, VA), Williams, Robert F.; (Norfolk, VA) Correspondence: Ostrolenk Faber Gerb & Soffen; 1180 Avenue OF The Americas; New York; NY; 100368403 Patent Application Number: 20030018018 Date filed: July 10, 2001 Abstract: A method of female contraception involves administering a combination of estrogen and progestin continuously for more than a year in which the daily amounts of estrogen and progestin are equivalent to about 5-35 mcg of ethinyl estradiol and about 0.025 to 10 mg of norethindrone acetate, respectively. The advantages include lack of menstrual bleeding, less patient anemia, less total exposure to medication when compared to a 35 microgram (low dose) containing oral contraceptive, reduced risk of endometrial cancer, higher compliance rates and more lifestyle convenience for patients who desire less uterine bleeding each year or longer.
Patents 183
Excerpt(s): The ovarian/menstrual cycle is a complex event characterized by an estrogen rich follicular phase and, after ovulation, a progesterone rich luteal phase. Each has a duration of approximately 14 days resulting in an intermenstrual interval of about 28 days. The endometrial tissue responds to the changes in hormonal milieu. The onset of menstruation is the beginning of a new menstrual cycle and is counted as day 1. During a span of about 5 to 7 days, the superficial layers of the endometrium, which grew and developed during the antecedent ovarian/menstrual cycle, are sloughed because demise of the extant corpus luteum in the non-fertile menstrual cycle is associated with a loss of progesterone secretion. Ovarian follicular maturation occurs progressively resulting in a rise in the circulating levels of estrogen, which in turn leads to new endometrial proliferation. The dominant ovarian follicle undergoes ovulation near mid-cycle, generally between menstrual cycle days 12 to 16 and is converted from a predominantly estrogen source to a predominantly progesterone source (the corpus luteum). The increasing level of progesterone in the blood converts the proliferative endometrium to a secretory phase in which the tissue proliferation has promptly abated, leading to the formation of endometrial glands or organs. When the ovulated oocyte is viably fertilized and continues its progressive embryonic cleavage, the secretory endometrium and the conceptus can interact to bring about implantation (nidation), beginning about 6 to 8 days after fertilization. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Use of ERbeta-selective ligands for regulating fertility and compounds useful therefor Inventor(s): Fritzemeier, Karl-Heinrich; (Berlin, DE), Hegele-Hartung, Christa; (Muehlheim a.d. Ruhr, DE), Kosemund, Dirk; (Erfurt, DE), Mueller, Gerd; (Jena, DE), Peters, Olaf; (Jena, DE), Schubert, Gerd; (Jena, DE), Tornus, Ingo; (Henningsdorf, DE), Yamanouchi, Hiroshi; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20030083377 Date filed: February 27, 2002 Abstract: The present invention discloses the use of ER.beta.-selective ligands for production of medicaments for regulating fertility without additional use of a progestin.ER.beta.-agonists are used for treatment of infertility and ER.beta.-antagonists for contraception. Excerpt(s): This application claims the benefit of the filing date of German Application No. 101 51 365.8 filed Oct. 17, 2001 and U.S. Provisional Applications Serial Nos. 60/271,409 filed Feb. 27, 2001 and 60/329,736 filed Oct. 18, 2001. (b) inhibiting pregnancy potential with ER.beta.-antagonists. (b) inhibition of pregnancy potential by inhibiting folliculogenesis, ovulation and preimplantational development of ovulated oocytes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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VANADIUM ACTIVITY
(IV)
METALLOCENE
COMPLEXES
HAVING
SPERMICIDAL
Inventor(s): D'CRUZ, OSMOND; (MAPLEWOOD, MN), GHOSH, PHALGUNI; (ST. ANTHONY, MN), UCKUN, FATIH M.; (WHITE BEAR LAKE, MN) Correspondence: Merchant & Gould PC; P.O. Box 2903; Minneapolis; MN; 55402-0903; US Patent Application Number: 20020099087 Date filed: December 8, 1999 Abstract: Novel spermicidal compounds which are organometallic cyclopentadienyl metal complexes, particularly vanadium IV complexes, are described including corresponding contraceptive and therapeutic compositions and method for providing contraception and selective killing of testicular germ cells. Included among the vanadium complexes are vanadocene dichloride, vanadocene dibromide, bis (methyl cyclopentadienyl) vanadium dichloride, vanadocene diiodide, vanadocene dipseudohalides, and others. Most active found was vanadocene diselenocyanate. Excerpt(s): This invention relates to metallocene compositions containing vanadium (IV). More particularly, the invention relates to Vanadium (IV) complexed metallocene, having spermicidal activity. The known spermicidal agents, nonoxynol-9 and gramicidin, exert their effects via a detergent-like ability to damage the sperm plasma membrane, perturb its conformation and destroy its semi-permeable nature thereby impairing the sperm motility and egg fertilizing functions (Wilborn, et al., Fertil Steril 1983; 39:717-719; Bourinbaiar, et al., Life Sci 1994; 54:PL 5-9). Because of their no)nspecific membrane disruptive properties, such vaginal spermicides have been shown to damage the cervicovaginal epithelium, as well, which may lead to a lower degree of protection from sexually transmitted diseases (Niruthisard, et al., Sex Transm Dis 1991; 18:176-179). A novel vaginal contraceptive preferably does not function with the nonspecific membrane toxicity mediated by detergent-type action of the currently available vaginal contraceptives. Vanadium is a physiologically essential element which can be found in one of five (I to V) oxidation states. Several inorganic salts containing vanadium with oxidation state +4 (IV) have been shown to function as modulators of cellular redox potential and to exert pleiotropic effects in multiple biological systems by catalyzing the generation of reactive oxygen intermediates. See, for example, Shi, et al., Ann Clin Lab Sci 1996; 26:390-49; Byczkowski, et al., Bull Environ Contain Toxicol 1988; 41:696-703; Younes, et al., Toxicology 1991; 66:63-74, and Sakurai, et al., Biochem Biophys Res Commun 1995; 206:133-137. Reactive oxygen intermediate!; have been reported to affect sperm motility by a combination of peroxidation of membrane lipids and proteins (Aitken, et al., Biol Reprod 1989; 40:183-197; Jones, et al., Fertil Steril 1979; 31:531-537). Peroxidative damage to the sperm plasma membrane is an important pathophysiological mechanism in the onset of male infertility (Aitken, e: al., BioEssays 1994; 16:259-267). It has also been shown that superoxide radicals generated by the action of xanthine oxidase exert a direct, suppressive effect on many aspects of sperm function (Aitken, et al., J. Reprod. Fertil. 1993; 97:441-450). Sperm are thought to be particularly susceptible to oxidative stress by virtue of their high content of unsaturated fatty acids and their relative paucity of cytoplasmic enzymes for scavenging the reactive oxygen intermediates that initiate lipid peroxidation (Alvarez, et al., J Androl 1987; 8:338-348). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Variant cleavage stimulation factor and its encoding nucleic acid Inventor(s): Dass, Brinda; (Lubbock, TX), MacDonald, Clinton C.; (Lubbock, TX), Wallace-Shannon, Allison Michelle; (The Woodlands, TX) Correspondence: Michael L. Goldman, ESQ.; Nixon Peabody Llp; Clinton Square; P.O. Box 31051; Rochester; NY; 14603-1051; US Patent Application Number: 20030215833 Date filed: December 9, 2002 Abstract: The present invention relates to an isolated human nucleic acid molecule encoding a protein or polypeptide which controls RNA polyadenylation, an isolated mouse nucleic acid molecule encoding a protein or polypeptide which controls RNA polyadenylation, and nucleic acid constructs, host cells and an expression system incorporating the nucleic acid molecules. The present invention also discloses methods of diagnosing male infertility; a method of contraception for mammals; and a method for diagnosing a cancerous condition in a subject using the nucleic acid molecules and proteins of the present invention. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application Serial No. 60/338,672, filed Dec. 11, 2001. The present invention relates to an isolated nucleic acid molecule encoding a variant of the human cleavage stimulation factor (hCstF-64) polyadenylation protein, h.tau.CstF-64; an isolated mouse nucleic acid molecule encoding the variant of the murine cleavage stimulation factor (mCstF-64) polyadenylation protein, m.tau.CstF-64; and methods of use for the nucleic acid molecules and the proteins in diagnosis and treatment of male infertility. Polyadenylation is the process of eukaryotic mRNA processing in which 3' end cleavage occurs, followed by the addition of as many as 250 adenosine residues. Messenger RNA polyadenylation is important for cellular processes including transcription termination, splicing, mRNA transport, translation, and mRNA stability. Polyadenylation requires at least five protein complexes, including the cleavage and polyadenylation specificity factor (CPSF), the cleavage stimulation factor (CstF), two cleavage factors (CFI and CFII), and the poly (A) polymerase. Other factors, including the poly(A)-binding protein II (which mediates poly(A) tail length), the U1A small nuclear ribonucleoprotein (SnRNP) (which interacts with both CPSF and the poly(A)polymerase) and DSEF-1 (which binds G-rich auxiliary elements), also contribute to efficient polyadenylation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with contraception, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “contraception” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on contraception.
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You can also use this procedure to view pending patent applications concerning contraception. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON CONTRACEPTION Overview This chapter provides bibliographic book references relating to contraception. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on contraception include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “contraception” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on contraception: •
Positive Images: Teaching Abstinence, Contraception, and Sexual Health Summary: This monograph is a manual for instructors of sex education and is based on the conviction that young people have a right and a need to understand their sexuality. It begins with a list of underlying principles, its objectives, and instructions on how to use the manual. The instructor is advised to examine the lessons and select those that are most appropriate for the particular group. It discusses abstinence, different methods of contraception, sexuality through the lifespan, and understanding reproductive health and how to access reproductive health services. It guides the user through a critical evaluation of websites with information on sexuality. The monograph also considers the effect of parental values on sexual behavior, the mixed sexual messages of society, and avoidance of unwanted pregnancy and sexually transmitted diseases. The monograph provides worksheets for students to practice decision-making and clarify personal feelings about issues and questions for discussion.
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I Con.If You Condom: The Ins & Outs of Contraception Contact: Gallopade Publishing, 235 E Ponce de Leon Ave, Ste 100, Decatur, GA, 30030, (919) 923-4291. Summary: This study guide provides detailed information on contraception to prevent both pregnancy and Sexually transmitted diseases (STD's). It explains that sexuality is a fact of life, and explains various types of contraception, including condoms, spermicides, the pill, IUD's, diaphragms, contraceptive sponges, the rhythm method, sterilization, withdrawal, abortion, and sexual abstinence.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “contraception” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “contraception” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “contraception” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Cooperative Method of Natural Birth Control by Margaret Nofziger; ISBN: 0913990841; http://www.amazon.com/exec/obidos/ASIN/0913990841/icongroupinterna
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A History of Contraception: From Antiquity to the Present Day by Angus McLaren (1992); ISBN: 0631187294; http://www.amazon.com/exec/obidos/ASIN/0631187294/icongroupinterna
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A New Era in Low-Dose Oral Contraception by J. R. Newton (Editor) (1990); ISBN: 1850703078; http://www.amazon.com/exec/obidos/ASIN/1850703078/icongroupinterna
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A Statistical Portrait of Adolescent Sex, Contraception and Childbearing by Kristin Moore, et al (1998); ISBN: 1586710133; http://www.amazon.com/exec/obidos/ASIN/1586710133/icongroupinterna
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Adolescents, Sex, and Contraception by D. Byrne (Editor) (1983); ISBN: 0898592178; http://www.amazon.com/exec/obidos/ASIN/0898592178/icongroupinterna
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Advances in Adolescent Mental Health: Contraception, Pregnancy, and Parenting (Advances in Adolescent Mental Health Series) by Ronald Feldman (Editor), Arlene R. Stiffman (Editor) (1990); ISBN: 1853020885; http://www.amazon.com/exec/obidos/ASIN/1853020885/icongroupinterna
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Advocating for Self: Women's Decisions Concerning Contraception (Haworth Innovations in Feminist Studies) by Peggy Matteson (1995); ISBN: 1560238682; http://www.amazon.com/exec/obidos/ASIN/1560238682/icongroupinterna
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Agenda of the Sexual Revolution: Abortion Contraception Sex Education and Related Evils by K. D. Whitehead; ISBN: 0819908118; http://www.amazon.com/exec/obidos/ASIN/0819908118/icongroupinterna
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189
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All About Birth Control: A Personal Guide by Jon Knowles, et al (1998); ISBN: 0517885069; http://www.amazon.com/exec/obidos/ASIN/0517885069/icongroupinterna
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An Atlas of Contraception by Pramilla Senanayake, Malcolm Potts; ISBN: 1850703876; http://www.amazon.com/exec/obidos/ASIN/1850703876/icongroupinterna
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Aspects Actuels De LA Contraception Hormonale by P.J. Keller (Editor) (1991); ISBN: 3805552637; http://www.amazon.com/exec/obidos/ASIN/3805552637/icongroupinterna
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Biochemical contraception : prospects for human development by Michael H. Briggs; ISBN: 0121346404; http://www.amazon.com/exec/obidos/ASIN/0121346404/icongroupinterna
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Birth Control by Harry W. Rudel (1973); ISBN: 0024044202; http://www.amazon.com/exec/obidos/ASIN/0024044202/icongroupinterna
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Birth Control (1973); ISBN: 0024044105; http://www.amazon.com/exec/obidos/ASIN/0024044105/icongroupinterna
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Birth Control and Abortion by Tietze (1972); ISBN: 0842270043; http://www.amazon.com/exec/obidos/ASIN/0842270043/icongroupinterna
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Birth Control and Controlling Birth: Women-Centered Perspectives (Contemporary Issues in Biomedicine, Ethics, and Society) by Helen B. Holmes (Editor), et al (1981); ISBN: 0896030229; http://www.amazon.com/exec/obidos/ASIN/0896030229/icongroupinterna
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Birth Control by Injection: The Story of Depo-Provera by Thomas J., M.D. Vecchio (1993); ISBN: 0533106958; http://www.amazon.com/exec/obidos/ASIN/0533106958/icongroupinterna
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Birth Control for Christians: Making Wise Choices by Jenell Williams Paris (2003); ISBN: 0801064376; http://www.amazon.com/exec/obidos/ASIN/0801064376/icongroupinterna
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Birth Control in Jewish Law: Marital Relations, Contraception, and Abortion As Set Forth in the Classic Texts of Jewish Law by David M. Feldman (1998); ISBN: 0765760584; http://www.amazon.com/exec/obidos/ASIN/0765760584/icongroupinterna
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Birth Control Politics in the United States, 1916-1945 by Carole R. McCann (1999); ISBN: 0801486122; http://www.amazon.com/exec/obidos/ASIN/0801486122/icongroupinterna
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Birth Control Technologies: Prospects by the Year 2000 by Michael J. K. Harper (1983); ISBN: 0292707398; http://www.amazon.com/exec/obidos/ASIN/0292707398/icongroupinterna
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Birth Control Vaccines by G. P. Talwar, Raj Raghupathy (1995); ISBN: 1570591261; http://www.amazon.com/exec/obidos/ASIN/1570591261/icongroupinterna
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Birth Control: A Woman's Choice by American College of Obstetricians and Gy (2003); ISBN: 0915473879; http://www.amazon.com/exec/obidos/ASIN/0915473879/icongroupinterna
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Cardiovascular Disease and Steroid Hormone Contraception: A Report of a WHO Scientific Group (Technical Report Series: 877) by K. Hagenfeldt (1998); ISBN:
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9241208775; http://www.amazon.com/exec/obidos/ASIN/9241208775/icongroupinterna •
Catch 22 and a Way Out: The Catholic Church and Contraception by Stuart Williams (1993); ISBN: 0722015607; http://www.amazon.com/exec/obidos/ASIN/0722015607/icongroupinterna
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Clinics, Contraception and Communication: Evaluation Studies of Family Planning Programs in Four Latin American Countries by J. Mayone Stycos (Editor) (1973); ISBN: 0891976256; http://www.amazon.com/exec/obidos/ASIN/0891976256/icongroupinterna
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Colonialism, Catholicism and Contraception: A History of Birth Control in Puerto Rico by Annette B. and Seipp, Conrad Ramirez De Arellano; ISBN: 0807815446; http://www.amazon.com/exec/obidos/ASIN/0807815446/icongroupinterna
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Conception and Contraception [DOWNLOAD: PDF]; ISBN: B00005QCTI; http://www.amazon.com/exec/obidos/ASIN/B00005QCTI/icongroupinterna
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Contraception by Drife (1997); ISBN: 0443049270; http://www.amazon.com/exec/obidos/ASIN/0443049270/icongroupinterna
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Contraception by Donna Shoupe, Forence P. Haseltine (Editor) (1993); ISBN: 0387978593; http://www.amazon.com/exec/obidos/ASIN/0387978593/icongroupinterna
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Contraception by Peter D. Bromwich, Anthony D. Parsons (1992); ISBN: 019261410X; http://www.amazon.com/exec/obidos/ASIN/019261410X/icongroupinterna
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Contraception by S. Shan Ratnam (Editor), et al (1987); ISBN: 1850701563; http://www.amazon.com/exec/obidos/ASIN/1850701563/icongroupinterna
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Contraception & Chronic Illness: A Clinician's Sourcebook by Lawrence S. Neinstein, Barbara Katz (1986); ISBN: 0960333258; http://www.amazon.com/exec/obidos/ASIN/0960333258/icongroupinterna
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Contraception (Fast Facts) by Anna Glasier, Beverly Winikoff (2000); ISBN: 1899541187; http://www.amazon.com/exec/obidos/ASIN/1899541187/icongroupinterna
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Contraception Across Cultures: Technologies, Choices, Constraints (Cross-Cultural Perspectives on Women (Paper)) by Andrew Russell (Editor), et al (2000); ISBN: 1859733867; http://www.amazon.com/exec/obidos/ASIN/1859733867/icongroupinterna
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Contraception and Abortion from the Ancient World to the Renaissance by John M. Riddle (1994); ISBN: 0674168763; http://www.amazon.com/exec/obidos/ASIN/0674168763/icongroupinterna
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Contraception and Abortion in Nineteenth-Century America (Cornell Paperbacks) by Janet Farrell Brodie (1997); ISBN: 0801484332; http://www.amazon.com/exec/obidos/ASIN/0801484332/icongroupinterna
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Contraception and Family Planning: A Medical Subject Analysis With Reference Bibliography by Jacob L. Liehaus (1987); ISBN: 0881644331; http://www.amazon.com/exec/obidos/ASIN/0881644331/icongroupinterna
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Contraception and Reproduction: Health Consequences for Women and Children in the Developing World by National Research Council Committee (1989); ISBN: 0309040949; http://www.amazon.com/exec/obidos/ASIN/0309040949/icongroupinterna
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191
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Contraception in the Third Millennium: A (R)evolution in Reproductive and Sexual Health by Slov European Society of Contraception World Congress 2000 Ljubljana, et al; ISBN: 1842140213; http://www.amazon.com/exec/obidos/ASIN/1842140213/icongroupinterna
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Contraception in Western Europe: A Current Appraisal by E. Ketting (Editor) (1990); ISBN: 185070290X; http://www.amazon.com/exec/obidos/ASIN/185070290X/icongroupinterna
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Contraception in Wildlife: Book 1 by Priscilla N. Cohn (Editor), et al (1996); ISBN: 0773488278; http://www.amazon.com/exec/obidos/ASIN/0773488278/icongroupinterna
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Contraception Into the Next Decade by P. J. Keller (Editor), C. Sirtori (Editor) (1988); ISBN: 1850702004; http://www.amazon.com/exec/obidos/ASIN/1850702004/icongroupinterna
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Contraception Today: The Proceedings of the 4th Congress of the European Society of Contraception by C. Coll Capdevila (Editor), et al; ISBN: 1850707677; http://www.amazon.com/exec/obidos/ASIN/1850707677/icongroupinterna
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Contraception vs. tradition; a Catholic critique by G. Egner (Author); ISBN: B00005XDX8; http://www.amazon.com/exec/obidos/ASIN/B00005XDX8/icongroupinterna
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Contraception, by Leroy Lester, Comp. Langley (1973); ISBN: 0879330252; http://www.amazon.com/exec/obidos/ASIN/0879330252/icongroupinterna
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Contraception, (1973); ISBN: 0127869158; http://www.amazon.com/exec/obidos/ASIN/0127869158/icongroupinterna
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Contraception: A Guide to Birth Control Methods by Vern L. Bullough, Bonnie Bullough (1997); ISBN: 1573921599; http://www.amazon.com/exec/obidos/ASIN/1573921599/icongroupinterna
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Contraception: A Guide to Birth Planning Methods by George Rumsey (Editor) (1981); ISBN: 0898360315; http://www.amazon.com/exec/obidos/ASIN/0898360315/icongroupinterna
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Contraception: Newer Pharmacological Agents, Devices, and Delivery Systems by Regine Sitruk-Ware, C. Wayne Bardin (Editor); ISBN: 0824787005; http://www.amazon.com/exec/obidos/ASIN/0824787005/icongroupinterna
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Contraception: Science and Practice by Marcus Filshie, et al (1989); ISBN: 0750611863; http://www.amazon.com/exec/obidos/ASIN/0750611863/icongroupinterna
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Contraception: The Proceedings of the 12th World Congress on Fertility and Sterility, Singapore, October 1986 (Advances in Fertility and Sterility Series, Vol 6) by EngSoon/ Lim, Su-Min World Congress on Fertility and Sterility 1986 Singapore)/ Teoh (Editor) (1988); ISBN: 0940813211; http://www.amazon.com/exec/obidos/ASIN/0940813211/icongroupinterna
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Contraception: Your Questions Answered by John Guillebaud (1993); ISBN: 0443040702; http://www.amazon.com/exec/obidos/ASIN/0443040702/icongroupinterna
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Directory of Authors of New Medical & Scientific Reviews of Contraception With Subject Index by Science, Life Consults (1995); ISBN: 0788305069; http://www.amazon.com/exec/obidos/ASIN/0788305069/icongroupinterna
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Drug Abuse and Contraception by J. Cochin (Editor) (1973); ISBN: 3805514700; http://www.amazon.com/exec/obidos/ASIN/3805514700/icongroupinterna
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Early Childbearing : Perspectives of Black Adolescents on Pregnancy, Abortion and Contraception by Ellen Wood Freeman (Author), Karl Rickels (Author) (1994); ISBN: 080395283X; http://www.amazon.com/exec/obidos/ASIN/080395283X/icongroupinterna
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Encyclopedia of Birth Control by Vern L. Bullough (Editor), et al; ISBN: 1576071812; http://www.amazon.com/exec/obidos/ASIN/1576071812/icongroupinterna
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Entering Adulthood: Understanding Reproduction Birth and Contraception/Student Workbook (Contemporary Health Series) (1989); ISBN: 0941816974; http://www.amazon.com/exec/obidos/ASIN/0941816974/icongroupinterna
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Eve's Herbs: A History of Contraception and Abortion in the West by John M. Riddle (1999); ISBN: 0674270266; http://www.amazon.com/exec/obidos/ASIN/0674270266/icongroupinterna
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Factors Affecting the Use and Non Use of Contraception Findings from a Comparative Analysis of Selected Kap Surveys (1979); ISBN: 0686689569; http://www.amazon.com/exec/obidos/ASIN/0686689569/icongroupinterna
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Female Contraception and Male Fertility Regulation (Advances in Gynecological and Obstetric Research Series, Vol 2) by B. Runnebaum, et al (1991); ISBN: 1850703345; http://www.amazon.com/exec/obidos/ASIN/1850703345/icongroupinterna
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Fertility Management: Contraception in Practice by C. J. Roux (1995); ISBN: 0702132543; http://www.amazon.com/exec/obidos/ASIN/0702132543/icongroupinterna
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Fertility, Sterility and Contraception by Braz World Congress of Gynecology and Obstetrics 1988 Rio De Janeiro, et al (1989); ISBN: 094081384X; http://www.amazon.com/exec/obidos/ASIN/094081384X/icongroupinterna
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Fertility, Sterility, and Contraception: Proceedings of the Xiiith World Congress of Gynecology and Obstetrics, Singapore, September 1991 by Eng-Soon Teoh, S. S. Ratnam (1992); ISBN: 1850704015; http://www.amazon.com/exec/obidos/ASIN/1850704015/icongroupinterna
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From Abortion to Contraception : A Resource to Public Policies and Reproductive Behavior in Central and Eastern Europe from 1917 to the Present by Henry P. David (Author) (1999); ISBN: 0313305870; http://www.amazon.com/exec/obidos/ASIN/0313305870/icongroupinterna
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Future Aspects in Contraception, Part 1: Male Contraception/Proceedings of an International Symposium Held in Heidelberg 5-8 September 1984 by L. Kiesel, et al (1985); ISBN: 0852008937; http://www.amazon.com/exec/obidos/ASIN/0852008937/icongroupinterna
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Future Aspects in Contraception, Part 2: Female Contraception/Proceedings of an International Symposium Held in Heidelberg 5-8 September 1984 by B. Runnebaum (Editor) (1985); ISBN: 0852009062; http://www.amazon.com/exec/obidos/ASIN/0852009062/icongroupinterna
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Gnrh Analogues in Cancer and Human Reproduction: Precocious Puberty, Contraception and Safety Issues (Gnrh Analogues in Cancer and Human Reproductio) by B. Lunenfeld (Editor), B. H. Vickery (Editor) (1991); ISBN: 079238931X; http://www.amazon.com/exec/obidos/ASIN/079238931X/icongroupinterna
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Guide to Birth Control Methods: Seven Accepted Methods Contraception (1985); ISBN: 0934586187; http://www.amazon.com/exec/obidos/ASIN/0934586187/icongroupinterna
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Handbook of Contraception and Family Planning by Suzanne Everett (1999); ISBN: 070202001X; http://www.amazon.com/exec/obidos/ASIN/070202001X/icongroupinterna
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Hormonal Contraception and Post-Menopausal Hormonal Therapy by Iarc Working Group on Evaluation of Carc (1999); ISBN: 928321272X; http://www.amazon.com/exec/obidos/ASIN/928321272X/icongroupinterna
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Hormonal Contraception: Pills, Implants & Injections by Joseph W. Goldzieher (1989); ISBN: 0929240073; http://www.amazon.com/exec/obidos/ASIN/0929240073/icongroupinterna
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I Con If You Condom: The Ins & Outs of Contraception: A Smart Sex Stuff for Kids Book by Carole Marsh (1995); ISBN: 1556091486; http://www.amazon.com/exec/obidos/ASIN/1556091486/icongroupinterna
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Immaculate Contraception: The Extraordinary Story of Birth Control from the First Fumblings to the Present Day by Emma Dickens (2000); ISBN: 1861053371; http://www.amazon.com/exec/obidos/ASIN/1861053371/icongroupinterna
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Infertility, Contraception & Reproductive Endocrinology (1991); ISBN: 0874894395; http://www.amazon.com/exec/obidos/ASIN/0874894395/icongroupinterna
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Is There a Solution to the Catholic Debate on Contraception? by James Arraj (1989); ISBN: 0914073192; http://www.amazon.com/exec/obidos/ASIN/0914073192/icongroupinterna
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It Takes Two - Creating Opportunities for Clients: Sexual Health, Contraception and Men - a Training Resource (1998); ISBN: 0752110632; http://www.amazon.com/exec/obidos/ASIN/0752110632/icongroupinterna
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Melatonin: From Contraception to Breast Cancer Prevention by Michael Cohen (1996); ISBN: 1880613107; http://www.amazon.com/exec/obidos/ASIN/1880613107/icongroupinterna
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Moral Evaluation of Contraception and Sterilization by A. Moraczewski, Gary Atkinson (1979); ISBN: 0935372059; http://www.amazon.com/exec/obidos/ASIN/0935372059/icongroupinterna
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Open Embrace: A Protestant Couple Rethinks Contraception by Sam Torode, et al (2002); ISBN: 0802839738; http://www.amazon.com/exec/obidos/ASIN/0802839738/icongroupinterna
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Oral Contraception in Perspective: Thirty Years of Clinical Experience With the Pill by Alexander Derek Gower Gunn (1987); ISBN: 0940813033; http://www.amazon.com/exec/obidos/ASIN/0940813033/icongroupinterna
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Oral Contraception Into the 1990's by H. W. Halbe (Editor), H. Rekers (Editor) (1989); ISBN: 1850702624; http://www.amazon.com/exec/obidos/ASIN/1850702624/icongroupinterna
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Pandora's Clock: Understanding Our Fertility: The Choices We Face Over Contraception, Pregnancy, Genetic Screening, Abortion and Infertility by Maureen Freely, Celia Pyper; ISBN: 0749319879; http://www.amazon.com/exec/obidos/ASIN/0749319879/icongroupinterna
194 Contraception
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Perspectives in Immunoreproduction: Conception and Contraception (Reproductive Health Technology) by Subbi Mathur (Editor) (1988); ISBN: 0891167838; http://www.amazon.com/exec/obidos/ASIN/0891167838/icongroupinterna
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Progress in Contraception (Recent Developments in Fertility and Sterility, Vol 3) by Y. Boutaleb, A. Gzouli (Editor) (1991); ISBN: 1850702861; http://www.amazon.com/exec/obidos/ASIN/1850702861/icongroupinterna
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Reforming Sex: The German Movement for Birth Control and Abortion Reform, 19201950 by Atina Grossmann (1997); ISBN: 0195121244; http://www.amazon.com/exec/obidos/ASIN/0195121244/icongroupinterna
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Responsible Parenthood: Discriminalizing Contraception in Canada by Brenda Margaret Appleby (1999); ISBN: 0802081894; http://www.amazon.com/exec/obidos/ASIN/0802081894/icongroupinterna
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Running After Pills : Politics, Gender, and Contraception in Colonial Zimbabwe by Amy Kaler (Author) (2003); ISBN: 0325070431; http://www.amazon.com/exec/obidos/ASIN/0325070431/icongroupinterna
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Sacred Choices: The Right to Contraception and Abortion in Ten World Religions (Sacred Energies Series) by Daniel C. Maguire (2001); ISBN: 0800634330; http://www.amazon.com/exec/obidos/ASIN/0800634330/icongroupinterna
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Sacred Rights: The Case for Contraception and Abortion in World Religions by Daniel C. Maguire (Editor) (2003); ISBN: 0195160010; http://www.amazon.com/exec/obidos/ASIN/0195160010/icongroupinterna
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Safe and Voluntary Surgical Contraception: Guidelines for Service Programs by Avsc International (1995); ISBN: 1885063067; http://www.amazon.com/exec/obidos/ASIN/1885063067/icongroupinterna
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Safely Sexual: Your Guide to Contraception and Sexual Health by Robert A. Hatcher (2004); ISBN: 0966490282; http://www.amazon.com/exec/obidos/ASIN/0966490282/icongroupinterna
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Sex, Contraception, and Motherhood in Jamaica by Eugene B. Brody (1982); ISBN: 0674802772; http://www.amazon.com/exec/obidos/ASIN/0674802772/icongroupinterna
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Sexually Transmitted Diseases and Contraception: Sexual Health Promotion and Service Delivery by Ali Kubba MD (Editor), et al (1997); ISBN: 1900603160; http://www.amazon.com/exec/obidos/ASIN/1900603160/icongroupinterna
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Sterilization: As a Means of Birth Control in Men and Women by Norman Morris, Humphrey Arthur (1982); ISBN: 0720603633; http://www.amazon.com/exec/obidos/ASIN/0720603633/icongroupinterna
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The Endometrium As a Target for Contraception (Ernst Schering Research Foundation Workshop, 18) by H. M. Beier (Editor), et al (1997); ISBN: 0387612572; http://www.amazon.com/exec/obidos/ASIN/0387612572/icongroupinterna
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The Evolution of an Earthly Code: Contraception in Catholic Doctrine (Powerful Conceptions) by Maggie Hume (1991); ISBN: 0915365219; http://www.amazon.com/exec/obidos/ASIN/0915365219/icongroupinterna
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The Selling of Contraception: The Dalkon Shield Case, Sexuality, and Women's Autonomy by Nicole J. Grant, Nicola Grant (Reader) (1993); ISBN: 0814206158; http://www.amazon.com/exec/obidos/ASIN/0814206158/icongroupinterna
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The Whole Truth About Contraception: A Guide to Safe and Effective Choices by Beverly Winikoff, et al (1997); ISBN: 030905494X; http://www.amazon.com/exec/obidos/ASIN/030905494X/icongroupinterna
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Trends in Oral Contraception: The Proceedings of an International Symposium Held at the Xith World Congress of Fertility and Sterility, Dublin, June by R. F. Harrison (Editor) (1984); ISBN: 085200771X; http://www.amazon.com/exec/obidos/ASIN/085200771X/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “contraception” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
A concept of contraception. Author: Neubardt, Selig,; Year: 1964; New York, Trident Press, 1967
•
Advanced concepts in contraception; professional conference series. Proceedings of four symposia: Los Angeles, Philadelphia, New York, Boston. Edited by Frederic Hoffman, in collaboration with Ronald L. Kleinman. Author: Hoffman, Fredric,; Year: 1964; [Amsterdam, New York] Excerpta Medica Foundation, 1968
•
Birth control simplified; describing effective and inexpensive modern methods of avoiding pregnancy, acceptable and accessible to the majority of couples. Author: Pillay, A. P.,; Year: 1964; Bombay, Taraporevala [1965]
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Birth control; contraception and abortion [by] Harry W. Rudel, Fred A. Kincl [and] Milan R. Henzl. Author: Rudel, Harry W.,; Year: 1966; New York, Macmillan [c1973]
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Conception, birth and contraception; a visual presentation [by] Robert J. Demarest [and] John J. Sciarra. Author: Demarest, Robert J.; Year: 1965; New York, McGraw-Hill [c1969]
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Contraception and Catholics; a new appraisal. Author: Dupré, Louis K.,; Year: 1964; Baltimore, Helicon [c1964]
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Contraception and holiness; the Catholic predicament.; Year: 1963; [New York] Herder and Herder [1964]
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Contraception and the natural law. Author: Grisez, Germain,; Year: 1963; Milwaukee, Bruce [c1964]
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Contraception: authority and dissent. Author: Curran, Charles E.; Year: 1966; [New York] Herder and Herder [1969]
11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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•
Handbook on oral contraception. Ed. for the Oral Advisory Group of the Medical Committee, by Eleanor Mears. Author: International Planned Parenthood Federation. Medical Committee.; Year: 1966; Boston, Little, Brown, 1965
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Honest love and human life; is the Pope right about contraception? Author: Derrick, Christopher.; Year: 1968; New York, Coward-McCann [1969]
•
Hormones, fertility and birth control; an interview with Dr. Hans R. Lindner, Head, Department of Biodynamics, The Weizmann Institute of Science. Author: Lindner, Hans R.; Year: 1966; [New York, American Committee for the Weizmann Institute of Science] 1970
•
Human reproduction: conception and contraception, edited by E. S. E. Hafez and T. N. Evans. Author: Hafez, E. S. E. (Elsayed Saad Eldin),; Year: 1962; Hagerstown, Md., Medical Dept., Harper; Row [c1973]; ISBN: 0061410659 http://www.amazon.com/exec/obidos/ASIN/0061410659/icongroupinterna
•
Medical history of contraception. Author: Himes, Norman E. (Norman Edwin),; Year: 1966; New York, Gamut Press, 1963
•
Methods of birth control. Author: Airi, Em.; Year: 1967; New Delhi, Varma [1950?]
•
Modern contraception; a practical guide to scientific birth control. Author: Bloom, Philip M.; Year: 1965; London, Delisle [9164]
•
The Catholic case for contraception. Author: Callahan, Daniel,; Year: 1967; London, Arlington Books [1969]; ISBN: 718190777
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The meaning of contraception. Author: Joyce, Mary Rosera.; Year: 1968; Staten Island, Alba House [c1970]; ISBN: 818901659
•
Woman's choice; a guide to contraception, fertility, abortion, and menopause [by] Robert H. Glass [and] Nathan G. Kase. Author: Glass, Robert H.,; Year: 1965; New York, Basic Books [c1970]; ISBN: 465092012
Chapters on Contraception In order to find chapters that specifically relate to contraception, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and contraception using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “contraception” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on contraception: •
Sex, Fertility, Contraception, and Pregnancy Source: in Gabriel, R. Patient's Guide to Dialysis and Transplantation. 4th ed. Hingham, MA: Kluwer Academic Publishers. 1990. p. 116-121. Contact: Available from Kluwer Academic Publishers. P.O. Box 358, Accord Station. Hingham, MA 02018. (617) 871-6600. PRICE: $24.50. ISBN: 0792389506. Summary: This chapter, from a general patient guide to the treatment of renal failure, considers the issues of sex, fertility, contraception, and pregnancy for the patient with kidney disease. The author discusses the interplay of self-esteem and sexuality, the changing levels of fertility for a woman on dialysis, the types of contraception that may
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be appropriate for renal patients, and the problems inherent in pregnancy for the woman with kidney failure. The author also briefly considers pregnancy in the posttransplant woman. •
Preconception, Conception, and Contraception Source: in Reece, E.A. and Coustan, D.R., eds. Diabetes Mellitus in Pregnancy. 2nd ed. New York, NY: Churchill Livingstone. 1995. p. 417-427. Contact: Available from Churchill Livingstone. 300 Lighting Way, Secaucus, NJ 07094. (800) 553-5426. PRICE: $92.00. ISBN: 0443089795. Summary: This chapter, from a text on diabetes mellitus in pregnancy, covers preconception, conception, and contraception. Topics include prepregnancy counseling; the aims and practices of prepregnancy care; prepregnancy care in women with NIDDM and previous gestational diabetes; identification of the date of conception and the 'early growth delay' hypothesis; and contraception for women with IDDM, including the use of oral contraceptives, intrauterine contraceptive devices, barrier methods, natural family planning, and sterilization. The author reports in detail on the experiences of the Edinburgh prepregnancy clinic. 1 table. 59 references.
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CHAPTER 8. MULTIMEDIA ON CONTRACEPTION Overview In this chapter, we show you how to keep current on multimedia sources of information on contraception. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on contraception is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “contraception” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “contraception” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on contraception: •
Swept away is not okay: Teens make decisions about sex and contraception Source: Hackensack, NJ: Planned Parenthood of Greater Northern New Jersey. n.d. 1 videotape, 2 lessons. Contact: Available from Planned Parenthood of Greater Northern New Jersey, 575 Main Street, Hackensack, NJ 07601. Telephone: (201) 489-1265. $14.95 plus $3.00 for shipping and handling; make check payable to Planned Parenthood of Greater Northern New Jersey. Summary: This videotape informs adolescents of the dangers of media messages that encourage sex but do not discuss contraception, of the importance of protecting themselves from unplanned pregnancies, and of the procedures at a birth control clinic, including the gynecological exam. The videotape is accompanied by two lesson plans, a worksheet entitled 'Facts and Feelings: Thinking About Birth Control,' and an evaluation form for the workshop on contraception.
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Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “contraception” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on contraception: •
Adolescent Health Initiative: New Partnership For HIV/AIDS, STD Prevention In Teens; the 16th National Lesbian & Gay Health Conference & 12th Annual AIDS/HIV Forum, New York, NY, June 24 - 26, Contact: Encore Cassettes, PO Box 231340, San Diego, CA, 92194, (619) 596-8402. Summary: This audio tape records a workshop on adolescent reproductive health presented by the Association of Reproductive Health Professionals (ARHP), a medical specialty organization based in Washington, DC. The speaker reviews the logistics of the workshop, followed by a formal presentation on adolescent reproductive health. The presentation includes a discussion of how the organization's Adolescent Health Initiative can be improved to ensure that there is more involvement of the gay and lesbian community, and specifically gay and lesbian youth. The principal objective of the workshop leaders is to receive input from the audience on this objective. The ARHP's focus is on sexually transmitted diseases, HIV, contraception, and menopause.
•
Listen Carefully Contact: Emory University, School of Medicine, Department of Gynecology/Obstetrics, 1462 Clifton Rd, Atlanta, GA, 30322, (404) 589-3556. Summary: This cassette contains information in a question-and-answer format about birth control pills and other forms of contraception. Special instructions for beginning oral contraceptives are given, as well as instructions on steps to be taken if pills are missed. Side effects and danger signs are also explained. While oral contraceptives are effective in preventing pregnancy, condoms are urged as an effective means of preventing sexually transmitted diseases (STD's), including HIV and AIDS.
Bibliography: Multimedia on Contraception The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in contraception (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on contraception: •
Contraception [filmstrip] Source: Medical Electronic Educational Services; produced by School of Nursing, University of Missouri-Columbia; Year: 1973; Format: Filmstrip; Tucson: The Services, c1973
•
Contraception [videorecording] Source: Dept. of Psychology and the Office of Telecourses, Continuing Education, University of Washington; Year: 1975; Format:
Multimedia 201
Videorecording; [Seattle]: The University: [for loan or sale by University of Washington Press, 1975] •
Contraception [videorecording]: an evolving art Source: Marshfield Clinic, Saint Joseph's Hospital; a presentation of the Marshfield Video Network; Year: 1994; Format: Videorecording; Marshfield, WI: The Clinic, [1994]
•
Contraception [videorecording]: the stalled revolution Source: produced by Better World Society and Maryland Public Television, in association with Lucky Duck Productions; Year: 1992; Format: Videorecording; [Washington, D.C.]: The Society, c1992
•
Contraception and Reproductive Health Branch [electronic resource]: report to the NACHHD Council, September 1999. Source: National Institute of Child Health and Human Development (U.S.). Contraception and Reproductive Health Branch; Year: 1999; Format: Electronic resource; [Bethesda, Md.]:
•
Contraception for adolescents [videorecording] Source: with David A. Grimes; Year: 1987; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, 1987
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Contraception in the 1990s [videorecording]: an update Source: American Academy of Family Physicians; produced by Gardiner-Caldwell SynerMed; Year: 1991; Format: Videorecording; Kansas City, Mo.: The Academy, c1991
•
Economic impact of unintended pregnancy [videorecording]: implications of safe & reliable contraception Source: Marshfield Clinic, Saint Joseph's Hospital; a presentation of the Marshfield Video Network; Year: 1998; Format: Videorecording; Marshfield, WI: The Network, c1998
•
Fertile territory (male contraception) [videorecording] Source: Chip Taylor Communications; a Wark Clements production; Year: 2002; Format: Videorecording; Derry, N.H.: Chip Taylor Communications, 2002
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Pelvic examination for contraception [motion picture] Source: [presented by] the Pathfinder Fund; Year: 1981; Format: Motion picture; Boston, Mass.: Pathfinder Fund, c1981
•
The art & science of contraception [electronic resource] Source: American College of Obstetricians and Gynecologists, Council on Resident Education in Obstretics and Gynecology; Year: 1999; Format: Electronic resource; [Washington, DC]: American College of Obstetricians and Gynecologists, c1999
•
The Growing crisis in contraception [videorecording] Source: presented by the Department of Gynecology and Obstetrics, Emory University, School of Medicine; Year: 1987; Format: Videorecording; Atlanta, Ga.: The University, 1987
•
The Question of abortion and contraception [sound recording] Source: Association for Clinical Pastoral Education, E. J. Meyer Memorial Hospital, and the Department of Psychiatry School of Medicine State University of New York at Buffalo; Year: 1975; Format: Sound recording; Buffalo: Communications in Learning, [1975]
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CHAPTER 9. PERIODICALS CONTRACEPTION
AND
NEWS
ON
Overview In this chapter, we suggest a number of news sources and present various periodicals that cover contraception.
News Services and Press Releases One of the simplest ways of tracking press releases on contraception is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “contraception” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to contraception. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “contraception” (or synonyms). The following was recently listed in this archive for contraception: •
Teens largely uninformed about emergency contraception Source: Reuters Medical News Date: November 17, 2003
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•
Vouchers reduce teens' access to contraception Source: Reuters Health eLine Date: November 06, 2003
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Emergency contraception effective up to 5 days after intercourse Source: Reuters Industry Breifing Date: June 02, 2003
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Few US minorities aware of emergency contraception Source: Reuters Industry Breifing Date: May 01, 2003
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Emergency contraception maker asks FDA for OTC switch Source: Reuters Industry Breifing Date: April 21, 2003
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Providing advance emergency contraception does not affect condom use Source: Reuters Industry Breifing Date: March 19, 2003
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Emergency contraception more tolerable with metoclopramide Source: Reuters Industry Breifing Date: March 10, 2003
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Workers sue railroad co. for birth control coverage Source: Reuters Health eLine Date: March 05, 2003
•
Lawsuit versus Union Pacific seeks birth control cover Source: Reuters Industry Breifing Date: March 05, 2003 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to
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Market Wire’s home page at http://www.marketwire.com/mw/home, type “contraception” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “contraception” (or synonyms). If you know the name of a company that is relevant to contraception, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “contraception” (or synonyms).
Newsletters on Contraception Find newsletters on contraception using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “contraception.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “contraception” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Contraception counts: State-by-state information Source: New York, NY: Alan Guttmacher Institute. 1997. 6 pp. Contact: Available from Alan Guttmacher Institute, 120 Wall Street, 21st Floor, New York, NY 10005. Telephone: (212) 248-1111 or (202) 296-4012 Washington, D.C. office / fax: (212) 248-1951; Washington, D.C. office (202) 223-5756 / e-mail:
[email protected] / Web site: http://www.agi- usa.org. Summary: This newsletter briefly describes the extent of unintended pregnancy in the United States today and examines the impact of contraceptive use on pregnancy prevention. It then provides a comprehensive look at the need for subsidized contraceptive services across the country and the extent to which that need is being met. Tables show the number of women at risk of experiencing an unintended pregnancy: for each state and the District of Columbia: with information on their income, insurance status, and need for subsidized contraceptive care; the number of family planning clinics and the proportion of teenage and adult women in need served in them; and the number of pregnancies being averted by publicly funded clinic services.
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Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “contraception” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on contraception: •
Pregnant Women With Lupus: The Role of Rheumatologist, Obstetrician, and Family Source: Minnesota Lupus News. 118:3-5; October/November 1996. Contact: Minnesota Chapter of the Lupus Foundation of America, Inc., International Market Square-19., 275 Market st. Minneapolis, MN 55405-1602. (612) 375-1131. Summary: This newsletter article for individuals with lupus addresses medical, social, and financial issues relevant to pregnant women with lupus. Women with lupus should discuss medical issues with their rheumatologist prior to pregnancy, including determining how to manage their lupus during pregnancy; consider social and financial issues; and prepare for the possibility of a premature birth. Women with lupus should be referred to an obstetrician with experience in managing high risk pregnancies, and they need to have a support system in place prior to delivery. Other issues that they need to consider are breast feeding and contraception.
•
Systemic Lupus Erythematosus: Women's Health Issues Source: Bulletin on the Rheumatic Diseases. 49(8): 1-3. 2001. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (404) 872-7100. Fax (404) 872-9559. Summary: This newsletter article provides health professionals with information on systemic lupus erythematosus (SLE) in relation to issues specific to women's health, including pregnancy, contraception, fertility, sexuality, management of menopause, osteoporosis, coronary artery disease, and chronic fatigue. Pregnancy is high risk for both the woman with SLE and her fetus. Pregnant women with SLE are at higher risk for both preeclampsia and premature membrane rupture. Fetal problems associated with SLE include preterm birth, intrauterine growth retardation, placental insufficiency, pregnancy loss, and congenital heart block. Although barrier contraception is the safest method in SLE, other options include oral contraceptives, the intrauterine device, and tubal ligation. Fertility is usually not a problem in women with SLE, but some SLE treatment regimens, such as monthly pulse intravenous cyclophosphamide, put fertility at risk. Women with SLE may face sexuality issues because their body image is affected both by the disease and by its treatment. More women with SLE are reaching menopause, and studies have suggested that estrogen replacement therapy does not increase SLE flares. Both premenopausal and postmenopausal women with SLE are at risk for osteoporosis because of the use of prednisone. The major cause of death in women with SLE is cardiovascular disease, so they should be considered as candidates for screening for early atherosclerosis. Chronic fatigue is a major complaint of women with SLE. 4 tables and 18 references.
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Academic Periodicals covering Contraception Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to contraception. In addition to these sources, you can search for articles covering contraception that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for contraception. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with contraception. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to contraception: Acitretin •
Systemic - U.S. Brands: Soriatane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203365.html
Danazol •
Systemic - U.S. Brands: Danocrine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202180.html
Estrogens and Progestins Oral Contraceptives •
Systemic - U.S. Brands: Alesse; Brevicon; Demulen 1/35; Demulen 1/50; Desogen; Estrostep; Estrostep Fe; Genora 0.5/35; Genora 1/35; Genora 1/50; Intercon 0.5/35; Intercon 1/35; Intercon 1/50; Jenest; Levlen; Levlite; Levora 0.15/30; Lo/Ovral; Loestrin 1.5/30; Loestrin 1/20; Lo http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202228.html
Isotretinoin •
Systemic - U.S. Brands: Accutane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202309.html
Medroxyprogesterone and Estradiol •
Systemic - U.S. Brands: Lunelle http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500255.html
Progesterone Intrauterine Device •
Iud) - U.S. Brands: Progestasert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202774.html
Progestins for Contraceptive Use •
Systemic - U.S. Brands: Depo-Provera Contraceptive Injection; Micronor; NORPLANT System; Nor-QD; Ovrette; Plan B http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202757.html
Rifampin •
Systemic - U.S. Brands: Rifadin; Rimactane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202511.html
Spermicides •
Vaginal - U.S. Brands: Advantage 24; Because; Conceptrol Contraceptive Inserts; Conceptrol Gel; Delfen; Emko; Emko Pre-Fil; Encare; Gynol II Extra Strength Contraceptive Jelly; Gynol II Original Formula Contraceptive Jelly; Koromex Cream; Koromex Crystal Clear Gel; Koromex Fo http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202531.html
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Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
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Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “contraception” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “contraception” (or synonyms) into the “For these words:” box. The following is a sample result: •
Abstinence First: Teen Birth Control Decisions (Version A) Contact: Human Relations Media Incorporated, 175 Tompkins Ave, Pleasantville, NY, 10570, (914) 769-7496. Summary: This information kit serves as an abstinence-based educational curriculum for adolescents. The information kit outlines the benefits of sexual abstinence, the physical and emotional consequences of adolescent pregnancy and sexually transmitted diseases (STDs), how to commit to and maintain abstinence, and how to talk to partners and friends about this decision. This version,Version A, of this curriculum emphasizes that an individual's decision to become sexually active should only be made in the context of marriage.
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Adolescent sex, contraception, and childbearing: A review of recent research Source: Washington, DC: Child Trends. 1995. 215 pp. Contact: Available from Child Trends, 4301 Connecticut Avenue, N.W., Suite 100, Washington, DC 20008. Telephone: (202) 362-5580 / fax: (202) 362-5533 / e-mail:
[email protected] / Web site: http://www.childtrends.org. $14.00 includes shipping and handling. Summary: This report contains a review of recent scientific research on the behavior that results in births to adolescents. It includes antecedents to sexual intercourse, the use of contraception at first intercourse, behaviors related to pregnancy and pregnancy resolution, and childbirth. It includes an introduction to the study, trend analysis, the research reviews, and summaries for each topic. The report discusses research priorities, bibliographical references are provided; and statistical tables and figures are also included. A related publication, 'Adolescent Pregnancy Prevention Programs: Interventions and Evaluations,' considers research on intervention and prevention programs. An overview of both research reviews appears in 'Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy, and Parenthood.'.
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American Teens Speak: Sex, Myths, TV and Birth Control Contact: Louis Harris and Associates, Inc., 111 Fifth Ave, New York, NY, 10003, (212) 539-9697. Summary: This report presents the results of a poll asking American teenagers, age 12 through 17, how they view the problem of teenage pregnancy. Topics in the survey include: why so many teenagers do not wait to have sexual intercourse; why so many fail to use contraceptives; arguments teens think would influence their peers to delay sexual activity and use birth control; areas of knowledge and ignorance about sexuality; sources of information about sexuality; the perceived realism of TV in dealing with sexual topics; the content of sex education in the schools; and the resulting impact on teenager's sexual behavior or knowledge, parental talks, and sex education courses. Chapters present detailed data on the following topics: problems of teenage sex and pregnancy; how teens learn about sex, conception, and birth control; outside help for the family from school and television; and what society can do. An appendix presents profiles of the American teenager and the three high-risk groups: those who have a low level of sexual information; those who have had sexual intercourse; and those who are sexually active but do not usually use birth control. A second appendix displays the questionnaire used in the survey, with marginal frequencies.
The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “contraception” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 31161 10000 900 742 7 42810
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quick15 16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
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reference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “contraception” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
18
The HSTAT URL is http://hstat.nlm.nih.gov/.
19
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 21
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on contraception can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to contraception. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to contraception. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “contraception”:
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Other guides Death and Dying http://www.nlm.nih.gov/medlineplus/deathanddying.html Disasters and Emergency Preparedness http://www.nlm.nih.gov/medlineplus/disastersandemergencypreparedness.html Teen Sexual Health http://www.nlm.nih.gov/medlineplus/teensexualhealth.html Teenage Pregnancy http://www.nlm.nih.gov/medlineplus/teenagepregnancy.html
Within the health topic page dedicated to contraception, the following was listed: •
General/Overviews Birth Control Source: American College of Obstetricians and Gynecologists http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ48OI527C&s ub_cat=5 Planning Your Family http://www.ncfh.org/pateduc/en-famplan.htm What Kind of Birth Control Is Best for You? http://www.fda.gov/opacom/lowlit/brthcon.html
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Specific Conditions/Aspects Are Fertility Awareness Methods Right for Me? Source: EngenderHealth http://www.engenderhealth.org/wh/fp/cfer1.html Birth Control for Women with Epilepsy Source: Epilepsy Foundation http://www.epilepsyfoundation.org/answerplace/Life/adults/women/weibirthc ontrol.cfm Birth Control Pills: Can Antibiotics Decrease Their Effectiveness? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00099 Birth Control Pills: Do They Increase Blood Pressure? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00204 Cervical Cap: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PR00074 Combined Injectable Contraceptives (CICs) FAQ Source: Family Health International http://www.fhi.org/en/RH/FAQs/CIC_faq.htm Condoms http://www.kff.org/content/2001/3117/Fact%2520Sheet.pdf
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Contraception While Breastfeeding Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ9XXA7AEC& sub_cat=5 Contraceptive Sponge: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00045 Counseling, Informed Choice, Informed Consent, and the Rights of the Client Source: EngenderHealth http://www.engenderhealth.org/wh/fp/iwhat.html Depo-Provera: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PR00076 Diaphragm: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PR00073 Emergency Contraception Source: National Women's Health Information Center http://www.4woman.gov/faq/econtracep.htm FDA Approves New Female Sterilization Device Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01168.html FDA Approves Seasonale Oral Contraceptive Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2003/ANS01251.html Fertility Awareness Methods: Questions & Answers Source: EngenderHealth http://www.engenderhealth.org/wh/fp/cfer2.html Intrauterine Devices: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00033 Lactational Amenorrhea FAQ Source: Family Health International http://www.fhi.org/en/RH/FAQs/lam_faq.htm Lunelle: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00032 Natural Family Planning Source: American Academy of Family Physicians http://familydoctor.org/handouts/126.html Natural Family Planning: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00035
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Natural Methods of Family Planning FAQ Source: Family Health International http://www.fhi.org/en/RH/FAQs/natural_faq.htm Oral Contraceptives and Cancer Risk Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_13.htm Pill Revisited: Benefits Beyond Birth Control Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01522 Right Way to Use a Condom Source: American Social Health Association http://www.ashastd.org/stdfaqs/condom_a.html Risk of Ectopic Pregnancy after Tubal Sterilization Source: Centers for Disease Control and Prevention http://www.cdc.gov/nccdphp/drh/mh_ectopic.htm Sterilization as Permanent Birth Control Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HO00141 Tubal Ligation: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00047 Vaginal Ring: The Right Form of Birth Control for You? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00036 •
Latest News FDA Approves Ovcon 35 as the First Chewable Oral Contraceptive Tablet for Women Source: 11/14/2003, Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2003/ANS01260.html More News on Birth Control/Contraception http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/alphanews_b.html#Bi rthControlContraception Oral Contraceptive Shown to Fight Acne Source: 11/24/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14817 .html U.S. Clears Bristol-Myers Chewable Contraceptive. Source: 11/14/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14676 .html Vouchers Reduce Teens' Access to Contraception Source: 11/06/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14562 .html
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Men Facts about Vasectomy Safety Source: National Institute of Child Health and Human Development http://www.nichd.nih.gov/publications/pubs/vasect.htm Vasectomy http://www.nlm.nih.gov/medlineplus/tutorials/vasectomyloader.html
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Organizations National Institute of Child Health and Human Development http://www.nichd.nih.gov/ National Women's Health Information Center Source: Dept. of Health and Human Services http://www.4woman.gov/ Sexuality Information and Education Council of the United States http://www.siecus.org/ United States Agency for International Development http://www.usaid.gov/
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Research Bone Loss in Depo-Provera Users Largely Reversible Source: National Institute of Child Health and Human Development http://www.nih.gov/news/pr/sep2002/nichd-06.htm Vasectomy and Cancer Risk Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_26.htm
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Statistics Contraceptive Use and Methods in the U.S. Source: Henry J. Kaiser Family Foundation http://www.kff.org/content/2002/3244/Contraception_Fact_Sheet_FINAL.pdf Family Planning Prevents Abortion http://www.usaid.gov/pop_health/pop/publications/docs/preventab.pdf FASTATS: Contraceptive Use Source: Centers for Disease Control and Prevention http://www.cdc.gov/nchs/fastats/usecontr.htm
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Teenagers Birth Control Pill Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_birth.html Cervical Cap Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_cap.html
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Condom Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_condom.h tml Depo-Provera Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_depo.html Diaphragm Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_diaphrag m.html Douching Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_douche.ht ml Emergency Contraception Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_emergenc y.html Intrauterine Device (IUD) Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_iud.html Rhythm Method Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_rhythm.ht ml Spermicide Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_spermicid e.html Withdrawal Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/contraception/contraception_withdraw al.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on contraception. CHID offers summaries that
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describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
No-Scalpel Vasectomy: Sterilization for Men Source: San Bruno, CA: StayWell Company. 2000. [2 p.]. Contact: Available from Staywell Company. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032. Fax (650) 244-4512. PRICE: $0.40 each; $20.00 per pack of 50; plus shipping and handling. Order number 91625. Summary: A vasectomy is a safe, simple, and effective surgical procedure that makes a man sterile (unable to father a child). This brochure describes 'no scalpel' vasectomy, a special technique for performing a vasectomy that often results in less swelling and pain than the traditional method. The no scalpel procedure is similar to a traditional vasectomy in many respects, but it is done without incisions or stitches. This generally results in faster healing. The brochure describes preparation, what to expect during the procedure, and postoperative recovery. One sidebar lists vasectomy risks and complications, including infection, internal bleeding in the scrotum, and rare problems including sperm granuloma, congestion in the testicles, sperm antibodies, testicular discomfort, or spontaneous return of fertility (very rare). One section of the brochure outlines the male reproductive system and exactly how the vasectomy works. The brochure reminds readers that they must continue to use another method of birth control after the vasectomy until the physician reports that the patient's sperm count is zero. Because sperm are often trapped in the upper part of the vasa, it takes a few months after the vasectomy before the man is sterile. The brochure is illustrated with full color line drawings. 6 figures.
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Facts About Birth Control Contact: Family Planning Council, Circle of Care, 260 S Broad St 10th Fl Ste 1000, Philadelphia, PA, 19102-3865, (215) 985-2657, http://www.familyplanning.org. Summary: This brochure discusses various methods of contraception, including the sponge, condoms, diaphragm, spermicides, oral contraception, and natural family planning in terms of their advantages and drawbacks, one of which is their ability or inability to prevent Sexually transmitted diseases (STD's), including Human immunodeficiency virus (HIV), the etiologic agent of Acquired immunodeficiency syndrome (AIDS).
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What Men Should Know About Contraception Contact: Channing L. Bete Company Incorporated, 200 State Rd, South Deerfield, MA, 01373-0200, (800) 477-4776, http://www.channing-bete.com. Summary: This brochure presents information for men about contraception for the prevention of Human immunodeficiency virus (HIV) infection and Acquired immunodeficiency syndrome (AIDS). It explains why it is important to be informed about contraception, and describes the risks of sex without contraception. It describes the methods available for both men and women. It endorses condoms as a good choice for male contraception and provides instructions for their use. Communication between sex partners and sharing of responsibility for safer-sex practice is advised.
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Choice Not Chance: Contraception for Young Men and Women Contact: New Zealand Ministry of Health, PO Box 5013, Wellington. Summary: This brochure states that abstinence and reliable contraceptives are the only ways to avoid a pregnancy. It discusses the advantages and disadvantages of condoms and the pill, how they work, and where to obtain them. It mentions health risks associated with the pill, illustrates likelihood of pregnancy based on method, and describes other methods of contraception.
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Does Your Birth Control Protect You Against AIDS? Contact: Women and AIDS Project, 302-1720 Grant St, Vancouver. Summary: This brochure warns women that of all contraceptive devices, only condoms provide protection against transmission of Human immunodeficiency virus (HIV), the etiologic agent of Acquired immunodeficiency syndrome (AIDS). Tips on using condoms are listed and a wrapped condom is included with the brochure.
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Birth control pills Source: Washington, DC: American College of Obstetricians and Gynecologists. 1994. 4 pp. Contact: Available from Rebecca Rinehart, American College of Obstetricians and Gynecologists, 409 12th Street, S.W., Washington, DC 20024-2188. Telephone: (202) 6385577 or (202) 863-2518 reference desk / Web site: http://www.acog.org/. Single copies available at no charge; Copies of 50 available for $15.00. Summary: This brochure, part of the American College of Obstetricians and Gynecologists' Patient Education series, is designed to educate women about oral contraceptives. It covers topics such as how they work, how they should be taken, and what side effects may occur. Line drawings illustrate the reproductive cycle. The authors used the SMOG formula to determine that the brochure is written at a sixthgrade reading level.
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Vasectomy: What to Expect From a Vasectomy Source: Kansas City, MO: American Academy of Family Physicians. 2000. 4 p. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $22.00 for 100 copies for members, $33.00 for 100 copies for nonmembers. Summary: This brochure, written in nontechnical language, provides basic information about vasectomy, an operation that makes a man unable to get a woman pregnant. A vasectomy involves cutting the vas deferens (tube through which the sperm travels) on each side so that sperm can no longer get into the semen. The brochure is written in a question and answer format. Topics include a description of the operation, the effectiveness of vasectomy in preventing pregnancy, reasons not to have a vasectomy, how to prepare for the operation, post-procedure self care, pain medications, the length of time until a vasectomy is effective as a birth control measure, risk factors and complications that may occur, and the impact of a vasectomy on the man's sex life. One sidebar lists specific strategies for minimizing post-procedure discomfort. One illustration depicts the testicles, vas deferens, and prostate gland, and shows where the vas deferens are cut for vasectomy. 1 figure.
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Condoms, Pills and Other Useful Things : A Young Person's Guide to Contraception and STIs Contact: AVERT, 4 Brighton Rd, Horsham, http://www.avert.org. Summary: This brochure, written with the input of young people for other young people aged 13 to 16 years, discusses pregnancy, birth control (i.e., the pill, condoms, diaphragms [the cap], intrauterine devices [IUDs], emergency contraceptives), first sexual experiences, and sexually transmitted diseases (STDs). The brochure explains how a girl becomes pregnant, how the pill works chemically to prevent pregnancy, what 'going on the pill' means and requires, and how to find out which type of pill is suitable. It discusses contraceptives that are effective against pregnancy and/or preventing STD transmission. The brochure discusses getting contraception from a family doctor or family planning clinic and the embarrassment that may be associated with getting contraception. It discusses pregnancy testing and STDs, their prevention, symptoms, and treatment. A list of resources for additional information is provided.
•
Abstinence First: Teen Birth Control Defense (Version B) Contact: Human Relations Media Incorporated, 175 Tompkins Ave, Pleasantville, NY, 10570, (914) 769-7496. Summary: This information kit serves as a curriculum with educational information regarding the benefits of sexual abstinence and how to practice and maintain it. The information kit discusses the physical and emotional consequences of adolescent pregnancy, the advantages of sexual abstinence over various methods of contraception, good decision-making habits, how to deflect peer pressure to have sex, and the importance of self-esteem in practicing sexual abstinence. This version, Version B, of the curriculum does not make judgments regarding an individual's decision to have or abstain from premarital sex.
•
Vasectomy: Patient Education Source: Tarrytown, NY: Bayer Corporation. 1999. 11 p. Contact: Available from Bayer Corporation. Diagnostics Division, 511 Benedict Avenue, Tarrytown, NY 10591-5097. (800) 445-5901. PRICE: Single copy free. Summary: This patient education brochure describes vasectomy, a common surgical procedure for men looking for permanent birth control. In this procedure, a portion of the duct that carries sperm is removed. Vasectomy is safe, highly effective, and has no impact on erection or sexual performance. The brochure describes the procedure, reviews the preoperative care and preparation, reviews post-procedure care, discusses alternative methods of birth control, and answers common questions about vasectomy. A vasectomy is usually performed in the doctor's office or in a hospital on an outpatient basis. The procedure takes 15 to 30 minutes and is performed with local anesthetic. Incisions (cuts) are made in the scrotum. Then the doctor cuts the sperm ducts, removing about one half inch of each duct; this is done to reduce the possibility of the sperm ducts rejoining. The most common side effects of vasectomy are minor bleeding (enough to), some discomfort, and mild swelling in the area of the incision. The most commonly reported complication is mild discomfort in the testicles that usually improves with medication, warm soaks, and by elevating the scrotum. Sperm can survive for 6 months or more, so patients are asked to bring a specimen of ejaculate for followup examination. Unprotected sexual intercourse should not take place until this sterility is assured. The brochure stresses that vasectomy should be considered a
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permanent form of birth control; for men who are unsure about their plans to have children, there are several nonsurgical alternatives to consider. The brochure concludes with a brief glossary of terms and a short list of resources for readers wishing to obtain additional information. A tear-off section lists the topics covered in the booklet; readers are encouraged to check off the items corresponding to issues they would like to discuss with their health care provider, to use the checklist as a reminder tool. 3 figures. 1 table. 6 references. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Adolescents Ask the Expert Summary: Answers to questions received from adolescents on topics related to sexuality -- contraception, abstinence, relationships and development. Source: Planned Parenthood Federation of America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4343
•
Birth Control Guide Summary: Efficacy rates in this chart are based on Contraceptive Technology. Source: U.S. Food and Drug Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1387
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Choosing a Birth Control Method Source: Association of Reproductive Health Professionals http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6045
•
Continuous Abstinence Summary: This online document details the meaning of this term as it relates to contraception. Links to other contraceptive information are also available on this page. Source: Planned Parenthood Federation of America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2035
•
Contraception Counts Summary: See how your state meets women's need for contraceptive services. Source: Alan Guttmacher Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7573
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Contraception Web Site Summary: This web site is maintained by AVSC International and includes basic information on contraception, as well as points you should consider when choosing a contraceptive method. Source: EngenderHealth http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3994
•
Contraceptive Use Summary: Facts about contraceptive use in the US -- who needs & uses contraception, who uses which methods, unintended pregnancies, and more. Source: Alan Guttmacher Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6021
•
Emergency Contraception Web Site Summary: Sponsored by the Office of Population Research at Princeton University, this site is designed to provide accurate information about emergency contraception derived from the medical literature and a Source: Educational Institution--Follow the Resource URL for More Information http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2091
•
healthfinder® just for you: Teenagers Summary: healthfinder®'s just for you: Teenagers section features topics such as alcohol, contraception, and HIV. Source: U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7016
•
Is Female Sterilization the Right Method For Me? Summary: Since the effects of this contraception method are meant to be permanent, this document is designed to provide couples with a number of important points for consideration, prior to having this Source: EngenderHealth http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2204
•
Is Vasectomy the Right Method for Me? Summary: There are a number of factors you should consider to determine whether vasectomy is the right contraceptive method for you. Source: EngenderHealth http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2672
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•
Norplant Birth Control: Questions and Answers Summary: A general overview on Norplant birth control -- a long-lasting but not permanent method of birth control. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6239
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Periodic Abstinence Summary: This online document details the meaning of this term as it relates to contraception. Links to other contraceptive information are also available on this page. Source: Planned Parenthood Federation of America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2036
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School-Based Health Centers and the Birth Control Debate Summary: Facts about school-based health centers in the United States and their role as a source of counseling and reproductive health care, especially for low-income and uninsured youth in the communities. Source: Alan Guttmacher Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6022
•
Sexuality Fact Sheets Summary: Online consumer health information fact sheets about sexuality, adolescents and abstinence, homosexuality, teen pregnancy, contraception and more. Source: Sexuality Information and Education Council of the United States http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2666
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Teen Talk: What You Should Know About Contraception Source: Office of Population Affairs, U.S. Department of Health and Human Service http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5624
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Vasectomy: Answers to Your Questions Summary: This consumer health information fact sheet answers questions that can help you determine whether vasectomy might be the best contraceptive method for you. Source: EngenderHealth http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3947 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate
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in some way to contraception. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to contraception. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with contraception. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about contraception. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/.
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Simply type in “contraception” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “contraception”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “contraception” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “contraception” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
23
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on contraception: •
Basic Guidelines for Contraception Birth control pills overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002599.htm Contraception and family planning Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001946.htm Vasectomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002995.htm
•
Signs & Symptoms for Contraception Breast tenderness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003152.htm Bruising Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm
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Discoloration of urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003139.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Hirsutism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003148.htm Jaundice Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm Mental changes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Nausea and/or vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Vaginal bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003156.htm •
Diagnostics and Tests for Contraception ANA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm Pap smear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003911.htm PRA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003698.htm Pregnancy test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003432.htm Sperm count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003627.htm
Online Glossaries 245
•
Nutrition for Contraception Lactation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002450.htm
•
Surgery and Procedures for Contraception Cesarean section Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002911.htm Tubal ligation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002913.htm Vasectomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002995.htm
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Background Topics for Contraception Birth control Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001946.htm Cervix Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002317.htm Condoms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/004001.htm Female condom Web site: http://www.nlm.nih.gov/medlineplus/ency/article/004002.htm Female condoms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/004002.htm Heart disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Intrauterine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002389.htm Male condoms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/004001.htm Pain medications Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Penis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002279.htm Postcoital contraception Web site: http://www.nlm.nih.gov/medlineplus/ency/article/007014.htm
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Scrotum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002296.htm Testes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002334.htm Vagina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002342.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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CONTRACEPTION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abortion, Habitual: Three or more consecutive spontaneous abortions. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Acrosin: A trypsin-like enzyme of spermatozoa which is not inhibited by alpha 1 antitrypsin. [NIH] Acrosome: Cap-like structure covering the nucleus and anterior part of the sperm head. [NIH]
Acrosome Reaction: Changes that occur to liberate the enzymes of the acrosome of spermatozoa that allow the entry of a spermatozoon into the ovum. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinomas: A malignant tumor of the epithelial cells of a gland which typically metastasizes by way of the lymphatics. [NIH]
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Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adherens Junctions: Anchoring points where the cytoskeleton of neighboring cells are connected to each other. They are composed of specialized areas of the plasma membrane where bundles of microfilaments attach to the membrane through the transmembrane linkers, cadherins, which in turn attach through their extracellular domains to cadherins in the neighboring cell membranes. In sheets of cells, they form into adhesion belts (zonula adherens) that go all the way around a cell. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Aggressiveness: The quality of being aggressive (= characterized by aggression; militant; enterprising; spreading with vigour; chemically active; variable and adaptable). [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions
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and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allograft: An organ or tissue transplant between two humans. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle
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relaxation. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgen-Binding Protein: Carrier proteins produced in the Sertoli cells of the testis, secreted into the seminiferous tubules, and transported via the efferent ducts to the epididymis. They participate in the transport of androgens. Androgen-binding protein has the same amino acid sequence as sex hormone binding-globulin. They differ by their sites of synthesis and post-translational oligosacaccharide modifications. [NIH] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Aneuploidy: The chromosomal constitution of cells which deviate from the normal by the addition or subtraction of chromosomes or chromosome pairs. In a normally diploid cell the loss of a chromosome pair is termed nullisomy (symbol: 2N-2), the loss of a single chromosome is monosomy (symbol: 2N-1), the addition of a chromosome pair is tetrasomy (symbol: 2N+2), the addition of a single chromosome is trisomy (symbol: 2N+1). [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH]
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Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]
Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antecedent: Existing or occurring before in time or order often with consequential effects. [EU]
Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibodies, Anticardiolipin: Antiphospholipid antibodies found in association with systemic lupus erythematosus (lupus erythematosus, systemic), antiphospholipid syndrome, and in a variety of other diseases as well as in healthy individuals. The antibodies are detected by solid-phase immunoassay employing the purified phospholipid antigen cardiolipin. [NIH] Antibodies, Antiphospholipid: Autoantibodies directed against phospholipids. These antibodies are characteristically found in patients with systemic lupus erythematosus, antiphospholipid syndrome, related autoimmune diseases, some non-autoimmune diseases, and also in healthy individuals. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH]
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Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiphospholipid Syndrome: The presence of antibodies directed against phospholipids (antibodies, antiphospholipid). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (antibodies, anticardiolipin). Present also are high levels of lupus anticoagulant (lupus coagulation inhibitor). [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU]
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Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Azoospermia: Absence of spermatozoa in the semen, or failure of formation of spermatozoa. [EU]
Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around
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smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biochemical Phenomena: Biochemical functions, activities, and processes at organic and molecular levels in humans, animals, microorganisms, and plants. [NIH] Bioengineering: The application of engineering principles to the solution of biological problems, for example, remote-handling devices, life-support systems, controls, and displays. [NIH] Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biological Phenomena: Biological functions and activities at the organic and molecular levels in humans, animals, microorganisms, and plants. For biochemical and metabolic processes, biochemical phenomena is available. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH]
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Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blastomeres: The undifferentiated cells formed by cleavage of the fertilized ovum. This includes cells in the cleavage, morula, and blastula stages of the embryo. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Morphogenetic Proteins: Bone-growth regulatory factors that are members of the transforming growth factor-beta superfamily of proteins. They are synthesized as large precursor molecules which are cleaved by proteolytic enzymes. The active form can consist of a dimer of two identical proteins or a heterodimer of two related bone morphogenetic proteins. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH]
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Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Cadherins: A group of functionally related glycoproteins responsible for the calciumdependent cell-to-cell adhesion mechanism. They are divided into subclasses E-, P-, and Ncadherins, which are distinct in immunological specificity and tissue distribution. They promote cell adhesion via a homophilic mechanism. These compounds play a role in the construction of tissues and of the whole animal body. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carcinogen: Any substance that causes cancer. [NIH]
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Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Aggregation: The phenomenon by which dissociated cells intermixed in vitro tend to group themselves with cells of their own type. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral
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proteins are embedded to varying degrees. [EU] Cell motility: The ability of a cell to move. [NIH] Cell Movement: The movement of cells from one location to another. [NIH] Cell Polarity: Orientation of intracellular structures especially with respect to the apical and basolateral domains of the plasma membrane. Polarized cells must direct proteins from the Golgi apparatus to the appropriate domain since tight junctions prevent proteins from diffusing between the two domains. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellular Structures: Components of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Ripening: A change in the cervix with respect to its readiness to relax. The cervix becomes softer, more flexible, more distensible, and shorter in the final weeks of pregnancy. Though naturally occurring during normal pregnancy, it can also be induced for certain cases of prolonged or high-risk pregnancy by administration of hormones. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative
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and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Chlamydia trachomatis: Type species of Chlamydia causing a variety of ocular and urogenital diseases. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlormadinone Acetate: An orally active synthetic progestational hormone used often in combinations as an oral contraceptive. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]
Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Cleave: A double-stranded cut in DNA with a restriction endonuclease. [NIH] Climacteric: Physiologic period, characterized by endocrine, somatic, and psychic changes with the termination of ovarian function in the female. It may also accompany the normal diminution of sexual activity in the male. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
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Clinical Protocols: Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]
Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Coculture: The culturing of normal cells or tissues with infected or latently infected cells or tissues of the same kind (From Dorland, 28th ed, entry for cocultivation). It also includes culturing of normal cells or tissues with other normal cells or tissues. [NIH] Coenzymes: Substances that are necessary for the action or enhancement of action of an enzyme. Many vitamins are coenzymes. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Coitus: Sexual intercourse. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline,
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hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colposcopy: The examination, therapy or surgery of the cervix and vagina by means of a specially designed endoscope introduced vaginally. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU]
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Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraceptive Agents: Chemical substances that prevent or reduce the probability of conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH]
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Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclins: Regulatory proteins that function in the cell cycle to activate maturation promoting factor. They complex with p34cdc2 (PROTEIN P34CDC2), the catalytic subunit of maturation-promoting factor, and modulate its protein kinase activity. Cyclins themselves have no enzymatic activity. [NIH] Cyclodextrins: A homologous group of cyclic glucans consisting of alpha-1,4 bound glucose units obtained by the action of cyclodextrin glucanotransferase on starch or similar substrates. The enzyme is produced by certain species of Bacillus. Cyclodextrins form inclusion complexes with a wide variety of substances. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it
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(phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Cytotoxins: Substances elaborated by microorganisms, plants or animals that are specifically toxic to individual cells; they may be involved in immunity or may be contained in venoms. [NIH]
Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]
Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desogestrel: A synthetic progestational hormone used often as the progestogenic
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component of combined oral contraceptive agents. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dioxins: Chlorinated hydrocarbons containing heteroatoms that are present as contaminants of herbicides. Dioxins are carcinogenic, teratogenic, and mutagenic. They have been banned from use by the FDA. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or
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in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Douche: A procedure in which water or a medicated solution is used to clean the vagina and cervix. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Delivery Systems: Systems of administering drugs through controlled delivery so that an optimum amount reaches the target site. Drug delivery systems encompass the carrier, route, and target. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dydrogesterone: A synthetic progestational hormone with no androgenic or estrogenic properties. Unlike many other progestational compounds, dydrogesterone produces no increase in temperature and does not inhibit ovulation. [NIH] Dynein: A transport protein that normally binds proteins to the microtubule. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]
Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]
Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH]
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Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory
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laboratory test results. [NIH] Enanthate: An oily injectable contraceptive given every 8 weeks. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the
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pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Factors: Events, characteristics, or other definable entities that have the potential to bring about a change in a health condition or other defined outcome. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]
Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]
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Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [NIH]
Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Fallopian Tubes: Two long muscular tubes that transport ova from the ovaries to the uterus. They extend from the horn of the uterus to the ovaries and consist of an ampulla, an infundibulum, an isthmus, two ostia, and a pars uterina. The walls of the tubes are composed of three layers: mucosal, muscular, and serosal. [NIH] Family Planning: Programs or services designed to assist the family in controlling
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reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flagellum: A whiplike appendage of a cell. It can function either as an organ of locomotion or as a device for moving the fluid surrounding the cell. [NIH] Flatus: Gas passed through the rectum. [NIH] Foetoplacental: Pertaining to the fetus and placenta. [EU]
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Fold: A plication or doubling of various parts of the body. [NIH] Follicles: Shafts through which hair grows. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gametogenesis: The first phase of sexual reproduction which involves the transforming of certain cells in the parent into specialized reproductive cells. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU]
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Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ cell tumors: Tumors that begin in the cells that give rise to sperm or eggs. They can occur virtually anywhere in the body and can be either benign or malignant. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycogen Storage Disease: A group of inherited metabolic disorders involving the enzymes responsible for the synthesis and degradation of glycogen. In some patients, prominent liver involvement is presented. In others, more generalized storage of glycogen occurs, sometimes with prominent cardiac involvement. [NIH]
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Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadotropic: Stimulating the gonads; applied to hormones of the anterior pituitary which influence the gonads. [EU] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Gossypol: Poisonous pigment found in cottonseed and potentially irritating to gastrointestinal tract. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gramicidin: Antibiotic mixture that is one of the two principle components of tyrothricin from Bacillus brevis. Gramicidin C or S is a cyclic, ten-amino acid polypeptide and gramicidins A, B, D, etc., seem to be linear polypeptides. The mixture is used topically for gram-positive organisms. It is toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Granulosa Cell Tumor: An ovarian tumor originating in the cells of the primordial membrana granulosa of the graafian follicle. It may be associated with excessive production of estrogen. [NIH] Granulosa Cells: Cells of the membrana granulosa lining the vesicular ovarian follicle which become luteal cells after ovulation. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU]
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Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hematopoiesis: The development and formation of various types of blood cells. [NIH] Hematopoietic Stem Cells: Progenitor cells from which all blood cells derive. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
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Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatotoxic: Toxic to liver cells. [EU] Herbicides: Pesticides used to destroy unwanted vegetation, especially various types of weeds, grasses, and woody plants. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimer: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
High Mobility Group Proteins: A group of non-histone proteins found in chromatin. Their role has not been definitely established, but they are believed to have a role in matrix stabilization, protection of single-stranded DNA, and are required for transcription. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]
Histocompatibility: The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homosexuality: Sexual attraction or relationship between members of the same sex. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH]
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Host: Any animal that receives a transplanted graft. [NIH] Human Development: Continuous sequential changes which occur in the physiological and psychological functions during the individual's life. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridoma: A hybrid cell resulting from the fusion of a specific antibody-producing spleen cell with a myeloma cell. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperandrogenism: A state characterized or caused by an excessive secretion of androgens by the adrenal cortex, ovaries, or testes. The clinical significance in males is negligible, so the term is used most commonly with reference to the female. The common manifestations in women are hirsutism and virilism. It is often caused by ovarian disease (particularly the polycystic ovary syndrome) and by adrenal diseases (particularly adrenal gland hyperfunction). [NIH] Hypericum: Genus of perennial plants in the family Clusiaceae (Hypericaceae). Herbal and homeopathic preparations are used for depression, neuralgias, and a variety of other conditions. Contains flavonoids, glycosides, mucilage, tannins, and volatile oils (oils, essential). [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of
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distribution. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in the formation of nucleic acids by the salvage pathway. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immaturity: The state or quality of being unripe or not fully developed. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immune Tolerance: The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large
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amounts of antibody. [NIH] Immunologic Factors: Biologically active substances whose activities affect or play a role in the functioning of the immune system. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incineration: High temperature destruction of waste by burning with subsequent reduction to ashes or conversion to an inert mass. [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Ingestion: Taking into the body by mouth [NIH]
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Inhibin: Glyceroprotein hormone produced in the seminiferous tubules by the Sertoli cells in the male and by the granulosa cells in the female follicles. The hormone inhibits FSH and LH synthesis and secretion by the pituitary cells thereby affecting sexual maturation and fertility. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Interferons: Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH]
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Intracellular Membranes: Membranes of subcellular structures. [NIH] Intraepithelial: Within the layer of cells that form the surface or lining of an organ. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Invertebrates: Animals that have no spinal column. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isozymes: The multiple forms of a single enzyme. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratan Sulfate: A sulfated mucopolysaccharide initially isolated from bovine cornea. At least two types are known. Type I, found mostly in the cornea, contains D-galactose and Dglucosamine-6-O-sulfate as the repeating unit; type II, found in skeletal tissues, contains Dgalactose and D-galactosamine-6-O-sulfate as the repeating unit. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in
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glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kinesin: A microtubule-associated mechanical adenosine triphosphatase, that uses the energy of ATP hydrolysis to move organelles along microtubules toward the plus end of the microtubule. The protein is found in squid axoplasm, optic lobes, and in bovine brain. Bovine kinesin is a heterotetramer composed of two heavy (120 kDa) and two light (62 kDa) chains. EC 3.6.1.-. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levonorgestrel: A progestational hormone with actions similar to those of progesterone and about twice as potent as its racemic or (+-)-isomer (norgestrel). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
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Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligase: An enzyme that repairs single stranded discontinuities in double-stranded DNA molecules in the cell. Purified DNA ligase is used in gene cloning to join DNA molecules together. [NIH] Ligase Chain Reaction: A DNA amplification technique based upon the ligation of oligonucleotide probes. The probes are designed to exactly match two adjacent sequences of a specific target DNA. The chain reaction is repeated in three steps in the presence of excess probe: (1) heat denaturation of double-stranded DNA, (2) annealing of probes to target DNA, and (3) joining of the probes by thermostable DNA ligase. After the reaction is repeated for 20-30 cycles the production of ligated probe is measured. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Living will: A health care directive that tells others how a person would like to be treated if they lose their capacity to make decisions about health care; it contains instructions about the person's choices of medical treatment and it is prepared in advance. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH]
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Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocyte Subsets: A classification of lymphocytes based on structurally or functionally different populations of cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to
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other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mass Media: Instruments or technological means of communication that reach large numbers of people with a common message: press, radio, television, etc. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maturation-Promoting Factor: Protein kinase that drives both the mitotic and meiotic cycles in all eukaryotic organisms. In meiosis it induces immature oocytes to undergo meiotic maturation. In mitosis it has a role in the G2/M phase transition. Once activated by cyclins, MPF directly phosphorylates some of the proteins involved in nuclear envelope breakdown, chromosome condensation, spindle assembly, and the degradation of cyclins. The catalytic subunit of MPF is protein P34CDC2. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] Medroxyprogesterone Acetate: An injectable contraceptive, generally marketed under the name Depo-Provera. [NIH] Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens.
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[NIH]
Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesoderm: The middle germ layer of the embryo. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metaphase: The second phase of cell division, in which the chromosomes line up across the equatorial plane of the spindle prior to separation. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this
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substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbicide: Any substance (gels, creams, suppositories, etc.) that can reduce transmission of sexually transmitted infections. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microfilaments: The smallest of the cytoskeletal filaments. They are composed chiefly of actin. [NIH] Microgram: A unit of mass (weight) of the metric system, being one-millionth of a gram (106 gm.) or one one-thousandth of a milligram (10-3 mg.). [EU] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Mifepristone: A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary Cushing syndrome. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mineralocorticoid: 1. Any of the group of C21 corticosteroids, principally aldosterone, predominantly involved in the regulation of electrolyte and water balance through their effect on ion transport in epithelial cells of the renal tubules, resulting in retention of sodium and loss of potassium; some also possess varying degrees of glucocorticoid activity. Their secretion is regulated principally by plasma volume, serum potassium concentration and angiotensin II, and to a lesser extent by anterior pituitary ACTH. 2. Of, pertaining to, having the properties of, or resembling a mineralocorticoid. [EU] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitogen-Activated Protein Kinase Kinases: A serine-threonine protein kinase family whose members are components in protein kinase cascades activated by diverse stimuli. These MAPK kinases phosphorylate mitogen-activated protein kinases and are themselves
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phosphorylated by MAP kinase kinase kinases. JNK kinases (also known as SAPK kinases) are a subfamily. EC 2.7.10.- [NIH] Mitogen-Activated Protein Kinases: A superfamily of protein-serine-threonine kinases that are activated by diverse stimuli via protein kinase cascades. They are the final components of the cascades, activated by phosphorylation by mitogen-activated protein kinase kinases which in turn are activated by mitogen-activated protein kinase kinase kinases (MAP kinase kinase kinases). Families of these mitogen-activated protein kinases (MAPKs) include extracellular signal-regulated kinases (ERKs), stress-activated protein kinases (SAPKs) (also known as c-jun terminal kinases (JNKs)), and p38-mitogen-activated protein kinases. EC 2,7,1.- [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Motors: Protein based machines that are involved in or cause movement such as the rotary devices (flagellar motor and the F1 ATPase) or the devices whose movement is directed along cytoskeletal filaments (myosin, kinesin and dynein motor families). [NIH] Molecular Probes: A group of atoms or molecules attached to other molecules or cellular structures and used in studying the properties of these molecules and structures. Radioactive DNA or RNA sequences are used in molecular genetics to detect the presence of a complementary sequence by molecular hybridization. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monosomy: The condition in which one chromosome of a pair is missing. In a normally diploid cell it is represented symbolically as 2N-1. [NIH]
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Monotherapy: A therapy which uses only one drug. [EU] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Morula: The early embryo at the developmental stage in which the blastomeres, resulting from repeated mitotic divisions of the fertilized ovum, form a compact mass. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mutagenic: Inducing genetic mutation. [EU] Mutagenicity: Ability to damage DNA, the genetic material; the power to cause mutations. [NIH]
Mutilation: Injuries to the body. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myometrium: The smooth muscle coat of the uterus, which forms the main mass of the organ. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needs Assessment: Systematic identification of a population's needs or the assessment of
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individuals to determine the proper level of services needed. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrotoxic: Toxic or destructive to kidney cells. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutralization: An act or process of neutralizing. [EU] Neutrophil: A type of white blood cell. [NIH] Nevirapine: A potent, non-nucleoside reverse transcriptase inhibitor used in combination with nucleoside analogues for treatment of HIV infection and AIDS. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nidation: Implantation of the conceptus in the endometrium. [EU] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide
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activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Non-nucleoside: A member of a class of compounds, including delavirdine, loviride and nevirapine, that acts to directly combine with and block the action of HIV's reverse transcriptase. [NIH] Nonoxynol: Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Nonoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide, formulated primarily as a component of vaginal foams and creams. [NIH] Norethindrone: A synthetic progestational hormone with actions similar to those of progesterone but functioning as a more potent inhibitor of ovulation. It has weak estrogenic and androgenic properties. The hormone has been used in treating amenorrhea, functional uterine bleeding, endometriosis, and for contraception. [NIH] Norgestrel: (+-)-13-Ethyl-17-hydroxy-18,19-dinorpregn-4-en-20-yn-3-one. A progestational agent with actions similar to those of progesterone. This racemic or (+-)-form has about half the potency of the levo form (levonorgestrel). Norgestrel is used as a contraceptive and ovulation inhibitor and for the control of menstrual disorders and endometriosis. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nulliparous: Having never given birth to a viable infant. [EU] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oestrogen: A generic term for oestrus-producing steroid compounds; the female sex hormones. In humans, oestrogen is formed in the ovary, possibly the adrenal cortex, the testis, and the foetoplacental unit; it has various functions in both sexes. It is responsible for
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the development of the female secondary sex characteristics, and during the menstrual cycle it acts on the female genitalia to produce an environment suitable for the fertilization, implantation, and nutrition of the early embryo. Oestrogen is used in oral contraceptives and as a palliative in cancer of the breast after menopause and cancer of the prostate; other uses include the relief of the discomforts of menopause, inhibition of lactation, and treatment of osteoporosis, threatened abortion, and various functional ovarian disorders. [EU]
Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oligonucleotide Probes: Synthetic or natural oligonucleotides used in hybridization studies in order to identify and study specific nucleic acid fragments, e.g., DNA segments near or within a specific gene locus or gene. The probe hybridizes with a specific mRNA, if present. Conventional techniques used for testing for the hybridization product include dot blot assays, Southern blot assays, and DNA:RNA hybrid-specific antibody tests. Conventional labels for the probe include the radioisotope labels 32P and 125I and the chemical label biotin. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Oogenesis: The formation, development, and maturation of the female germ cell. [NIH] Oophoritis: Inflammation of an ovary. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH]
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Ovarian Follicle: Spheroidal cell aggregation in the ovary containing an ovum. It consists of an external fibro-vascular coat, an internal coat of nucleated cells, and a transparent, albuminous fluid in which the ovum is suspended. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Ovum Implantation: Endometrial implantation of the blastocyst. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store
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and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Paternity: Establishing the father relationship of a man and a child. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pellucida: The hyaline or faintly radially striated oesinophilic membrane in immediate contact with the outer wall of the ovum. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perennial: Lasting through the year of for several years. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Periodicity: The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be
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annual, seasonal, monthly, daily, or more frequently (ultradian). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylates: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photoreceptors: Cells specialized to detect and transduce light. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs
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of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Placental Insufficiency: Failure of the placenta to deliver an adequate supply of nutrients and oxygen to the fetus. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH]
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Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet-Derived Growth Factor: Mitogenic peptide growth hormone carried in the alphagranules of platelets. It is released when platelets adhere to traumatized tissues. Connective tissue cells near the traumatized region respond by initiating the process of replication. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Population Control: Includes mechanisms or programs which control the numbers of individuals in a population of humans or animals. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of
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the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progestogen: A term applied to any substance possessing progestational activity. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should
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fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins F: (9 alpha,11 alpha,13E,15S)-9,11,15-Trihydroxyprost-13-en-1-oic acid (PGF(1 alpha)); (5Z,9 alpha,11,alpha,13E,15S)-9,11,15-trihydroxyprosta-5,13-dien-1-oic acid (PGF(2 alpha)); (5Z,9 alpha,11 alpha,13E,15S,17Z)-9,11,15-trihydroxyprosta-5,13,17-trien-1oic acid (PGF(3 alpha)). A family of prostaglandins that includes three of the six naturally occurring prostaglandins. All naturally occurring PGF have an alpha configuration at the 9carbon position. They stimulate uterine and bronchial smooth muscle and are often used as oxytocics. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Kinase C: An enzyme that phosphorylates proteins on serine or threonine residues in the presence of physiological concentrations of calcium and membrane phospholipids. The additional presence of diacylglycerols markedly increases its sensitivity to both calcium and phospholipids. The sensitivity of the enzyme can also be increased by phorbol esters and it is believed that protein kinase C is the receptor protein of tumor-promoting phorbol esters. EC 2.7.1.-. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]
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Protein-Serine-Threonine Kinases: A group of enzymes that catalyzes the phosphorylation of serine or threonine residues in proteins, with ATP or other nucleotides as phosphate donors. EC 2.7.10. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]
Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH]
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Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Pyramidal Cells: Projection neurons in the cerebral cortex and the hippocampus. Pyramidal cells have a pyramid-shaped soma with the apex and an apical dendrite pointed toward the pial surface and other dendrites and an axon emerging from the base. The axons may have local collaterals but also project outside their cortical region. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptivity: The condition of the reproductive organs of a female flower that permits effective pollination. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH]
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Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Research Support: Financial support of research activities. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous
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membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Reverse Transcriptase Polymerase Chain Reaction: A variation of the PCR technique in which cDNA is made from RNA via reverse transcription. The resultant cDNA is then amplified using standard PCR protocols. [NIH] Rhythm Method: A contraceptive method whereby abstinence is practiced a few days before and after the estimated day of ovulation. [NIH] Rhythmicity: Regular periodicity. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribonuclease: RNA-digesting enzyme. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Safe Sex: Sex behavior that prevents or decreases the spread of sexually transmitted diseases or pregnancy. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scalpel: A small pointed knife with a convex edge. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical
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structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sea Urchins: Somewhat flattened, globular echinoderms of the class Echinoidea, having thin, brittle shells of calcareous plates. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Selection Bias: The introduction of error due to systematic differences in the characteristics between those selected and those not selected for a given study. In sampling bias, error is the result of failure to ensure that all members of the reference population have a known chance of selection in the sample. [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Seminiferous Epithelium: Specialized epithelium lining the seminiferous tubules containing developing and mature spermatozoa and Sertoli cells. [NIH] Seminiferous tubule: Tube used to transport sperm made in the testes. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal
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osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Education: Education which increases the knowledge of the functional, structural, and behavioral aspects of human reproduction. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic
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system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sperm Capacitation: The process by which a spermatozoon becomes capable of fertilizing an ovum after it reaches the ampullary portion of the uterine tube. [NIH] Sperm Count: A count of sperm in the ejaculum, expressed as number per milliliter. [NIH] Sperm Head: The anterior, usually ovoid, nucleus-containing part of spermatozoa. [NIH] Sperm Maturation: Posttesticular ripening of spermatozoa. [NIH] Sperm Motility: Ability of the spermatozoon to move by flagellate swimming. [NIH] Spermatids: Male germ cells derived from spermatocytes and developing into spermatozoa. [NIH]
Spermatocytes: Male germ cells derived from spermatogonia and developing into spermatids. [NIH] Spermatogenesis: Process of formation and development of spermatozoa, including spermatocytogenesis and spermiogenesis. [NIH] Spermatogonia: The spermatocytes. [NIH]
primitive
differentiated
male
gametes
which
give
rise
to
Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Spermatozoon: The mature male germ cell. [NIH] Spermicide: An agent that is destructive to spermatozoa. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes,
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filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Spotting: A slight discharge of blood via the vagina, especially as a side-effect of oral contraceptives. [EU] Squamous: Scaly, or platelike. [EU] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Squamous intraepithelial lesion: SIL. A general term for the abnormal growth of squamous cells on the surface of the cervix. The changes in the cells are described as low grade or high grade, depending on how much of the cervix is affected and how abnormal the cells appear. [NIH]
Stabilization: The creation of a stable state. [EU] Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] State Government: The level of governmental organization and function below that of the national or country-wide government. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue.
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These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Superovulation: Occurrence or induction of release of more ova than are normally released at the same time in a given species. The term applies to both animals and humans. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Suprarenal: Above a kidney. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]
Symphysis: A secondary cartilaginous joint. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU]
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Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level
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(absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombopenia: Reduction in the number of platelets in the blood. [NIH] Thrombophilia: A disorder of hemostasis in which there is a tendency for the occurrence of thrombosis. [NIH] Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tome: A zone produced by a number of irregular spaces contained in the outermost layer of denture of the root of a tooth. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH]
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Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transgenes: Genes that are introduced into an organism using gene transfer techniques. [NIH]
Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Trichomonas: A genus of parasitic flagellate protozoans distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]
Trophoblast: The outer layer of cells of the blastocyst which works its way into the endometrium during ovum implantation and grows rapidly, later combining with mesoderm. [NIH]
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Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tubal ligation: An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Tyrothricin: A polypeptide antibiotic mixture obtained from Bacillus brevis. It consists of a mixture of three tyrocidines (60%) and several gramicidins (20%) and is very toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. It is used topically. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Diseases: Diseases of the urogenital tract. [NIH] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This
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includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Vanadium: Vanadium. A metallic element with the atomic symbol V, atomic number 23, and atomic weight 50.94. It is used in the manufacture of vanadium steel. Prolonged exposure can lead to chronic intoxication caused by absorption usually via the lungs. [NIH] Vas Deferens: The excretory duct of the testes that carries spermatozoa. It rises from the scrotum and joins the seminal vesicles to form the ejaculatory duct. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasectomy: An operation to cut or tie off the two tubes that carry sperm out of the testicles. [NIH]
Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venoms: Poisonous animal secretions forming fluid mixtures of many different enzymes, toxins, and other substances. These substances are produced in specialized glands and secreted through specialized delivery systems (nematocysts, spines, fangs, etc.) for disabling prey or predator. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinarians: Individuals with a degree in veterinary medicine that provides them with training and qualifications to treat diseases and injuries of animals. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virilism: Development of masculine traits in the female. [NIH]
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Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wetting Agents: A surfactant that renders a surface wettable by water or enhances the spreading of water over the surface; used in foods and cosmetics; important in contrast media; also with contact lenses, dentures, and some prostheses. Synonyms: humectants; hydrating agents. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The
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compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia. [NIH] Zona Pellucida: The transport non-cellular envelope surrounding the mammalian ovum. [NIH]
Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
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INDEX A Abdominal, 154, 247, 248, 265, 293 Aberrant, 47, 154, 178, 247 Abortion, Habitual, 169, 247 Acceptor, 247, 283, 293 Acetylcholine, 247, 290 Acne, 30, 93, 127, 226, 247, 263, 302 Acquired Immunodeficiency Syndrome, 156, 247 Acrosin, 151, 247 Acrosome, 6, 10, 46, 55, 157, 247 Acrosome Reaction, 10, 46, 55, 157, 247 Action Potentials, 167, 247 Acyl, 158, 180, 247 Adaptability, 247, 257, 258 Adaptation, 27, 247 Adenine, 247, 248, 301 Adenocarcinomas, 165, 247 Adenosine, 50, 185, 248, 278, 282, 295 Adenovirus, 52, 248 Adherens Junctions, 17, 248 Adhesives, 155, 248 Adipocytes, 248, 262, 282 Adjustment, 247, 248 Adjuvant, 12, 26, 248, 272 Adolescence, 29, 248 Adrenal Cortex, 146, 248, 249, 250, 269, 277, 291, 298 Adverse Effect, 25, 30, 248, 305 Aerobic, 248, 287 Afferent, 248, 282 Affinity, 9, 11, 13, 153, 159, 160, 248, 305 Aggressiveness, 153, 248 Agonist, 22, 111, 112, 148, 164, 181, 248, 266, 309 Albumin, 248, 296, 309 Aldehydes, 249, 314 Aldosterone, 249, 287 Algorithms, 249, 255 Alkaline, 249, 256, 309 Alkaloid, 249, 260 Alleles, 35, 43, 57, 249 Allergen, 249, 304 Allograft, 40, 249 Alopecia, 249, 263 Alpha-1, 249, 263 Alternative medicine, 204, 249 Amebiasis, 249, 286
Amenorrhea, 11, 13, 69, 127, 182, 225, 249, 291, 297 Amino Acid Sequence, 249, 250, 251, 272 Amino Acids, 249, 256, 272, 290, 294, 297, 299, 303, 311 Amphetamines, 249, 260 Amplification, 250, 283 Anabolic, 165, 166, 181, 250, 265 Anaerobic, 250, 313 Anaesthesia, 250, 279 Anal, 20, 25, 37, 250, 271, 283 Analogous, 12, 149, 172, 250, 311 Anaphylatoxins, 250, 261 Anaplasia, 250, 290 Anatomical, 11, 250, 253, 258, 279, 303 Androgen-Binding Protein, 49, 250 Androgenic, 146, 165, 166, 167, 168, 177, 181, 250, 266, 291 Androgens, 49, 111, 146, 159, 166, 177, 181, 248, 250, 277, 285 Androstenedione, 146, 250 Anemia, 165, 182, 250, 284, 315 Aneuploidy, 50, 169, 250 Angiogenesis, 153, 250, 285 Animal model, 13, 16, 23, 26, 61, 250 Anionic, 151, 251 Anions, 249, 251, 281, 305 Annealing, 251, 283 Anorectal, 37, 251 Anovulation, 251, 297 Antecedent, 10, 183, 251 Antibacterial, 251, 306 Antibiotic, 26, 251, 256, 274, 306, 312 Antibodies, Anticardiolipin, 251, 252 Antibodies, Antiphospholipid, 251, 252 Anticoagulant, 251, 252, 299, 314 Antiemetic, 251, 286 Antiepileptic, 86, 251 Antigen, 10, 158, 176, 248, 251, 261, 264, 276, 277, 278, 279, 280, 285, 301, 304 Antigen-Antibody Complex, 251, 261 Antigen-presenting cell, 251, 264 Anti-inflammatory, 252, 273, 298 Antimicrobial, 33, 83, 252, 265 Antineoplastic, 252, 263 Antioxidant, 252, 293 Antiphospholipid Syndrome, 111, 251, 252
318 Contraception
Antiviral, 14, 252 Anuria, 252, 281 Anus, 250, 251, 252, 253, 255, 302 Anxiety, 167, 252 Aperture, 174, 252 Apolipoproteins, 252, 283 Apoptosis, 31, 46, 252, 257 Applicability, 159, 252 Aqueous, 164, 252, 253, 263, 277, 282 Arginine, 250, 252, 290, 312 Aromatic, 252, 256, 295, 308 Arrhythmia, 167, 252 Arterial, 252, 253, 259, 277, 299, 309 Arteries, 252, 253, 255, 262, 284, 287, 289 Arterioles, 252, 253, 255 Arteriolosclerosis, 252, 253 Arteriosclerosis, 27, 253 Aseptic, 253, 307 Assay, 26, 27, 60, 253, 301 Asymptomatic, 44, 249, 253 Atresia, 172, 253 Atrial, 167, 253, 314 Atrial Fibrillation, 253, 314 Atrium, 253, 313 Atrophy, 146, 253 Attenuated, 176, 253 Atypical, 54, 253 Autoimmune disease, 9, 148, 251, 253 Autoimmunity, 55, 253 Autonomic, 167, 247, 253, 295 Axons, 253, 295, 301 Azoospermia, 36, 167, 253 B Bacteria, 33, 157, 176, 247, 251, 253, 267, 270, 274, 287, 296, 306, 311, 313 Bacterial Physiology, 247, 253 Bacteriophage, 253, 311 Base, 12, 13, 38, 45, 247, 253, 264, 270, 272, 281, 282, 301, 309 Basement Membrane, 253, 270 Benign, 152, 154, 160, 165, 178, 252, 254, 273, 290, 314 Benzene, 165, 254 Bewilderment, 254, 262 Bilateral, 254, 297 Bile, 254, 272, 283, 307 Bioavailability, 9, 42, 60, 254 Bioavailable, 50, 254 Biochemical, 10, 14, 18, 35, 36, 47, 111, 113, 189, 249, 254, 282 Biochemical Phenomena, 254 Bioengineering, 42, 216, 254
Biogenesis, 44, 254 Biological Phenomena, 153, 254 Biological therapy, 254, 275 Biological Transport, 254, 265 Biomarkers, 30, 254 Biopsy, 9, 30, 45, 254 Biopsy specimen, 9, 254 Biotechnology, 63, 64, 113, 154, 178, 195, 204, 217, 255 Bladder, 255, 299, 312 Blastocyst, 8, 255, 261, 267, 293, 296, 311 Blastomeres, 176, 255, 289 Blood Coagulation, 255, 256, 310 Blood Glucose, 4, 5, 255, 275, 280 Blood pressure, 27, 255, 257, 277, 288, 291, 305 Blood vessel, 250, 255, 257, 258, 259, 267, 268, 281, 286, 305, 307, 310, 313 Body Composition, 25, 255 Body Fluids, 175, 254, 255, 266, 305, 312 Body Image, 206, 255 Bone Density, 24, 86, 255 Bone Marrow, 254, 255, 278, 284, 305, 307, 315 Bone Morphogenetic Proteins, 177, 255 Bone scan, 31, 255 Bowel, 250, 255, 265, 279, 280 Bowel Movement, 255, 265 Bradykinin, 256, 290, 296 Branch, 26, 113, 201, 241, 256, 263, 267, 272, 294, 300, 306, 309 Breakdown, 50, 256, 265, 272, 285 Breast Feeding, 123, 124, 206, 256 Breeding, 35, 44, 57, 174, 256 Broad-spectrum, 14, 32, 256 Buccal, 40, 146, 256, 284 C Cadherins, 248, 256 Calcification, 253, 256 Calcium, 24, 25, 167, 175, 256, 261, 285, 293, 294, 299, 300, 305, 309 Callus, 256, 267 Capsules, 5, 154, 256, 271, 272 Carbohydrate, 11, 65, 256, 273, 297 Carbon Dioxide, 256, 271, 296, 302 Carboxy, 256 Carboxylic Acids, 85, 256 Carcinogen, 47, 256, 287 Carcinogenic, 254, 257, 265, 280, 292, 299, 307 Carcinoma, 179, 257, 263
Index 319
Cardiac, 28, 167, 253, 257, 269, 273, 289, 293, 307 Cardiovascular, 5, 27, 52, 155, 166, 189, 206, 257 Cardiovascular disease, 52, 155, 206, 257 Carrier Proteins, 257, 296, 301 Case report, 257, 260 Case series, 257, 260 Caspase, 32, 257 Cations, 257, 281 Caudal, 257, 265, 278, 297 Causal, 62, 257 Cause of Death, 206, 257 Cell Adhesion, 54, 256, 257, 280 Cell Aggregation, 257, 293 Cell Cycle, 51, 257, 263 Cell Death, 14, 31, 252, 257, 289 Cell Differentiation, 23, 60, 150, 257, 305 Cell Division, 175, 253, 257, 258, 263, 275, 286, 288, 296, 299, 304 Cell membrane, 23, 148, 248, 254, 257, 264, 270, 281, 295 Cell motility, 153, 258 Cell Movement, 153, 258 Cell Polarity, 54, 258 Cell proliferation, 253, 258, 305 Cell Respiration, 258, 287, 302 Cell Survival, 177, 258, 275 Cellular Structures, 258, 288 Cellulose, 14, 258, 296 Central Nervous System, 150, 247, 249, 254, 258, 260 Cerebral, 258, 262, 269, 270, 284, 301, 309 Cerebrovascular, 257, 258 Cervical, 4, 6, 12, 14, 21, 29, 31, 39, 45, 72, 83, 127, 149, 156, 161, 174, 224, 227, 258 Cervical Ripening, 12, 258 Cervix, 150, 174, 245, 258, 261, 266, 302, 307 Chemoprevention, 12, 258 Chemotactic Factors, 258, 261 Chemotherapy, 167, 258 Chin, 159, 258 Chlamydia, 24, 27, 29, 39, 97, 100, 258, 259 Chlamydia trachomatis, 24, 97, 100, 259 Chlorine, 172, 259 Chlormadinone Acetate, 179, 259 Cholesterol, 5, 23, 32, 254, 259, 262, 283, 284, 307, 309 Cholesterol Esters, 259, 283 Chondroitin sulfate, 153, 259 Chromaffin System, 259, 268
Chromatin, 35, 168, 173, 252, 259, 276, 306 Chromosomal, 35, 168, 250, 259, 296, 303 Chromosome, 35, 154, 173, 250, 259, 275, 283, 285, 288, 303, 304, 311 Chronic, 18, 50, 53, 165, 166, 190, 206, 249, 259, 268, 279, 281, 282, 297, 308, 309, 313 Chronic renal, 259, 297 Chylomicrons, 259, 283 Circulatory system, 259, 268 CIS, 60, 226, 227, 259 Clear cell carcinoma, 259, 264 Cleave, 11, 259 Climacteric, 177, 259 Clinical Medicine, 58, 259, 298 Clinical Protocols, 21, 260 Clinical study, 13, 67, 125, 260 Clinical trial, 6, 12, 22, 30, 41, 58, 88, 139, 142, 217, 260, 262, 266, 300, 301 Clone, 10, 52, 260 Cloning, 16, 157, 175, 255, 260, 283 Coagulation, 252, 255, 260, 275, 296, 310, 314 Coal, 254, 260 Coca, 260 Cocaine, 52, 260 Coculture, 18, 260 Coenzymes, 260, 290 Cofactor, 260, 299, 310 Cognition, 165, 260 Coitus, 4, 154, 260 Colitis, 260, 279 Collagen, 248, 254, 260, 262, 270, 272, 285, 297 Collapse, 163, 256, 261 Colloidal, 249, 261, 267, 304 Colposcopy, 45, 261 Combination Therapy, 261, 270 Complement, 44, 250, 261, 272, 280, 296, 304 Complementary and alternative medicine, 119, 130, 261 Complementary medicine, 119, 261 Computational Biology, 217, 261 Concomitant, 43, 262 Condoms, 4, 6, 17, 26, 39, 67, 92, 157, 163, 188, 200, 224, 229, 230, 231, 245, 262 Cone, 156, 262, 308 Confusion, 49, 262, 265, 312 Congestion, 229, 262 Conjugated, 161, 262 Connective Tissue, 153, 176, 252, 255, 260, 262, 272, 284, 286, 295, 307, 309
320 Contraception
Connective Tissue Cells, 262 Connective Tissue Diseases, 252, 262 Constriction, 262, 281, 303 Consumption, 262, 265, 302 Contraceptive Agents, 262, 265 Contraindications, ii, 262 Control group, 28, 262 Convulsions, 262, 266, 298 Cornea, 262, 274, 281, 307 Coronary, 5, 206, 257, 262, 287, 289 Coronary heart disease, 257, 262 Coronary Thrombosis, 262, 287, 289 Corpus, 150, 183, 263, 284, 294, 298, 309 Corpus Luteum, 183, 263, 284, 298 Cortex, 162, 166, 181, 263, 270, 276, 301 Cortical, 263, 301 Corticosteroids, 263, 273, 287, 298 Cortisone, 159, 263, 298 Crossing-over, 263, 301 Curative, 263, 290, 309 Cutaneous, 263, 284 Cyclic, 23, 263, 274, 275, 291, 295, 304 Cyclins, 263, 285 Cyclodextrins, 32, 263 Cyclophosphamide, 206, 263 Cyproterone, 179, 263 Cyproterone Acetate, 179, 263 Cysteine, 32, 263 Cystine, 263 Cytogenetics, 263, 303 Cytokine, 45, 263 Cytoplasm, 175, 252, 257, 263, 264, 268, 274, 303 Cytoskeleton, 54, 248, 264, 280 Cytotoxic, 45, 264, 305 Cytotoxicity, 61, 264 Cytotoxins, 149, 264 D Databases, Bibliographic, 217, 264 Decidua, 9, 264, 287, 296 Defense Mechanisms, 264, 280 Degenerative, 264, 276 Deletion, 252, 264 Dementia, 247, 264 Denaturation, 264, 283 Dendrites, 264, 290, 301 Dendritic, 43, 264 Dendritic cell, 43, 264 Density, 20, 24, 25, 30, 42, 71, 255, 264, 283, 292 Depolarization, 264, 305 Deprivation, 32, 264
DES, 15, 250, 264 Desogestrel, 87, 179, 264 Detergents, 157, 265, 291 Detoxification, 37, 265 Deuterium, 265, 277 Developing Countries, 39, 265 Diabetes Mellitus, 3, 4, 5, 11, 197, 265, 273, 275 Diagnostic procedure, 145, 205, 265 Diaphragm, 4, 5, 72, 76, 77, 102, 103, 154, 225, 228, 229, 265 Diastole, 265 Diastolic, 167, 265, 277 Diencephalon, 265, 278, 309 Diffusion, 41, 136, 254, 265, 281 Digestion, 254, 255, 265, 280, 283, 307 Digestive system, 143, 265 Dihydrotestosterone, 166, 181, 263, 265, 302 Dioxins, 171, 265 Diploid, 175, 250, 265, 288, 296, 311 Direct, iii, 19, 35, 39, 49, 55, 57, 61, 140, 174, 184, 209, 258, 259, 265, 266, 273, 302, 308 Discrimination, 101, 265 Disorientation, 262, 265 Dissociation, 248, 265, 281 Distal, 36, 266, 300 Dopamine, 260, 266, 286, 295 Dose-dependent, 34, 266, 315 Double-blinded, 24, 266 Douche, 228, 266 Drive, ii, vi, 35, 109, 266, 281, 282 Drug Delivery Systems, 146, 182, 266 Drug Interactions, 211, 266 Drug Tolerance, 266, 310 Duct, 36, 231, 266, 303, 313 Dydrogesterone, 169, 266 Dynein, 266, 288 Dysmenorrhea, 30, 53, 158, 180, 266 Dyspareunia, 146, 266, 270 E Eclampsia, 266, 298 Ectopic, 9, 77, 96, 226, 266 Ectopic Pregnancy, 9, 77, 96, 226, 266 Edema, 266, 298 Effector, 43, 247, 261, 267, 290, 295 Effector cell, 267, 290 Ejaculation, 36, 267, 304 Elasticity, 253, 267 Electrolyte, 249, 267, 282, 287, 297, 305 Electrons, 252, 253, 267, 281, 293, 301
Index 321
Electrophoresis, 15, 267 Electrophysiological, 36, 167, 267 Emaciation, 247, 267 Emboli, 267, 314 Embolism, 267, 301, 314 Embolization, 267, 314 Embolus, 267, 279 Embryo, 9, 18, 36, 46, 53, 57, 150, 175, 255, 257, 267, 279, 286, 289, 292, 298, 307 Embryo Transfer, 36, 57, 267, 298 Embryogenesis, 153, 267 Empirical, 14, 135, 267 Enanthate, 166, 167, 181, 268 Encapsulated, 154, 268 Endemic, 268, 284 Endocrine Glands, 268, 293 Endocrine System, 172, 268, 290 Endocrinology, 16, 21, 48, 53, 71, 82, 88, 90, 101, 102, 159, 193, 268, 275 Endometrial, 9, 13, 18, 26, 30, 94, 111, 151, 158, 162, 169, 180, 182, 183, 268, 293 Endometriosis, 12, 21, 30, 53, 127, 152, 158, 165, 169, 177, 180, 268, 282, 291 Endometrium, 9, 21, 26, 57, 83, 100, 151, 161, 165, 170, 183, 194, 264, 268, 286, 287, 290, 311 Endoscope, 261, 268 Endothelial cell, 268, 271, 310 Endothelium, 268, 290, 296 Endothelium-derived, 268, 290 Endotoxins, 261, 268 End-stage renal, 259, 268, 297 Energy balance, 268, 282 Enhancers, 153, 182, 268 Environmental Health, 216, 218, 268 Enzymatic, 35, 44, 46, 175, 256, 261, 263, 268, 271 Enzyme Inhibitors, 268, 296 Eosinophil, 33, 268 Eosinophilic, 268 Epidemic, 16, 22, 174, 269 Epidemiologic Factors, 40, 269 Epidemiological, 40, 41, 269 Epidermal, 151, 269, 314 Epidermal Growth Factor, 151, 269 Epidermis, 269 Epinephrine, 266, 269, 312 Epithelial, 9, 36, 37, 42, 45, 48, 61, 151, 157, 247, 254, 264, 269, 276, 287 Epithelial Cells, 61, 157, 247, 269, 276, 287 Epithelium, 9, 17, 36, 42, 146, 157, 162, 184, 253, 268, 269, 293, 304
Epitope, 9, 43, 65, 269 Erectile, 165, 269, 294 Erection, 231, 269 ERV, 220, 269, 270 Erythrocytes, 250, 255, 269, 304 Erythropoiesis, 181, 269 Esophagus, 253, 265, 269, 307 Estradiol, 24, 25, 30, 89, 129, 161, 169, 210, 269 Estrogen receptor, 160, 164, 165, 269 Estrogen Replacement Therapy, 206, 270 Ethinyl Estradiol, 30, 105, 169, 170, 182, 270 Eukaryotic Cells, 46, 173, 270, 279, 292 Evoke, 270, 307 Excipients, 165, 270 Excrete, 252, 270, 281 Exhaustion, 270, 284 Exocytosis, 6, 10, 270 Exogenous, 270, 299 Expiratory, 269, 270 Expiratory Reserve Volume, 269, 270 Extracellular, 7, 46, 150, 153, 157, 248, 262, 270, 280, 285, 288, 305, 309 Extracellular Matrix, 7, 153, 157, 262, 270, 280, 285 Extracellular Matrix Proteins, 270, 285 Extracellular Space, 270 Eye Infections, 248, 270 F Fallopian Tubes, 270, 302, 312 Fat, 82, 248, 255, 262, 267, 271, 282, 283, 305, 308, 309 Fatigue, 165, 206, 271 Fatty acids, 82, 184, 249, 256, 271, 299 Femoral, 25, 271 Femur, 271 Fertilization in Vitro, 271, 298 Fetus, 40, 162, 206, 271, 278, 296, 298, 307, 312 Fibrin, 255, 271, 296, 310 Fibrinogen, 27, 271, 296, 310 Fibrinolysis, 90, 271 Fibroblast Growth Factor, 151, 271 Filler, 171, 271 Fixation, 271, 304 Flagellum, 271, 311 Flatus, 271, 272 Foetoplacental, 271, 291 Fold, 28, 40, 272 Follicles, 150, 272, 280 Follicular Phase, 183, 272
322 Contraception
Foramen, 258, 272 Forearm, 255, 272 Friction, 160, 272 G Gallbladder, 247, 265, 272 Gametogenesis, 44, 53, 152, 168, 272 Gas, 172, 256, 259, 265, 269, 271, 272, 277, 290, 291, 313 Gasoline, 254, 272 Gastric, 269, 272 Gastrin, 272, 276 Gastrointestinal, 182, 256, 269, 272, 274, 284, 308, 312 Gastrointestinal tract, 272, 274, 312 Gelatin, 272, 308 Gels, 272, 287 Gene Expression, 32, 40, 49, 59, 166, 168, 272 General practitioner, 97, 272 Genetic Code, 272, 291 Genetic Engineering, 113, 255, 260, 272 Genetics, 8, 16, 34, 54, 110, 263, 272, 288 Genital, 36, 43, 61, 65, 83, 259, 272, 275, 312 Genitourinary, 73, 97, 272, 312 Genotype, 27, 47, 273, 295 Germ cell tumors, 23, 273 Germ Cells, 17, 21, 23, 37, 44, 46, 49, 51, 59, 150, 184, 273, 286, 292, 293, 306, 309 Gestation, 40, 273, 294, 296, 307 Gestational, 3, 5, 197, 273 Giardiasis, 273, 286 Glomerular, 273, 282, 302 Glucans, 263, 273 Glucocorticoid, 159, 162, 165, 273, 287, 298 Glucose, 3, 5, 27, 255, 258, 263, 265, 273, 275, 280, 303 Glucose Intolerance, 265, 273 Glucose tolerance, 3, 273 Glucose Tolerance Test, 273 Glucuronic Acid, 273, 276 Glycogen, 74, 259, 273 Glycogen Storage Disease, 74, 273 Glycoprotein, 10, 150, 271, 274, 310 Glycosaminoglycan, 153, 259, 274 Gonad, 274 Gonadal, 21, 149, 152, 177, 274, 307 Gonadotropic, 32, 274 Gonadotropin, 22, 50, 148, 149, 152, 158, 274 Gonorrhea, 29, 39, 274 Gossypol, 89, 112, 125, 274
Governing Board, 274, 298 Grade, 45, 230, 274, 307 Graft, 274, 277 Grafting, 274, 279 Gramicidin, 184, 274 Gram-negative, 258, 274 Gram-positive, 274 Granulocytes, 274, 282, 305, 314 Granuloma, 229, 274 Granulosa Cell Tumor, 160, 274 Granulosa Cells, 34, 171, 274, 280, 284 Gravidity, 274, 294 Group Practice, 65, 275 Growth factors, 151, 275 Guanylate Cyclase, 275, 291 H Habitat, 44, 275 Haploid, 175, 275, 296 Haptens, 248, 275, 301 Health Services, 14, 187, 275 Health Status, 5, 275 Heart attack, 257, 275 Hematopoiesis, 177, 275 Hematopoietic Stem Cells, 148, 275 Hemodialysis, 275, 281, 282 Hemoglobin, 250, 269, 275 Hemorrhage, 275, 307 Hemostasis, 104, 275, 280, 310 Heparin, 151, 153, 276 Hepatic, 179, 249, 273, 276 Hepatitis, 175, 276 Hepatocytes, 276 Hepatotoxic, 17, 276 Herbicides, 265, 276 Heredity, 272, 276 Heterodimer, 255, 276 Heterogeneity, 248, 276 High Mobility Group Proteins, 153, 154, 178, 276 Hippocampus, 276, 301 Hirsutism, 30, 244, 263, 276, 277 Histocompatibility, 40, 276 Histology, 17, 30, 45, 276 Homologous, 10, 154, 249, 263, 276, 304, 308 Homosexuality, 234, 276 Hormonal, 4, 5, 7, 12, 19, 21, 25, 26, 29, 30, 32, 34, 37, 39, 43, 44, 45, 47, 50, 51, 54, 59, 65, 66, 67, 68, 69, 71, 72, 75, 76, 77, 83, 84, 85, 86, 87, 90, 92, 94, 95, 96, 98, 104, 106, 107, 111, 113, 125, 140, 141,
Index 323
146, 147, 149, 151, 152, 155, 168, 169, 170, 179, 181, 183, 193, 253, 270, 276, 294 Hormonal therapy, 5, 181, 276 Hormone Replacement Therapy, 12, 77, 95, 113, 146, 166, 169, 178, 179, 181, 182, 276 Hormone therapy, 181, 276, 285 Host, 23, 148, 185, 253, 277, 278, 312, 314 Human Development, 13, 20, 139, 140, 141, 142, 189, 201, 216, 227, 277 Human papillomavirus, 83, 277 Hybrid, 15, 47, 150, 260, 277, 292 Hybridization, 277, 288, 292 Hybridoma, 150, 277 Hydration, 153, 277 Hydrogen, 11, 158, 179, 180, 247, 253, 256, 264, 265, 270, 277, 283, 288, 293, 295, 300 Hydrogen Peroxide, 277, 283 Hydrolysis, 33, 151, 277, 281, 282, 295, 297, 300, 312 Hydrophilic, 265, 277 Hydrophobic, 11, 265, 277, 283 Hyperandrogenism, 82, 277 Hypericum, 129, 130, 141, 277 Hyperplasia, 165, 277 Hypersensitivity, 127, 249, 268, 277, 304 Hypertension, 27, 167, 252, 257, 277, 298 Hypertrichosis, 276, 277 Hypertrophy, 152, 277, 278 Hypogonadism, 165, 278 Hypothalamic, 11, 25, 278 Hypothalamus, 11, 17, 150, 152, 168, 265, 278, 296, 309 Hypoxanthine, 278, 314 I Id, 114, 126, 224, 225, 226, 235, 240, 242, 278 Idiopathic, 36, 151, 278 Immaturity, 45, 278 Immune response, 10, 43, 152, 153, 176, 248, 251, 253, 263, 275, 278, 304, 308, 312, 314 Immune Sera, 278 Immune system, 251, 253, 254, 267, 278, 279, 284, 295, 313, 314 Immune Tolerance, 40, 278 Immunity, 42, 152, 156, 247, 264, 278, 311 Immunization, 9, 33, 158, 278, 304 Immunodeficiency, 56, 229, 230, 247, 278 Immunodeficiency syndrome, 229, 230, 278 Immunofluorescence, 50, 278
Immunogenic, 150, 152, 157, 278, 301 Immunoglobulin, 251, 278, 288 Immunohistochemistry, 17, 278 Immunologic, 45, 258, 278, 279, 315 Immunologic Factors, 45, 279 Immunology, 97, 110, 248, 279 Immunosuppressive, 263, 273, 279 Impairment, 49, 254, 270, 279, 286 Implantation, 9, 18, 40, 53, 150, 161, 162, 183, 261, 279, 290, 292, 293 Impotence, 269, 279 In situ, 11, 50, 51, 60, 279 In Situ Hybridization, 11, 50, 60, 279 In vitro, 8, 13, 17, 18, 23, 32, 34, 43, 46, 51, 60, 62, 160, 175, 257, 267, 279 In vivo, 11, 14, 17, 18, 23, 32, 35, 38, 43, 50, 62, 148, 153, 159, 160, 276, 279 Incineration, 172, 279 Incision, 231, 279, 281 Indicative, 40, 153, 188, 279, 294, 313 Induction, 10, 12, 50, 158, 166, 176, 181, 250, 279, 298, 308 Infarction, 71, 279 Inflammation, 128, 247, 249, 252, 260, 270, 276, 279, 292, 309 Inflammatory bowel disease, 110, 279 Ingestion, 147, 273, 279, 286, 297, 309 Inhibin, 177, 280 Initiation, 28, 49, 136, 280, 311 Initiator, 32, 280 Inlay, 280, 302 Inorganic, 61, 184, 280, 289 Insight, 32, 280 Insulin, 3, 4, 9, 27, 82, 273, 280 Insulin-dependent diabetes mellitus, 3, 280 Insulin-like, 9, 280 Integrins, 17, 280 Interferons, 151, 280 Intermittent, 56, 280 Internal Medicine, 22, 76, 78, 99, 146, 268, 280 International Cooperation, 55, 280 Interstitial, 270, 280, 302 Intestinal, 42, 273, 280 Intestine, 42, 255, 280, 282 Intoxication, 280, 313, 314 Intracellular, 32, 165, 166, 175, 181, 258, 279, 280, 281, 286, 291, 297, 304, 305 Intracellular Membranes, 281, 286 Intraepithelial, 281 Intravenous, 206, 281
324 Contraception
Intrinsic, 32, 248, 254, 281 Invasive, 9, 124, 153, 278, 281 Invertebrates, 23, 281 Ion Channels, 10, 55, 167, 281, 290 Ion Transport, 36, 281, 287 Ionization, 15, 281 Ions, 46, 253, 265, 267, 277, 281, 300 Ischemia, 253, 281 Isozymes, 43, 281 J Joint, 20, 22, 28, 41, 133, 281, 308, 309 K Kb, 216, 281 Keratan Sulfate, 153, 281 Kidney Disease, 10, 143, 196, 216, 281 Kidney Failure, 197, 268, 281, 282 Kidney Failure, Acute, 281 Kidney Failure, Chronic, 281, 282 Kinesin, 282, 288 Kinetic, 13, 167, 282 L Labile, 261, 282 Lactation, 72, 121, 245, 282, 292, 298 Large Intestine, 265, 280, 282, 302, 305 Lectin, 282, 286 Lens, 282, 302 Leprosy, 45, 282 Leptin, 11, 282 Lesion, 45, 274, 282, 283 Leucocyte, 249, 268, 282 Leukopenia, 282, 315 Levonorgestrel, 21, 56, 60, 64, 67, 73, 74, 76, 77, 84, 88, 89, 93, 95, 100, 103, 282, 291 Libido, 165, 168, 181, 250, 282 Library Services, 240, 282 Ligament, 283, 299 Ligands, 157, 183, 280, 283 Ligase, 27, 283 Ligase Chain Reaction, 27, 283 Ligation, 155, 226, 283 Light microscope, 283, 287 Linkage, 16, 28, 283 Lipid, 23, 184, 252, 253, 280, 283, 293 Lipid Peroxidation, 184, 283, 293 Lipoprotein, 28, 274, 283, 284 Liver, 110, 160, 247, 249, 254, 263, 265, 272, 273, 274, 276, 283, 298, 303, 312 Living will, 71, 283 Localization, 15, 35, 44, 50, 54, 278, 283 Localized, 33, 43, 268, 271, 276, 277, 279, 283, 296
Locomotion, 271, 283, 296 Longitudinal Studies, 29, 41, 283 Longitudinal study, 7, 25, 283 Low-density lipoprotein, 283, 284 Lumbar, 25, 284 Lumen, 36, 163, 171, 284 Lupus, 127, 128, 141, 206, 251, 252, 284, 309 Luteal Phase, 146, 183, 284, 287 Lutein Cells, 284, 298 Lymph, 258, 259, 268, 284, 308 Lymph node, 258, 284 Lymphatic, 268, 279, 284, 286, 305, 306, 310 Lymphocyte, 45, 85, 247, 251, 284, 285 Lymphocyte Count, 247, 284 Lymphocyte Subsets, 85, 284 Lymphoid, 251, 263, 282, 284 Lytic, 148, 284 M Macrophage, 280, 284 Malaria, 52, 284 Malaria, Falciparum, 284 Malaria, Vivax, 284 Malignancy, 47, 284, 293 Malignant, 148, 154, 160, 178, 247, 252, 273, 280, 285, 290 Malignant tumor, 148, 154, 178, 247, 285 Malnutrition, 249, 253, 285 Mammary, 47, 147, 179, 285, 309 Mandible, 258, 285 Mass Media, 80, 137, 285 Matrix metalloproteinase, 26, 285 Maturation-Promoting Factor, 50, 263, 285 Medial, 11, 253, 285, 292 Mediate, 11, 15, 20, 59, 157, 266, 285 Mediator, 166, 181, 285 Medical Records, 54, 285 Medical Staff, 266, 285 Medicament, 164, 177, 285, 308 MEDLINE, 217, 285 Medroxyprogesterone, 24, 30, 31, 71, 76, 89, 90, 91, 129, 161, 210, 285 Medroxyprogesterone Acetate, 24, 30, 71, 89, 90, 91, 161, 285 Megestrol, 174, 285 Megestrol Acetate, 174, 285 Meiosis, 18, 50, 51, 168, 173, 175, 285, 286, 308 Melanin, 286, 295, 312 Membrane Proteins, 10, 286 Memory, 163, 264, 286
Index 325
Meninges, 258, 274, 286, 312 Menopause, 21, 107, 146, 164, 196, 200, 206, 286, 292, 294, 297, 298 Menstrual Cycle, 5, 139, 146, 161, 162, 183, 272, 284, 286, 292, 298 Menstruation, 147, 183, 249, 264, 266, 272, 284, 286, 292 Mental Disorders, 143, 286, 300 Mental Health, iv, 6, 143, 188, 216, 220, 286, 300 Mentors, 12, 55, 63, 286 Mesenchymal, 9, 269, 286 Mesoderm, 286, 311 Metabolic disorder, 273, 286 Metaphase, 175, 286 Metastasis, 285, 286, 290 Methanol, 172, 286 Methyltransferase, 168, 173, 286 Metoclopramide, 204, 286 Metronidazole, 82, 286 MI, 74, 103, 246, 287 Microbe, 287, 311 Microbicide, 14, 21, 23, 53, 59, 287 Microbiology, 247, 253, 287 Microfilaments, 248, 287 Microgram, 182, 287 Microorganism, 260, 287, 294, 314 Microsurgery, 171, 287 Mifepristone, 56, 65, 66, 89, 110, 159, 287 Migration, 41, 42, 54, 153, 171, 287 Milligram, 287 Milliliter, 255, 287, 306 Mineralocorticoid, 165, 287 Mitochondria, 47, 287, 292 Mitochondrial Swelling, 287, 289 Mitogen-Activated Protein Kinase Kinases, 287, 288 Mitogen-Activated Protein Kinases, 50, 287, 288 Mitosis, 173, 176, 252, 285, 288 Mitotic, 176, 285, 288, 289 Mobility, 154, 178, 288 Modeling, 55, 91, 288 Modification, 33, 35, 61, 272, 288, 314 Modulator, 13, 20, 165, 181, 288 Molecular, 7, 8, 11, 15, 16, 17, 21, 23, 25, 26, 32, 35, 36, 39, 42, 43, 46, 47, 50, 53, 54, 55, 60, 121, 153, 154, 167, 178, 217, 220, 250, 254, 255, 261, 263, 271, 276, 288, 296, 298, 308 Molecular Motors, 54, 288 Molecular Probes, 153, 288
Monitor, 7, 30, 288, 291 Monoclonal, 150, 288 Monoclonal antibodies, 150, 288 Mononuclear, 274, 288 Monosomy, 250, 288 Monotherapy, 37, 289 Morphogenesis, 54, 289 Morphological, 47, 49, 267, 289 Morula, 255, 289 Motility, 15, 46, 61, 184, 289 Motion Sickness, 289 Motivations, 19, 289 Mucosa, 284, 289, 298, 308 Mucus, 14, 21, 42, 157, 161, 289 Mutagenic, 265, 289 Mutagenicity, 17, 289 Mutilation, 149, 289 Myeloma, 277, 289 Myocardial infarction, 262, 287, 289, 314 Myocardium, 287, 289 Myometrium, 151, 289 Myosin, 288, 289 N Natural selection, 254, 289 Nausea, 167, 244, 251, 289, 312 NCI, 1, 142, 215, 226, 227, 259, 289 Necrosis, 171, 252, 279, 287, 289 Needs Assessment, 108, 126, 289 Neonatal, 10, 290 Neoplasms, 151, 247, 252, 290 Nephropathy, 281, 290 Nephrotoxic, 17, 290 Nerve, 150, 247, 253, 258, 264, 285, 290, 297, 302, 304, 307, 311, 313 Nervous System, 248, 258, 285, 290, 308 Networks, 20, 41, 58, 290 Neuroendocrine, 11, 55, 290 Neuronal, 11, 167, 176, 177, 290, 295 Neurons, 11, 167, 260, 264, 290, 301, 308 Neuropeptide, 11, 290 Neurosecretory Systems, 268, 290 Neurotransmitters, 167, 290 Neutralization, 152, 176, 290 Neutrophil, 26, 290 Nevirapine, 37, 59, 290, 291 Niacin, 115, 290 Nidation, 147, 183, 267, 290 Nitric Oxide, 175, 290 Nitrogen, 249, 250, 263, 270, 271, 282, 291 Non-nucleoside, 290, 291 Nonoxynol, 14, 37, 61, 157, 184, 291 Norethindrone, 30, 182, 291
326 Contraception
Norgestrel, 282, 291 Normotensive, 40, 291 Nuclear, 18, 51, 55, 60, 175, 185, 267, 270, 285, 289, 291 Nuclei, 11, 267, 272, 288, 291, 300 Nucleic acid, 153, 176, 178, 185, 272, 277, 278, 279, 291, 292, 301, 314 Nucleus, 247, 252, 259, 263, 265, 270, 286, 288, 291, 299, 300, 306, 307 Nulliparous, 40, 99, 291 O Observational study, 59, 64, 107, 291 Ocular, 259, 291 Oestrogen, 155, 291 Oligomenorrhea, 292, 297 Oligonucleotide Probes, 283, 292 Oliguria, 281, 282, 292 Oncogenic, 83, 280, 292 Oocytes, 10, 50, 51, 157, 175, 183, 285, 292 Oogenesis, 23, 55, 292 Oophoritis, 158, 292 Opacity, 264, 292 Operon, 292, 302 Opportunistic Infections, 52, 247, 292 Optic Chiasm, 278, 292 Organelles, 263, 282, 292 Orgasm, 267, 292 Osmotic, 249, 287, 292, 305 Osteoporosis, 24, 31, 146, 165, 179, 181, 206, 270, 292 Outpatient, 231, 292 Ovarian Follicle, 30, 34, 51, 183, 263, 274, 293 Ovaries, 9, 175, 270, 277, 293, 297, 302, 305, 312 Ovary, 10, 146, 154, 157, 160, 165, 250, 263, 269, 274, 291, 292, 293, 308 Overdose, 243, 293 Ovum, 175, 247, 255, 263, 264, 273, 289, 293, 294, 298, 306, 311, 314, 315 Ovum Implantation, 293, 311 Oxidation, 32, 184, 247, 252, 263, 283, 293 Oxidative Stress, 184, 293 P Pacemaker, 167, 293 Palliative, 41, 263, 285, 292, 293, 309 Pancreas, 247, 254, 265, 280, 293, 312 Papillomavirus, 24, 293 Parasite, 293, 311 Parasitic, 293, 311 Parathyroid, 151, 293, 309 Parathyroid Glands, 293
Parathyroid hormone, 151, 293 Parity, 5, 294 Particle, 294, 311 Parturition, 291, 294, 298 Patch, 4, 60, 101, 104, 294, 311 Paternity, 44, 294 Pathogen, 35, 44, 57, 294 Pathologic, 252, 254, 262, 277, 294 Pathologic Processes, 252, 294 Patient Education, 27, 69, 228, 230, 231, 238, 240, 246, 294 Patient Satisfaction, 30, 294 Pellucida, 150, 157, 176, 294 Pelvic, 29, 53, 128, 155, 201, 268, 294, 299 Pelvic inflammatory disease, 155, 294 Penis, 149, 156, 245, 262, 267, 294, 302 Peptide, 9, 84, 97, 148, 151, 153, 176, 271, 282, 294, 297, 299, 300 Perception, 87, 95, 262, 294, 303 Perennial, 277, 294 Perforation, 252, 272, 294 Pericardium, 294, 309 Perimenopausal, 151, 178, 179, 294 Perinatal, 37, 59, 74, 294 Periodicity, 294, 303 Peripheral blood, 45, 85, 295 Peripheral Nerves, 282, 295 PH, 255, 295 Phagocyte, 42, 295 Phagocytosis, 280, 295 Pharmaceutical Preparations, 179, 258, 272, 295 Pharmacist, 19, 91, 95, 104, 140, 295 Pharmacokinetic, 21, 95, 295 Pharmacologic, 95, 113, 295, 311 Phenotype, 27, 48, 295 Phenyl, 159, 162, 177, 180, 295 Phenylalanine, 295, 312 Phosphodiesterase, 50, 295 Phospholipases, 295, 305 Phospholipids, 251, 252, 271, 283, 295, 299 Phosphorus, 256, 293, 295 Phosphorylates, 285, 295, 299 Phosphorylation, 32, 288, 295, 300 Photoreceptors, 167, 295 Physical Examination, 54, 295 Physiologic, 27, 166, 181, 248, 259, 286, 296, 301 Physiology, 25, 36, 39, 44, 51, 55, 111, 113, 123, 181, 267, 268, 275, 296 Pigment, 274, 296 Pilot Projects, 48, 296
Index 327
Pilot study, 19, 49, 74, 79, 296 Pituitary Gland, 150, 168, 271, 296 Placenta, 40, 269, 271, 296, 298, 300 Placental Insufficiency, 206, 296 Plants, 123, 124, 249, 254, 256, 260, 264, 273, 276, 277, 282, 296, 303, 311 Plasma cells, 251, 289, 296 Plasma protein, 9, 249, 296, 300, 304 Plasma Volume, 287, 296 Plasmid, 176, 296, 313 Plasmin, 296 Plasminogen, 27, 296 Plasminogen Activators, 296 Platelet Activation, 90, 297, 305 Platelet Aggregation, 250, 290, 297 Platelet-Derived Growth Factor, 151, 297 Platelets, 290, 297, 310 Poisoning, 280, 289, 297 Polycystic, 10, 165, 277, 297 Polycystic Ovary Syndrome, 165, 277, 297 Polymerase, 185, 297, 302 Polymers, 43, 297, 299, 308 Polymorphic, 28, 297 Polypeptide, 44, 168, 185, 249, 260, 269, 271, 274, 277, 296, 297, 298, 312, 315 Polysaccharide, 153, 251, 258, 274, 297 Population Control, 148, 159, 297 Posterior, 250, 293, 297 Postmenopausal, 5, 24, 48, 95, 146, 206, 270, 292, 297 Postoperative, 229, 297 Postsynaptic, 297, 305, 308 Post-translational, 250, 297 Potassium, 167, 249, 287, 297 Potentiation, 297, 305 Practice Guidelines, 219, 298 Preclinical, 56, 62, 298 Precursor, 148, 250, 255, 263, 266, 267, 268, 295, 296, 298, 300, 312 Prednisolone, 298 Prednisone, 206, 298 Preeclampsia, 40, 206, 298 Pregnancy Outcome, 61, 298 Premenopausal, 178, 179, 206, 298 Prenatal, 267, 298 Prevalence, 17, 20, 42, 298 Probe, 283, 292, 298 Progeny, 10, 298 Progestogen, 71, 96, 105, 110, 112, 169, 170, 179, 298 Progression, 47, 52, 250, 298
Progressive, 49, 183, 252, 257, 259, 264, 266, 270, 275, 282, 289, 297, 298, 302 Projection, 39, 264, 298, 301 Prolactin, 151, 298 Promoter, 38, 51, 59, 299 Prone, 171, 299 Prophase, 51, 175, 292, 299, 308 Prophylaxis, 147, 156, 174, 299, 302, 313, 314 Proportional, 41, 299 Prospective study, 29, 45, 83, 86, 91, 283, 299 Prostaglandins, 287, 299 Prostaglandins F, 287, 299 Prostate, 152, 165, 166, 181, 230, 254, 292, 299, 302, 312 Prostate gland, 230, 299 Protein Binding, 51, 299 Protein C, 15, 172, 185, 249, 252, 253, 283, 299 Protein Kinase C, 287, 288, 299 Protein S, 195, 255, 272, 299, 303 Protein-Serine-Threonine Kinases, 288, 300 Proteinuria, 298, 300 Proteolytic, 249, 255, 261, 271, 296, 300 Prothrombin, 300, 310 Protocol, 13, 21, 52, 300 Protons, 277, 300, 301 Protozoa, 157, 287, 300 Proximal, 150, 266, 300 Psychiatric, 166, 286, 300 Psychiatry, 22, 167, 201, 271, 300 Psychic, 259, 282, 300 Puberty, 146, 192, 300 Public Health, 12, 15, 24, 31, 37, 41, 58, 62, 63, 73, 91, 110, 120, 123, 137, 175, 220, 300 Public Policy, 217, 300 Publishing, 4, 6, 63, 188, 300 Puerperium, 291, 300 Pulmonary, 255, 259, 262, 269, 281, 300, 301, 308, 313, 314 Pulmonary Artery, 255, 300, 301, 313 Pulmonary Edema, 259, 281, 300 Pulmonary Embolism, 301, 314 Pulse, 206, 288, 301 Purines, 301, 314 Pyramidal Cells, 167, 301 R Race, 19, 24, 30, 282, 287, 291, 301 Radiation, 278, 286, 301, 314
328 Contraception
Radioactive, 255, 277, 279, 281, 288, 291, 292, 301 Radioimmunoassay, 13, 21, 58, 301 Randomized, 12, 21, 24, 27, 28, 30, 31, 33, 39, 49, 56, 57, 63, 65, 66, 68, 86, 91, 98, 105, 267, 301 Randomized clinical trial, 12, 49, 56, 301 Rape, 123, 301 Reagent, 259, 301 Receptivity, 14, 18, 147, 162, 301 Recombinant, 7, 21, 33, 55, 97, 150, 176, 301, 313 Recombinant Proteins, 176, 301 Recombination, 169, 301 Rectal, 59, 302 Rectum, 251, 252, 255, 265, 271, 272, 279, 282, 299, 302, 308 Recurrence, 258, 294, 302 Reductase, 166, 181, 302 Refer, 1, 256, 261, 271, 283, 302 Refraction, 302, 306 Regeneration, 153, 154, 178, 271, 302 Regimen, 18, 30, 65, 77, 81, 91, 110, 170, 260, 267, 302 Registries, 16, 62, 302 Reliability, 155, 302 Renal failure, 196, 302 Repressor, 51, 292, 302 Reproduction Techniques, 47, 298, 302 Reproductive cells, 163, 272, 273, 302 Reproductive system, 11, 229, 299, 302 Research Support, 48, 302 Resolving, 9, 302 Respiration, 256, 288, 302 Restoration, 18, 302, 314 Retina, 282, 292, 302, 303 Retinoids, 302, 303 Retinol, 116, 302 Reverse Transcriptase Polymerase Chain Reaction, 45, 303 Rhythm Method, 154, 188, 228, 303 Rhythmicity, 167, 303 Riboflavin, 115, 303 Ribonuclease, 33, 303 Ribose, 248, 303 Ribosome, 303, 311 Rigidity, 296, 303 Risk factor, 5, 27, 29, 41, 47, 54, 230, 299, 303 Rod, 103, 303 S Safe Sex, 28, 303
Salivary, 265, 303, 308 Salivary glands, 265, 303 Saponins, 303, 307 Satellite, 36, 57, 303 Scalpel, 229, 303 Schizoid, 303, 314 Schizophrenia, 41, 303, 314 Schizotypal Personality Disorder, 303, 314 Sclerosis, 252, 253, 303 Screening, 16, 19, 29, 31, 45, 97, 100, 166, 168, 193, 206, 260, 304 Scrotum, 229, 231, 246, 304, 309, 313 Sea Urchins, 10, 304 Second Messenger Systems, 290, 304 Secretion, 36, 37, 55, 167, 183, 269, 277, 280, 282, 287, 289, 304 Secretory, 18, 33, 49, 162, 170, 183, 304, 308 Segregation, 173, 176, 301, 304 Selection Bias, 28, 304 Selective estrogen receptor modulator, 304, 309 Self Care, 230, 304 Sella, 296, 304 Semen, 150, 230, 253, 267, 299, 304 Seminal vesicles, 304, 313 Seminiferous Epithelium, 17, 304 Seminiferous tubule, 37, 50, 51, 250, 280, 304, 306 Semisynthetic, 270, 304 Senile, 292, 304 Sensitization, 182, 304 Serum, 21, 30, 32, 101, 249, 250, 261, 274, 278, 282, 284, 287, 301, 304 Serum Albumin, 32, 301, 304 Sex Characteristics, 168, 248, 250, 292, 300, 305, 309 Sex Education, 19, 136, 187, 188, 219, 305 Sexual Abstinence, 188, 218, 231, 305 Sexually Transmitted Diseases, 28, 29, 67, 156, 160, 174, 184, 187, 194, 200, 218, 231, 303, 305 Side effect, 5, 13, 34, 60, 62, 148, 155, 156, 161, 200, 209, 230, 231, 248, 254, 263, 305, 310 Signal Transduction, 17, 32, 55, 305 Skeletal, 30, 250, 281, 305 Skeleton, 177, 271, 281, 305 Skull, 305, 309 Small intestine, 259, 273, 276, 280, 305, 312 Smooth muscle, 249, 250, 262, 289, 299, 305, 308 Social Problems, 31, 305
Index 329
Sodium, 167, 249, 287, 305 Soft tissue, 255, 305 Solid tumor, 250, 305 Solvent, 172, 254, 286, 292, 306 Soma, 23, 301, 306 Somatic, 18, 35, 168, 248, 259, 267, 286, 288, 306 Somatic cells, 18, 168, 286, 288, 306 Specialist, 235, 306 Specificity, 10, 43, 135, 185, 248, 256, 306 Spectrum, 3, 14, 39, 306 Sperm, 6, 10, 14, 15, 18, 21, 23, 32, 33, 36, 37, 44, 46, 55, 61, 76, 77, 84, 89, 123, 151, 154, 156, 157, 161, 171, 172, 174, 175, 184, 188, 210, 229, 230, 231, 244, 247, 250, 259, 273, 302, 304, 306, 309, 313 Sperm Capacitation, 32, 306 Sperm Count, 229, 306 Sperm Head, 7, 247, 306 Sperm Maturation, 33, 55, 173, 306 Sperm Motility, 15, 44, 184, 306 Spermatids, 17, 59, 306 Spermatocytes, 17, 46, 306 Spermatogenesis, 17, 23, 25, 32, 35, 37, 40, 49, 51, 55, 59, 87, 102, 166, 167, 168, 169, 181, 306 Spermatogonia, 306 Spermatozoa, 14, 44, 46, 158, 166, 247, 253, 304, 306, 313 Spermatozoon, 247, 306 Spermicide, 23, 62, 103, 228, 306 Spinal cord, 150, 258, 259, 286, 290, 295, 306 Spleen, 277, 284, 306 Spontaneous Abortion, 54, 247, 298, 307 Spotting, 26, 161, 307 Squamous, 45, 83, 307 Squamous cells, 307 Squamous intraepithelial lesion, 83, 307 Stabilization, 276, 307 Standard therapy, 45, 307 State Government, 62, 307 Steel, 307, 313 Sterile, 22, 149, 229, 253, 293, 307 Sterility, 76, 83, 85, 89, 92, 105, 148, 155, 191, 192, 194, 195, 231, 263, 279, 307 Sterilization, 4, 6, 54, 124, 136, 148, 150, 163, 171, 188, 193, 194, 197, 225, 226, 229, 233, 307 Steroid, 9, 21, 30, 47, 99, 121, 152, 159, 165, 166, 177, 181, 182, 189, 250, 263, 291, 303, 307
Stillbirth, 298, 307 Stimulus, 150, 266, 267, 281, 307, 310 Stomach, 247, 265, 269, 272, 273, 276, 289, 305, 307 Strand, 297, 307 Stress, 128, 149, 288, 289, 293, 307 Stroke, 15, 78, 143, 155, 216, 257, 307 Stroma, 9, 307 Stromal, 9, 48, 151, 268, 307 Stromal Cells, 151, 307 Styrene, 86, 112, 123, 124, 308 Subacute, 279, 308 Subclinical, 27, 279, 308 Subcutaneous, 56, 248, 266, 308 Submaxillary, 269, 308 Subspecies, 306, 308 Substance P, 298, 304, 308 Substrate, 11, 268, 308 Superovulation, 8, 308 Superoxide, 184, 308 Suppositories, 157, 272, 287, 308 Suppression, 30, 57, 71, 81, 87, 102, 147, 161, 167, 168, 174, 308, 315 Suppressive, 56, 184, 308 Suprarenal, 162, 308 Surfactant, 61, 291, 308, 314 Symphysis, 258, 299, 308 Synapses, 290, 308 Synaptic, 305, 308 Synergistic, 298, 309 Synovial, 153, 309 Synovial Fluid, 153, 309 Synovial Membrane, 309 Systemic, 45, 61, 112, 128, 141, 206, 210, 251, 252, 255, 269, 279, 298, 309, 311, 314 Systemic lupus erythematosus, 141, 206, 251, 252, 309 Systolic, 277, 309 T Tamoxifen, 12, 65, 304, 309 Temporal, 47, 50, 57, 59, 276, 309 Teratogenic, 265, 309 Terminator, 309, 315 Testicles, 229, 230, 231, 304, 309, 313 Testicular, 17, 59, 110, 113, 184, 229, 309 Testis, 17, 21, 35, 37, 40, 50, 51, 55, 58, 59, 172, 181, 250, 269, 291, 309 Testosterone, 87, 88, 102, 112, 146, 166, 167, 168, 181, 250, 302, 309 Tetany, 293, 309 Therapeutics, 146, 211, 309 Thigh, 271, 309
330 Contraception
Third Ventricle, 278, 309 Thoracic, 265, 309 Thorax, 284, 309 Threshold, 167, 277, 309 Thrombin, 90, 271, 297, 299, 300, 310 Thromboembolism, 64, 81, 93, 99, 107, 310 Thrombolytic, 296, 310 Thrombomodulin, 299, 310 Thrombopenia, 252, 310 Thrombophilia, 99, 310 Thromboses, 252, 310 Thrombosis, 28, 104, 280, 299, 307, 310 Thrombus, 262, 279, 297, 310, 313 Thymus, 278, 284, 310 Thyroid, 293, 310, 312 Thyroid Gland, 293, 310 Tolerance, 55, 88, 120, 247, 273, 310 Tome, 129, 310 Tomography, 255, 310 Tooth Preparation, 247, 310 Topical, 14, 156, 157, 277, 310 Torsion, 279, 310 Toxaemia, 298, 310 Toxic, iv, 23, 61, 254, 264, 274, 276, 278, 286, 290, 308, 310, 311, 312, 315 Toxicity, 14, 17, 23, 37, 61, 111, 172, 184, 266, 311 Toxicology, 13, 84, 93, 172, 184, 218, 311 Toxins, 42, 149, 176, 251, 268, 273, 279, 288, 310, 311, 313 Transcriptase, 290, 291, 311 Transcription Factors, 52, 55, 59, 165, 311 Transdermal, 60, 88, 95, 104, 105, 113, 182, 311 Transduction, 32, 305, 311 Transfection, 51, 255, 311 Transfer Factor, 278, 311 Transgenes, 8, 38, 311 Translating, 48, 311 Translation, 57, 185, 311 Translational, 53, 55, 311 Transmitter, 247, 266, 281, 285, 308, 311 Transplantation, 48, 196, 259, 267, 278, 282, 311 Trauma, 289, 311 Triage, 46, 311 Trichomonas, 29, 311 Trichomoniasis, 39, 286, 311 Trisomy, 250, 311 Trophoblast, 9, 255, 311 Trypsin, 247, 312, 315 Tubal ligation, 155, 163, 206, 245, 312
Tuberculosis, 262, 284, 312 Tumor marker, 254, 312 Tyrosine, 32, 266, 312 Tyrothricin, 274, 312 U Ultrasonography, 105, 312 Unconscious, 264, 278, 312 Urban Population, 49, 312 Uremia, 281, 302, 312 Urethra, 157, 294, 299, 312 Urinary, 30, 128, 272, 292, 312, 314 Urinary tract, 312 Urine, 27, 29, 244, 252, 255, 269, 282, 292, 300, 303, 312 Urogenital, 146, 259, 272, 274, 312 Urogenital Diseases, 259, 312 Urologist, 55, 312 Urology, 22, 48, 312 V Vaccination, 9, 158, 312 Vaccine, 9, 35, 46, 57, 84, 156, 176, 248, 300, 313 Vagina, 42, 149, 150, 156, 157, 174, 246, 258, 261, 264, 266, 286, 302, 307, 313 Vaginosis, 45, 313 Vanadium, 61, 184, 313 Vas Deferens, 86, 112, 171, 230, 313 Vascular, 151, 154, 178, 268, 279, 290, 293, 296, 310, 313 Vascular endothelial growth factor, 151, 313 Vasectomy, 100, 163, 171, 227, 229, 230, 231, 233, 234, 243, 245, 313 Vasodilators, 290, 313 Vasomotor, 146, 270, 313 VE, 11, 75, 112, 192, 313 Vector, 176, 311, 313 Vein, 281, 291, 303, 313 Venoms, 264, 313 Venous, 64, 81, 99, 107, 151, 252, 299, 313, 314 Venous Thrombosis, 313, 314 Ventricle, 276, 300, 301, 309, 313 Vertebrae, 306, 313 Vesicular, 274, 313 Veterinarians, 149, 313 Veterinary Medicine, 217, 313 Viral, 42, 148, 176, 292, 311, 313, 314, 315 Virilism, 277, 313 Virulence, 253, 311, 314 Virus, 56, 229, 230, 247, 253, 268, 272, 277, 311, 313, 314
Index 331
Viscera, 306, 314 Vitro, 18, 23, 276, 314 Vivo, 18, 23, 38, 62, 148, 181, 314 W Warfarin, 64, 314 Warts, 277, 314 Weight Gain, 25, 314 Wetting Agents, 291, 314 White blood cell, 251, 282, 284, 289, 290, 296, 314 Withdrawal, 18, 30, 147, 154, 161, 188, 228, 314 Womb, 119, 302, 312, 314
Wound Healing, 153, 177, 271, 280, 285, 314 X Xanthine, 184, 314 Xanthine Oxidase, 184, 314 Xenograft, 250, 314 X-ray, 11, 25, 255, 291, 314 Y Yeasts, 295, 314 Z Zidovudine, 140, 314 Zona Pellucida, 6, 10, 97, 150, 157, 176, 315 Zygote, 176, 261, 315 Zymogen, 299, 315
332 Contraception
