scholarly journals Safety and Benefits of Contraceptives Implants: A Systematic Review

2021 ◽  
Vol 14 (6) ◽  
pp. 548
Author(s):  
Morena Luigia Rocca ◽  
Anna Rita Palumbo ◽  
Federica Visconti ◽  
Costantino Di Carlo
Keyword(s):  
Systematic Review ◽  
Post Partum ◽  
Pubmed Central ◽  
Contraceptive Effect ◽  
Highly Effective ◽  
Effective System ◽  
Subdermal Implants ◽  
Contraceptive Implants ◽  
Long Acting ◽  
Post Abortion

Progestin-only contraceptive implants provide long-acting, highly effective reversible contraception. We searched the medical publications in PubMed, CENTRAL, and EMBASE for relevant articles on hormonal implants published in English between 1990 and 2021. Levonorgestrel (LNG) 6-capsule subdermal implants represented the first effective system approved for reversible contraception. The etonogestrel (ENG) single rod dispositive has been widely employed in clinical practice, since it is a highly effective and safe contraceptive method. Abnormal menstrual bleeding is a common ENG side effect, representing the main reason for its premature discontinuation. Emerging evidence demonstrated that it is possible to extend the use of the ENG implant beyond the three-year period for which it is approved. The ENG implant could be an effective and discrete alternative to the IUD in young girls, such as post-partum/post-abortion. Implants should be inserted by trained skilled clinicians who previously provide adequate counselling about their contraceptive effect, benefits, and any possible adverse events. More studies are needed to validate the extended use of the ENG implant for up to 5 years.

Reproductive Control for Men

2016 ◽  
Author(s):  
Margaret P. Battin
Keyword(s):  
Male Contraception ◽  
Failure Rates ◽  
Intrauterine Devices ◽  
Reproductive Control ◽  
Highly Effective ◽  
The Common ◽  
Subdermal Implants ◽  
Long Acting ◽  
Double Coverage

Although women have many contraceptive options—gels, foams, pills, patches, rings, injections, subdermal implants, intrauterine devices, most with low failure rates and good reversibility—men have only the condom, withdrawal, and vasectomy, all with high failure rates or no guarantee of reversibility. This leaves men with unequal options for reproductive control, yet they may be held responsible for support of a child whether they wanted to reproduce or not. Five types of modern male contraception are now under development: they all raise issues of effectiveness, acceptability, and risk, but would give males far greater reproductive control. However, the common “one’s enough” assumption—that it is sufficient if either the male or the female contracepts—means that reproductive control could shift from females to males. “One’s enough” must be challenged in favor of “double coverage,” highly effective long-acting reversible contraception as routine for both parties, the nearest guarantee of female–male equality in reproductive control.

scholarly journals Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 137
Author(s):  
Kalliopi Kappou ◽  
Myrto Ntougia ◽  
Aikaterini Kourtesi ◽  
Eleni Panagouli ◽  
Elpis Vlachopapadopoulou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Anorexia Nervosa ◽  
Large Scale ◽  
Temporal Cortex ◽  
Adolescents And Young Adults ◽  
Pubmed Central ◽  
Executive Control Network ◽  
Young Females ◽  
Weight Restoration

Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. Results: Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. Conclusions: Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance.

scholarly journals Triple versus LAMA/LABA combination therapy for patients with COPD: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Koarai ◽  
Mitsuhiro Yamada ◽  
Tomohiro Ichikawa ◽  
Naoya Fujino ◽  
Tomotaka Kawayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Triple Therapy ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Beta Agonist ◽  
History Of ◽  
Dyspnea Score ◽  
Long Acting

Abstract Background Recently, the addition of inhaled corticosteroid (ICS) to long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination therapy has been recommended for patients with COPD who have severe symptoms and a history of exacerbations because it reduces the exacerbations. In addition, a reducing effect on mortality has been shown by this treatment. However, the evidence is mainly based on one large randomized controlled trial IMPACT study, and it remains unclear whether the ICS add-on treatment is beneficial or not. Recently, a large new ETHOS trial has been performed to clarify the ICS add-on effects. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety including ETHOS trial. Methods We searched relevant randomized control trials (RCTs) and analyzed the exacerbations, quality of life (QOL), dyspnea symptom, lung function and adverse events including pneumonia and mortality, as the outcomes of interest. Results We identified a total of 6 RCTs in ICS add-on protocol (N = 13,579). ICS/LAMA/LABA treatment (triple therapy) significantly decreased the incidence of exacerbations (rate ratio 0.73, 95% CI 0.64–0.83) and improved the QOL score and trough FEV1 compared to LAMA/LABA. In addition, triple therapy significantly improved the dyspnea score (mean difference 0.33, 95% CI 0.18–0.48) and mortality (odds ratio 0.66, 95% CI 0.50–0.87). However, triple therapy showed a significantly higher incidence of pneumonia (odds ratio 1.52, 95% CI 1.16–2.00). In the ICS-withdrawal protocol including 2 RCTs, triple therapy also showed a significantly better QOL score and higher trough FEV1 than LAMA/LABA. Concerning the trough FEV1, QOL score and dyspnea score in both protocols, the differences were less than the minimal clinically important difference. Conclusion Triple therapy causes a higher incidence of pneumonia but is a more preferable treatment than LAMA/LABA due to the lower incidence of exacerbations, higher trough FEV1 and better QOL score. In addition, triple therapy is also superior to LABA/LAMA due to the lower mortality and better dyspnea score. However, these results should be only applied to patients with symptomatic moderate to severe COPD and a history of exacerbations. Clinical Trial Registration: PROSPERO; CRD42020191978.

scholarly journals Efficiency of The use of Long-Acting Reversible Contraception: A Systematic Review of the Literature

2018 ◽  
Vol 21 ◽  
pp. S164
Author(s):  
F Gomez de la Rosa ◽  
J Alvis Zakzuk ◽  
N Alvis Guzman ◽  
DJ Moreno ◽  
M Rincon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Review Of The Literature ◽  
Long Acting
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