The use of misoprostol in termination of second-trimester pregnancy

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Chen-Ju Lin

2011-09-01

Full Text Available Misoprostol, a synthetic prostaglandin E1 analog, is initially used to prevent peptic ulcer. The initial US Food and Drug Administration-approved indication in the product labeling is the treatment and prevention of intestinal ulcer disease resulting from nonsteroidal anti-inflammatory drugs use. In recent two decades, misoprostol has approved to be an effective agent for termination of pregnancy in various gestation, cervical ripening, labor induction in term pregnancy, and possible management of postpartum hemorrhage. For the termination of second-trimester pregnancy using the combination of mifepristone and misoprostol seems to have the highest efficacy and the shortest time interval of abortion. When mifepristone is not available, misoprostol alone is a good alternative. Misoprostol, 400 μg given vaginally every 3–6 hours, is probably the optimal regimen for second-trimester abortion. More than 800 μg of misoprostol is likely to have more side effects, especially diarrhea. Although misoprostol can be used in women with scarred uterus for termination of second-trimester pregnancy, it is recommended that women with a scarred uterus should receive lower doses and do not double the dose if there is no initial response. It is also important for us to recognize the associated teratogenic effects of misoprostol and thorough consultation before prescribing this medication to patients regarding these risks, especially when failure of abortion occurs, is needed.

Oral misoprostol versus oxytocin in the management of third stage of labour

International Nuclear Information System (INIS)

Aziz, S.; Kazi, S.; Haq, G.; Soomro, N.

2014-01-01

Objectives: To compare oral misoprostol versus intramuscular oxytocin in the management of third stage of labour. Methods: The quasi-experimental study was conducted at the Obstetrics and Gynaecology Unit II, Civil Hospital, Karachi, from June 20 to December 19, 2006. A total of 70 patients diagnosed in active phase of labour who fulfilled the inclusion criteria were selected by non-probability convenience sampling. These patients were divided into 2 groups of 35 patients each, for Oxytocin (Group 1) and misoprostol (Group 2). Main and secondary outcome measures were analysed. SPSS 10 was used for statistical analysis. Results: Average amount of blood loss(ml) was 267.14+-140.35 with Oxytocin versus 302.86+-160.4, with Misoprostol, this difference was statistically insignificant (p=0.236). Average drop in haemoglobin concentration (g/dl) with Oxytocin was 1.55+-0.38 vs 1.66+-0.61 with Misoprostol (p=0.684). Drop in haematocrit (%) was 4.18+-0.64 with Oxytocin vs. 4.50+-0.92 with Misoprostol (p=0.133). There was also insignificant difference in duration of third stage of labour, between oxytocin and Misoprostol groups (5.37+-2.20 vs. 5.23+-2.46, p=0.451) Shivering, in Misoprostol group occured in n=11 (31.4%) vs n=3 (8.6%) with Oxytocin (p=0.017) and pyrexia in n=6 (17.1%) with misoprostol vs n=0, with oxytocin (p=0.025) thus significantly higher in misoprostol group. Conclusion: There were no major differences in oral misoprostol and intramuscular oxytocin in the management of third stage of labour. (author)

Is the Time of administration of misoprostol of value? The uterotonic effect of misoprostol given pre- and post-operative after elective cesarean section

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Ahmed H. Abd-Ellah

2014-03-01

Conclusion: Pre-operative rectally administrated misoprostol appears to be more effective than post-operative rectally administrated misoprostol in reducing blood loss, and in decreasing the need for other uterotonic drugs in cesarean section delivery.

Modeling maternal mortality in Bangladesh: the role of misoprostol in postpartum hemorrhage prevention.

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Prata, Ndola; Bell, Suzanne; Quaiyum, Md Abdul

2014-02-20

Bangladesh is one of the few countries that may actually achieve the fifth Millennium Development Goal (MDG) in time, despite skilled birth attendance remaining low. The purpose of this paper is to examine the potential role misoprostol can play in the decline of maternal deaths attributed to postpartum hemorrhage (PPH) in Bangladesh. Using data from a misoprostol and blood loss measurement tool feasibility study in Bangladesh, observed cause specific maternal mortality ratios (MMRs) were estimated and contrasted with expected ratios using estimates from the Bangladesh Maternal Mortality Survey (BMMS) data. Using Crystal Ball 7 we employ Monte Carlo simulation techniques to estimate maternal deaths in four scenarios, each with different levels of misoprostol coverage. These scenarios include project level misoprostol coverage (69%), no (0%), low (40%), and high (80%) misoprostol coverage. Data on receipt of clean delivery kit, use of misoprostol, experience of PPH, and cause of death were used in model assumptions. Using project level misoprostol coverage (69%), the mean number of PPH deaths expected was 40 (standard deviation = 8.01) per 100,000 live births. Assuming no misoprostol coverage (0%), the mean number of PPH deaths expected was 51 (standard deviation = 9.30) per 100,000 live births. For low misoprostol coverage (40%), the mean number of PPH deaths expected was 45 (standard deviation = 8.26) per 100,000 live births, and for high misoprostol coverage (80%), the mean number of PPH deaths expected was 38 (standard deviation = 7.04) per 100,000 live births. This theoretical exercise hypothesizes that prophylactic use of misoprostol at home births may contribute to a reduction in the risk of death due to PPH, in addition to reducing the incidence of PPH. If findings from this modeling exercise are accurate and uterotonics can prevent maternal death, misoprostol could be the tool countries need to further reduce maternal mortality at home births.

Recommendations for scale-up of community-based misoprostol distribution programs.

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Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

2014-06-01

Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

A randomised clinical trial of misoprostol for radiation mucositis

International Nuclear Information System (INIS)

Faroudi, F.; Timms, I.; Sathiyuaseelan, Y.; Cakir, B.; Tiver, K.W.; Gebski, V.; Veness, M.

2003-01-01

Radiation mucositis is a major acute toxicity of radiation therapy for head and neck malignancies. We tested whether Misoprostol, a synthetic prostaglandin E 1 analogue given prophylactically decreased intensity of radiation mucositis. A double blind randomized trial was conducted. The intervention consisted of swishing dissolved drug or placebo as a mouthwash, and then swallowing two hours prior to radiation treatment. Patients were stratified based on concurrent chemotherapy, altered fractionation, smoking, extent of oral mucosa in radiation field, and institution. The main end point was the extent of RTOG grade III mucositis, taking into account both time and duration of mucositis. 42 patients were randomized to active drug, and 41 patients to placebo. The trial was designed to have 70 patients in each arm. The trial closed due to poor accrual. In the Misoprostol group 18/42 (43%) had grade III/IV mucositis, and in the placebo group 17/40 (42%). The mean difference between the areas under the curve was 0.38 (p-value: 0.38). For grade II mucositis the corresponding figures were 18 (42%) and 19 (47%). The time from commencement of radiation therapy to the development of peak mucositis was 49 days in the misoprostol patients and 51 days in the placebo group. The duration of grade III mucositis 12.5 days in the Misoprostol patients and 7 days in the placebo patients. In the Misoprostol arm 4 patients had an interruption to their Radiation Therapy, in the Placebo arm 5 had interruptions. Patients average weight loss was 8.1 and 8.2kg. Average self-assessment was via a 10cm LASA scale for soreness of throat and overall well-being. Misoprostol showed a worse QoL on soreness of mouth (mean difference: 0.84 units (p-value .03), but overall well-being was similar on both treatment arms 1 patient withdrew in the Misoprostol arm and 2 in the placebo arm. Misoprostol given prophylactically does not reduce the incidence of Grade III/IV mucositis, is associated with a shorter

Diclofenac/misoprostol during early pregnancy and the risk of miscarriage

DEFF Research Database (Denmark)

Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L

2016-01-01

INTRODUCTION: Misoprostol can be used in the prevention of gastric ulcer in treatment with diclofenac and is used in rheumatic diseases. Since misoprostol causes contractions of the uterus, it can also be used to induce abortions when administrated vaginally. The aim of the study was to investigate...... if early pregnancy exposure to oral diclofenac/misoprostol was associated with miscarriage. METHOD: We conducted a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2011. All births were identified using the Medical Birth Registry, and all records of induced abortion...... and miscarriage were from the National Hospital Register. Data on drug use were from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to diclofenac/misoprostol in early pregnancy. RESULT: We identified 1...

Evaluation of effect of letrozole prior to misoprostol in comparison with misoprostol alone in success rate of induced abortion.

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Behroozi-Lak, T; Derakhshan-Aydenloo, S; Broomand, F

2018-03-01

Abortion, spontaneous or induced, is a common complication of pregnancy and exploration of available and safe regimens for medical abortion in developing countries seems crucial. The present study was aimed to assess the effect of letrozole in combination with misoprostol in women eligible for legal therapeutic abortion with gestational age ≤14weeks. This clinical randomized trial was conducted on 78 women who were candidate of medical abortion and eligible for legal abortion with gestational age ≤14 weeks that were randomly divided into two groups of case and controls. Case group received daily oral dose of 10mg letrozole for three days followed by vaginal misoprostol. In control group the patients received only vaginal misoprostol. The rate of complete abortion, induction-of-abortion time, and side-effects were assessed. Complete abortion was observed in 30 patients (76.9%) in case group and 9 (23.1%) cases were failed. In control group there was 16 (41.03%) complete abortions and 23 (58.97%) cases were failed to abort. Patients with gestational age of between 6 and 10 weeks did not show significant difference in both groups (P=0.134). Regarding pregnancy remnants there were significant differences between two groups (P=0.034). The time form admission to discharge in case groups were significantly shorter than those in control group (P=0.001). The indication for curettage in case group was significantly less than control group (P=0.001). A 3-day course of letrozole (10mg/daily) followed by misoprostol was associated with a higher complete abortion and lower curettage rates and reduction in time from admission to discharge in women with gestational age ≤14 weeks compared to misoprostol alone. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Misoprostol sublingual versus vaginal para indução do parto a termo Sublingual versus vaginal misoprostol for labor induction of term pregnancies

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Olímpio Barbosa de Moraes Filho

2005-01-01

Full Text Available OBJETIVO: comparar efetividade e segurança de uso de comprimido sublingual de 25 µg de misoprostol com o comprimido vaginal de 25 µg do misoprostol na indução do parto com idade gestacional e > 37 semanas e colo uterino desfavorável. MÉTODOS: realizou-se ensaio clínico controlado e aleatorizado, não cego, na Maternidade Monteiro de Morais (CISAM-UPE, em Recife, no período de outubro de 2003 a fevereiro de 2004. Participaram do estudo 123 gestantes com idade gestacional e > 37 semanas, índice de Bishop PURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg versus vaginal misoprostol (25 µg (Prostokos® for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE, in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22, or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11. The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95, meconium incidence (5.2 vs 4.8%, p=0.74, Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98 and other adverse effects. CONCLUSION: twenty-five micrograms of

[Rehabilitation for intravaginal ejaculatory dysfunction with using a masturbation aid].

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Kobori, Yoshitomo; Aoki, Hiroaki; Nishio, Koujiro; Sato, Ryo; Ashizawa, Yoshio; Yagi, Hiroshi; So, Shigehiro; Arai, Gaku; Okada, Hiroshi

2012-05-01

Recently the incidence of intravaginal ejaculatory dysfunction is increasing among infertile couples in Japan. Some unusual ways of masturbation and psychogenic issues were reported to cause this disorder. Patients, who had done masturbation in an unusual way for long time since their adolescence, were difficult to gain normal intravaginal ejaculation by the behavior therapy which was used for erectile dysfunction. We, therefore, used a masturbation aid (TENGA) for rehabilitation of ejaculation to overcome this condition. From January, 2010 through March, 2011, a total of 16 patients with intravaginal ejaculatory dysfunction underwent rehabilitation of ejaculation using TENGA. Patients' satisfaction and achievement of intravaginal ejaculation were evaluated by the questionnaire. Twelve patients (75%) could ejaculate in the masturbation aid (TENGA). Five patients (31%) succeeded to ejaculate in the partner's vagina after rehabilitation. A masturbation aid (TENGA) was a useful tool to correct the way of masturbation and achieve normal intravaginal ejaculation. This masturbation aid can be one of the effective options for the treatment of intravaginal ejaculatory dysfunction.

Hjertestop induceret af vasospastisk angina pectoris efter vaginalt administreret misoprostol

DEFF Research Database (Denmark)

Matthesen, Terese; Olsen, Rasmus Huan; Bosselmann, Helle Skovmand

2017-01-01

A 41-year-old woman developed cardiac arrest after administration of misoprostol in order to induce an abortion. She was successfully resuscitated. Coronary angiography revealed coronary artery spasm which responded to nitroglycerine. Misoprostol is first-line treatment for medically induced abor...

Avaliação de riscos teratogênicos em gestações expostas ao misoprostol Evaluation of the teratogenic risks in gestations exposed to misoprostol

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Emérita Sátiro Opaleye

2010-01-01

Full Text Available OBJETIVOS: a tentativa de aborto mal sucedida com o uso do misoprostol (Cytotec® sem indicação médica tem sido associada a malformações congênitas. Este estudo teve por objetivo identificar, em recém-nascidos malformados e controles normais, a frequência de exposição ao misoprostol e o espectro de malformações associadas. MÉTODOS: estudo de caso-controle desenvolvido em 2005 nas quatro principais maternidades públicas de Fortaleza (CE. Através de busca ativa diária, foram identificados recém-nascidos com diagnóstico de malformação fetal (caso e controles saudáveis de mesmo sexo nascidos em seguida na mesma maternidade (pareamento 1:1. A amostra foi de 252 parturientes entrevistadas por equipe treinada utilizando questionário estruturado com base no Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC. Além de abordar questões sociodemográficas e histórico familiar de malformação, o questionário objetivou identificar exposições diversas durante a gestação, incluindo o misoprostol. A análise bivariada com teste do χ2 comparou os grupos quanto às características e fatores associados à malformação e foi calculada a Odds Ratio para verificar a razão de chances de o Grupo Caso apresentar malformação em relação ao Grupo Controle com relação à exposição ao misoprostol. RESULTADOS: não houve diferenças significativas entre os grupos caso e controle quanto à maioria dos fatores de riscos investigados para malformações. O relato de tentativa de aborto foi de 6,8%, havendo uma maior exposição ao misoprostol durante a gestação em neonatos malformados comparados a saudáveis, Odds Ratio (OR=3,65 (IC95%=0,74-17,91. O espectro de malformações encontradas entre os recém-nascidos expostos ao misoprostol foi compatível com a literatura, como os decorrentes de defeitos do tubo neural e disrupção vascular. CONCLUSÕES: os achados deste estudo, apesar de não apresentarem signific

Knowledge and provision of misoprostol among pharmacy workers in Senegal: a cross sectional study.

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Reiss, Kate; Footman, Katharine; Burke, Eva; Diop, Nafissatou; Ndao, Ramatoulaye; Mane, Babacar; van Min, Maaike; Ngo, Thoai D

2017-07-03

Making misoprostol widely available for management of postpartum haemorrhage (PPH) and post abortion care (PAC) is essential for reducing maternal mortality. Private pharmacies (thereafter called "pharmacies") are integral in supplying medications to the general public in Senegal. In the case of misoprostol, pharmacies are also the main supplier to public providers and therefore have a key role in increasing its availability. This study seeks to understand knowledge and provision of misoprostol among pharmacy workers in Dakar, Senegal. A cross-sectional survey was conducted in Dakar, Senegal. 110 pharmacy workers were interviewed face-to-face to collect information on their knowledge and practice relating to the provision of misoprostol. There are low levels of knowledge about misoprostol uses, registration status, treatment regimens and side effects among pharmacy workers, and corresponding low levels of training on its uses for reproductive health. Provision of misoprostol was low; of the 72% (n = 79) of pharmacy workers who had heard of the product, 35% (n = 27) reported selling it, though rarely for reproductive health indications. Almost half (49%, n = 25) of the respondents who did not sell misoprostol expressed willingness to do so. The main reasons pharmacy workers gave for not selling the product included stock outs (due to product unavailability from the supplier), perceived lack of demand and unwillingness to stock an abortifacient. Knowledge and availability of misoprostol in pharmacies in Senegal is low, posing potential challenges for delivery of post-abortion care and obstetric care. Training is required to address low levels of knowledge of misoprostol registration and uses among pharmacy workers. Barriers that prevent pharmacy workers from stocking misoprostol, including weaknesses in the supply chain and stigmatisation of the product must be addressed. Low reported sales for reproductive health indications also suggest limited prescribing of

Comparison of oral and vaginal misoprostol for cervical ripening before evacuation of first trimester missed miscarriage

International Nuclear Information System (INIS)

Jabir, Maysoon M.; Smeet, Rania I.

2009-01-01

Objective was to assess the effectiveness of misoprostol in cervical ripening before evacuation of conception in the first trimester missed miscarriages and to compare between oral and vaginal routes of administration. A randomized control study was carried out in Baghdad Teaching Hospital, Baghdad, Iraq in 2006. One hundred and twenty women with first fist trimester missed miscarriages were divided into 2 study groups, randomized for oral and vaginal (400 mcg) misoprostol priming of cervix and 2 control groups randomized for oral and vaginal placebo, before undergoing surgical evacuation of conception after 3 hours. Measured outcomes were: post medication cervical dilatation, time needed to dilate the cervix surgically, blood loss and developments of the side effects of misoprostol. Post medication cervical dilation was higher in the misoprostol group (7.07+-1.36 mm for oral misoprostol, 7.77+-1.22 mm for vaginal misoprostol), versus the control groups (2.43+-0.5 mm). Post medication cervical dilatation was significantly higher in the vaginal misoprostol group, compared to the oral group (p=0.04). The time required to dilate the cervix in the misoprostol group was shorter, compared with placebo. There were no significant differences in the amount of blood loss between oral (p=0.074) and vaginal misoprostol groups (p=0.62) and gastrointestinal side effects were significantly more in the oral misoprostol group (p=0.014). Misoprostol is an effective cervical priming agent when administered either orally or vaginally before evacuation of conception in the termination of the first trimester missed miscarriage. (author)

[Vaginal misoprostol in the prevention of postpartum hemorrhage].

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Quiroga Díaz, Ricardo; Esparza Arechiga, Miguel; Batiza Reséndiz, Víctor; Coronado López, Oscar; Hernández Ayup, Samuel; Martínez Cuervo, Jesús

2002-11-01

To show the advantages of the use of vaginal misoprostol, a prostaglandine E1 analogue, in the prevention of the post-partum haemorrhage. This was a prospective, observational, comparative study. The study included 400 patients with high risk of postpartum haemorrhage at our center between January 1999 and may 2001. Patients were divided in two groups. In group I (208 patients) misoprostol was used in a dose of 800 ugr and in group II (192 patients) in whom misoprostol was not used. Both groups were treated initially with our conventional oxytocin protocol. We evaluated the use of additional oxytocin or ergotamine, haemoglobin levels pre and post-partum, the amount of blood loss, and the need for blood transfusion or hysterectomy. The need for additional oxytocin or ergotamine was reduced to less than 10% in group I when compared to group II; the drop in haemoglobin levels and the amount of blood loss were also less in group I (p: 0.03). In this group only one patient needed for blood transfusion and no patient needed hysterectomy. In group II six patients need a blood transfusion and there was the need for two hysterectomies. The use of vaginal misoprostol is effective to control the postpartum bleeding, reducing the blood loss after birth in women with high risk of post-partum haemorrhage as well as the need for blood transfusion. It's use has mild side effects and is of low cost.

How often and under which circumstances do Mexican pharmacy vendors recommend misoprostol to induce an abortion?

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Lara, Diana; García, Sandra G; Wilson, Kate S; Paz, Francisco

2011-06-01

Misoprostol was used by women across Mexico to induce abortion even before 2007, when first-trimester abortion was legalized in Mexico City. Pharmacy vendors' misoprostol recommendation practices across subregions of Mexico after abortion legalization warrant examination. Overall, 192 pharmacies in four regions of Mexico were randomly selected and visited by simulated clients presenting three scenarios (a young woman, an adult woman and a male partner). Bivariate and multivariate analyses were used to explore associations between pharmacy, vendor and client characteristics and drug access. In 558 encounters with simulated clients, 78% of vendors provided information about misoprostol-18% recommended it spontaneously and 60% recommended it only after the client asked specifically for the drug. Fifteen percent of vendors recommended a potentially effective misoprostol dosing regimen. Mexico City-based pharmacies and those in the Central region were significantly less likely than those in the North region to require a prescription to sell misoprostol (odds ratios, 0.2 and 0.3, respectively). Independent pharmacies and those from low-?income areas were significantly more likely to sell misoprostol by the pill than chain pharmacies and those in medium-income areas (3.2 and 2.7, respectively). Access to misoprostol is influenced by neighborhood socioeconomic level, pharmacy location and pharmacy type. The frequently inaccurate and incomplete information provided to clients about using misoprostol for abortion suggests the need to improve pharmacy vendor training in medication abortion options and to develop ways to directly inform women about misoprostol use.

Knowledge, acceptability, and use of misoprostol for preventing postpartum hemorrhage following home births in rural Ethiopia.

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Gebre, Betemariam; Taddese, Zinaw; Deribe, Kebede; Legesse, Tsigereda; Omar, Meftuh; Biadgilign, Sibhatu

2016-07-01

To assess knowledge of, and intentions to use misoprostol to preventing postpartum hemorrhage by women in a pastoralist community of the Somali Region of Ethiopia. A cross-sectional study enrolled women aged 15-49years living in Adadle district, Ethiopia, between April 26 and May 3, 2012. A structured questionnaire was used to collect data on participants' knowledge of misoprostol and if they had any intention to use it in the future. Participants also detailed their preferred healthcare provider for administering misoprostol. A total of 829 women were enrolled in the study. Among the participants, 42 (5.1%) had knowledge of misoprostol and 302 (36.4%) described themselves as being willing to use misoprostol in the future. Among respondents who were willing to use misoprostol in the future, traditional birth attendants were the preferred healthcare practitioners to administer it. Awareness of misoprostol was low in the study sample but willingness to use the drug was somewhat higher. Raising awareness and knowledge among communities and traditional birth attendants regarding the advantages of misoprostol is crucial to enhance uptake and reduce the incidence of postpartum hemorrhage. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The Use of Misoprostol for Induction of Labour in a Low-Resource ...

African Journals Online (AJOL)

) responded very well to misoprostol, with majority requiring only a single 50µg dose to go into active labour. Women with sickle cell disease showed no adverse effect to misoprostol responded in a manner similar to the normal population.

Oral misoprostol versus dinoprostone vaginal tablets for labor induction

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Khaled Ibrahim Abu El aish

2013-06-01

Full Text Available Background: Induction of labour is common in obstetric practice. We conducted this study to find the appropriate and safe drug for labour induction and to compare the safety and efficacy of oral misoprostol and vaginal dinoprostone for labour induction. Methods: In a provisional, prospective and cross-sectional study, one hundred and fifty five singleton cephalic presentation full term pregnancies with medical or obstetric indication for labour induction were allocated in two groups. First group received oral 50 micrograms for nulliparas and low parity group (1-4, and 25micrograms for grand multiparas (≥ 5 misoprostol orally every 6 hours to a maximum of four doses daily. In the second group vaginal tablets of dinoprostone 3mg then 1.5mg for nulliparas and 1.5mg for low parity and grand multiparas groups were inserted in the posterior fornix, every 8 hours. Primary outcome measures were: induction success, induction-delivery interval and number of used doses. Secondary outcome measures included: maternal side effects, caesarean section rate, mode of delivery and neonatal outcome. Data was collected from patient case notes and analyzed using software SPSS (version 13.0 and p-value < 0.05 was used as statistical significance of differences. Results: In our study there were no significant differences in baseline parameters in the two groups nor in the indications for labor induction except misoprostol was used in premature rupture of membrane. Induction of labor succeeded in 123 (79.35% women without other interventions from other methods (80.26%misoprostol group versus 78.5% dinoprostone p=0.492. It was observed that there were no significant differences between the two groups in final outcomes nor in obstetrical complications. There was no significance in differences between misoprostol and dinoprostone groups in induction-delivery interval (15.2 ± 14.5 hours versus 16.4 ± 11.3 hours p=0.6 resp.. Conclusions: This study demonstrated that oral

Motivations for Intravaginal Product Use among a Cohort of Women in Los Angeles.

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Joelle M Brown

Full Text Available Intravaginal practices-including behaviors such as intravaginal cleansing and insertion of products-have been linked to a number of adverse reproductive health outcomes, including increased risk for bacterial vaginosis, sexually transmitted infections, and HIV. Currently, little is known about the motivations for intravaginal practices among women in the United States. The objective of this study was to identify and describe motivations for intravaginal washing and intravaginal insertion of products among women of differing ages and racial/ethnic groups.Between 2008 and 2010, we enrolled a convenience sample of sexually active women aged 18-65 years living in Los Angeles recruited through community education and outreach activities in HIV/AIDS service organizations, women's health clinics, community-based organizations, and HIV testing sites. At the enrollment visit, women completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, intravaginal practices, and motivations for intravaginal practices over the past month and past year.We enrolled 141 women; 34% of participants were Caucasian, 40% African American, and 26% Latina. Peri-sexual intravaginal washing was common in all groups, whether to clean up after sex (70% or to prepare for sex (54%. African American women were more likely to report learning to wash intravaginally from their mothers compared to Latina or Caucasian women (70% vs. 49%, P = 0.04. Sixty-one percent of African American women reported using a douching device over the past year compared to 41% of Latina and 40% of Caucasian women (p = 0.02. Younger women were more likely to report that their male partners wanted them to wash intravaginally than older women (77% vs. 24%, P<0.01, and more likely to report the removal of odors as a motive than older women (65% vs. 40%, P = 0.04. The most commonly used intravaginal products included sexual lubricants, petroleum jelly, body lotions

Comparison of manual vacuum aspiration and misoprostol in the management of incomplete abortion

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Gabkika Bray Madoue

2016-11-01

Full Text Available Background: Incomplete abortions can be managed expectantly, surgically and medically (using misoprostol. Expectant management is safe in places where women have access to information, appropriate care and follow-up; however, in isolated and poor areas women who come for help need an intervention. Objective: To compare the efficiency of manual vacuum aspiration (MVA and misoprostol in the treatment of incomplete abortion. Patients and method: This was a prospective study over five months from March to August 2015. All patients admitted with a diagnosis of incomplete abortion were recruited into the study. Results: 308 patients with incomplete abortion were randomized into two treatment groups - MVA (done under local anaesthesia and misoprostol (400 micrograms by the vaginal route. MVA was successfully performed for all patients. Two patients presented with anaemia. In the misoprostol group, 23 patients had vaginal bleeding, and 10 persistence of incomplete abortion. Conclusion: MVA is more effective than misoprostol with less complications in the treatment of incomplete abortion when it is done by a trained person.

A COMPARATIVE STUDY OF OXYTOCIN/MISOPROSTOL/METHYLERGOMETRINE FOR ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR

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Mundlapaty Sabitha

2017-08-01

Full Text Available BACKGROUND The third stage of labour is indeed the unforgiving stage of the labour and in it lurks more unheralded treachery than in both the other stages of labour combined. Many lifesaving drugs have been discovered and used for the management of this stage of labour. According to the WHO multicentric randomised trial using oral misoprostol with oxytocic, they concluded that oral misoprostol was associated with significantly high incidence of side effects like shivering and rise in body temperature and hence oxytocin is preferred to 600 mg of oral misoprostol in management of 3rd stage of labour in hospital settings, but still misoprostol has been suggested for the management of third stage of labour in developing countries, because it has strong uterotonic effects, can be given orally, inexpensive and does not need refrigeration. The aim of the study is to compare oxytocin, misoprostol, methylergometrine for active management of the third stage of labour. MATERIALS AND METHODS A total of 300 women of 37 weeks to 42 weeks of gestation delivering vaginally in Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh. 300 women allocated into 3 groups of 100 each to receive 10 IU I.M. oxytocin, 600 mcg sublingual misoprostol or 200 mcg I.M. methylergometrine, respectively. Primary outcome measure was blood loss in the third stage of labor; secondary measures were duration of the third stage, side effects and complications. RESULTS Subjects who received 600 mcg of misoprostol had the least blood loss (113 mL, followed by oxytocin and methylergometrine. The shortest mean duration of the third stage was with misoprostol (4.34 mins.. Shivering and pyrexia were observed in misoprostol group and raised blood pressure in methylergometrine group. CONCLUSION Misoprostol is as effective as oxytocin and both are more effective than methylergometrine in active management of the third stage of labour. Misoprostol therefore can be used in places

Prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin: a double-blind randomised controlled trial.

Science.gov (United States)

Bellad, M B; Tara, D; Ganachari, M S; Mallapur, M D; Goudar, S S; Kodkany, B S; Sloan, N L; Derman, R

2012-07-01

Sublingual misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum measured blood loss with 400 μg powdered sublingual misoprostol and after standard care using 10 iu intramuscular (IM) oxytocin. Double-blind randomised controlled trial. A teaching hospital: J N Medical College, Belgaum, India. A cohort of 652 consenting eligible pregnant women admitted to the labour room. Subjects were assigned to receive the study medications and placebos within 1 minute of clamping and cutting the cord by computer-generated randomisation. Chi-square and bootstrapped Student's t-tests were used to test categorical and continuous outcomes, respectively. Measured mean postpartum blood loss and haemorrhage (PPH, loss ≥ 500 ml), >10% pre- to post-partum decline in haemoglobin, and reported side effects. The mean blood loss with sublingual misoprostol was 192 ± 124 ml (n=321) and 366 ± 136 ml with oxytocin IM (n=331, P ≤ 0.001). The incidence of PPH was 3.1% with misoprostol and 9.1% with oxytocin (P=0.002). No woman lost ≥ 1000 ml of blood. We observed that 9.7% and 45.6% of women experienced a haemoglobin decline of >10% after receiving misoprostol and oxytocin, respectively (P ≤ 0.001). Side effects were significantly greater in the misoprostol group than in the oxytocin group. Unlike other studies, this trial found sublingual misoprostol more effective than intramuscular oxytocin in reducing PPH, with only transient side effects being greater in the misoprostol group. The sublingual mode and/or powdered formulation may increase the effectiveness of misoprostol, and render it superior to injectable oxytocin for the prevention of PPH. Further research is needed to confirm these results. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

A randomised controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum haemorrhage.

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Al-Sawaf, A; El-Mazny, A; Shohayeb, A

2013-04-01

This study aims to evaluate the efficacy and side-effects of 200 μg sublingual misoprostol vs 5 IU i.m. oxytocin, administered immediately following cord clamping in normal non-augmented vaginal delivery, in prevention of postpartum haemorrhage (PPH). A total of 104 women were randomised into three groups: misoprostol group (28 patients); oxytocin group (37 patients) and control group (39 patients). Misoprostol and oxytocin significantly minimised the blood loss during the third stage of labour and reduced the need for additional treatments for PPH as compared with the control group. Oxytocin was more effective than misoprostol in minimising blood loss and the need for additional uterotonic treatments. However, a significant decrease in systolic and diastolic blood pressure, associated with tachycardia was observed in the oxytocin group. In conclusion, sublingual misoprostol appears to be less effective than i.m. oxytocin in the prevention of PPH; however, it has the potential advantages of being easily used, cost-effective and stable at room temperature. Therefore, sublingual misoprostol is still a feasible drug for routine management of third stage, especially in areas with limited medical facilities.

Exploring the feasibility of obtaining mifepristone and misoprostol from the internet.

Science.gov (United States)

Murtagh, Chloe; Wells, Elisa; Raymond, Elizabeth G; Coeytaux, Francine; Winikoff, Beverly

2018-04-01

We aimed to document the experience of buying abortion pills from online vendors that do not require a prescription and to evaluate the active ingredient content of the pills received. We searched the internet to identify a convenience sample of websites that sold mifepristone and misoprostol to purchasers in the United States and attempted to order these products. We documented price, shipping time and other aspects of ordering. We sent the samples received to a testing laboratory that measured the amount of active ingredient in individual tablets. We identified 18 websites and ordered 22 products: 20 mifepristone-misoprostol combination products and 2 that contained only misoprostol. We received 18 combination products and the 2 misoprostol products from 16 different sites. No site required a prescription or any relevant medical information. The time between order and receipt of the 20 products ranged from 3 to 21 business days (median 9.5 days). The price for the 18 combination products ranged from $110 to $360, including shipping and fees; the products without mifepristone cost less. Chemical assays found that the 18 tablets labeled 200 mg mifepristone contained between 184.3 mg and 204.1 mg mifepristone, while the 20 tablets labeled 200 mcg misoprostol contained between 34.1 mcg and 201.4 mcg of the active ingredient. Obtaining abortion medications from online pharmaceutical websites is feasible in the United States. The mifepristone tablets received contained within 8% of the labeled amount of active agent. The misoprostol tablets all contained that compound but usually less than labeled. Given our findings, we expect that some people for whom clinic-based abortion is not easily available or acceptable may consider self-sourcing pills from the internet to be a rational option. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The continuing problem with misoprostol

African Journals Online (AJOL)

discovered additional benefit, it is predominantly a psychotropic agent for the treatment of psychotic delusions in schizophrenia. Misoprostol can be used in low doses to soften the cervix to allow instrumentation for suction evacuation of the uterus in termination or incomplete miscarriage, or to soften the cervix prior.

Advance distribution of misoprostol for prevention of postpartum hemorrhage (PPH) at home births in two districts of Liberia

Science.gov (United States)

2014-01-01

Background A postpartum hemorrhage prevention program to increase uterotonic coverage for home and facility births was introduced in two districts of Liberia. Advance distribution of misoprostol was offered during antenatal care (ANC) and home visits. Feasibility, acceptability, effectiveness of distribution mechanisms and uterotonic coverage were evaluated. Methods Eight facilities were strengthened to provide PPH prevention with oxytocin, PPH management and advance distribution of misoprostol during ANC. Trained traditional midwives (TTMs) as volunteer community health workers (CHWs) provided education to pregnant women, and district reproductive health supervisors (DRHSs) distributed misoprostol during home visits. Data were collected through facility and DRHS registers. Postpartum interviews were conducted with a sample of 550 women who received advance distribution of misoprostol on place of delivery, knowledge, misoprostol use, and satisfaction. Results There were 1826 estimated deliveries during the seven-month implementation period. A total of 980 women (53.7%) were enrolled and provided misoprostol, primarily through ANC (78.2%). Uterotonic coverage rate of all deliveries was 53.5%, based on 97.7% oxytocin use at recorded facility vaginal births and 24.9% misoprostol use at home births. Among 550 women interviewed postpartum, 87.7% of those who received misoprostol and had a home birth took the drug. Sixty-three percent (63.0%) took it at the correct time, and 54.0% experienced at least one minor side effect. No serious adverse events reported among enrolled women. Facility-based deliveries appeared to increase during the program. Conclusions The program was moderately effective at achieving high uterotonic coverage of all births. Coverage of home births was low despite the use of two channels of advance distribution of misoprostol. Although ANC reached a greater proportion of women in late pregnancy than home visits, 46.3% of expected deliveries did not

Advance distribution of misoprostol for prevention of postpartum hemorrhage (PPH) at home births in two districts of Liberia.

Science.gov (United States)

Smith, Jeffrey Michael; Baawo, Saye Dahn; Subah, Marion; Sirtor-Gbassie, Varwo; Howe, Cuallau Jabbeh; Ishola, Gbenga; Tehoungue, Bentoe Z; Dwivedi, Vikas

2014-06-04

A postpartum hemorrhage prevention program to increase uterotonic coverage for home and facility births was introduced in two districts of Liberia. Advance distribution of misoprostol was offered during antenatal care (ANC) and home visits. Feasibility, acceptability, effectiveness of distribution mechanisms and uterotonic coverage were evaluated. Eight facilities were strengthened to provide PPH prevention with oxytocin, PPH management and advance distribution of misoprostol during ANC. Trained traditional midwives (TTMs) as volunteer community health workers (CHWs) provided education to pregnant women, and district reproductive health supervisors (DRHSs) distributed misoprostol during home visits. Data were collected through facility and DRHS registers. Postpartum interviews were conducted with a sample of 550 women who received advance distribution of misoprostol on place of delivery, knowledge, misoprostol use, and satisfaction. There were 1826 estimated deliveries during the seven-month implementation period. A total of 980 women (53.7%) were enrolled and provided misoprostol, primarily through ANC (78.2%). Uterotonic coverage rate of all deliveries was 53.5%, based on 97.7% oxytocin use at recorded facility vaginal births and 24.9% misoprostol use at home births. Among 550 women interviewed postpartum, 87.7% of those who received misoprostol and had a home birth took the drug. Sixty-three percent (63.0%) took it at the correct time, and 54.0% experienced at least one minor side effect. No serious adverse events reported among enrolled women. Facility-based deliveries appeared to increase during the program. The program was moderately effective at achieving high uterotonic coverage of all births. Coverage of home births was low despite the use of two channels of advance distribution of misoprostol. Although ANC reached a greater proportion of women in late pregnancy than home visits, 46.3% of expected deliveries did not receive education or advance

Clinical Effects of Lithospermum Ruderal on Medical Abortion by Mifepristone with Misoprostol

Institute of Scientific and Technical Information of China (English)

法韫玉; 刘建华; 孙桦; 曹爱华

1996-01-01

Early pregnancies (0. 05 ). In all, the medical abortion by mifepristone and Lithospermum Ruderal with misoprostol was even more successful, with less bleeding time. Therefore it is essential to make researches on the auxiliary effects of Lithospermum Ruderal on the medical abortion by mifepristone with misoprostol.

Eficácia de dinoprostone e misoprostol para indução do trabalho de parto em nulíparas Efficacy of dinoprostone and misoprostol for labor induction in nulliparous women

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Tenilson Amaral Oliveira

2011-03-01

Full Text Available OBJETIVO: verificar a eficácia e a segurança de dinoprostone e misoprostol para indução do parto vaginal, com ou sem o uso de ocitocina em nulíparas. MÉTODOS: realizou-se estudo retrospectivo, observacional, envolvendo 238 pacientes que foram submetidas à indução do parto de janeiro de 2008 a fevereiro de 2010 com uso de misoprostol 25 mcg via vaginal ou pessário contendo 10 mg de dinoprostone. Desse grupo, foram selecionadas 184 pacientes, que apresentavam as seguintes características: nulíparas, gestação entre 37 e 42 semanas, feto único, apresentação cefálica, membranas íntegras e índice de Bishop PURPOSE: to determine the efficacy and safety of dinoprostone and misoprostol for the induction of vaginal childbirth, with or without the use of oxytocin in nulliparous women. METHODS: in this retrospective observational study, 238 patients were subjected to the induction of delivery from January 2008 to February 2010 with the use of misoprostol 25 mcg by the vaginal route or a pessary containing 10 mg of dinoprostone. A total of 184 patients were selected, with the following characteristics: nulliparous, gestational age of 37-42 weeks, singleton pregnancies, cephalic presentation, intact membranes, and Bishop score < 3. Obstetric and neonatal data were analyzed and compared between groups. The Student t-test, chi-square test and Fisher's exact test were used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the rate of vaginal childbirth did not differ significantly in patients who used misoprostol and dinoprostone (43.2% versus 50%; p = 0.35, respectively. The ripening of cervix was higher in the group treated with misoprostol (87.3% versus 75.6%, p=0.04. The use of oxytocin was necessary in 58.8% of the misoprostol group and 57.3% in the dinoprostone group after the ripening of cervix. Failed induction was the primary indication of caesarean section delivery in both groups, with no significant

Reduction of aspirin-induced fecal blood loss with low-dose misoprostol tablets in man

International Nuclear Information System (INIS)

Cohen, M.M.; Clark, L.; Armstrong, L.; D'Souza, J.

1985-01-01

Misoprostol (SC-29333), a synthetic prostaglandin E1 methyl ester analog, was given simultaneously with acetylsalicylic acid in a double-blind, placebo-controlled randomized prospective study of 32 healthy human male subjects. Fecal blood loss was measured for eight days using the 51 Cr-labeled red blood cell technique. Aspirin (650 mg qid) and misoprostol (25 micrograms qid) or placebo were given during days 3, 4, and 5. There was a significant (P less than 0.05) increase in median blood loss (modified Friedman test) from 0.81 to 6.05 ml/day in the aspirin with placebo group (N = 16). Median blood loss was increased (from 0.75 to 3.75 ml/day) in the aspirin with misoprostol group (N = 16), but this was significantly less (Mann-Whitney U test, P less than 0.01) than the placebo group. Mean serum salicylate concentrations in the placebo and misoprostol groups were similar (7.8 and 6.8 micrograms/ml, respectively). There were no significant changes in laboratory values in any of the subjects studied, nor were any major side-effects encountered. This study demonstrates that oral misoprostol reduces aspirin-induced gastrointestinal bleeding even when administered simultaneously and at a dose level below its threshold for significant acid inhibition. This indicates a potential role for misoprostol in the prevention of gastric mucosal damage in selected patients

Misoprostol use under routine conditions for termination of pregnancies with intrauterine fetal death

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Maria Isabel do Nascimento

2013-08-01

Full Text Available OBJECTIVE: To analyze the misoprostol use in pregnancies with intrauterine fetal death (IUFD, considering mode of delivery and induction-delivery interval. METHODS: Descriptive study including 171 pregnant women with IUFD, in the second or third trimester, submitted to labor induction with vaginal misoprostol and/or induction/augmentation with intravenous oxytocin, from 2005 to 2008, at a teaching-hospital of the Brazilian Unified Health System (Sistema Único de Saúde -SUS. RESULTS: Misoprostol alone (treatment A, misoprostol plus oxytocin (treatment B, and oxytocin alone (treatment C were administered in 9.3%, 19.9%, and 70.8% of the cases, respectively. One-third of pregnancies were less than 28 weeks, and 2.9% required a caesarean section. The percentage of vaginal delivery in treatments A and B combined (98.0% was similar to treatment C (96.7%. The mean induction-delivery interval was 15.4 hours. Comparing multiple groups, the mean induction-delivery interval was significantly shorter in treatment A (20.1 hours than in treatment B (33.3 hours, and was longer than in treatment C (9.7 hours. The majority (71% of cases required a single administration of misoprostol, and the total dosage was lower in treatment A (mean: 98.4 µg compared with treatment B (mean: 157.0 µg. CONCLUSION: Misoprostol effectively contributed to delivery of IUFD by vaginal route assisted under routine conditions of a public health service in Brazil, demonstrating its importance in cases resistant to usual induction methods, and its availability in Brazilian public health services is recommended.

Differential effects of misoprostol and ranitidine on the pharmacokinetics of diclofenac and gastrointestinal symptoms.

OpenAIRE

Dammann, H G; Simon-Schultz, J; Steinhoff, I; Damaschke, A; Schmoldt, A; Sallowsky, E

1993-01-01

1. The effects of oral misoprostol (800 microg day(-1)) and ranitidine (300 mg day(-1)) on the pharmacokinetics of diclofenac (100 mg) were assessed in a three-way randomized crossover study in 18 healthy male subjects. 2. Subjects were studied over three 8 day periods, during which they received twice-daily placebo, misoprostol, or ranitidine. A single dose of diclofenac was given orally on days 1 and 8, and plasma diclofenac concentrations were measured by h.p.l.c. over 24 h. 3. Misoprostol...

Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date.

Science.gov (United States)

Smith, Jeffrey Michael; Gubin, Rehana; Holston, Martine M; Fullerton, Judith; Prata, Ndola

2013-02-20

Hemorrhage continues to be a leading cause of maternal death in developing countries. The 2012 World Health Organization guidelines for the prevention and management of postpartum hemorrhage (PPH) recommend oral administration of misoprostol by community health workers (CHWs). However, there are several outstanding questions about distribution of misoprostol for PPH prevention at home births. We conducted an integrative review of published research studies and evaluation reports from programs that distributed misoprostol at the community level for prevention of PPH at home births. We reviewed methods and cadres involved in education of end-users, drug administration, distribution, and coverage, correct and incorrect usage, and serious adverse events. Eighteen programs were identified; only seven reported all data of interest. Programs utilized a range of strategies and timings for distributing misoprostol. Distribution rates were higher when misoprostol was distributed at a home visit during late pregnancy (54.5-96.9%) or at birth (22.5-83.6%), compared to antenatal care (ANC) distribution at any ANC visit (22.5-49.1%) or late ANC visit (21.0-26.7%). Coverage rates were highest when CHWs and traditional birth attendants distributed misoprostol and lower when health workers/ANC providers distributed the medication. The highest distribution and coverage rates were achieved by programs that allowed self-administration. Seven women took misoprostol prior to delivery out of more than 12,000 women who were followed-up. Facility birth rates increased in the three programs for which this information was available. Fifty-one (51) maternal deaths were reported among 86,732 women taking misoprostol: 24 were attributed to perceived PPH; none were directly attributed to use of misoprostol. Even if all deaths were attributable to PPH, the equivalent ratio (59 maternal deaths/100,000 live births) is substantially lower than the reported maternal mortality ratio in any of these

Effectiveness of Misoprostol for Induction of First-Trimester Miscarriages; Experience at a single tertiary care centre in Oman

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Qamariya Ambusaidi

2015-11-01

Full Text Available Objectives: Non-invasive methods of inducing a miscarriage are now considered an effective alternative to surgical evacuation (dilatation and curettage. This study aimed to evaluate the effectiveness of misoprostol in the termination of first-trimester miscarriages. Methods: This prospective study was conducted between October 2009 and September 2010 and assessed all patients admitted to the Royal Hospital in Muscat, Oman, for the termination of first-trimester miscarriages during the study period. All patients received misoprostol and the rates of successful termination were measured. Patient satisfaction was assessed using a short questionnaire. Results: A total of 290 women were included in the study. Termination with misoprostol was successful in 61.38% of the subjects. Of the remaining subjects requiring additional surgical evacuation (n = 112, 58.93% required evacuation due to failed termination with misoprostol and 65.18% underwent early evacuation (≤24 hours since their last misoprostol dose. The majority of patients experienced no side-effects due to misoprostol (89.66%. Pain was controlled with simple analgesics in 70.00% of the subjects. A high satisfaction rate (94.83% with the misoprostol treatment was reported. Conclusion: Misoprostol was a well-tolerated drug which reduced the rate of surgical evacuation among the study subjects. This medication can therefore be used safely in the management of incomplete miscarriages.

Titrated Misoprostol Versus Dinoprostone for Labor Induction

African Journals Online (AJOL)

Aim: This study designed to compare titrated misoprostol regarding its safety and efficacy with dinoprostone for induction of labor. ... Statistical analysis done using Student's t-test for quantitative data and ..... induction: A pilot study. Rev Bras ...

Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

Science.gov (United States)

Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

2014-02-01

To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

Early medical abortion with methotrexate and misoprostol.

Science.gov (United States)

Borgatta, L; Burnhill, M S; Tyson, J; Leonhardt, K K; Hausknecht, R U; Haskell, S

2001-01-01

To evaluate the introduction of an early medical abortion program with methotrexate and misoprostol, using a standardized protocol. A total of 1973 women at 34 Planned Parenthood sites participated in a case series of early medical abortion. Ultrasound was used to confirm gestational age of less than 49 days from the first day of the last menstrual period. Women were given intramuscular methotrexate 50 mg/m(2) of body surface area on day 1, and then they inserted misoprostol 800 microg vaginally at home on day 5, 6, or 7. Women were advised to have a suction curettage if the pregnancy appeared viable 2 weeks after methotrexate or if any gestational sac persisted 4 weeks after methotrexate. Outcomes were complete medical abortion and suction curettage. Sixteen hundred fifty-nine women (84.1%) had a complete medical abortion, and 257 (13.0%) had suction curettage. The most common reason for curettage was patient option (8.9%). At 2 weeks after methotrexate use, 1.4% of women had curettage because of a viable pregnancy; at 4 weeks, 1.6% of women had curettage because of a persistent but nonviable pregnancy. One percent of women had curettage because of physician recommendation, most commonly for bleeding. Suction curettage rates decreased with site experience (P <.006) and were lower at early gestational ages (P <.004) and in nulliparous women (P <.004). Medical abortion with methotrexate and misoprostol is safe and effective and can be offered in a community setting.

Beliefs and practices in using misoprostol for induction of labour among obstetricians in Zimbabwe

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M Madziyire

2017-05-01

Full Text Available Background. Misoprostol is commonly used for induction of labour in term pregnancy. There are different routes and dosing schedules for administering the drug.Objectives. To describe the prescribing pattern (dose, route, duration, beliefs and factors affecting use of misoprostol for inducing term pregnancy among practising obstetricians in Zimbabwe.Methods. A cross-sectional descriptive survey was undertaken among practising obstetricians in Zimbabwe. A questionnaire was sent as an email, WhatsApp or short message service (SMS, or text web link to all practising obstetricians in Zimbabwe using the SurveyMonkey online tool. All consenting practitioners were requested to respond online. The responses were analysed using the SurveyMonkey software.Results. There were 52 responses from the 63 questionnaires, a response rate of 82.5%. Seventy-six percent preferred oral misoprostol for induction of labour. The most common indication for induction was prolonged pregnancy accounting for 58% of respondents. The largest group of the practitioners who responded (36% learnt their misoprostol dosing regimen from WHO/FIGO/NICE guidelines. A composite of highly variable dose regimens referred to as ‘other regimens’ was the dosing regimen preferred by 34% of respondents. Fiftyeight percent of practitioners used two cycles of misoprostol dosing before concluding that induction had failed and 52% would resort to caesarean section immediately if induction failed.Conclusion. The results show marked heterogeneity in the dosing schedules employed by obstetricians for induction of labour with the majority not following standard misoprostol guidelines for labour induction.

Uso do misoprostol em substituição à curetagem uterina em gestações interrompidas precocemente Misoprostol in substitution at uterine curettage in early pregnancy failure

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Francisco Carlos Nogueira Arcanjo

2011-06-01

Full Text Available OBJETIVOS: Avaliar a eficácia do misoprostol administrado via vaginal para esvaziamento uterino em gestações interrompidas precocemente, bem como o tempo entre a administração e o esvaziamento, correlacionando-os com a idade gestacional. MÉTODOS: Ensaio clínico com 41 pacientes com gestações interrompidas entre a 7ª e a 12ª semanas gestacionais, com média de idade de 27,3 (±6,1 anos. A paridade média foi de 2,2 (±1,2 partos; o número médio de abortamentos prévios foi 0,2 (±0,5. Foram administrados 800 µg de misoprostol via vaginal, em dose única; após 24 horas, foi realizado ultrassom transvaginal. Considerou-se abortamento completo quando o diâmetro anteroposterior da cavidade endometrial media 8 semanas de idade gestacional em relação aos desfechos: frequência de abortamento completo e intervalo entre administração de misoprostol e o abortamento (em minutos. O nível de significância utilizado foi de 5%. RESULTADOS: A idade gestacional, no momento do diagnóstico, foi de 8,5 semanas em média (DP=1,5. Os intervalos entre a administração de misoprostol e as contrações uterinas, e entre a administração e o abortamento, foram de 322,5±97,0 min e 772,5±201,0 min, respectivamente. Houve abortamento completo em 80,3%. No primeiro grupo, a taxa de sucesso foi de 96,2% e no segundo, de 53,3% (pPURPOSE: To evaluate the effectiveness of misoprostol administered vaginally for uterine evacuation in interrupted early pregnancies and the time between the administration and emptying correlated with gestational age. METHODS: Clinical trial with 41 patients with pregnancies interrupted between the 7th and the 12th gestational weeks. The mean age was 27.3 (±6.1 years. Mean parity was 2.2 (±1.2 deliveries. The average number of previous abortions was 0.2 (± 0.5. Misoprostol was administered vaginally in a single 800 µg dose and transvaginal ultrasound was performed after 24 hours. Abortion was considered complete when the

Misoprostol, an anti-ulcer agent and PGE2 receptor agonist, protects against cerebral ischemia.

Science.gov (United States)

Li, Jun; Liang, Xibin; Wang, Qian; Breyer, Richard M; McCullough, Louise; Andreasson, Katrin

2008-06-20

Induction of COX-2 activity in cerebral ischemia results in increased neuronal injury and infarct size. Recent studies investigating neurotoxic mechanisms of COX-2 demonstrate both toxic and paradoxically protective effects of downstream prostaglandin receptor signaling pathways. We tested whether misoprostol, a PGE(2) receptor agonist that is utilized clinically as an anti-ulcer agent and signals through the protective PGE(2) EP2, EP3, and EP4 receptors, would reduce brain injury in the murine middle cerebral artery occlusion-reperfusion (MCAO-RP) model. Administration of misoprostol, at the time of MCAO or 2h after MCAO, resulted in significant rescue of infarct volume at 24 and 72h. Immunocytochemistry demonstrated dynamic regulation of the EP2 and EP4 receptors during reperfusion in neurons and endothelial cells of cerebral cortex and striatum, with limited expression of EP3 receptor. EP3-/- mice had no significant changes in infarct volume compared to control littermates. Moreover, administration of misoprostol to EP3+/+ and EP3-/- mice showed similar levels of infarct rescue, indicating that misoprostol protection was not mediated through the EP3 receptor. Taken together, these findings suggest a novel function for misoprostol as a protective agent in cerebral ischemia acting via the PGE(2) EP2 and/or EP4 receptors.

Effect of misoprostol on patients with aspirin-exacerbated respiratory disease undergoing aspirin challenge and desensitization.

Science.gov (United States)

Walters, Kristen M; Simon, Ronald A; Woessner, Katharine M; Wineinger, Nathan E; White, Andrew A

2017-07-01

Prostaglandin E 2 (PGE 2 ) is an anti-inflammatory compound that inhibits 5-lipoxygenase activity. Diminished PGE 2 regulation in aspirin-exacerbated respiratory disease (AERD) leads to respiratory reactions on cyclooxygenase 1 inhibition. In vitro studies have found that exogenous PGE 2 stabilizes inflammatory mediator release. To examine whether misoprostol (oral prostaglandin E 1 analogue) use during aspirin challenge and desensitization might decrease the severity of aspirin-induced symptoms and make desensitization safer for patients with AERD. Forty-five patients undergoing aspirin challenge and/or desensitization were randomized to misoprostol (n = 30) or placebo (n = 15) and compared with a group of historical controls (n = 31). Misoprostol (200 μg) was administered at 30 minutes, 90 minutes, and 4 hours after the first dose of nasal ketorolac. Measured end points included change in forced expiratory volume in 1 second (FEV 1 ), peak nasal inspiratory flow rate (PNIF), number of treatments received for induced reactions, and adverse gastrointestinal effects. A difference in FEV 1 and PNIF reduction was detected between misoprostol and placebo (P = .03) and misoprostol and historical controls (P = .01), respectively, during nasal ketorolac challenge. No difference was detected among aspirin reactors. Among all reactors, no difference in magnitude was found for FEV 1 (P = .13) or PNIF (P = .07) reduction across all 3 groups. Total treatment requirement was similar (P = .14). Patients receiving misoprostol were more likely to report adverse gastrointestinal effects (P = .02). The addition of misoprostol to current aspirin challenge and/or desensitization protocols reveals no protective effect in reducing the intensity of nonsteroidal anti-inflammatory drug-induced symptoms and is not recommended based on the findings in this study. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Prevention of postpartum haemorrhage: cost consequences analysis of misoprostol in low-resource settings.

Science.gov (United States)

Lang, Danielle L; Zhao, Fei-Li; Robertson, Jane

2015-11-23

While inferior to oxytocin injection in both efficacy and safety, orally administered misoprostol has been included in the World Health Organization Model List of Essential Medicines for use in the prevention of postpartum haemorrhage (PPH) in low-resource settings. This study evaluates the costs and health outcomes of use of oral misoprostol to prevent PPH in settings where injectable uterotonics are not available. A cost-consequences analysis was conducted from the international health system perspective, using data from a recent Cochrane systematic review and WHO's Mother-Baby Package Costing Spreadsheet in a hypothetical cohort of 1000 births in a mixed hospital (40% births)/community setting (60% births). Costs were estimated based on 2012 US dollars. Using oxytocin in the hospital setting and misoprostol in the community setting in a cohort of 1000 births, instead of oxytocin (hospital setting) and no treatment (community setting), 22 cases of PPH could be prevented. Six fewer women would require additional uterotonics and four fewer women a blood transfusion. An additional 130 women would experience shivering and an extra 42 women fever. Oxytocin/misoprostol was found to be cost saving (US$320) compared to oxytocin/no treatment. If misoprostol is used in both the hospital and community setting compared with no treatment (i.e. oxytocin not available in the hospital setting), 37 cases of PPH could be prevented; ten fewer women would require additional uterotonics; and six fewer women a blood transfusion. An additional 217 women would experience shivering and 70 fever. The cost savings would be US$533. Sensitivity analyses indicate that the results are sensitive to the incidence of PPH-related outcomes, drug costs and the proportion of hospital births. Our findings confirm that, even though misoprostol is not the optimum choice in the prevention of PPH, misoprostol could be an effective and cost-saving choice where oxytocin is not or cannot be used due to a

Clinical indicators for success of misoprostol treatment after early pregnancy failure.

Science.gov (United States)

Robledo, C; Zhang, J; Troendle, J; Barnhart, K; Creinin, M D; Westhoff, C; Huang, X; Frederick, M

2007-10-01

To identify clinical indicators for success of misoprostol treatment after early pregnancy failure. A total of 473 women with early pregnancy failure received 800 microg of vaginal misoprostol on treatment day 1. At the follow-up visit on day 3, a second dose was given if expulsion was incomplete. On day 8, vacuum aspiration was offered if expulsion had not occurred. Ultrasonography was used as gold standard for success. A Classification and Regression Tree analysis was undertaken to derive two decision trees for the success of misoprostol treatment on study days 3 and 8. Heavy bleeding after the first dose and an open cervical os were identified as clinical indicators of treatment success on day 3. Treatment success occurred in 84% of women with either or both indicators. Reporting passage of tissue after a second misoprostol dose and old blood in the vagina were potential indicators of treatment success or failure on day 8. A woman with either of these indicators has a 65% chance of treatment success after the second dose. Conversely, a woman with neither indicator on day 8 has a 94% chance of treatment failure. Standard clinical findings may be useful as indicators for success or failure of medical management of early pregnancy failure in settings with limited or no access to ultrasonography. More research to identify even better indicators is warranted.

Comparison of gemeprost and vaginal misoprostol in first trimester mifepristone-induced abortion

DEFF Research Database (Denmark)

Svendsen, Pernille Fog; Rørbye, Christina; Vejborg, Thomas

2005-01-01

Abstract Background The aim of this study was to compare efficacy and side effects of gemeprost and vaginal misoprostol in mifepristone-induced abortions in women up to 63 days of gestation. Methods A retrospective study of 833 consecutive patients admitted for medical termination of first......, gemeprost and vaginal misoprostol are equally effective for termination of first trimester abortion, but may be associated with varying intensity of side effects....

Exposure to misoprostol and hormones during pregnancy and risk of congenital anomalies Exposição ao misoprostol e hormônios durante a gravidez e risco de anomalia congênita

Directory of Open Access Journals (Sweden)

Tatiane da Silva Dal Pizzol

2008-06-01

Full Text Available This study evaluated the association between use of misoprostol and other drugs to induce menstruation, and congenital anomalies. A sample of 4,856 pregnant women 20 years and older were enrolled consecutively in prenatal services in the Unified National Health System, in six Brazilian State capitals. Data on socio-demographics and use of medicines were obtained using an interview from the 21st to 28th week of pregnancy. Other data, including information on delivery and diagnosis of congenital anomalies by the attending neonatal physician were obtained from patient charts. Potential confounders were adjusted by logistic regression. Use of drugs to induce menstruation was reported by 707 women (14.6%, of whom 120 (17% reported use of misoprostol. After adjusting for the study center, a positive association was observed between misoprostol and congenital anomalies (OR = 2.64; 95%CI: 1.03-6.75; a positive association was also observed for sex hormones (OR = 2.24; 95%CI: 1.06-4.74. The results suggest that the use of misoprostol or sex hormones during pregnancy increases the risk of congenital anomalies.Este estudo avalia a associação do uso do misoprostol e de outros produtos utilizados para induzir a menstruação com anomalia congênita. Foram arroladas consecutivamente 4.856 mulheres com vinte anos de idade ou mais, procedentes de serviços de pré-natal do Sistema Único de Saúde em seis capitais brasileiras. Dados sócio-demográficos e o uso de medicamentos foram obtidos por meio de entrevista, entre a 21ª e a 28ª semanas de gestação. Outros dados, incluindo informações sobre o parto e o diagnóstico de anomalia congênita, realizado pelo médico que assistiu o recém-nascido, foram obtidos no prontuário. Potenciais confundidores foram ajustados por meio de regressão logística. O uso de produtos para induzir a menstruação foi relatado por 707 gestantes (14,6%, das quais 120 (17% referiram-se ao misoprostol. Após ajustamento

Buccal or sublingual misoprostol for cervical ripening and induction of labour.

Science.gov (United States)

Muzonzini, G; Hofmeyr, G J

2004-10-18

This is one of a series of reviews of cervical ripening and labour induction using standardised methodology. Misoprostol administered by the oral and sublingual routes have the advantage of rapid onset of action, while the sublingual and vaginal routes have the advantage of prolonged activity and greatest bioavailability. To determine the effectiveness and safety of misoprostol administered buccally or sublingually for third trimester cervical ripening and induction of labour. We searched the Cochrane Pregnancy and Childbirth Group trials register (8 December 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2003), and bibliographies of relevant papers. Randomised controlled trials comparing buccal or sublingual misoprostol used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods. A generic strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. Data were extracted onto standardized forms, checked for accuracy, and analysed using RevMan software. Three studies (502 participants) compared buccal/sublingual misoprostol respectively with a vaginal regimen (200 microg versus 50 microg) and with oral administration (50 versus 50 microg and 50 versus 100microg).The buccal route was associated with a trend to fewer caesarean sections than with the vaginal route (18/73 versus 28/79; relative risk (RR) 0.70; 95% confidence interval (CI) 0.42 to 1.15). There were no significant differences in any other outcomes. When the same dosage was used sublingually versus orally, the sublingual route was associated with less failures to achieve vaginal delivery within 24 hours (12/50 versus 19/50; RR 0.63, 95% CI 0.34 to 1.16), reduced oxytocin augmentation (17/50 versus 23/50; RR 0.74, 95% CI 0.45 to 1.21) and reduced caesarean section (8/50 versus 15/50; RR 0.53, 95% CI 0.25 to

The biomedicalisation of illegal abortion: the double life of misoprostol in Brazil

OpenAIRE

Zordo, Silvia De

2016-01-01

Abstract This paper examines the double life of misoprostol in Brazil, where it is illegally used by women as an abortifacient and legally used in obstetric hospital wards. Based on my doctoral and post-doctoral anthropological research on contraception and abortion in Salvador, Bahia, this paper initially traces the “conversion” of misoprostol from a drug to treat ulcers to a self-administered abortifacient in Latin America, and its later conversion to aneclectic global obstetric tool. It th...

Effectiveness of rectal misoprostol in cessation of Post Partum Haemorrhage

International Nuclear Information System (INIS)

Nasreen, S.; Baqai, S.; Iftikhar, S.

2018-01-01

Objective: To determine the efficacy of rectal misoprostol in management of Post Partum Haemorrhage in third stage of labour. Study Design: Interventional study. Place and Duration of Study: Gynaecology and obstetrics department at PNS Shifa Hospital Karachi, from Sep 2012 to Mar 2013. Material and Methods: All singleton and multiple pregnancies of gestation 37-42 weeks, who presented in labour room to deliver and had prolonged second stage of labour (n=112) were enrolled in the study. Patients, who were having coagulopathy, abruption, placenta previa, and allergy to prostaglandins were excluded from the study. Third stage was managed actively according to hospital standard routine. Hemoglobin was measured at the time of admission and repeated after delivery in patients having PPH. Blood was estimated by weighing all gauzes and packs. If blood loss more than 500ml one hour after delivery and all traumatic causes and retained placenta were excluded, 600 mu g (3 tablets) of misoprostol were given per rectally, which were inserted up to a digit depth. After one hour total amount of blood loss was calculated. The data were then entered in a proforma and analyzed. Results: Majority (44.6%) of the women were 26-33 years of age, 8.9% had PPH with fall in hemoglobin by 1.5-2 gms/dl. Ninety percent of the patients responded to rectal misoprostol. Conclusion: Active management of third stage of labour has a definite role in the preventive of PPH. Rectal administration of misoprostol should be considered for control of PPH in low resource settings like ours as it was found effective in the study. (author)

Clinical Effects of Lithospermum Ruderale Dosage and Using-time on Medicinal Abortion Induced by Mifepris tone and Misoprostol

Institute of Scientific and Technical Information of China (English)

无

2000-01-01

The clinical effects of dosage during the period of treatment of Lithospermum Ruderale extract-a kind of Chinese traditional herbal medicine-on medicinal abor tion induced by mifepristone and misoprostol were studied. Lithospermum Ruderale extract was administrated 3 d before, 3 d after or 3 d before plus 3 d after the admin istration of misoprostol respectively. The dose of Lithospermum Ruderale extract was 50 g, 75 g or 100g respectively. Thus 1 350 women of early pregnancy were grouped into 9 groups and observed. The results showed that the effects of Lithospermum Rud erale used 3 d before, and 3 d before plus 3 d after (6 days misoprostol were signifi cantly better than those only used 3 d after misoprostol both for complete abortion and bleeding (P＜0.05). The dosage between 50 g and l00 g made no significant differ ence in clinical effects. Therefore it is reasonable to use 50 g Lithospermum Ruderale before misoprostol to improve medicinal abortion.

Misoprostol alone for the termination of Pregnancy

African Journals Online (AJOL)

The use of Misoprostol for ter- mination of pregnancy has been approved by the Medicines Control. Council of South Africa. It is part of the approved protocol for termina- tion of pregnancy in public sector facilities in the Western Cape.1. Reference. 1. Provincial Administration: Western Cape: Termination of Pregnancy (Top):.

Safety and Efficacy of Misoprostol versus Oxytocin for the Prevention of Postpartum Hemorrhage

Directory of Open Access Journals (Sweden)

Minoo Rajaei

2014-01-01

Full Text Available Postpartum hemorrhage (PPH is the commonest cause of maternal death worldwide. Studies suggest that the use of misoprostol may be beneficial in clinical settings where oxytocin is unavailable. The aim of this study was to compare the safety and efficacy of oxytocin and misoprostol when used in the prevention of PPH. In a double-blind randomized controlled trial, 400 pregnant women who had a vaginal delivery were assigned into two groups: to receive either 20 IU of oxytocin in 1000 mL Ringer’s solution and two placebo tablets or 400 mcg oral misoprostol (as two tablets and 2 mL normal saline in 1000 mL Ringer’s solution. The quantity of blood loss was higher in the oxytocin group in comparison to the misoprostol group. There was no significant difference in the decrease in hematocrit and hemoglobin between the two groups. Although there was no significant difference in the need for transfusions between the two groups, the patients in the oxytocin group had greater need for additional oxytocin. Results from this study indicate that it may be considered as an alternative for oxytocin in low resource clinical settings. This study is registered with ClinicalTrials.gov NCT01863706.

Misoprostol-induced radioprotection of Syrian hamster embryo cells in utero from cell death and oncogenic transformation

International Nuclear Information System (INIS)

Miller, R.C.; LaNasa, P.; Hanson, W.R.

1994-01-01

Misoprostol, a PGE analog, is an effective radioprotector of murine intestine and hematopoietic and hair cell renewal systems. The radioprotective nature of misoprostol was extended to examine its ability to influence clonogenic cell survival and induction of oncogenic transformation in Syrian hamster embryo cells exposed to X rays in utero and assayed in vitro. Hamsters in their 12th day of pregnancy were injected subcutaneously with misoprostal, and 2 h later the pregnant hamsters were exposed to graded doses of X rays. Immediately after irradiation, hamsters were euthanized and embryonic tissue was explanted into culture dishes containing complete growth medium. After a 2-week incubation period, clongenic cell survival and morphologically transformed foci were determined. Survival of misoprostol-treated SHE cells was increased and yielded a dose reduction factor of 1.5 compared to SHE cells treated with X rays alone. In contrast, radiation-induced oncogenic transformation of misoprostol-treated cells was reduced by a factor of 20 compared to cells treated with X rays alone. These studies suggest that misoprostol not only protects normal tissues in vivo from acute radiation injury, but also protects cells, to a large extent, from injury leading to transforming events. 26 refs., 6 figs., 2 tabs

Potential Cost-Effectiveness of Prenatal Distribution of Misoprostol for Prevention of Postpartum Hemorrhage in Uganda.

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Solomon J Lubinga

Full Text Available In settings where home birth rates are high, prenatal distribution of misoprostol has been advocated as a strategy to increase access to uterotonics during the third stage of labor to prevent postpartum hemorrhage (PPH. Our objective was to project the potential cost-effectiveness of this strategy in Uganda from both governmental (the relevant payer and modified societal perspectives.To compare prenatal misoprostol distribution to status quo (no misoprostol distribution, we developed a decision analytic model that tracked the delivery pathways of a cohort of pregnant women from the prenatal period, labor to delivery without complications or delivery with PPH, and successful treatment or death. Delivery pathway parameters were derived from the Uganda Demographic and Health Survey. Incidence of PPH, treatment efficacy, adverse event and case fatality rates, access to misoprostol, and health resource use and cost data were obtained from published literature and supplemented with expert opinion where necessary. We computed the expected incidence of PPH, mortality, disability adjusted life years (DALYs, costs and incremental cost effectiveness ratios (ICERs. We conducted univariate and probabilistic sensitivity analyses to examine robustness of our results. In the base-case analysis, misoprostol distribution lowered the expected incidence of PPH by 1.2% (95% credibility interval (CrI: 0.55%, 1.95%, mortality by 0.08% (95% CrI: 0.04%, 0.13% and DALYs by 0.02 (95% CrI: 0.01, 0.03.” and “ICERs were US$181 (95% CrI: 81, 443 per DALY averted from a governmental perspective, and US$64 (95% CrI: -84, 260 per DALY averted from a modified societal perspective [corrected].Prenatal distribution of misoprostol is potentially cost-effective in Uganda and should be considered for national-level scale up for prevention of PPH.

Sublingual misoprostol versus standard surgical care for treatment of incomplete abortion in five sub-Saharan African countries

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Shochet Tara

2012-11-01

Full Text Available Abstract Background In low-resource settings, where abortion is highly restricted and self-induced abortions are common, access to post-abortion care (PAC services, especially treatment of incomplete terminations, is a priority. Standard post-abortion care has involved surgical intervention but can be hard to access in these areas. Misoprostol provides an alternative to surgical intervention that could increase access to abortion care. We sought to gather additional evidence regarding the efficacy of 400 mcg of sublingual misoprostol vs. standard surgical care for treatment of incomplete abortion in the environments where need for economical non-surgical treatments may be most useful. Methods A total of 860 women received either sublingual misoprostol or standard surgical care for treatment of incomplete abortion in a multi-site randomized trial. Women with confirmed incomplete abortion, defined as past or present history of vaginal bleeding during pregnancy and an open cervical os, were eligible to participate. Participants returned for follow-up one week later to confirm clinical status. If abortion was incomplete at that time, women were offered an additional follow-up visit or immediate surgical evacuation. Results Both misoprostol and surgical evacuation are highly effective treatments for incomplete abortion (misoprostol: 94.4%, surgical: 100.0%. Misoprostol treatment resulted in a somewhat lower chance of success than standard surgical practice (RR = 0.90; 95% CI: 0.89-0.92. Both tolerability of side effects and women’s satisfaction were similar in the two study arms. Conclusion Misoprostol, much easier to provide than surgery in low-resource environments, can be used safely, successfully, and satisfactorily for treatment of incomplete abortion. Focus should shift to program implementation, including task-shifting the provision of post-abortion care to mid- and low- level providers, training and assurance of drug availability. Trial

The availability of Misoprostol in pharmacies and patent medicine ...

African Journals Online (AJOL)

The availability of Misoprostol in pharmacies and patent medicine stores in two Nigerian ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... pharmacists or vendors of pharmaceutical and patent medicine outlets in two ...

Randomization of two dosing regimens of vaginal misoprostol for ...

African Journals Online (AJOL)

2013-09-06

Sep 6, 2013 ... Key words: Cervical ripening, labour induction, misoprostol. Date of Acceptance: ... was obtained from each participant before inclusion in the study. Inclusion ... Chi‑square for categorical variables, student's t‑test for normally ...

Effect of Misoprostol on the Pharmacokinetics of Sustained Release Diclofenac in Myanmar Healthy Male Volunteers

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Htet Htet Aung

2017-03-01

Full Text Available Background: Sustained release diclofenac (diclofenac SR is the commonly used non-steroidal anti-inflammatory drug for chronic inflammatory conditions such as rheumatoid arthritis. Misoprostol, prostaglandin analogue, is the agent that enhances gastrointestinal mucosal defense. Concomitant administration of misoprostol with diclofenac SR can prevent the gastrointestinal side effects of diclofenac SR. Objective: The purpose of the study was to explore the effect of misoprostol on the pharmacokinetics of diclofenac SR in healthy volunteers. Methods: Crossover study was evaluated in 14 male volunteers. Single oral dose of 100 mg diclofenac SR was concomitantly administered with 200 μg misoprostol with one-week wash out period. Plasma concentrations at 0, 0.5, 1, 1.5, 2, 3, 6 and 10 hrs were determined by high performance liquid chromatography (HPLC. Pharmacokinetic parameters such as area under concentration-time curve (AUC0-α, peak plasma concentration (Cmax, time to achieve peak plasma concentration (Tmax, absorption half-life (T½(ab, elimination half-life (T1/2(el, absorption rate constant (Kab, and elimination rate constant (Kel were determined. Results: With misoprostol, the mean AUC0-α of diclofenac SR was significantly reduced from 12.11±5.25μg/ mL×hr to 4.17±2.72μg/mL×hr (p0.05. The mean T½(ab was decreased from 0.56±0.23hr to 0.54±0.19hr (p>0.05. The mean Kab were almost the same 1.43±0.54hr-1 and 1.43±0.48hr-1. The mean T1/2(el was decreased from 3.68±1.64hr to 3.03±1.08hr (p>0.05. The mean Kel was increased from 0.21±0.09hr-1 to 0.25±0.09hr-1 (p>0.05. Conclusion: There was a significant reduction in the extent of absorption of diclofenac SR when concomitantly administered with misoprostol. Therefore, the dose of diclofenac SR may need to be increased to avoid therapeutic failure of diclofenac SR or concurrent use with misoprostol may need to be changed to other gastroprotective agents.

Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis.

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Nicola Low

2011-02-01

Full Text Available Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition.We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I(2 values 0.0%-16.1%. Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18-1.83, insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00-1.71, and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01-1.53 remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04-1.47. Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, p<0.001 or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, p<0.001, respectively.This study provides evidence to suggest that some intravaginal practices increase

Misoprostol for the prevention of postpartum hemorrhage during home births in rural Lao PDR: establishing a pilot program for community distribution.

Science.gov (United States)

Durham, Jo; Phengsavanh, Alongkone; Sychareun, Vanphanom; Hose, Isaac; Vongxay, Viengnakhone; Xaysomphou, Douangphachanh; Rickart, Keith

2018-01-01

The purpose of this study was to gather the necessary data to support the design and implementation of a pilot program for women who are unable to deliver in a healthcare facility in the Lao People's Democratic Republic (PDR), by using community distribution of misoprostol to prevent postpartum hemorrhage (PPH). The study builds on an earlier research that demonstrated both support and need for community-based distribution of misoprostol in Lao PDR. This qualitative study identified acceptability of misoprostol and healthcare system needs at varying levels to effectively distribute misoprostol to women with limited access to facility-based birthing. Interviews (n=25) were undertaken with stakeholders at the central, provincial, and district levels and with community members in five rural communities in Oudomxay, a province with high rates of maternal mortality. Focus group discussions (n=5) were undertaken in each community. Respondents agreed that PPH was the major cause of preventable maternal mortality with community distribution of misoprostol an acceptable and feasible interim preventative solution. Strong leadership, training, and community mobilization were identified as critical success factors. While several participants preferred midwives to distribute misoprostol, given the limited availability of midwives, there was a general agreement that village health workers or other lower level workers could safely administer misoprostol. Many key stakeholders, including women themselves, considered that these community-level staff may be able to provide misoprostol to women for self-administration, as long as appropriate education on its use was included. The collected data also helped identify appropriate educational messages and key indicators for monitoring and evaluation for a pilot program. The findings strengthen the case for a pilot program of community distribution of misoprostol to prevent PPH in remote communities where women have limited access to a

Community-level Distribution of Misoprostol to Prevent Postpartum ...

African Journals Online (AJOL)

In Nigeria, most deaths due to postpartum hemorrhage (PPH) occur in the absence of skilled birth attendants. A study using community mobilization and the training of community drug keepers to increase access to misoprostol for PPH prevention was conducted in five communities around Zaria in Kaduna State, Nigeria.

Civil Society Organizations and medicines policy change: a case study of registration, procurement, distribution and use of misoprostol in Uganda.

Science.gov (United States)

Atukunda, Esther Cathyln; Brhlikova, Petra; Agaba, Amon Ganafa; Pollock, Allyson M

2015-04-01

Misoprostol use for postpartum haemorrhage (PPH) has been promoted by Civil Society Organizations (CSOs) since the early 2000s. Yet, CSOs' role in improving access to misoprostol and shaping health policy at global and national levels is not well understood. We document the introduction of misoprostol in Uganda in 2008 from its registration, addition to treatment guidelines and national Essential Medicines List (EML), to its distribution and use. We then analyse the contribution of CSOs to this health policy change and service provision. Policy documents, procurement data and 82 key informant interviews with government officials, healthcare providers, and CSOs in four Ugandan districts of Kampala, Mbarara, Apac, Bundibugyo were collected between 2010 and 2013. Five key CSOs promoted and accelerated the rollout of misoprostol in Uganda. They supported the registration of misoprostol with the National Drug Authority, the development of clinical guidelines, and the piloting and training of health care providers. CSOs and National Medical Stores were procuring and distributing misoprostol country-wide to health centres two years before it was added to the clinical guidelines and EML of Uganda and in the absence of good evidence. The evidence suggests an increasing trend of misoprostol procurement and availability over the medicine of choice, oxytocin. This shift in national priorities has serious ramifications for maternal health care that need urgent evaluation. The absence of clinical guidelines in health centres and the lack of training preclude rational use of misoprostol. CSOs shifted their focus from the public to the private sector, where some of them continue to promote its use for off-label indications including induction of labour and abortion. There is an urgent need to build capacity to improve the robustness of the national and local institutions in assessing the safety and effectiveness of all medicines and their indications in Uganda. Copyright © 2015

Introducing Misoprostol for the Treatment of Incomplete Abortion in ...

African Journals Online (AJOL)

Despite legal restriction, induced abortions and resulting complications are common in Nigeria. Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered ...

Misoprostol for treatment of incomplete abortion- providers practice ...

African Journals Online (AJOL)

Remnant products of conception in the uterine cavity following a miscarriage or induced abortion presents a serious threat to a woman because it increases the risk of infection or continued bleeding and therefore uterine evacuation in such cases is imperative. Surgical and medical methods using drugs like misoprostol may ...

A comparison of orally administered misoprostol and membrane ...

African Journals Online (AJOL)

Objectives. This study assessed the efficacy of the two outpatient processes of single-dose 50 μg oral misoprostol (OM) and membrane sweeping (MS) on the outcome of labour induction and the possibility of reducing the need for hospital admission for cervical ripening/labour induction in uncomplicated post-term singleton ...

Inhibition of food stimulated acid secretion by misoprostol, an orally active synthetic E1 analogue prostaglandin.

OpenAIRE

Ramage, J K; Denton, A; Williams, J G

1985-01-01

The effect of 200 micrograms misoprostol (a synthetic prostaglandin E1 analogue) on food stimulated intragastric acidity has been monitored over a 9 h period in 16 normal volunteers. Misoprostol caused a significant inhibition of intragastric acidity for 2 h post-dosing, but no significant effect was seen thereafter on either basal or food stimulated acidity.

Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo-controlled trial.

Science.gov (United States)

Mobeen, N; Durocher, J; Zuberi, Nf; Jahan, N; Blum, J; Wasim, S; Walraven, G; Hatcher, J

2011-02-01

to determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries. a randomised, double-blind, placebo-controlled trial. Chitral, Khyber Pakhtunkhwa Province, Pakistan. a total of 1119 women giving birth at home. from June 2006 to June 2008, consenting women were randomised to receive 600 microg oral misoprostol (n = 534) or placebo (n = 585) after delivery to determine whether misoprostol reduced the incidence of PPH (≥ 500 ml). the primary outcomes were measured blood loss ≥ 500 ml after delivery and drop in haemoglobin >2 g/dl from before to after delivery. oral misoprostol was associated with a significant reduction in the rate of PPH (≥ 500 ml) (16.5 versus 21.9%; relative risk 0.76, 95% CI 0.59-0.97). There were no measurable differences between study groups for drop in haemoglobin >2 g/dl (relative risk 0.79, 95% CI 0.62-1.02); but significantly fewer women receiving misoprostol had a drop in haemoglobin >3 g/dl, compared with placebo (5.1 versus 9.6%; relative risk 0.53, 95% CI 0.34-0.83). Shivering and chills were significantly more common with misoprostol. There were no maternal deaths among participants. postpartum administration of 600 microg oral misoprostol by trained TBAs at home deliveries reduces the rate of PPH by 24%. Given its ease of use and low cost, misoprostol could reduce the burden of PPH in community settings where universal oxytocin prophylaxis is not feasible. Continual training and skill-building for TBAs, along with monitoring and evaluation of programme effectiveness, should accompany any widespread introduction of this drug.

An Unreported Uterine Rupture in an Unscarred Uterus After Induced Labor With 25 μg Misoprostol Vaginally

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Eva Rydahl

2014-01-01

Full Text Available Uterine rupture without a former history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy and labor. Misoprostol is widely used to induce labor but there is a lack of knowledge about serious adverse effects. It is especially challenging to collect reports on side effects because misoprostol is not a registered drug. We report a case of a woman induced by one dose 25 μg misoprostol vaginally. Her pregnancy was uncomplicated and she had an unscarred uterus. Her labor progressed rapidly and she experienced hyperstimulation, meconium stained amniotic fluid, uterine rupture, and excessive blood loss of approximately 14 l. The child survived but is diagnosed with cerebral palsy. The case was never reported as an adverse event. This case questions the safety of misoprostol even in low dosage. It also underlines the need to report side effects to national reporting systems.

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

Science.gov (United States)

Chatterjee, Susmita; Sarkar, Anupam; Rao, Krishna D

2016-01-01

Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg). An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention. This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach. The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1) per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6) million to the government to implement the primary prevention compared to the secondary prevention strategy. As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary prevention

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

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Susmita Chatterjee

Full Text Available Postpartum heammorrhage (PPH, defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg. An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention.This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach.The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1 per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6 million to the government to implement the primary prevention compared to the secondary prevention strategy.As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary

randomised controlled trial of the efficacy of misoprostol used

African Journals Online (AJOL)

application to register misoprostol for use as a cervical primer in TOPs, the ... to dissolve in the vagina with no known effects on the cervix. Both drugs were ... rapidly at the edges making them appear round. ..... In this study the decision to use a ...

Feasibility, Acceptability, and Programme Effectiveness of Misoprostol for Prevention of Postpartum Haemorrhage in Rural Bangladesh: A Quasiexperimental Study

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Abdul Quaiyum

2014-01-01

Full Text Available We explored the feasibility of distributing misoprostol tablets using two strategies in prevention of postpartum haemorrhage (PPH among women residing in the Abhoynagar subdistrict of Bangladesh. We conducted a quasiexperimental study with a posttest design and nonequivalent comparison and intervention groups. Paramedics distributed three misoprostol tablets, one delivery mat (Quaiyum’s delivery mat, a packet of five standardized sanitary pads, and one lidded plastic container with detailed counseling on their use. All materials except misoprostol were also provided with counseling sessions to the control group participants. Postpartum blood loss was measured by paramedics using standardized method. This study has demonstrated community acceptability to misoprostol tablets for the prevention of PPH that reduced overall volume of blood loss after childbirth. Likewise, the delivery mat and pad were found to be useful to mothers as tools for assessing the amount of blood loss after delivery and informing care-seeking decisions. Further studies should be undertaken to explore whether government outreach health workers can be trained to effectively distribute misoprostol tablets among rural women of Bangladesh. Such a study should explore and identify the programmatic requirements to integrate this within the existing reproductive health program of the Government of Bangladesh.

Baixas doses de misoprostol vaginal (12,5 versus 25 mcg para indução do parto a termo Low-dose vaginal misoprostol (12.5 versus 25 µg for induction of labor at term

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Francisco Airton Rangel Filho

2007-12-01

Full Text Available OBJETIVO: comparar a efetividade de baixas doses de misoprostol vaginal (12,5 versus 25 mcg para indução do trabalho de parto. MÉTODOS: ensaio clínico controlado, randomizado, duplo-cego, realizado entre maio de 2005 e abril de 2006. Foram incluídas 62 gestantes com gravidez a termo, membranas íntegras, que necessitaram de indução do parto. Foi administrado 25 mcg (32 ou 12,5 mcg de misoprostol (30, a cada quatro horas, até, no máximo, oito doses. Estudaram-se o tipo de parto, tempo entre o início da indução e o parto, complicações perinatais e efeitos maternos adversos. As variáveis de controle foram idades materna e gestacional, paridade e índice de Bishop. Os testes estatísticos utilizados foram cálculos de médias, desvios padrão e teste t de Student (variáveis numéricas contínuas, c² (variáveis categóricas e Mann-Whitney (variáveis discretas. RESULTADOS: não houve diferença significante entre o Grupo de 12,5 e 25 mcg em relação ao intervalo de tempo entre a primeira dose e o parto (1.524 minutos versus 1.212 minutos, p=0,3, na freqüência de partos vaginais (70 versus 71,8%, p=0,7, no escore de Apgar inferior a sete ao quinto minuto (3,3 versus 6,25%, p=0,5 e na freqüência de taquissistolia (3,3 versus 6,2%, p=0,5. A média da dose total administrada de misoprostol foi significativamente maior no Grupo de 25 mcg (40 versus 61,2 mcg, p=0,03. CONCLUSÕES: misoprostol vaginal na dose de 12,5 mcg foi eficiente, com efeitos colaterais semelhante, à dose de 25 mcg de misoprostol vaginal, para indução do parto a termo.PURPOSE: to compare the effectiveness of low doses of vaginal misoprostol (12.5 versus 25 µg for induction of labor. METHODS: a double-blind, randomized, controlled clinical trial was performed in Santa Casa de Misericórdia de Sobral, from May 2005 to April 2006. Sixty-two term pregnant women, with intact membranes and with indication for labor induction, were included. They randomly received 25

Randomized comparison of oral misoprostol and oxytocin for labor induction in term prelabor membrane rupture.

Science.gov (United States)

Butt, K D; Bennett, K A; Crane, J M; Hutchens, D; Young, D C

1999-12-01

To compare labor induction intervals between oral misoprostol and intravenous oxytocin in women who present at term with premature rupture of membranes. One hundred eight women were randomly assigned to misoprostol 50 microg orally every 4 hours as needed or intravenous oxytocin. The primary outcome measure was time from induction to vaginal delivery. Sample size was calculated using a two-tailed alpha of 0.05 and power of 80%. Baseline demographic data, including maternal age, gestation, parity, Bishop score, birth weight, and group B streptococcal status, were similar. The mean time +/-standard deviation to vaginal birth with oral misoprostol was 720+/-382 minutes compared with 501+/-389 minutes with oxytocin (P = .007). The durations of the first, second, and third stages of labor were similar. There were no differences in maternal secondary outcomes, including cesarean birth (eight and seven, respectively), infection, maternal satisfaction with labor, epidural use, perineal trauma, manual placental removal, or gastrointestinal side effects. Neonatal outcomes including cord pH, Apgar scores, infection, and admission to neonatal intensive care unit were not different. Although labor induction with oral misoprostol was effective, oxytocin resulted in a shorter induction-to-delivery interval. Active labor intervals and other maternal and neonatal outcomes were similar.

O comércio de medicamentos de gênero na mídia impressa brasileira: misoprostol e mulheres The illegal market for gender-related drugs as portrayed in the Brazilian news media: the case of misoprostol and women

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Debora Diniz

2011-01-01

Full Text Available Este artigo analisa como a mídia impressa brasileira noticia o comércio clandestino do misoprostol, o principal medicamento para aborto. Foram recuperadas 1.429 notícias, de 220 veículos de informação impressos e eletrônicos, entre 2004 e 2009. A análise foi realizada em 524 notícias de 62 veículos impressos regionais e nacionais. O misoprostol é pauta permanente, mas o enquadramento das notícias é policial, diverso do aborto como uma questão religiosa, política e de saúde pública que domina a mídia brasileira. O misoprostol está inserido no mercado ilegal de medicamentos de gênero, tais como os para emagrecimento, disfunção erétil ou anabolizantes. Sessenta e quatro (12% notícias impressas apresentam histórias de vida de mulheres que abortaram com o misoprostol. As mulheres têm de 13 a 46 anos e sua inserção de classe demarca diferentes experiências de aborto. Três personagens foram identificados nos itinerários de aborto: amigas, intermediários e médicos. As histórias de aborto tardio são confundidas com a tipificação penal do infanticídio e são casos-limite para a narrativa midiática.This article analyzes how the Brazilian news media covers the illegal market for misoprostol, the main drug used to induce abortion. A total of 1,429 news stories were retrieved from 220 print and electronic media channels from 2004 to 2009. The analysis included 524 stories from 62 regional and national newspapers. Misoprostol appeared repeatedly in the news, but was usually approached from a criminal perspective, unlike abortion as a whole, which the Brazilian media routinely covers as a religious, political, and public health issue. Misoprostol is part of the illegal gender-related drug market, along with drugs for weight loss and erectile dysfunction and anabolic steroids. Sixty-four (12% of the news stories told life histories of women who had aborted with misoprostol. The women's ages ranged from 13 to 46 years, and

Misoprostol for the prevention of postpartum hemorrhage during home births in rural Lao PDR: establishing a pilot program for community distribution

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Durham J

2018-05-01

Full Text Available Jo Durham,1 Alongkone Phengsavanh,2 Vanphanom Sychareun,2 Isaac Hose,1 Viengnakhone Vongxay,2 Douangphachanh Xaysomphou,2 Keith Rickart3 1Faculty of Medicine, School of Public Health, University of Queensland, Brisbane, Queensland, Australia; 2Faculty of Post-Graduate Studies, University of Health Sciences, Vientiane, Lao PDR; 3Communicable Diseases Branch, Department of Health, Brisbane, Queensland, Australia Purpose: The purpose of this study was to gather the necessary data to support the design and implementation of a pilot program for women who are unable to deliver in a healthcare facility in the Lao People’s Democratic Republic (PDR, by using community distribution of misoprostol to prevent postpartum hemorrhage (PPH. The study builds on an earlier research that demonstrated both support and need for community-based distribution of misoprostol in Lao PDR.Methods: This qualitative study identified acceptability of misoprostol and healthcare system needs at varying levels to effectively distribute misoprostol to women with limited access to facility-based birthing. Interviews (n=25 were undertaken with stakeholders at the central, provincial, and district levels and with community members in five rural communities in Oudomxay, a province with high rates of maternal mortality. Focus group discussions (n=5 were undertaken in each community.Results: Respondents agreed that PPH was the major cause of preventable maternal mortality with community distribution of misoprostol an acceptable and feasible interim preventative solution. Strong leadership, training, and community mobilization were identified as critical success factors. While several participants preferred midwives to distribute misoprostol, given the limited availability of midwives, there was a general agreement that village health workers or other lower level workers could safely administer misoprostol. Many key stakeholders, including women themselves, considered that these

A comparative study of DA-9601 and misoprostol for prevention of NSAID-associated gastroduodenal injury in patients undergoing chronic NSAID treatment.

Science.gov (United States)

Lee, Oh Young; Kang, Dae-Hwan; Lee, Dong Ho; Chung, Il-Kwun; Jang, Jae Young; Jang, Jae-Young; Kim, Jin-Il; Cho, Jin-Woong; Rew, Jong-Sun; Lee, Kang-Moon; Kim, Kyoung Oh; Choi, Myung-Gyu; Lee, Sang-Woo; Lee, Soo-Teik; Kim, Tae-Oh; Shin, Yong-Woon; Seol, Sang-Yong

2014-10-01

Misoprostol is reported to prevent non-steroidal anti-inflammatory drug (NSAID)-associated gastroduodenal complications. There is, however, limited information regarding the efficacy of DA-9601 in this context. We performed a comparative study on the relative efficacy of DA-9601 and misoprostol for prevention of NSAID-associated complications. In this multicenter, double-blinded, active-controlled, stratified randomized, parallel group, non-inferiority trial, 520 patients who were to be treated with an NSAID (aceclofenac, 100 mg, twice daily) over a 4-week period were randomly assigned to groups for coincidental treatment with DA-9601 (60 mg, thrice daily) (236 patients for full analysis) or misoprostol (200 μg, thrice daily) (242 patients for full analysis). [corrected]. The primary endpoint was the gastric protection rate, and secondary endpoints were the duodenal protection rate and ulcer incidence rate. Endpoints were assessed by endoscopy after the 4-week treatment period. Drug-related adverse effects, including gastrointestinal (GI) symptoms, were also compared. At week 4, the gastric protection rates with DA-9601 and misoprostol were 81.4 % (192/236) and 89.3 % (216/242), respectively. The difference between the groups was -14.2 %, indicating non-inferiority of DA-9601 to misoprostol. Adverse event rates were not different between the two groups; however, the total scores for GI symptoms before and after administration were significantly lower in the DA-9601 group than in the misoprostol group (-0.2 ± 2.8 vs 1.2 ± 3.2; p DA-9601 is as effective as misoprostol in preventing NSAID-associated gastroduodenal complications, and has a superior adverse GI effect profile.

Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date

OpenAIRE

Smith, Jeffrey Michael; Gubin, Rehana; Holston, Martine M; Fullerton, Judith; Prata, Ndola

2013-01-01

Abstract Background Hemorrhage continues to be a leading cause of maternal death in developing countries. The 2012 World Health Organization guidelines for the prevention and management of postpartum hemorrhage (PPH) recommend oral administration of misoprostol by community health workers (CHWs). However, there are several outstanding questions about distribution of misoprostol for PPH prevention at home births. Metho...

A comparison of oral misoprostol and vaginal prostaglandin e2 tablets for induction of labour at term

International Nuclear Information System (INIS)

Munzar, Z.

2015-01-01

To compare the efficacy and safety of oral misoprostol with prostaglandin E2 vaginal tablets for ripening of cervix and induction of labour at term. Study Design: A non blinded, randomised, controlled trial. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pakistan Air Force Hospital, Air Headquarters Islamabad from July 2005 to January 2006. Patients and Methods: Hundred pregnant women with a singleton live pregnancy, at term (37-42 weeks) with cephalic presentation were selected for induction of labour for various indications having a Bishop's score of < or =5. These women were randomly allocated to receive either 100 micro gm of misoprostol rally repeated four hourly to a maximum of four doses or a 3mg PGE2 tablet vaginally repeated six hourly to a maximum of two doses. Main outcomes measured: Cervical score before and after oral misoprostol and prostaglandin E2 vaginal tablets, vaginal birth within 24 hours of first prostaglandin dose, no of patients having failed induction, caesarean sections (all), caesarean section for fetal distress and uterine hyperstimulation with associated changes in fetal heart rate. Results: Over the period of one year 100 women were recruited for the study, 50 to the misoprostol group and 50 to the vaginal prostaglandin E2 group. There was no significant differences between the two treatment groups in the primary outcomes: improvement in bishops score in both the groups, no of patients with failed induction in both the groups misoprostol 2/50 (4%) v PGE2 3/50 (6%) , vaginal birth achieved in 24 hours (misoprostol 27/50 (54%) v PGE2 29/50 (58%), caesarean sections 14/50 (28%) v 12/50(24%) caesarean section for fetal distress 4/50((8%) v 5/50(9%); uterine hyperstimulation with fetal heart rate changes 2/50 ((4%) v none in the PGE2 group.). Neonatal outcomes were not significantly different in the two groups. Conclusion: Oral misoprostol in strength of 100 micro gm has similar efficacy to vaginal PGE2 tablets

Efficacy and acceptability of a mifepristone-misoprostol combined regimen for early induced abortion among women in Mexico City.

Science.gov (United States)

Peña, Melanie; Dzuba, Ilana G; Smith, Patricio Sanhueza; Mendoza, Luis Jorge Arellano; Bousiéguez, Manuel; Martínez, María Laura García; Polanco, Ranulfo Ríos; Villalón, Antonio Eduardo Flores; Winikoff, Beverly

2014-10-01

To evaluate the experience of women receiving mifepristone-misoprostol for early induced abortion in public sector facilities in the Federal District of Mexico City. An open-label prospective study was conducted with 1000 pregnant women who sought induced abortion with a pregnancy of up to 63days of gestation, as measured from the date of their last menstrual period. The study was conducted in three public sector healthcare facilities: two secondary level hospitals and one primary care clinic. Women ingested 200mg mifepristone on day 1, followed by 800μg buccal misoprostol 24hours later, and they returned for follow-up on day 8. The primary outcome was complete abortion without recourse to surgical intervention. A total of 971 women received mifepristone-misoprostol and were included in the analysis for efficacy of treatment. The overall efficacy of the combined medical abortion regimen studied was 97.3% (n=945); the success rate did not vary significantly by gestational age (95.9%-100%; P=0.449). Most women (n=922, 95.0%) had a successful induced abortion with only one dose of misoprostol. The combined mifepristone and buccal misoprostol regimen was found to be highly effective and acceptable among Mexican women. www.ClinicalTrials.gov: NCT00386282. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Availability and provision of misoprostol and other medicines for menstrual regulation among pharmacies in Bangladesh via mystery client survey.

Science.gov (United States)

Huda, Fauzia A; Ngo, Thoai D; Ahmed, Anisuddin; Alam, Anadil; Reichenbach, Laura

2014-02-01

To explore the availability and provision of misoprostol and other medicines for menstrual regulation (MR) among pharmacies in Bangladesh. Between March and November 2011, a cross-sectional study using mystery client visits was conducted among pharmacy workers in Dhaka and Gazipur Districts, Bangladesh. Mystery clients were trained to present 1 of 4 pre-developed situations to pharmacy workers to elicit information on the regimen, adverse effects, and complications of misoprostol use. Mystery clients visited 331 pharmacies. Among the 331 pharmacy workers, 45.8% offered the mystery clients misoprostol and/or other medicines for MR; 25.7% referred them to private clinics or hospitals. Only 7% recommended an effective regimen of misoprostol for MR; 65% suggested administering vaginal and oral misoprostol together. Overall, 72.4% did not provide any advice on complications; the remainder suggested visiting trained providers for complications. Counseling on excessive bleeding as a danger sign was provided by 46% of pharmacy workers. Most (94%) did not provide or refer for post-MR family planning. Pharmacy workers in urban Bangladesh are providing ineffective drugs and regimens for MR. A training package is needed to strengthen service delivery by providing accurate information, high-quality products, and referral mechanisms for women seeking MR through pharmacies. © 2013.

Misoprostol in obstetrics and gynaecology — benefits and risks

African Journals Online (AJOL)

Enrique

fetal tachycardia were detected on electronic fetal heart rate and external uterine pressure monitoring. A tablet. (200 µg) of misoprostol was found in the posterior vaginal fornix. The tablet was removed, 10 µg of intravenous ipradol given and labour managed expectantly, with normal delivery of a healthy baby. She informed ...

A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer

International Nuclear Information System (INIS)

Hille, Andrea; Schmidberger, Heinz; Hermann, Robert M.; Christiansen, Hans; Saile, Bernhard; Pradier, Olivier; Hess, Clemens F.

2005-01-01

Purpose: Acute radiation proctitis is the most relevant complication of pelvic radiation and is still mainly treated supportively. Considering the negative impact of acute proctitis symptoms on patients' daily activities and the potential relationship between the severity of acute radiation injury and late damage, misoprostol was tested in the prevention of acute radiation-induced proctitis. Methods and Materials: A total of 100 patients who underwent radiotherapy for prostate cancer were entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. Radiation-induced toxicity was evaluated weekly during radiotherapy using the Common Toxicity Criteria. Results: Between the placebo and the misoprostol groups, no significant differences in proctitis symptoms occurred: 76% of patients in each group had Grade 1 toxicity, and 26% in the placebo group and 36% in the misoprostol group had Grade 2 toxicity. No differences were found in onset or symptom duration. Comparing the peak incidence of patients' toxicity symptoms, significantly more patients experienced rectal bleeding in the misoprostol group (p = 0.03). Conclusion: Misoprostol given as a once-daily suppository did not decrease the incidence and severity of radiation-induced acute proctitis and may increase the incidence of acute bleeding

effectiveness and safety of 2-hourly 20 mcg oral misoprostol solution

African Journals Online (AJOL)

2014-09-01

Sep 1, 2014 ... misoprostol were augmented with oxytocin and delivered vaginally. The Caesarean .... who accepted to participate were recruited and signed the informed ... the research assistant mid wife then picked a sealed opaque ...

Intravaginal hormonal contraception for women of reproductive age with excessive body mass

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I. B. Gridina

2015-12-01

Full Text Available There are a number of disadvantages inherent in all oral hormonal contraceptives: need for daily administration, fluctuations of hormone levels throughout the day, metabolism in the gastrointestinal tract, the effect of the first passage through the liver. All this became a prerequisite to the creation of prolonged oral hormonal methods of contraception, which would be devoid of these shortcomings. One of such method of hormonal contraception is intravaginal hormonal system. The aim was to determine the safety and efficacy of its use in women of reproductive age with overweight. 43 women were included. State of lipid metabolism, changes of the hemostatic system, blood pressure and weight fluctuations in the past 6 months of using intravaginal hormonal contraceptive system were studied. Results. It is established that hormonal intravaginal contraceptive ring gives minimal metabolic effects. Conclusion. This suggests that this ring can be used successfully in patients with excessive body mass, because there is no effect of the ring on hemostasis, lipid metabolism and body weight.

Randomised controlled trial of the efficacy of misoprostol used as a ...

African Journals Online (AJOL)

Randomised controlled trial of the efficacy of misoprostol used as a cervical ripening agent prior to termination of pregnancy in the first trimester. Eric T M de Jonge, Rachel Jewkes, Jonathan Levin, Helen Rees ...

A randomized controlled study of the efficacy of misoprostol and hyaluronic acid in preventing adhesion formation after gynecological surgery: a rat uterine horn model.

Science.gov (United States)

Kaya, Cihan; Sever, Nurten; Cengiz, Hüseyin; Yıldız, Şükrü; Ekin, Murat; Yaşar, Levent

2014-05-01

To investigate the effect of misoprostol in the reduction of adhesion formation after gynecological surgery. A double blind, randomized controlled experimental study was designed. Twenty-one female Wistar Hannover rats were divided into three groups as control, misoprostol and Hyalobarrier(®) groups. A uterine horn adhesion model was created. After anesthesia induction, 1.5-2cm injuries were made to the each uterine horn by cautery. The control group received no special medications except for the standard surgical procedure. The misoprostol group received 10μcg/kg misoprostol in addition to the standard surgical procedure, and the Hyalobarrier(®) group received 1cm(3) ready-for-use Hyalobarrier(®) gel intraperitoneally in addition to the standard surgical procedure. After 14 days from the first surgical procedure, adhesion scores were evaluated. The extent (p<0.001), severity (p<0.001), degree (p<0.001) and total adhesion score (p<0.001) values of the control group were statistically higher than the values of misoprostol and Hyalobarrier(®) groups. The inflammation score value of misoprostol group was statistically lower than control and Hyalobarrier(®) groups (p<0.001). In this study, we have found a new therapeutic potential of misoprostol that may be useful in preventing pelvic adhesion and reducing inflammation scores. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Misoprostol inhibits gastric mucosal release of endogenous prostaglandin E2 and thromboxane B2 in healthy volunteers

DEFF Research Database (Denmark)

Mertz-Nielsen, A; Eskerod, O; Bukhave, K

1995-01-01

Prostaglandin analogues of the E-series theoretically offer the ideal antiulcer drugs. Peptic ulcer healing with prostaglandin analogues is, however, no better than would be predicted from their ability to inhibit gastric acid secretion and they are less effective than histamine H2 receptor...... antagonists in preventing ulcer relapse. It could be that prostaglandin analogues inhibit gastric mucosal synthesis or release of endogenous eicosanoids, thereby abrogating their own effects. This study, therefore, examined how a single therapeutic dose (200 micrograms) of misoprostol, a synthetic analogue...... blind, cross over design. In each subject misoprostol or placebo was instilled in randomised order into the stomach, which was subsequently perfused with isotonic mannitol. Misoprostol significantly decreased basal as well as acid stimulated output of PGE2 and TXB2, without affecting output of LTB4...

Induction of labor with titrated oral misoprostol solution versus oxytocin in term pregnancy: randomized controlled trial Indução do trabalho de parto por meio de solução oral titulada de misoprostol versus oxitocina em gestação a termo: estudo controlado randomizado

Directory of Open Access Journals (Sweden)

Rezvan Aalami-Harandi

2013-02-01

Full Text Available PURPOSE: To evaluate the effectiveness and the safety of orally administered misoprostol in comparison to intravenously infused oxytocin for labor induction in term pregnant women. METHODS: Between 2008 and 2010, a total of 285 term pregnant women whom were candidate for vaginal delivery were assessed for eligibility to enter the study. Twenty five patients were excluded for different reasons; and 260 included women were randomly assigned to one of the two groups according to the method of treatment, misoprostol or oxytocin. The misoprostol group received 25 µg every 2 hours for up to 24 hours for induction. The oxytocin group received an infusion of 10 IU which was gradually increased. The time from induction to delivery and induction to the beginning of the active phase and successful inductions within 12, 18, and 24 hours were recorded. The trial is registered at irct.ir, number IRCT2012061910068N1. RESULTS: Failure of induction, leading to caesarean section was around 38.3% in the oxytocin group and significantly higher than that of the misoprostol group (20.3% (pOBJETIVO: Avaliar a eficácia e segurança do misoprostol administrado por via oral em comparação à infusão de oxitocina para a indução do trabalho de parto em gestantes a termo. MÉTODOS: Entre 2008 e 2010, um total de 285 gestantes a termo candidatas para parto vaginal foram avaliadas quanto à eligibilidade para inclusão no estudo. Vinte e cinco pacientes foram excluídas por várias razões, e as 260 mulheres incluídas foram divididas aleatoriamente em dois grupos de acordo com o método de tratamento, misoprostol ou oxitocina. O grupo tratado com o misoprostol recebeu 25 µg cada 2 horas durante um máximo de 24 horas para indução. O grupo tratado com oxitocina recebeu infusão de 10 UI, que foi aumentada gradativamente. O tempo a partir da indução até o início da fase ativa e as induções bem-sucedidas dentro de 12, 18 e 24 horas foram registrados. O ensaio foi

Oral misoprostol in the prevention of uterine bleeding after surgical ...

African Journals Online (AJOL)

2013-03-13

Mar 13, 2013 ... Oral misoprostol in the prevention of uterine bleeding after surgical evacuation of first trimester abortion: A comparative study of three uterotonic agents. TM Aramide, AK Olusegun1, AC Akinfolarin2, DF Oriola. Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, ...

Comparison of vaginal and oral misoprostol, for the induction of ...

African Journals Online (AJOL)

Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death. ... It is a tertiary institution serving predominantly black indigenous population. Main outcome measures: The primary outcome measure was the induction to delivery time, and secondary outcome measures were ...

Treatment of retained placenta with misoprostol: a randomised controlled trial in a low-resource setting (Tanzania

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Fauteck Heiner

2009-10-01

Full Text Available Abstract Background Retained placenta is one of the common causes of maternal mortality in developing countries where access to appropriate obstetrical care is limited. Current treatment of retained placenta is manual removal of the placenta under anaesthesia, which can only take place in larger health care facilities. Medical treatment of retained placenta with prostaglandins E1 (misoprostol could be cost-effective and easy-to-use and could be a life-saving option in many low-resource settings. The aim of this study is to assess the efficacy and safety of sublingually administered misoprostol in women with retained placenta in a low resource setting. Methods Design: Multicentered randomised, double-blind, placebo-controlled trial, to be conducted in 5 hospitals in Tanzania, Africa. Inclusion criteria: Women with retained placenta, at a gestational age of 28 weeks or more and blood loss less than 750 ml, 30 minutes after delivery of the newborn despite active management of third stage of labour. Trial Entry & Randomisation & Study Medication: After obtaining informed consent, eligible women will be allocated randomly to the treatment groups using numbered envelopes that will be randomized in variable blocks containing identical capsules with either 800 microgram of misoprostol or placebo. The drugs will be given sublingually. The women, maternal care providers and researchers will be blinded to treatment allocation. Sample Size: 117 women, to show a 40% reduction in manual removals of the placenta (p = 0.05, 80% power. The randomization will be misoprostol: placebo = 2:1 Primary Study Outcome: Expulsion of the placenta without manual removal. Secondary outcome is the number of blood transfusions. Discussion This is a protocol for a randomized trial in a low resource setting to assess if medical treatment of women with retained placenta with misoprostol reduces the incidence of manual removal of the placenta. Clinical Trial Registration Current

Solução oral escalonada de misoprostol para indução do parto: estudo piloto Titrated oral solution of misoprostol for labour induction: a pilot study

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Alex Sandro Rolland Souza

2010-05-01

Full Text Available OBJETIVO: avaliar a efetividade e a segurança da administração de uma nova formulação de misoprostol em solução por via oral, com doses escalonadas, para indução do parto de feto vivo a termo. MÉTODOS: realizou-se um estudo multicêntrico, do tipo ensaio clínico, aberto, não-randomizado, no período de Julho a Dezembro de 2008. Foram incluídas 30 pacientes com indicação de indução do trabalho de parto, a termo, com feto vivo, índice de Bishop 5. Foram excluídas mulheres com cicatriz uterina, cardiotocografia alterada, gestação múltipla, restrição de crescimento fetal, hemorragia genital e presença de tumores, ulcerações ou malformações genitais. A dose inicial da solução oral foi de 20µg/h de misoprostol, nas primeiras 6 horas, aumentando em 20µg/h de misoprostol a cada 6 horas, se o trabalho de parto não fosse deflagrado, até uma dose máxima de 80µg/h, nas primeiras 24 horas, mantendo a dose máxima (80µg/h por mais 24 horas, se necessário. RESULTADOS: o trabalho de parto foi induzido satisfatoriamente em 96,7% das gestantes. O intervalo entre a primeira dose e o início das contrações uterinas foi de 3,8±1,8 horas, enquanto o intervalo entre a dose inicial e o parto variou entre 6 e 24 horas. A frequência de parto vaginal foi de 80% (n=24. A maioria das gestantes iniciou o trabalho de parto com a dose de 20µg/h (60%; n=18. A taquissistolia ocorreu em 13,3% das gestações e líquido meconial foi detectado em 20% dos casos. Houve dois casos de escore de Apgar PURPOSE: to test effectiveness and safety of the oral administration of a new misoprostol formulation in titrated doses for the induction of delivery of a live fetus at term. METHODS: an open pilot multicenter, non-randomized clinical trial was conducted from July to December 2008. A total of 30 patients with indications for induction of labor were included. The patients had a live fetus, Bishop score 5. Exclusion criteria were previous uterine

Comparison of labour induction with misoprostol and dinoprostone and characterization of uterine response based on electrohysterogram.

Science.gov (United States)

Benalcazar-Parra, Carlos; Monfort-Orti, Rogelio; Ye-Lin, Yiyao; Prats-Boluda, Gema; Alberola-Rubio, Jose; Perales, Alfredo; Garcia-Casado, Javier

2017-12-17

The objective of this study is to compare the uterine activity response between women administered dinoprostone (prostaglandin E2) and misoprostol (prostaglandin E1) for induction of labour (IOL) by analysing not only the traditional obstetric data but also the parameters extracted from uterine electrohysterogram (EHG). Two cohorts were defined: misoprostol (25-µg vaginal tablets; 251 women) and dinoprostone cohort (10 mg vaginal inserts; 249 women). All the mothers were induced by a medical indication of a Bishop Score PMU) 60' after drug administration, while spectral parameters significantly increased after 150'. This response was not observed in failed inductions. In the successful dinoprostone group, the duration and number of contractions increased significantly after 120', PMU did so after 180', and no significant differences were found for spectral parameters, possibly due to the slower pharmacokinetics of this drug. Successful inductions of labour by misoprostol are associated with earlier effective contractions than in labours induced by dinoprostone.

Effectiveness of Per Rectal Misoprostol Versus Intramuscular Oxytocin for Prevention of Primary Postpartum Haemorrhage.

Science.gov (United States)

Asmat, Raheela; Ashraf, Tasneem; Asmat, Fazila; Asmat, Shakila; Asmat, Nagina

2017-01-01

To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). Randomised controlled trial study. Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'. The patients were followed within 24 hours of spontaneous vaginal deliveries. Pads soaked were used to assess the amount of blood loss. A total of 1,678 patients were included in the study. The mean age of patients in group-A was 29.11 years while the mean age of patients in group-B was 29.16 years. One hundred and twenty-three (14.66%) patients in group-A and 120 (14.31%) patients in group-B had PPH. Among the total 1,678 patients, 243 (14.49%) had postpartum haemorrhage among whom 24 (9.88%) had major haemorrhage with a blood loss ≥1000 mL. Among the sub-group (839 patients) administered misoprostol had 123 (14.66%) patients with blood loss greater than 500 mL and the rest 716 patients (85.34%) had blood loss less than 500 mL. The sub-group administered oxytocin have 120 (14.31%) out of 839 patients with postpartum haemorrhage while 719 (85.69%) had blood loss less than 500 mL. Active management of 3rd stage of labour with per rectal misoprostol administration was as effective as intramuscular oxytocin. Both were equally effective to reduce PPH and the subsequent need for surgical interventions.

The biomedicalisation of illegal abortion: the double life of misoprostol in Brazil

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Silvia De Zordo

Full Text Available Abstract This paper examines the double life of misoprostol in Brazil, where it is illegally used by women as an abortifacient and legally used in obstetric hospital wards. Based on my doctoral and post-doctoral anthropological research on contraception and abortion in Salvador, Bahia, this paper initially traces the “conversion” of misoprostol from a drug to treat ulcers to a self-administered abortifacient in Latin America, and its later conversion to aneclectic global obstetric tool. It then shows how, while reducing maternal mortality, its use as an illegal abortifacient has reinforced the double reproductive citizenship regime existing in countries with restrictive abortion laws and poor post-abortion care services, where poor women using it illegally are stigmatised, discriminated against and exposed to potentially severe health risks.

Incidence of fetal distress in 6 hourly vaginally administered 3 doses, of misoprostol versus dinoprostone for labour induction: a comparative study

International Nuclear Information System (INIS)

Rashid, N.; Hanif, A.

2013-01-01

Background: Artificial labor pain always poses the risk of fetal distress and is more painful than spontaneous labour. The pharmacological agents that are involved in stimulating uterine contraction may initiate a chain of processes that may lead the baby to suffocate, being deficient of essential oxygen and suffer from distress. The accelerated efforts to adapt safe and advanced measures are inevitable to make the labour induction easier and more secure for both lives involved. Objective: The objective of this study was to compare the incidence of fetal distress in 6 hourly vaginally administered 3 doses, of misoprostol versus dinoprostone for labour induction. Methods: This observational type of comparative study was conducted in Obstetrics Ward Lady Aitchison Hospital Lahore. A total of 200 postdate primigravidas undergoing induction of labour at 41 weeks were selected for this study. They were randomly divided into misoprostol and dinoprostone group, each containing 100 patients. The dose of misoprostol was 50 microgram each time up to a maximum of 150 microgram (3 doses) and dose of dinoprostone was 2 mg and only 2 doses of dinoprostone were used with an interval of 6 hours. Continuous fetal heart rate monitoring was done after induction. Signs of fetal distress like meconium staining of liquor after rupture of membranes and CTG changes were noted. After delivery of baby Apgar score at 5 minutes was taken and any resuscitation required or need for keeping the baby in nursery was noted. Results: The mean age of the patients in misoprostol group was 25.4+-4.5 years and in dinoprostone group was 23.3+-3.4 years. The mean duration of induction to delivery interval in misoprostol group was 16.4+-6.4 hours and in dinoprostone group was 13.1+-4.6 hours. In misoprostol group, 40 (40%) patients delivered with LSCS and 60 (60%) patients delivered with spontaneous vaginal delivery. In dinoprostone group, 36 (36%) patients delivered with LSCS and 64 (64%) patients

Development and evaluation of accelerated drug release testing methods for a matrix-type intravaginal ring.

Science.gov (United States)

Externbrink, Anna; Eggenreich, Karin; Eder, Simone; Mohr, Stefan; Nickisch, Klaus; Klein, Sandra

2017-01-01

Accelerated drug release testing is a valuable quality control tool for long-acting non-oral extended release formulations. Currently, several intravaginal ring candidates designed for the long-term delivery of steroids or anti-infective drugs are being in the developing pipeline. The present article addresses the demand for accelerated drug release methods for these formulations. We describe the development and evaluation of accelerated release methods for a steroid releasing matrix-type intravaginal ring. The drug release properties of the formulation were evaluated under real-time and accelerated test conditions. Under real-time test conditions drug release from the intravaginal ring was strongly affected by the steroid solubility in the release medium. Under sufficient sink conditions that were provided in release media containing surfactants drug release was Fickian diffusion driven. Both temperature and hydro-organic dissolution media were successfully employed to accelerate drug release from the formulation. Drug release could be further increased by combining the temperature effect with the application of a hydro-organic release medium. The formulation continued to exhibit a diffusion controlled release kinetic under the investigated accelerated conditions. Moreover, the accelerated methods were able to differentiate between different prototypes of the intravaginal ring that exhibited different release profiles under real-time test conditions. Overall, the results of the present study indicate that both temperature and hydro-organic release media are valid parameters for accelerating drug release from the intravaginal ring. Variation of either a single or both parameters yielded release profiles that correlated well with real-time release. Copyright © 2016 Elsevier B.V. All rights reserved.

Intravaginal insertion in KwaZulu Natal: sexual practices and preferences in the context of microbicide gel use

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Gafos, M.; Mzimela, M.; Sukazi, S.; Pool, R.; Montgomery, C.; Elford, J.

2010-01-01

Intravaginal insertion is often associated with the concept of ‘dry’ sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal

Posterior intravaginal slingplasty with preservation of the uterus: a modified surgical technique in a young myelomeningocele patient

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Verguts, Jasper; Roovers, Jan-Paul; de Ridder, Dirk; Coremans, Georges; Deprest, Jan

2007-01-01

We report a case of uterine prolapse in a young woman, treated by posterior intravaginal slingplasty with preservation of the uterus as a feasible and safe surgical procedure. Posterior intravaginal slingplasty is commonly used to correct vaginal vault prolapse, but may be a valuable alternative to

Experiences in the use of misoprostol in the management of first ...

African Journals Online (AJOL)

Objective: To determine the effectiveness and acceptability of misoprostol in the evacuation of the uterus in first trimester missed abortion. Study Design: This was a non‑randomized trial. Setting: This study was conducted in the Gynecologic Unit, Abubakar Tafawa Balewa University Teaching Hospital Bauchi,. Nigeria.

Experiences in the use of misoprostol in the management of first ...

African Journals Online (AJOL)

Objective: To determine the effectiveness and acceptability of misoprostol in the evacuation of the uterus in first trimester missed abortion. Study Design: This was a non‑randomized trial. Setting: This study was conducted in the Gynecologic Unit, Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Nigeria.

[The illegal market for gender-related drugs as portrayed in the Brazilian news media: the case of misoprostol and women].

Science.gov (United States)

Diniz, Debora; Castro, Rosana

2011-01-01

This article analyzes how the Brazilian news media covers the illegal market for misoprostol, the main drug used to induce abortion. A total of 1,429 news stories were retrieved from 220 print and electronic media channels from 2004 to 2009. The analysis included 524 stories from 62 regional and national newspapers. Misoprostol appeared repeatedly in the news, but was usually approached from a criminal perspective, unlike abortion as a whole, which the Brazilian media routinely covers as a religious, political, and public health issue. Misoprostol is part of the illegal gender-related drug market, along with drugs for weight loss and erectile dysfunction and anabolic steroids. Sixty-four (12%) of the news stories told life histories of women who had aborted with misoprostol. The women's ages ranged from 13 to 46 years, and socioeconomic status was associated with different experiences with abortion. Three characters appeared in the women's abortion itineraries: girlfriends (confidantes), go-betweens, and physicians. Stories of late-stage abortion are confused with the criminal characterization of infanticide and provide the extreme cases in the media's narrative on abortion.

A Rare Cause of Scrotal Mass in a Newborn: Antenatal Intravaginal Testicular Torsion

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Ahmet Ali Tuncer

2018-04-01

Full Text Available Intravaginal testicular torsion is a very rare pathology in the neonatal period. However, it is the most common type of torsion in puberty. In this article, we present a male patient with testicular hyperemia and a mass in the testis. Ultrasonography revealed intravaginal testicular torsion and absence of testicular blood flow. This paper aims to draw attention to the importance of neonatal examination for the presence of testicular torsion which is a rare pathology in newborns with scrotal colour change or presence of an abnormal mass.

Feasibility and acceptability of clean birth kits containing misoprostol for self-administration to prevent postpartum hemorrhage in rural Papua New Guinea.

Science.gov (United States)

Vallely, Lisa M; Homiehombo, Primrose; Walep, Elizabeth; Moses, Michael; Tom, Marynne; Kelly-Hanku, Angela; Vallely, Andrew; Nataraye, Eluo; Ninnes, Caroline; Mola, Glen D; Morgan, Chris; Kaldor, John M; Wand, Handan; Whittaker, Andrea; Homer, Caroline S E

2016-06-01

To determine the feasibility and acceptability of providing clean birth kits (CBKs) containing misoprostol for self-administration in a rural setting in Papua New Guinea. A prospective intervention study was conducted between April 8, 2013, and October 24, 2014. Eligible participants were women in the third trimester of pregnancy who attended a prenatal clinic in Unggai Bena. Participants received individual instruction and were then given a CBK containing 600μg misoprostol tablets for self-administration following an unsupervised birth if they could demonstrate their understanding of correct use of items in the CBK. Data regarding the use and acceptability of the CBK and misoprostol were collected during postpartum follow-up. Among 200 participants, 106 (53.0%) had an unsupervised birth, and 99 (93.4%) of these women used the CBK. All would use the CBK again and would recommend it to others. Among these 99 women, misoprostol was self-administered by 98 (99.0%), all of whom would take the drug again and would recommend it to others. The findings strengthen the case for community-based use of misoprostol to prevent postpartum hemorrhage in remote communities. Large-scale interventions should be planned to further evaluate impact and acceptability. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Baixa dose de misoprostol sublingual (12,5 µg para indução do parto Low dose of sublingual misoprostol (12.5 µg for labor induction

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Daniele Sofia de Moraes Barros Gattás

2012-04-01

Full Text Available OBJETIVO: Descrever os resultados maternos e perinatais utilizando 12,5 µg de misoprostol sublingual para indução do parto em gestantes com feto vivo a termo. MÉTODOS: Realizou-se um estudo multicêntrico, tipo ensaio clínico, aberto e não randomizado, no período de julho a dezembro de 2009. Foram incluídas 30 gestantes com indicação de indução do parto, a termo, feto vivo, escore de Bishop menor ou igual a seis, apresentação cefálica, peso fetal estimado menor que 4.000 g e índice de líquido amniótico maior que cinco. Foram excluídas mulheres com cicatriz uterina, alteração da vitalidade fetal, anomalias congênitas, gestação múltipla, restrição de crescimento intrauterino, hemorragia genital e contraindicações ao parto vaginal. O comprimido de misoprostol sublingual 12,5 µg foi administrado a cada seis horas, até o início do trabalho de parto, máximo de oito doses. RESULTADOS: O trabalho de parto foi induzido satisfatoriamente em 90% das gestantes. As médias dos intervalos entre a primeira dose e o início das contrações uterinas e o parto foram de 14,3±11,7 horas e 25,4±13 horas, respectivamente. A frequência de parto vaginal foi de 60%. A taquissistolia ocorreu em duas gestantes, sendo revertida em ambos os casos sem necessitar de cesariana. A eliminação de mecônio foi observada em quatro pacientes e o escore de Apgar foi menor que sete no quinto minuto em um recém-nascido. CONCLUSÃO: Os desfechos maternos e perinatais foram favoráveis depois da indução do parto com misoprostol sublingual na dose de 12,5 µg a cada seis horas. No entanto, são necessários ensaios clínicos controlados comparando esse esquema posológico com outras doses e vias de administraçãoPURPOSE: To describe the maternal and perinatal outcomes after the use of 12.5 µg of sublingual misoprostol for labor induction in women with term pregnancy and a live fetus. METHODS: We conducted a multicenter, open and non

Comparison of two dose regimens of misoprostol for second-trimester pregnancy termination

NARCIS (Netherlands)

Brouns, Joseph Franciscus Gertrudis Maria; van Wely, Madelon; Burger, Mattheus Petrus Maria; van Wijngaarden, Willem Jacobus

2010-01-01

Objective: The study was conducted to compare the efficacy of two different dose regimens of misoprostol administered vaginally in combination with mifepristone for second trimester termination of viable and non-viable pregnancies. Design: Double-blind randomized controlled trial conducted at the

ROLE OF 400 MCG INTRAOPERATIVE SUBLINGUAL MISOPROSTOL FOR REDUCTION OF CAESAREAN BLOOD LOSS

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Lalmohan Nayak

2017-02-01

Full Text Available BACKGROUND Lower segment caesarean section is a common surgical procedure. Postpartum haemorrhage incidence after LSCS is 4%. Misoprostol is a prostaglandin E1 analogue with good uterotonic properties, easy availability, low cost, thermostability, long shelf life, easy administration and few adverse effects at therapeutic dose. It is readily absorbed by oral, sublingual, buccal, vaginal or rectal route. Sublingual route attains quickest concentration. Dose of 400 mcg was chosen in this study to minimise adverse effects with optimal therapeutic benefit. The aim of the study is to determine the efficacy of sublingual misoprostol in reducing caesarean blood loss. MATERIALS AND METHODS It is a prospective experimental study done in VSSIMSAR, Burla. Women undergoing LSCS were randomly assigned to study and control groups of equal strength of 100 each. In all cases, preoperative Hb%, haematocrit, pulse, BP was noted. Study group were given 400 mcg misoprostol at the time of cord clamping. In control group, nothing was given. In all patients, active management of third stage of labour was done by using oxytocin 10 IU (IV along with uterine massage. Blood loss soaked by tetra was calculated using formula, blood loss = wet weight-dry weight/1.05 (1.05 is constant. Amount of blood loss, postoperative Hb%, haematocrit, pulse rate, BP was noted in both groups and compared. BP and pulse were noted after 1 hour and Hb%, haematocrit were noted after 24 hours. RESULTS Study group showed significant decrease in total blood loss (around 117.9 mL as compared to control group. There was significant decrease in the postoperative fall in Hb in the study group as compared to control, the mean difference being 0.631 gm%. Study group also showed decrease in postoperative fall in haematocrit as compared to control, the mean difference being 0.055. CONCLUSION Misoprostol significantly reduced caesarean blood loss and doesn’t affect foetal outcome without significant

Pregnancy outcome of home intravaginal insemination in couples with unconsummated marriage

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Kaberi Banerjee

2017-01-01

Full Text Available Unconsummated marriage are mainly due to vaginismus or erectile dysfunction. They contribute to about 5% of couples in an infertility clinic. Their incidence is increasing in the metropolitan cities because of stressful lifestyles. Many of couples are advised intrauterine insemination as fertility treatment. However, home insemination is a simple, inexpensive and effective way of achieving pregnancy in such couples. We present the first study to document pregnancy rates of artificial home intravaginal insemination in couples with unconsummated marriage. Aim: To assess the pregnancy rates (PR with intravaginal insemination (IVI by couples with nonconsummation of marriage. Setting: Infertility outpatient clinic, New Delhi. Design: Retrospective analysis. Material and Methods: 55 couples of unconsummated marriage were evaluated in a period of two years. Group 1 contains 29 patients aged between 20 to 33 years; group 2 includes 14 patients aged between 33 to 36 years and group 3 includes 12 patients aged more than 36 years. Result(s: Unconsummated marriage was caused by vaginismus in 67% of the cases, erectile dysfunction in 22% and premature ejaculation in 11%. Clinical pregnancy rate was 69% in group 1; 43% in group 2 and 25% in group 3 after 6 cycles of AI. Conclusion(s: Intravaginal insemination is a simple, short, economical, effective and painless procedure for conception in nonconsummation of marriage.

Pregnancy Outcome of Home Intravaginal Insemination in Couples with Unconsummated Marriage

Science.gov (United States)

Banerjee, Kaberi; Singla, Bhavana

2017-01-01

Unconsummated marriage are mainly due to vaginismus or erectile dysfunction. They contribute to about 5% of couples in an infertility clinic. Their incidence is increasing in the metropolitan cities because of stressful lifestyles. Many of couples are advised intrauterine insemination as fertility treatment. However, home insemination is a simple, inexpensive and effective way of achieving pregnancy in such couples. We present the first study to document pregnancy rates of artificial home intravaginal insemination in couples with unconsummated marriage. Aim: To assess the pregnancy rates (PR) with intravaginal insemination (IVI) by couples with nonconsummation of marriage. Setting: Infertility outpatient clinic, New Delhi. Design: Retrospective analysis. Material and Methods: 55 couples of unconsummated marriage were evaluated in a period of two years. Group 1 contains 29 patients aged between 20 to 33 years; group 2 includes 14 patients aged between 33 to 36 years and group 3 includes 12 patients aged more than 36 years. Result(s): Unconsummated marriage was caused by vaginismus in 67% of the cases, erectile dysfunction in 22% and premature ejaculation in 11%. Clinical pregnancy rate was 69% in group 1; 43% in group 2 and 25% in group 3 after 6 cycles of AI. Conclusion(s): Intravaginal insemination is a simple, short, economical, effective and painless procedure for conception in nonconsummation of marriage. PMID:29430157

Analysis of misoprostol and chlorhexidine policy gains in Pakistan: the advocacy experience of Mercy Corps Pakistan.

Science.gov (United States)

Sarwar, Zahida; Cutherell, Andrea; Noor, Arif; Naureen, Farah; Norman, Jennifer

2015-11-25

While Pakistan has made progress toward achieving Millennium Development Goal 5 for maternal health, it is unlikely to achieve the target; further, it is also not on track for Millennium Development Goal 4 regarding child health. Two low-cost, temperature stable and life-saving drugs, misoprostol and chlorhexidine, can respectively avert maternal and newborn deaths, and are particularly pertinent for poor and marginalized areas which bear the brunt of maternal and newborn deaths in Pakistan. In response, Mercy Corps led focused advocacy efforts to promote changes in policies, protocols, and regulatory environments for misoprostol (2012-2014) and for chlorhexidine (2014). These short-duration advocacy projects facilitated significant policy gains, such as inclusion of misoprostol and chlorhexidine into province-specific essential drug lists, development and endorsement of clinical protocols for the two drugs by provincial health departments, inclusion of misoprostol into pre-service training curriculum for several health cadres, and application for registration of chlorhexidine (at the concentration required for newborn care) by two pharmaceutical companies. These results were achieved by a consultative and evidence-based process which generated feedback from community members, program implementers, and policymakers, and ultimately put the government in the driver's seat to facilitate change. Community Action Dialogue forums were linked with provincial-level Technical Working Groups and Provincial Steering Committees, who passed on endorsed recommendations to the Health Secretary. The key factors which facilitated change were the identification of champions within the provincial health departments, prioritization of relationship building and follow-up, focus on concrete advocacy aims rather than broad objectives, and the use of multi-stakeholder forums to secure an enabling environment for the policy changes to take root. While these advocacy initiatives resulted in

Side-effects of oral misoprostol in the third stage of labour – a ...

African Journals Online (AJOL)

Postpartum blood loss in the first hour was measured by collection in a special ... of postpartum oral misoprostol 600 Jlg with shivering, pyrexia and hypertension. ... as for the trend towards increased abdominal pain, may be secondary to the ...

Results from a study using misoprostol for management of incomplete abortion in Vietnamese hospitals: implications for task shifting.

Science.gov (United States)

Ngoc, Nguyen Thi Nhu; Shochet, Tara; Blum, Jennifer; Hai, Pham Thanh; Dung, Duong Lan; Nhan, Tran Thanh; Winikoff, Beverly

2013-05-22

Complications following spontaneous or induced abortion are a major cause of maternal morbidity. To manage these complications, post-abortion care (PAC) services should be readily available and easy to access. Standard PAC treatment includes surgical interventions that are highly effective but require surgical providers and medical centers that have the necessary space and equipment. Misoprostol has been shown to be an effective alternative to surgical evacuation and can be offered by lower level clinicians. This study sought to assess whether 400 mcg sublingual misoprostol could effectively evacuate the uterus after incomplete abortion and to confirm its applicability for use at lower level settings. All women presenting with incomplete abortion at one of three hospitals in Vietnam were enrolled. Providers were not asked to record if the abortion was spontaneous or induced. It is likely that all were spontaneous given the legal status and easy access to abortion services in Vietnam. Participants were given 400 mcg sublingual misoprostol and instructed to hold the pills under their tongue for 30 minutes and then swallow any remaining fragments. They were then asked to return one week later to confirm their clinical status. Study clinicians were instructed to confirm a complete expulsion clinically. All women were asked to complete a questionnaire regarding satisfaction with the treatment. Three hundred and two women were enrolled between September 2009 and May 2010. Almost all participants (96.3%) had successful completions using a single dose of 400 mcg misoprostol. The majority of women (87.2%) found the side effects to be tolerable or easily tolerable. Most women (84.3%) were satisfied or very satisfied with the treatment they received; only one was dissatisfied (0.3%). Nine out of ten women would select this method again and recommend it to a friend (91.0% and 90.0%, respectively). This study confirms that 400 mcg sublingual misoprostol effectively evacuates

Implementation of misoprostol for postabortion care in Kenya and Uganda: a qualitative evaluation

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Joachim Osur

2013-04-01

Full Text Available Objective: Evaluate implementation of misoprostol for postabortion care (MPAC in two African countries. Design: Qualitative, program evaluation. Setting: Twenty-five public and private health facilities in Rift Valley Province, Kenya, and Kampala Province, Uganda. Sample: Forty-five MPAC providers, health facility managers, Ministry of Health officials, and non-governmental (NGO staff involved in program implementation. Methods and main outcome measures: In both countries, the Ministry of Health, local health centers and hospitals, and NGO staff developed evidence-based service delivery protocols to introduce MPAC in selected facilities; implementation extended from January 2009 to October 2010. Semi-structured, in-depth interviews evaluated the implementation process, identified supportive and inhibitive policies for implementation, elicited lessons learned during the process, and assessed provider satisfaction and providers’ impressions of client satisfaction with MPAC. Project reports were also reviewed. Results: In both countries, MPAC was easy to use, and freed up provider time and health facility resources traditionally necessary for provision of PAC with uterine aspiration. On-going support of providers following training ensured high quality of care. Providers perceived that many women preferred MPAC, as they avoided instrumentation of the uterus, hospital admission, cost, and stigma associated with abortion. Appropriate registration of misoprostol for use in the pilot, and maintaining supplies of misoprostol, were significant challenges to service provision. Support from the Ministry of Health was necessary for successful implementation; lack of country-based standards and guidelines for MPAC created challenges. Conclusions: MPAC is simple, cost-effective and can be readily implemented in settings with high rates of abortion-related mortality.

Poland syndrome associated with an aberrant subclavian artery and vascular abnormalities of the retina in a child exposed to misoprostol during pregnancy.

Science.gov (United States)

Rosa, Rafael Fabiano Machado; Travi, Giovanni M; Valiatti, Fabiana; Zen, Paulo Ricardo Gazzola; Pinto, Louise Lapagesse; Kiss, Andrea; Graziadio, Carla; Paskulin, Giorgio Adriano

2007-06-01

Poland syndrome has been attributed to a process of vascular disruption, and exposure to misoprostol at 6-8 weeks of gestation has been shown to produce defects attributed to vascular disruption. Herein we report the first case of a patient with Poland syndrome associated with an aberrant subclavian artery and vascular abnormalities of the retina, whose mother used misoprostol during pregnancy. A White boy of 1 year and 7 months of age, whose mother used misoprostol during the second month of pregnancy, presented with bilateral epicanthal folds, aplasia of the sternocostal head of the pectoralis major muscle with a hypoplastic nipple on the right side, and asymmetry between the upper limbs. The results of an angiotomographic study showed the presence of an aberrant right subclavian artery. Ultrasonographic evaluation showed turbulence and a high peak in the diastolic velocity in both carotid arteries, suggesting stenosis. Ophthalmologic assessment disclosed an intense bilateral tortuosity of the retinal blood vessels, with arterialnarrowing and rarefaction of the retinal pigment epithelium. This case suggests that the mechanism of vascular disruption of misoprostol could be related to the aberrant subclavian artery and the observed Poland syndrome. His retinal findings are different from those in cases described thus far in the literature, and this pattern of anomaly has never been associated with a gestational exposure to misoprostol. The possibility of a relationship of the aberrant right subclavian artery and the pattern of blood flow verified in the carotid arteries with the eye fundus abnormalities could be causally related or simply coincidental.

A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up: A cohort study.

Science.gov (United States)

Grossman, Daniel; Baum, Sarah E; Andjelic, Denitza; Tatum, Carrie; Torres, Guadalupe; Fuentes, Liza; Friedman, Jennifer

2018-01-01

In Peru, abortion is legal only to preserve the life and health of the woman. A non-profit clinic system in Peru implemented a harm-reduction model for women with unwanted pregnancy that included pre-abortion care with instructions about misoprostol use and post-abortion care; they started offering telephone follow-up for clients in 2011. This study aimed to evaluate the effectiveness and safety of the harm-reduction model, and to compare outcomes by type of follow-up obtained. Between January 2012 and March 2013, 500 adult women seeking harm-reduction services were recruited into the study. Telephone surveys were conducted approximately four weeks after their initial harm-reduction counseling session with 262 women (response rate 52%); 9 participants were excluded. The survey focused on whether women pursued an abortion, and if so, what their experience was. Demographic and clinical data were also extracted from clinic records. Eighty-six percent of participants took misoprostol; among those taking misoprostol, 89% reported a complete abortion at the time of the survey. Twenty-two percent obtained an aspiration after taking misoprostol and 8% self-reported adverse events including hemorrhage without transfusion, infection, or severe pain. Among women who took misoprostol, 46% reported receiving in-person follow-up (in some cases both telephone and in-person), 34% received telephone only, and 20% did not report receiving any form of follow-up. Those who had in-person follow-up with the counselor were most likely to report a complete abortion (<0.001). Satisfaction with both types of follow-up was very high, with 81%-89% reporting being very satisfied. Liberalization of restrictive abortion laws is associated with improvements in health outcomes, but the process of legal reform is often lengthy. In the interim, giving women information about evidence-based regimens of misoprostol, as well as offering a range of follow-up options to ensure high quality post

Mifepristone-misoprostol for menstrual regulation in public sector facilities in Bangladesh.

Science.gov (United States)

Alam, Anadil; Lotarevich, Tatyana; Das, Tapash R; Reichenbach, Laura; Bracken, Hillary

2018-02-01

To examine the use of mifepristone and misoprostol for menstrual regulation among Bangladeshi women attending public sector facilities. In a prospective study, women (aged ≥18 years) with up to 9 weeks of amenorrhea were enrolled at 24 government health facilities in Bangladesh from November 2012 to June 2015. Paramedics or female welfare visitors provided most menstrual regulation care. Participants took 200 mg mifepristone followed by 800 μg buccal misoprostol after 24 hours, and were asked to return to the clinic 10-14 days later for clinical assessment and an exit interview. The primary outcome was successful evacuation of the uterus without need for surgical intervention. Women who completed follow-up were included in analyses for the primary outcome. Among 1744 enrolled participants, 1738 completed follow-up. Most (1674, 96.3%) had a successful uterine evacuation without the need for surgical intervention. A successful outcome was significantly more common in primary (724/744, 97.3%) and secondary facilities (861/895, 96.2%) than in the specialty hospital (89/99, 89.9%; Ppublic sector facilities in Bangladesh. CLINICALTRIALS.GOV: NCT01798017. © 2017 International Federation of Gynecology and Obstetrics.

Sonda de Foley cervical versus misoprostol vaginal para o preparo cervical e indução do parto: um ensaio clínico randomizado Cervical Foley catheter versus vaginal misoprostol for cervical ripening and induction of labor: a randomized clinical trial

Directory of Open Access Journals (Sweden)

Maria Virginia de Oliveira e Oliveira

2010-07-01

Full Text Available OBJETIVO: comparar a efetividade da sonda e Foley com o uso de misoprostol vaginal para o preparo cervical e indução do parto. MÉTODOS: ensaio clínico randomizado, não cego, realizado entre Janeiro de 2006 a Janeiro de 2008. Foram incluídas 160 gestantes com indicação de indução do parto, divididas em dois grupos: 80 para uso da sonda de Foley e 80 para misoprostol vaginal. Os critérios de inclusão foram: idade gestacional a partir de 37 semanas, feto único, vivo, cefálico e índice de Bishop igual ou menor que 4. Foram excluídas pacientes com cicatriz uterina, ruptura das membranas, peso fetal estimado maior que 4000 g, placenta prévia, corioamnionite e condições que impunham o término imediato da gestação. Os testes estatísticos utilizados foram Mann-Whitney, χ2 de Pearson ou exato de Fischer, sendo considerado significativo se menor que 0,005. RESULTADOS: o misoprostol desencadeou mais vezes o parto de forma espontânea (50,0 versus 15,0% para Foley pPURPOSE: to compare the effectiveness of the Foley balloon with vaginal misoprostol for cervical ripening and labor induction. METHODS: randomized clinical trial, not blind, conducted from January 2006 to January 2008. A total of 160 pregnant women with indication for induction of labor were included and divided into two groups, 80 for Foley and 80 for vaginal misoprostol. Inclusion criteria were: gestational age of 37 weeks or more, a live single fetus with cephalic presentation and a Bishop score of four or less. We excluded patients with a uterine scar, ruptured membranes, estimated fetal weight greater than 4000 g, placenta previa, chorioamnionitis and conditions that imposed the immediate termination of pregnancy. Statistical tests employed were Mann-Whitney, χ2 test or Fisher's exact test, and p value was significant if less than 0.005. RESULTS: misoprostol triggered more frequently spontaneous delivery (50.0 versus 15.0% for Foley, p<0.001 and required less use of

Qualitative and quantitative analysis of bacteria from vaginitis associated with intravaginal implants in ewes following estrus synchronization

OpenAIRE

Carlos Otávio de Paula Vasconcelos; Felipe Zandonadi Brandão; Gabriel Martins; Bruno Penna; Joanna Maria Gonçalves de Souza-Fabjan; Walter Lilenbaum

2016-01-01

ABSTRACT: This study evaluated the presence of vaginitis and the bacterial load associated with different intravaginal implants in ewes. Twenty-four Dorper and crossbred ewes were allocated into three groups and received intravaginal implant containing 0.3g progesterone (CIDR(r)), 60mg MAP or sponges without progesterone (CONTROL) for six days. Then, CIDR and MAP treated-ewes received 12.5mg dinoprost and 300IU eCG. Vaginal mucus samples were collected at four times: before device insertion, ...

Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

Science.gov (United States)

Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

2012-12-01

A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.

Polyurethane intravaginal ring for controlled delivery of dapivirine, a nonnucleoside reverse transcriptase inhibitor of HIV-1.

Science.gov (United States)

Gupta, Kavita M; Pearce, Serena M; Poursaid, Azadeh E; Aliyar, Hyder A; Tresco, Patrick A; Mitchnik, Mark A; Kiser, Patrick F

2008-10-01

Women-controlled methods for prevention of male-to-female sexual transmission of HIV-1 are urgently needed. Providing inhibitory concentrations of HIV-1 reverse transcriptase inhibitors to impede the replication of the virus in the female genital tissue offers a mechanism for prophylaxis of HIV-1. To this end, an intravaginal ring device that can provide long duration delivery of dapivirine, a nonnucleoside reverse transcriptase inhibitor of HIV-1, was developed utilizing a medical-grade polyether urethane. Monolithic intravaginal rings were fabricated and sustained release with cumulative flux linear with time was demonstrated under sink conditions for a period of 30 days. The release rate was directly proportional to the amount of drug loaded. Another release study conducted for a week utilizing liposome dispersions as sink conditions, to mimic the partitioning of dapivirine into vaginal tissue, also demonstrated release rates constant with time. These results qualify polyether urethanes for development of intravaginal rings for sustained delivery of microbicidal agents. (c) 2008 Wiley-Liss, Inc. and the American Pharmacists Association

Estradiol-induced vaginal mucus inhibits antigen penetration and CD8(+) T cell priming in response to intravaginal immunization.

Science.gov (United States)

Seavey, Matthew M; Mosmann, Tim R

2009-04-14

Although vaginal immunization has been explored as a strategy to induce mucosal immunity in the female reproductive tract, this site displays unique immunological features that probably evolved to inhibit anti-paternal T cell responses after insemination to allow successful pregnancy. We previously demonstrated that estradiol, which induces an estrus-like state, prevented CD8(+) T cell priming during intravaginal immunization of mice. We now show that estradiol prevented antigen loading of vaginal antigen presenting cells (APCs) after intravaginal immunization. Histological examination confirmed that estradiol prevented penetration of peptide antigen into the vaginal wall. Removal of the estradiol-induced mucus barrier by mucinase partially restored antigen loading of vaginal APC and CD8(+) T cell proliferation in vivo. The estradiol-induced mucus barrier may thus prevent exposure to antigens delivered intravaginally, supplementing additional estradiol-dependent mechanism(s) that inhibit CD8(+) T cell priming after insemination or vaginal vaccination.

Estradiol-induced vaginal mucus inhibits antigen penetration and CD8+ T cell priming in response to intravaginal immunization

Science.gov (United States)

Seavey, Matthew M.; Mosmann, Tim R.

2010-01-01

Although vaginal immunization has been explored as a strategy to induce mucosal immunity in the female reproductive tract, this site displays unique immunological features that probably evolved to inhibit anti-paternal T cell responses after insemination to allow successful pregnancy. We previously demonstrated that estradiol, which induces an estrus-like state, prevented CD8+ T cell priming during intravaginal immunization of mice. We now show that estradiol prevented antigen loading of vaginal antigen presenting cells (APC) after intravaginal immunization. Histological examination confirmed that estradiol prevented penetration of peptide antigen into the vaginal wall. Removal of the estradiol-induced mucus barrier by mucinase partially restored antigen loading of vaginal APC and CD8+ T cell proliferation in vivo. The estradiol-induced mucus barrier may thus prevent exposure to antigens delivered intravaginally, supplementing additional estradiol-dependent mechanism(s) that inhibit CD8+ T cell priming after insemination or vaginal vaccination. PMID:19428849

Oxytocin via Uniject (a prefilled single-use injection) versus oral misoprostol for prevention of postpartum haemorrhage at the community level: a cluster-randomised controlled trial.

Science.gov (United States)

Diop, Ayisha; Daff, Bocar; Sow, Maimouna; Blum, Jennifer; Diagne, Mamadou; Sloan, Nancy L; Winikoff, Beverly

2016-01-01

Access to injectable uterotonics for management of postpartum haemorrhage remains limited in Senegal outside health facilities, and misoprostol and oxytocin delivered via Uniject have been deemed viable alternatives in community settings. We aimed to compare the efficacy of these drugs when delivered by auxiliary midwives at maternity huts. We did an unmasked cluster-randomised controlled trial at maternity huts in three districts in Senegal. Maternity huts with auxiliary midwives located 3-21 km from the closest referral centre were randomly assigned (1:1; via a computer-generated random allocation overseen by Gynuity Health Projects) to either 600 μg oral misoprostol or 10 IU oxytocin in Uniject (intramuscular), stratified by reported previous year clinic volume (deliveries) and geographical location (inland or coastal). Maternity huts that had been included in a previous study of misoprostol for prevention of postpartum haemorrhage were excluded to prevent contamination. Pregnant women in their third trimester were screened for eligibility either during community outreach or at home-based prenatal visits. Only women delivered by the auxiliary midwives in the maternity huts were eligible for the study. Women with known allergies to prostaglandins or pregnancy complications were excluded. The primary outcome was mean change in haemoglobin concentration measured during the third trimester and after delivery. This study was registered with ClinicalTrials.gov, number NCT01713153. 28 maternity hut clusters were randomly assigned-14 to the misoprostol group and 14 to the oxytocin group. Between June 6, 2012, and Sept 21, 2013, 1820 women were recruited. 647 women in the misoprostol group and 402 in the oxytocin group received study drug and had recorded pre-delivery and post-delivery haemoglobin concentrations, and overall 1412 women delivered in the study maternity huts. The mean change in haemoglobin concentrations was 3·5 g/L (SD 16·1) in the misoprostol group

Associação de misoprostol, síndrome de Moebius e hipoventilação central congênita: relato de caso

OpenAIRE

NUNES, MAGDA LAHORGUE; FRIENDRICH, MAURÍCIO A. G.; LOCH, LUIZ FERNANDO

1999-01-01

We report a case showing the association of Moebius syndrome, the use of misoprostol during pregnancy and the development of central congenital alveolar hypoventilation. Pathophysiological aspects of these three diseases are discussed and also the unfavorable prognosis of this association.Descrevemos o caso de um paciente com Síndrome de Moebius associada ao uso de misoprostol durante a gestação. A criança necessitou de suporte ventilatório desde o primeiro dia de vida e evoluiu com quadro de...

Effectiveness and safety of misoprostol distributed to antenatal women to prevent postpartum haemorrhage after child-births: a stepped-wedge cluster-randomized trial.

Science.gov (United States)

Ononge, Sam; Campbell, Oona M R; Kaharuza, Frank; Lewis, James J; Fielding, Katherine; Mirembe, Florence

2015-11-26

Oral misoprostol, administered by trained health-workers is effective and safe for preventing postpartum haemorrhage (PPH). There is interest in expanding administration of misoprostol by non-health workers, including task-shifting to pregnant women themselves. However, the use of misoprostol for preventing PPH in home-births remains controversial, due to the limited evidence to support self-administration or leaving it in the hands of non-health workers. This study aimed to determine if antenatally distributing misoprostol to pregnant women to self-administer at home birth reduces PPH. Between February 2013 and March 2014, we conducted a stepped-wedge cluster-randomized trial in six health facilities in Central Uganda. Women at 28+ weeks of gestation attending antenatal care were eligible. Women in the control-arm received the standard-of-care; while the intervention-arm were offered 600 mcg of misoprostol to swallow immediately after birth of baby, when oxytocin was not available. The primary outcome (PPH) was a drop in postpartum maternal haemoglobin (Hb) by ≥ 2 g/dl, lower than the prenatal Hb. Analysis was by intention-to-treat at the cluster level and we used a paired t-tests to assess whether the mean difference between the control and intervention groups was statistically significant. 97% (2466/2545) of eligible women consented to participate; 1430 and 1036 in the control and intervention arms respectively. Two thousand fifty-seven of the participants were successfully followed up and 271 (13.2%) delivered outside a health facility. There was no significant difference between the study group in number of women who received a uterotonic at birth (control 80.4% vs intervention 91.4%, mean difference = -11.0%, 95% confidence interval [CI] -25.7% to 3.6%, p = 0.11). No woman took misoprostol before their baby's birth. Shivering and fever were 14.9% in the control arm compared to 22.2% in the intervention arm (mean difference = -7.2%, 95% CI -11.1% to -3

Externally placed vs intravaginally positioned radio frequency coils for quantitative spin-spin relaxometry of ovarian follicular fluid

International Nuclear Information System (INIS)

Sarty, G.E.; Baerwald, A.R.; Loewy, J.; Pierson, R.A.

2005-01-01

To evaluate different imaging protocols, especially with respect to radio frequency (RF) receiver coil location, for Their suitability in providing least squares derived quantitative T 2 values of ovarian follicular fluid for investigations of basic ovarian physiology. Methods: The ovaries of 10 women were imaged via magnetic resonance imaging (MRI) using externally positioned and intravaginally placed RF receiver coils. Half-Fourier acquisition with single-shot turbo spin-echo (HASTE), multiple-echo T 2 , Dixon, turbo spin-echo, and 3-dimensional (3D) fast imaging with steady-state precession (FISP) and time-reversed FISP (PSIF) sequences were used. Quantitative T 2 nuclear spin relaxation rate information from the ovarian follicles between data acquired with the external and intravaginal coils were compared. Additionally, the amount of ovarian follicle and corpora lutea structural detail visible was qualitatively assessed. Results: The T 2 computations indicated that there was no difference in the follicular fluid T 2 values or in the heterogeneity (spatial variance) of the T 2 values between data acquired with the external RF coil and date acquired with the intravaginal RF coil. The best sequences for the visualization of ovarian internal structure were the 3D PSIF sequences and the multiple-echo T 2 -weighted images, confirming our earlier imaging work on excised cow ovaries. Conclusion: It is best to use an externally placed RF coil for quantitative MRI study of ovarian physiology given the lack of difference in quantitative T 2 information and the difficulty associated with imaging the ovaries using an intravaginal RF probe. (author)

Compartmental transport model of microbicide delivery by an intravaginal ring

Science.gov (United States)

Geonnotti, Anthony R.; Katz, David F.

2010-01-01

Topical antimicrobials, or microbicides, are being developed to prevent HIV transmission through local, mucosal delivery of antiviral compounds. While hydrogel vehicles deliver the majority of current microbicide products, intravaginal rings (IVRs) are an alternative microbicide modality in preclinical development. IVRs provide a long-term dosing alternative to hydrogel use, and might provide improved user adherence. IVR efficacy requires sustained delivery of antiviral compounds to the entire vaginal compartment. A two-dimensional, compartmental vaginal drug transport model was created to evaluate the delivery of drugs from an intravaginal ring. The model utilized MRI-derived ring geometry and location, experimentally defined ring fluxes and vaginal fluid velocities, and biophysically relevant transport theory. Model outputs indicated the presence of potentially inhibitory concentrations of antiviral compounds along the entire vaginal canal within 24 hours following IVR insertion. Distributions of inhibitory concentrations of antiviral compounds were substantially influenced by vaginal fluid flow and production, while showing little change due to changes in diffusion coefficients or ring fluxes. Additionally, model results were predictive of in vivo concentrations obtained in clinical trials. Overall, this analysis initiates a mechanistic computational framework, heretofore missing, to understand and evaluate the potential of IVRs for effective delivery of antiviral compounds. PMID:20222027

Differential radioprotective effects of misoprostol in DNA repair-proficient and -deficient or radiosensitive cell systems

NARCIS (Netherlands)

van Buul, P. P.; van Duyn-Goedhart, A.; de rooij, D. G.; Sankaranarayanan, K.

1997-01-01

The protective effects of misoprostol (MP), an analogue of prostaglandin E1, on X-ray-induced chromosomal aberrations, were studied in normal or mutant Chinese hamster cell lines grown as spheroids in vitro and on cell-killing in stem-cell spermatogonia of a mutant (acid) mouse strain or its

Randomized Trial of Oral Misoprostol Treatment for Cervical Ripening Before Tandem Application in Cervix Cancer

International Nuclear Information System (INIS)

Cepni, Kimia; Gul, Sule; Cepni, Ismail; Gueralp, Onur; Sal, Veysel; Mayadagli, Alpaslan

2011-01-01

Purpose: To investigate the efficacy of oral misoprostol administered to facilitate tandem application to the cervix as a part of brachytherapy in patients with cervical cancer. Methods and Materials: Eighty patients with cervical cancer who had been planned to undergo brachytherapy at Dr. Luetfi Kirdar Kartal Training and Research Hospital were evaluated in a double-blind, prospective, randomized trial. Patients were divided randomly into two groups of 40 patients. The first and second groups received 400 μg of misoprostol orally and placebo, respectively, 3 h before tandem application. The two groups were compared in terms of age, diameter of tumor, parity, age at first intercourse, amount of bleeding and pain at first tandem application, length of endometrial cavity measured by hysterometer, and size of Hegar dilators used for cervical dilatation. Results: Of all cases, 63.6%, 16.3%, 10%, 6.3%, 2.5%, and 1.3% were Stage IIB, IIIB, IIIA, IVA, IIA and IIC, respectively. Mean (±SD) age (range) was 49.3 ± 13.1 (25-83) years and 56.6 ± 13.2 (30-78) years in the study and control groups, respectively (p = 0.015). Age at first intercourse, diameter of tumor, parity, amount of bleeding at first tandem application, and length of endometrial cavity measured by hysterometer were not significantly different between the two groups. Pain score was significantly higher in the control group (p < 0.001). Application was significantly easier in the study group compared with controls (p < 0.001). Average size of initial Hegar dilators used for cervical dilatation was significantly higher in the study group compared with controls (p = 0.017). Conclusion: Administration of misoprostol 400 μg orally for cervical ripening before tandem application facilitates the procedure, increases patient tolerability and comfort, and may decrease complication rates.

One or two day mifepristone-misoprostol interval for second trimester abortion

DEFF Research Database (Denmark)

Nilas, Lisbeth; Glavind-Kristensen, M; Vejborg, Thomas

2007-01-01

METHODS: A retrospective 2-year cohort study of 127 women, with gestation between 13 and 24 weeks and a live fetus, seeking induced abortion. The aim was to compare the effect of a 1-day and a 2-day interval between oral mifepristone (200 mg) and vaginal misoprostol (400 microg) every 3 h. RESULTS......: The time to fetal expulsion was longer (9.8 versus 7.5 h; pabortion occurred in 98% within 24 h in both groups The time to abortion was longer in women with a gestation of 17-22 weeks compared to women...

Comparison of misoprostol (pge1) analogue with dinoprostone (pge2) for induction of labour

International Nuclear Information System (INIS)

Tahir, N.; Afzal, B.; Chohan, S.

2013-01-01

Objective: To compare the results of induction of labour with misoprostol (PGE1 analogue) with dinoprostone (PGE2 analogue) in terms of induction delivery interval, mode of delivery, and the need for oxytocin augmentation. Setting: Department of Obstetrics and Gynaecology, Combined Military Hospital, Rawalpindi. Duration of Study: Six months Study Design: Randomized controlled trial. Subject and Method: Total 100 subjects were included in this study. These patients were divided in groups-A and B. Group-A was induced with prostin tablet i.e. dinoprostone PGE2 3 mg tablets maximum of 2 doses, 6 hours apart. Group-B induced with prosotec 50 mu gm 4 hourly, 4 doses. The subjects were full term pregnant women who were either primigravida, 2nd or 3rd gravid and had bishop score less than 5. Results: The patients included in the study were between the ages of 19 to 37 years. The mean age of group-A was 26.72 +- 4.62 years and of group-B was 28.4 +- 4.94 years (p value > 0.05). All the patients in both groups were between 37 to 42 weeks of gestation. The mean gestational age of group-A was 39.74 +- 2.09 weeks and in group-B it was 39.62 +- 1.55 weeks (p > 0.05). Oxytocin augmentation was required in late 1st stage and 2nd stage in group-A in 68% cases but it was required in only 30% cases in group-B cases. The maximum duration of labour was more than 11 hours in 24% cases in group-A but only 6% in group-B. Conclusion: Misoprostol (PGE1 analogue) is a useful drug for labour induction. There is short induction delivery interval and reduced need for the use of oxytocin augmentation. There are also less failure rates of induction with misoprostol. Rate of instrumental delivery and caesarean section is also less. (author)

High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus

Science.gov (United States)

Nalca, Aysegul; Rossi, Franco D.; Miller, Lynn J.; Wiley, Michael R.; Perez-Sautu, Unai; Washington, Samuel C.; Norris, Sarah L.; Wollen-Roberts, Suzanne E.; Shamblin, Joshua D.; Kimmel, Adrienne E.; Bloomfield, Holly A.; Valdez, Stephanie M.; Sprague, Thomas R.; Principe, Lucia M.; Bellanca, Stephanie A.; Cinkovich, Stephanie S.; Lugo-Roman, Luis; Cazares, Lisa H.; Pratt, William D.; Palacios, Gustavo F.; Bavari, Sina; Pitt, M. Louise; Nasar, Farooq

2017-01-01

Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present. PMID:28548637

High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus.

Science.gov (United States)

Haddow, Andrew D; Nalca, Aysegul; Rossi, Franco D; Miller, Lynn J; Wiley, Michael R; Perez-Sautu, Unai; Washington, Samuel C; Norris, Sarah L; Wollen-Roberts, Suzanne E; Shamblin, Joshua D; Kimmel, Adrienne E; Bloomfield, Holly A; Valdez, Stephanie M; Sprague, Thomas R; Principe, Lucia M; Bellanca, Stephanie A; Cinkovich, Stephanie S; Lugo-Roman, Luis; Cazares, Lisa H; Pratt, William D; Palacios, Gustavo F; Bavari, Sina; Pitt, M Louise; Nasar, Farooq

2017-08-01

Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present.

Evaluation of the acceptability of intravaginal prasterone ovule administration using an applicator.

Science.gov (United States)

Montesino, Marlene; Labrie, Fernand; Archer, David F; Zerhouni, Jaâfar; Côté, Isabelle; Lavoie, Lyne; Beauregard, Adam; Martel, Céline; Vaillancourt, Mario; Moyneur, Erick; Balser, John

2016-01-01

The objective of the study is to evaluate the acceptability of the intravaginal administration of ovules/suppositories of DHEA (dehydroepiandrosterone, prasterone) for the treatment of vulvovaginal atrophy (VVA) in women with moderate to severe dyspareunia who were administered daily for 12 weeks intravaginal 0.50% (6.5 mg) DHEA or placebo. There were a total of 373 women in the per-protocol population who responded to the questionnaire for both treatment groups. While it was planned that the applicator would be evaluated as suitable if at least 80% of participants have a global score  ≤ 2 units, 99% and 100% of participants had a score  ≤ 2 units in the placebo and DHEA groups, respectively, for the global score (mean of 5 questions). When asked about like and dislike the technique of drug administration, 284 comments were positive, while 114 women gave no comment. About 92-94% of women indicated that they were very confident to be able use the applicator successfully in the future. The survey shows a high degree of satisfaction and of confidence to use the applicator successfully in the future.

An Unreported Uterine Rupture in an Unscarred Uterus after Induction of Labour with 25 μg Misoprostol

DEFF Research Database (Denmark)

Rydahl, Eva; Clausen, Jette Aaroe

2014-01-01

Uterine rupture without a former history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy and labor. Misoprostol is widely used to induce labor but there is a lack of knowledge about serious adverse effects. It is especially challenging to collect reports ...

Comparative Study on Effects of Arnebia Euchroma (Royle) Johnst Granular and Decoction Forms on Medical Abortion with Mifepristone and Misoprostol

Institute of Scientific and Technical Information of China (English)

Jian-hua LIU; Hua SUN; Yun-yu FA

2004-01-01

Objective To compare the effects of 2 dosage-forms (granular and decoction) of Arnebia euchroma (royle) Johnst (Arnebia EJ in short below) on medical abortion with that of mifepristone combined with misoprostol Methods Totally 648 women, who had pregnancy of 38-45 d and were willing to terminate pregnancy with mifepristone and misoprostol, were randomly divided into 3groups, each of which was respectively given granular of Arnebia E J, placebo granular,or decoction of Arnebia EJ besides mifepristone and misoprostol. The abortion results,bleeding duration, menstruation recovery and side-effects were observed.Results Neither complete abortion rates nor average bleeding durations of the granular group and the decoction group were significantly different (P＞0. 05). The complete abortion rate and bleeding duration of the two groups were respectively higher and shorter than those of the placebo group (P＜0. 05). However, the menstruation recovery was not significantly different among the three groups (P＞0. 05). The decoctionof Arnebia EJ caused significantly more nausea and vomiting than the other groups (P＜0. 05).Conclusion The granular form did not have the odor of Arnebia E J, and caused much less nausea and vomiting compared with the decoction form. The granular and decoction forms were equally effective in improving the results of medical abortion. Therefore it is necessary to conduct further studies on the granular form of Arnebia EJ.

Comparison of the Effect of Rectal Misoprostol and IM Syntometrin in the Prevention of Post Partum Hemorrhage

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M. Samimi

2011-07-01

Full Text Available Introduction & Objective: In developing countries, postpartum hemorrhage is one of the preventable causes of maternal mortality. The aim of this study is comparison of the effect of rectal misoprostol and intramascular syntometerine in the prevention of postpartum hemorrhage. Materials & Methods: This study was a double blind randomized clinical trial and carried on 200 pregnant women referred to Shabiehkhani maternity center in 2010. The first group received 1ml intramuscular syntometrine and the second group received 600 µg misoprostol rectal suppository after placental delivery. The two groups were matched for confounding variables. All of the study subjects were followed up for 24hrs and their blood pressure, pulse rate, uterine tone, before and after delivery hemoglobin, need to additional uterotonic drugs and drug side effects were evaluated and the results were recorded in an information sheet. Finally all the data were entered into SPSS software and analyzed with statistical tests. Results: The mean age of subjects was 25.61±4.75 years, mean gestational age was 38.8±1.2 weeks, and Mean neonatal birth weight was 3346.2±349.56 grams. The mean fall in hemoglobin level in misorostol group was significantly lower than in syntometrin group (P=0.009. But there weren't any significant differences between the two groups in uterine tone, blood pressure, and pulse rate and also in drug side effects. Conclusion: In this study we demonstrated that rectal misoprostol suppository was more effective than injection syntometrin in decreasing postpartum hemorrhage. Thus, it can be used as a choice drug for third stage management (Sci J Hamadan Univ Med Sci 2011;18(2:38-44

If we can do it for misoprostol, why not for mifepristone? The case for taking mifepristone out of the office in medical abortion.

Science.gov (United States)

Gold, Marji; Chong, Erica

2015-09-01

Given the highly political nature of abortion in the United States, the provision of medical abortion with mifepristone (Mifeprex®) and misoprostol has always occurred under a unique set of circumstances. The Food and Drug Administration-approved regimen requires clinicians to administer the mifepristone in the office and also requires women to return to the office for the misoprostol. In the US, where off-label drug use is an accepted practice when supportive evidence exists, most clinicians give women the misoprostol at the initial visit for her to take at home, eliminating an unnecessary visit to the office. This commentary suggests that, based on current studies, there is also enough evidence to offer women the option to self-administer mifepristone out of the office and that this is just another feature of off-label use. Six studies, enrolling over 1800 women, found that the option of taking mifepristone out of the office was popular and acceptable among women and providers. Given that it is safe, highly acceptable and not burdensome on providers, outside-office-use of mifepristone should be offered to all women as part of routine medical abortion services. Copyright © 2015 Elsevier Inc. All rights reserved.

Misoprostol for cervical priming prior to hysteroscopy in postmenopausal and premenopausal nulliparous women; a multicentre randomised placebo controlled trial

NARCIS (Netherlands)

Tasma, M L; Louwerse, M D; Hehenkamp, W J; Geomini, P M; Bongers, M Y; Veersema, S; van Kesteren, P J; Tromp, E; Huirne, J A; Graziosi, G C

OBJECTIVE: To evaluate the reduction of pain by misoprostol compared with placebo prior to hysteroscopy in postmenopausal and premenopausal nulliparous women. DESIGN: Randomised multicentre double-blind placebo controlled trial. SETTING: Two Dutch teaching hospitals and one Dutch university medical

Safety and efficacy of oral versus vaginal misoprostol use for induction of labor at term

International Nuclear Information System (INIS)

Abbasi, R.M.; Rivi, S.

2008-01-01

To compare the safety and efficacy of Misoprostol through oral and vaginal routes for induction of labour at term. Quasi-experimental study. Eighty term patients who met the inclusion criteria were selected for induction of labour with (50 macro g) Misoprostol, either by oral or vaginal route. The patients were allocated in two groups-A and B, using non-probability convenient sampling technique. The dose was repeated at an interval of 6 hours upto maximum dose of 150 macro g. Improvement in Bishop's score, analgesic requirements, route of delivery, maternal complications, neonatal outcomes were noted. The commonest indication in group-A was premature rupture of membranes in 16 patients (40%) and in 8 (20%) patients of group-B. Mean improvement in Bishop's score after 6 hours was greater in group-A (3.6 + 3.09) than group-B (3.3 + 3.45, p=0.70). Induction to delivery interval was less in group-A (6.7 + 4.4 hours) than group-B (7.5 + 4.3 hours, p=0.41). Oxytocin augmentation was required more in group-B as compared to group-A. Normal vaginal deliveries were achieved in 95% of group-A and in 80% of group-B. The dose of 50 macro g was effective in 31(77.5%) patients of group-A as compared to 24 (60.0%) patients of group-B, while 100 macro g was needed in 6 (15.0%) patients of group-A as compared to 13 (32.5%) patients in group-B. There was no significant difference between both the groups with regard to analgesic requirement, instrumental delivery, maternal complications and neonatal outcome. Safety and efficacy was comparable between low-dose vaginal and oral Misoprostol uses for induction of labour. However, oral route was better with respect to treatment interval, number of doses required and route of delivery. Both routes of administration can alternatively be used for induction of labour in developing countries where cost of drug does matter. (author)

Intra-vaginal Zinc Oxide Tetrapod Nanoparticles as Novel Immunoprotective Agents against Genital Herpes

Science.gov (United States)

Antoine, Thessicar E.; Hadigal, Satvik R.; Yakoub, Abraam; Mishra, Yogendra K.; Bhattacharya, Palash; Haddad, Christine; Valyi-Nagy, Tibor; Adelung, Rainer; Prabhakar, Bellur S.; Shukla, Deepak

2016-01-01

Virtually all efforts to generate an effective protection against the life-long, recurrent genital infections caused by Herpes simplex virus-2 (HSV-2) have failed. Apart from sexual transmission, the virus can also be transmitted from mothers to neonates, and is a key facilitator of HIV co-acquisition. Here, we uncover a nanoimmunotherapy using specially designed Zinc Oxide Tetrapod Nanoparticles (ZOTEN) with engineered oxygen vacancies. We demonstrate that ZOTEN, when used intravaginally as a microbicide, is an effective suppressor of HSV-2 genital infection in female BALB/c mice. The strong HSV-2 trapping ability of ZOTEN significantly reduced the clinical signs of vaginal infection and effectively decreased animal mortality. In parallel, ZOTEN promoted the presentation of bound HSV-2 virions to mucosal antigen presenting cells, enhancing T cell- mediated and antibody-mediated responses to the infection, and thereby, suppressing a re-infection. We also found that ZOTEN exhibits strong adjuvant-like properties, which is highly comparable to alum, a commonly used adjuvant. Overall, our study provides very first evidence for the protective efficacy of an intravaginal microbicide/vaccine or microbivac platform against primary and secondary female genital herpes infections. PMID:27183601

Misoprostol, an anti-ulcer agent and PGE2 receptor agonist, protects against cerebral ischemia

OpenAIRE

Li, Jun; Liang, Xibin; Wang, Qian; Breyer, Richard M.; McCullough, Louise; Andreasson, Katrin

2008-01-01

Induction of COX-2 activity in cerebral ischemia results in increased neuronal injury and infarct size. Recent studies investigating neurotoxic mechanisms of COX-2 demonstrate both toxic and paradoxically protective effects of downstream prostaglandin receptor signaling pathways. We tested whether misoprostol, a PGE2 receptor agonist that is utilized clinically as an anti-ulcer agent and signals through the protective PGE2 EP2, EP3, and EP4 receptors, would reduce brain injury in the murine m...

Engineering a degradable polyurethane intravaginal ring for sustained delivery of dapivirine.

Science.gov (United States)

Kaur, Manpreet; Gupta, Kavita M; Poursaid, Azadeh E; Karra, Prasoona; Mahalingam, Alamelu; Aliyar, Hyder A; Kiser, Patrick F

2011-06-01

We describe the engineering of a degradable intravaginal ring (IVR) for the delivery of the potent HIV-1 reverse transcriptase inhibitor dapivirine. The degradable polymer used in fabricating the device incorporated poly(caprolactone) ester blocks in a poly(tetramethylene ether) glycol ABA type polyurethane backbone. The polymer was designed to maintain its structure for 1 month during usage and then degrade in the environment post-disposal. In vitro release of dapivirine showed zero-order kinetics for up to 1 month and significant levels of drug release into engineered vaginal tissue. The mechanical properties of the degradable IVR were comparable to those of a widely used contraceptive intravaginal ring upon exposure to simulated vaginal conditions. Incubation under simulated vaginal conditions for a month caused minimal degradation with minimal effect on the mechanical properties of the ring and polymer. The cytotoxicity evaluation of the drug-loaded IVRs against Vk2/E6E7 human vaginal epithelial cells, Lactobacillus jensenii, and engineered vaginal tissue constructs showed the degradable polyurethane to be non-toxic. In vitro evaluation of inflammatory potential monitored through the levels of inflammatory cytokines IL-8, IL-1α, IL-6, IL-1β, and MIP-3α when engineered EpiVaginal™ tissue was incubated with the polyurethanes suggested that the degradable polyurethane was comparable to commercial medical grade polyurethane. These results are encouraging for further development of this degradable IVR for topical vaginal delivery of microbicides.

Acute intestinal injury induced by acetic acid and casein: prevention by intraluminal misoprostol

International Nuclear Information System (INIS)

Miller, M.J.; Zhang, x.J.; Gu, x.A.; Clark, D.A.

1991-01-01

Acute injury was established in anesthetized rabbits by intraluminal administration of acetic acid with and without bovine casein, into loops of distal small intestine. Damage was quantified after 45 minutes by the blood-to-lumen movement of 51 Cr-labeled ethylenediaminetetraacetic acid (EDTA) and fluorescein isothiocyanate-tagged bovine serum albumin as well as luminal fluid histamine levels. The amount of titratable acetic acid used to lower the pH of the treatment solutions to pH 4.0 was increased by the addition of calcium gluconate. Luminal acetic acid caused a 19-fold increase in 51 Cr-EDTA accumulation over saline controls; casein did not modify this effect. In saline controls, loop fluid histamine levels bordered on the limits of detection (1 ng/g) but were elevated 19-fold by acetic acid exposure and markedly increased (118-fold) by the combination of acid and casein. Intraluminal misoprostol (3 or 30 micrograms/mL), administered 30 minutes before acetic acid, significantly attenuated the increase in epithelial permeability (luminal 51 Cr-EDTA, fluorescein isothiocyanate-bovine serum albumin accumulation) and histamine release (P less than 0.05). Diphenhydramine, alone or in combination with cimetidine, and indomethacin (5 mg/kg IV) were not protective. It is concluded that exposure of the epithelium to acetic acid promotes the transepithelial movement of casein leading to enhanced mast cell activation and mucosal injury. Damage to the epithelial barrier can be prevented by misoprostol

Acute intestinal injury induced by acetic acid and casein: prevention by intraluminal misoprostol

Energy Technology Data Exchange (ETDEWEB)

Miller, M.J.; Zhang, x.J.; Gu, x.A.; Clark, D.A. (Department of Pediatrics, Louisiana State University School of Medicine, New Orleans (USA))

1991-07-01

Acute injury was established in anesthetized rabbits by intraluminal administration of acetic acid with and without bovine casein, into loops of distal small intestine. Damage was quantified after 45 minutes by the blood-to-lumen movement of {sup 51}Cr-labeled ethylenediaminetetraacetic acid (EDTA) and fluorescein isothiocyanate-tagged bovine serum albumin as well as luminal fluid histamine levels. The amount of titratable acetic acid used to lower the pH of the treatment solutions to pH 4.0 was increased by the addition of calcium gluconate. Luminal acetic acid caused a 19-fold increase in {sup 51}Cr-EDTA accumulation over saline controls; casein did not modify this effect. In saline controls, loop fluid histamine levels bordered on the limits of detection (1 ng/g) but were elevated 19-fold by acetic acid exposure and markedly increased (118-fold) by the combination of acid and casein. Intraluminal misoprostol (3 or 30 micrograms/mL), administered 30 minutes before acetic acid, significantly attenuated the increase in epithelial permeability (luminal {sup 51}Cr-EDTA, fluorescein isothiocyanate-bovine serum albumin accumulation) and histamine release (P less than 0.05). Diphenhydramine, alone or in combination with cimetidine, and indomethacin (5 mg/kg IV) were not protective. It is concluded that exposure of the epithelium to acetic acid promotes the transepithelial movement of casein leading to enhanced mast cell activation and mucosal injury. Damage to the epithelial barrier can be prevented by misoprostol.

Factors influencing women's preferences for subsequent management in the event of incomplete evacuation of the uterus after misoprostol treatment for miscarriage

NARCIS (Netherlands)

Hentzen, Judith E. K. R.; Verschoor, Marianne A.; Lemmers, Marike; Ankum, Willem M.; Mol, Ben Willem J.; van Wely, Madelon

2017-01-01

STUDY QUESTION: What affects women's treatment preferences in the management of an incomplete evacuation of the uterus after misoprostol treatment for a first-trimester miscarriage? SUMMARY ANSWER: Women's treatment preferences in the management of an incomplete evacuation of the uterus after

Effect of intravaginal dehydroepiandrosterone (DHEA) on the female sexual function in postmenopausal women: ERC-230 open-label study.

Science.gov (United States)

Bouchard, Céline; Labrie, Fernand; Derogatis, Leonard; Girard, Ginette; Ayotte, Normand; Gallagher, John; Cusan, Leonello; Archer, David F; Portman, David; Lavoie, Lyne; Beauregard, Adam; Côté, Isabelle; Martel, Céline; Vaillancourt, Mario; Balser, John; Moyneur, Erick

2016-03-01

Intravaginal DHEA (dehydroepiandrosterone, prasterone), the exclusive precursor of androgens and estrogens in postmenopausal women, has previously been shown to improve all the domains of sexual function by a strictly local action in the vagina. The well recognized female sexual function index (FSFI) questionnaire was used in the present study. The long-term effect of 52-week treatment with daily intravaginal 0.50% (6.5 mg) DHEA was evaluated on the various domains of female sexual function using the FSFI questionnaire at baseline, Week 26 and Week 52. One hundred and fifty-four postmenopausal women with at least one mild to severe symptom of vulvovaginal atrophy (VVA) and who have completed the FSFI questionnaire at baseline and at least one post-baseline timepoint were included in the analysis. The FSFI domains desire, arousal, lubrication, orgasm, satisfaction and pain were increased by 28%, 49%, 115%, 51%, 41% and 108%, respectively (p<0.0001 for all parameters) at 52 weeks vs. baseline, while the total score was increased from 13.4±0.62 at baseline to 21.5±0.82 (+60%, p<0.0001) at 52 weeks. As the serum levels of DHEA and all its metabolites, including estradiol and testosterone, show no meaningful change, the present clinical data indicate a stimulatory effect of intravaginal DHEA through a strictly local action in agreement with the preclinical data showing that the androgens made locally from DHEA in the vagina induce an increase in local nerve density.

Novel intravaginal nanomedicine for the targeted delivery of saquinavir to CD4+ immune cells

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Yang S

2013-08-01

Full Text Available Sidi Yang,1,2 Yufei Chen,1,2 Kaien Gu,1,2 Alicia Dash,1,2 Casey L Sayre,1 Neal M Davies,1 Emmanuel A Ho1,2 1Faculty of Pharmacy, 2Laboratory for Drug Delivery and Biomaterials, University of Manitoba, Winnipeg, MB, Canada Abstract: The goal of this study was to develop and characterize an intravaginal nanomedicine for the active targeted delivery of saquinavir (SQV to CD4+ immune cells as a potential strategy to prevent or reduce HIV infection. The nanomedicine was formulated into a vaginal gel to provide ease in self-administration and to enhance retention within the vaginal tract. SQV-encapsulated nanoparticles (SQV-NPs were prepared from poly(lactic-co-glycolic acid(PLGA and conjugated to antihuman anti-CD4 antibody. Antibody-conjugated SQV-NPs (Ab-SQV-NPs had an encapsulation efficiency (EE% of 74.4% ± 3.7% and an antibody conjugation efficiency (ACE% of 80.95% ± 1.10%. Over 50% of total loaded SQV was released from NPs over 3 days. NPs were rapidly taken up by Sup-T1 cells, with more than a twofold increase in the intracellular levels of SQV when delivered by Ab-SQV-NPs in comparison to controls 1 hour post-treatment. No cytotoxicity was observed when vaginal epithelial cells were treated for 24 hours with drug-free Ab-NPs (1,000 µg/mL, 1% HEC placebo gel (200 mg/mL, or 1% HEC gel loaded with drug-free Ab-NPs (5 mg NPs/g gel, 200 mg/mL of gel mixture. Overall, we described an intravaginal nanomedicine that is nontoxic and can specifically deliver SQV into CD4+ immune cells. This platform may demonstrate potential utility in its application as postexposure prophylaxis for the treatment or reduction of HIV infection, but further studies are required. Keywords: nanoparticles, saquinavir, antibody conjugation, intravaginal gel, HIV/AIDS, microbicide

Efficacy of Sublingual Misoprostol versus Intramuscular Methylergometrine in Prevention of Primary Postpartum Hemorrhage

International Nuclear Information System (INIS)

Anwar, R.; Ambreen, A.; Khuram, A.; Mushtaq, M.

2013-01-01

Post partum hemorrhage still remains a major cause of maternal morbidity and mortality in developing countries. Most of oxytocics like methylergometrine require parenteral administration, which requires special storage. Misoprostol is thermo stable, has a long shelf life and is widely recommended for prevention of postpartum hemorrhage. This can be a choice of oxytocic in developing countries like ours, where storage facilities and resources are limited. Objectives: To compare efficacy of sublingual Misoprostol versus intramuscular Methylergometrine in prevention of primary postpartum hemorrhage after delivery. Study Design: Quasi experimental study Place and Duration of Study: Department of Gynae/Obs, Military Hospital and Combined Military Hospital Rawalpindi cantt. December 2007 to July 2008. Material and Methods: One hundred and thirty six pregnant ladies were selected. On arrival each patient was examined thoroughly along with baseline investigations. Therapeutic option was allocated to the patients simply by using a table of random numbers and dividing them in two equal groups. Informed written consent was taken. Each patient was observed for blood loss estimation and hematocrit drop. All the data was analyzed using SPSS version 10.0. Mean +- SD for age, pre-delivery and post-delivery hematocrit, percentage of drop in hematocrit and blood loss during labour was calculated. Results: Mean drop of hematocrit and blood loss were compared among two groups. At the end, it was revealed that there was no significant difference among two groups in blood loss (p=0.49) and hematocrit drop (p=0.14). Conclusion: There is no significant better effect in preventing post partum hemorrhage among the two drugs. (author)

Medical management of early pregnancy failure (EPF): a retrospective analysis of a combined protocol of mifepristone and misoprostol used in clinical practice.

Science.gov (United States)

Colleselli, Valeria; Schreiber, Courtney A; D'Costa, Elisabeth; Mangesius, Stephanie; Wildt, Ludwig; Seeber, Beata E

2014-06-01

To evaluate the efficacy of a combined protocol of mifepristone and misoprostol in the management of early pregnancy failure (EPF) and the average time to expulsion of tissue and rate of side effects. Retrospective chart review of all consecutive women treated with primary medical management for EPF at our institution from 2006 to 2012. 168 patients were included in the present study. The overall success rate, defined as the absence of the need for surgical intervention, was 61 % and did not differ by calendar year. There was no difference in success rate grouped by diagnosis [intrauterine embryonic/fetal demise (IUED/IUFD) vs. anembryonic gestation; p = 0.30] or gestational age (800 μg (68 vs. 50 %, p = 0.029). Of the possible predictive factors of success, only the dose of misoprostol required was a significant independent negative predictor. Mean and median time to tissue expulsion after the first dose of misoprostol were 8.4 and 5.5 h, respectively. The incidence of side effects was low with no blood transfusions required. The success rate in this study is markedly below published data. This can possibly be attributed to retrospective study design, allowing for physician subjectivity and patients' wishes in the absence of strict study requirements. The protocol was well tolerated with a paucity of side effects. We make suggestions for enhancing success rates in the clinical setting by optimizing medication protocols, establishing precise treatment guidelines and training physicians in the accurate interpretation of treatment outcomes.

Assessment of quality of life and oral function of patients participating in a phase II study of radioprotection of oral and pharyngeal mucosa by the prostaglandin e1 analog misoprostol (RTOG 96-07)

International Nuclear Information System (INIS)

Johnson, Darlene J.; Scott, Charles B.; Marks, James E.; Seay, Thomas E.; Atkins, James N.; Berk, Lawrence B.; Meoz, Raul T.; Wheeler, James A.

2002-01-01

Purpose: The oral complications associated with radiotherapy to the head and neck are a significant dose-limiting factor. The goals of this study were to determine whether oropharyngeal rinsing and ingestion of misoprostol protect mucous membranes from the acute effects of irradiation, and to evaluate the quality-of-life (QOL) outcomes of patients receiving misoprostol. We report the results of the QOL outcomes of patients in this study. Methods and Materials: A total of 33 patients with resected or intact cancer of the oral cavity, oropharynx, supraglottic larynx, or hypopharynx were registered to receive postoperative radiotherapy plus misoprostol or primary radiotherapy plus misoprostol. All patients were scheduled to receive 60-70 Gy at 2 Gy/d within 6-7 weeks. QOL and function were evaluated. Results: A decrease in the QOL and function occurred in all areas covered by the questionnaire at the 6-week interval. This decrease was significant for eating, saliva, taste, and mucous. Of these significant factors, taste, saliva, and mucous consistency had not resolved by 12 weeks. Conclusion: Increased understanding of the impact of treatment on QOL and symptoms will formulate the rational design of toxicity interventions and enhance the multidisciplinary care of head-and-neck patients

Fescues of the Intravaginal group of Festuca L. section Festuca in the lowland and montane areas of the northeastern Iberian Peninsula

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Pyke, S.

2013-12-01

Full Text Available Fescues of the Intravaginal group of Festuca L. section Festuca in the lowland and montane areas of the northeastern Iberian Peninsula.— Morphologically similar fescues occur across the study area (Mediterranean area of the northeastern Iberian Peninsula at low and middle elevations. With the exception of the high mountain or alpine species, these populations are reviewed here, with particular attention being paid to the Festuca inops (F. gracilior group, as well as to some other species, in particular F. lemanii, which are not easily understood and can complicate identification, especially where the taxa occur sympatrically. The application of the binomen F. inops De Not. to some of the Iberian populations constituting the F. inops group is discussed. New records for F. tarraconensis, F. occitanica, F. michaelis and F. heteroidea amplify the distribution range of these little-known taxa within the Iberian Peninsula.Diferentes especies de Festuca morfológicamente afines crecen en gran parte del territorio objeto de esta reseña (tierras mediterráneas del nordeste de la Península Ibérica, a baja y mediana altitud. Excluyendo las especies de alta montaña, estas poblaciones se han estudiado aquí haciendo hincapié en Festuca grupo inops (F. gracilior, y se han tratado otras especies (F. lemanii en especial que a veces complican la identificación de los miembros de dicho grupo, sobre todo cuando solapan sus distribuciones. Se comenta la aplicación del binomen F. inops De Not. a algunas poblaciones ibéricas del grupo F. inops. Nuevas citas de F. tarraconensis, F. occitanica, F. michaelis y F. heteroidea amplían la distribución de estos taxones dentro de la Península Ibérica.

Unexpected Inflammatory Effects of Intravaginal Gels (Universal Placebo Gel and Nonoxynol-9 on the Upper Female Reproductive Tract: A Randomized Crossover Study.

Directory of Open Access Journals (Sweden)

Karen Smith-McCune

Full Text Available Intravaginal anti-HIV microbicides could provide women with a self-controlled means for HIV prevention, but results from clinical trials have been largely disappointing. We postulated that unrecognized effects of intravaginal gels on the upper female reproductive tract might contribute to the lower-than-expected efficacy of HIV microbicides. Our objective was to study the effects of intravaginal gels on the immune microenvironment of the cervix and uterus. In this randomized crossover study, 27 healthy female volunteers used a nightly application of intravaginal nonoxynol-9 (N9 gel as a "failed" microbicide or the universal placebo gel (UPG as a "safe" gel (intervention cycles, or nothing (control cycle from the end of menses to the mid-luteal phase. At a specific time-point following ovulation, all participants underwent sample collection for measurements of T-cell phenotypes, gene expression, and cytokine/chemokine protein concentrations from 3 anatomic sites above the vagina: the cervical transformation zone, the endocervix and the endometrium. We used hierarchical statistical models to estimate mean (95% CI intervention effects, for N9 and UPG relative to control. Exposure to N9 gel and UPG generated a common "harm signal" that included transcriptional up-regulation of inflammatory genes chemokine (C-C motif ligand 20 (macrophage inflammatory factor-3alpha and interleukin 8 in the cervix, decreased protein concentrations of secretory leukocyte protease inhibitor, and transcriptional up-regulation of inflammatory mediators glycodelin-A and osteopontin in the endometrium. These results need to be replicated with a larger sample, but underscore the need to consider the effects of microbicide agents and gel excipients on the upper female reproductive tract in studies of vaginal microbicides.

High Levels of Inflammatory Cytokines in the Reproductive Tract of Women with BV and Engaging in Intravaginal Douching: A Cross-Sectional Study of Participants in the Women Interagency HIV Study.

Science.gov (United States)

Alcaide, Maria L; Rodriguez, Violeta J; Brown, Megan R; Pallikkuth, Suresh; Arheart, Kristopher; Martinez, Octavio; Roach, Margaret; Fichorova, Raina N; Jones, Deborah L; Pahwa, Savita; Fischl, Margaret A

2017-04-01

High levels of inflammatory cytokines in the genital tract suggest mucosal vulnerability and increased risk of HIV and sexually transmitted infection (STI) acquisition. Intravaginal douching is associated with bacterial vaginosis (BV) in women in the United States, and both douching and BV are linked to HIV and STI acquisition. This study evaluates inflammatory cytokines in the genital tract to increase understanding of the effects of both BV and intravaginal douching to the vaginal mucosa. A cross-sectional study of participants in the Miami WIHS investigated 72 reproductive age women (45 HIV + and 27 high-risk HIV - ) who completed intravaginal douching questionnaires and underwent collection of vaginal swabs and cervicovaginal lavages (CVLs). BV was assessed using the Nugent score. Inflammatory cytokines in the CVLs (interleukin [IL]-6, IL-8, IL-1α, IL-1β, soluble intracellular adhesion molecule-1 [sICAM-1], interferon [IFN]α2, chemokine C ligand 5 (CCL5), vascular endothelial growth factor (VEGF), monocyte chemotactic protein-1 (MCP1), tumor necrosis factor alpha (TNFα), and secretory leukocyte protease inhibitor [SLPI]) were measured. Fourteen (19%) women reported intravaginal douching; 24 (33%) had BV. BV, intravaginal douching, and HIV were associated with higher levels of inflammatory cytokines. After controlling for demographic and risk factors and HIV status, women who had BV and douched had higher levels of inflammatory cytokines than those without BV and who did not douche, or who only had BV or only douched. These findings suggest that BV and douching are associated with greater mucosal inflammation and may facilitate HIV acquisition and transmission. Although longitudinal studies are needed to determine temporal associations and causality, interventions to decrease rates of intravaginal douching and BV could significantly decrease women's risks of acquiring STIs and HIV and limit the spread of HIV.

Does sublingual misoprostol reduce pain and facilitate IUD insertion in women with no previous vaginal delivery? A randomized controlled trial

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Amr Adel Mansy

2018-03-01

Conclusion: Although misoprostol is used in cervical ripening in labour induction and medical evacuation of missed abortion, its use to facilitate IUD insertion in women with tight cervix or in whom vaginal delivery was not experienced, has no role in pain reduction or increase the ease of IUD insertion.

Post operative high dose rate intravaginal irradiation in endometrial cancer: a safe and effective outpatient treatment

International Nuclear Information System (INIS)

Chen, Peter; Gibbons, Susan; Vicini, Frank; Weiner, Sheldon; Dmuchowski, Carl; Mele, Beth; Brabbins, Donald; Jennings, John; Gustafson, Gary; Martinez, Alvaro

1995-01-01

Purpose: We reviewed our experience with out patient high dose rate (HDR) intravaginal irradiation given post-operatively in endometrial cancer to assess local control, survival, and toxicity when used alone or in combination with external beam irradiation. Methods and Materials: From (12(88)) to (12(92)), 78 patients underwent TAH/BSO and received post-operative HDR intravaginal irradiation for endometrial cancer. Pathologic stage distribution was IB/IC: 56%, II: 22%, III: 22%. Adjuvant therapy was given in one of three schemes: HDR vaginal radiation alone (6 weekly fractions of 500 cGy prescribed 5 mm from the applicator surface treating the upper 4 cm of the vagina), pelvic irradiation with vaginal HDR (500 cGy x 4 weekly fractions) or whole abdomen/pelvic irradiation (WAPI) with vaginal HDR treatment (500 cGy x 3 weekly fractions). Prior to the first HDR vaginal treatment, a simulation with placement of vaginal apex metallic markers was performed to assure proper positioning of the intravaginal cylinders. Pelvic midline blocking was designed from the HDR intravaginal simulation films. The 55 patients who underwent combined external beam irradiation/brachytherapy received a median dose to the pelvis of 5040 cGy (range 25.2-51.6 Gy), and a median total vaginal dose of 5060 cGy (range 30.0-57.6 Gy). Results: Median follow-up is 37 months (range 6-73 months). Local control (vaginally) is 98.7%. The one vaginal failure was in the distal vagina, outside the treatment volume. All other failures (4) were distant with the vagina controlled [3 intra-abdominal and one bone/intra-abdominal]. For stages I and II, the disease free survival is 92.8%. For stage III the disease free survival is 86.5%. Median overall time to failure is 14.3 months (range 8.5-18.6 months). In terms of acute toxicity, no grade 3-4 acute toxicity of the vagina or bladder was seen. However, 9% acute GI toxicity was encountered. Chronic grade 1-2 toxicities included: vaginal 21.8% (foreshortening and

Intravaginal testicular torsion in newborns. To fix or not to fix the contralateral testis?

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G. Bordin

2013-10-01

Full Text Available Scrotal swelling suggesting testicular torsion is a rare urological emergency which requires a clinical urgent evaluation and most of the times must be managed surgically. In newborns it can occur in the postnatal period, usually within the twenty-eighth day of life, or more frequently in utero, during the descent of the testis into the scrotum. Usually its poor fixedness allows the testis an abnormal mobility inside the scrotum, configuring the framework of extravaginal torsion. On the contrary during the perinatal period a twist that takes place inside the tunica vaginalis, known as intravaginal torsion, is extremely uncommon and only few cases are well documented in the literature. Authors present a rare case of intravaginal testicular torsion occurred in perinatal period. In this situation only the early surgical exploration of the scrotum may allow the rescue of the gonad, although in rare cases. Timing of surgical treatment and need for contralateral testicular fixation remain controversial. However since the anatomical defect of the tunica vaginalis can be bilateral the surgical fixation even of the contralateral testis is important, now or later, in order to prevent any future torsion of this gonad. The authors also present a brief review of recent literature on the subject.

Qualitative and quantitative intravaginal targeting: Key to anti-HIV-1 microbicide delivery from test tube to in vivo success

CSIR Research Space (South Africa)

Pillay, V

2012-06-01

Full Text Available employed. We hereby propose a thorough scientific qualitative and quantitative investigation of important aspects involved in HIV-1 transmission as a prerequisite for microbicide delivery. Intravaginal targeting of HIV-1 increases the chances of microbicide...

Transport and Biodistribution of Dendrimers Across Human Fetal Membranes: Implications for Intravaginal Administration of Dendrimers

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Menjoge, Anupa R.; Navath, Raghavendra S.; Asad, Abbas; Kannan, Sujatha; Kim, Chong Jai; Romero, Roberto; Kannan, Rangaramanujam M.

2010-01-01

Dendrimers are emerging as promising topical antimicrobial agents, and as targeted nanoscale drug delivery vehicles. Topical intravaginal antimicrobial agents are prescribed to treat the ascending genital infections in pregnant women. The fetal membranes separate the extra-amniotic space and fetus. The purpose of the study is to determine if the dendrimers can be selectively used for local intravaginal application to pregnant women without crossing the membranes into the fetus. In the present study, the transport and permeability of PAMAM (poly(amidoamine)) dendrimers, across human fetal membrane (using a side-by-side diffusion chamber), and its biodistribution (using immunofluorescence) are evaluated ex-vivo. Transport across human fetal membranes (from the maternal side) was evaluated using Fluorescein (FITC), an established transplacental marker (positive control, size~ 400 Da) and fluorophore-tagged G4-PAMAM dendrimers (~ 16 kDa). The fluorophore-tagged G4-PAMAM dendrimers were synthesized and characterized using 1H NMR, MALDI TOF-MS and HPLC analysis. Transfer was measured across the intact fetal membrane (chorioamnion), and the separated chorion and amnion layers. Over a five hour period, the dendrimer transport across all the three membranes was less than transport of FITC was relatively fast with as much as 49% transport across the amnion. The permeability of FITC (7.9 × 10-7 cm2/s) through the chorioamnion was 7-fold higher than that of the dendrimer (5.8 × 10-8 cm2/s). The biodistribution showed that the dendrimers were largely present in interstitial spaces in the decidual stromal cells and the chorionic trophoblast cells (in 2.5 to 4 h) and surprisingly, to a smaller extent internalized in nuclei of trophoblast cells and nuclei and cytoplasm of stromal cells. Passive diffusion and paracellular transport appear to be the major route for dendrimer transport. The overall findings further suggest that entry of drugs conjugated to dendrimers would be

Efficacy and safety of misoprostol, dinoprostone and Cook's balloon for labour induction in women with foetal growth restriction at term.

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Duro-Gómez, Jorge; Garrido-Oyarzún, María Fernanda; Rodríguez-Marín, Ana Belén; de la Torre González, Antonio Jesús; Arjona-Berral, José Eduardo; Castelo-Branco, Camil

2017-10-01

To compare effectiveness and safety of dinoprostone, misoprostol and Cook's balloon as labour-inducing agents in women with intrauterine growth restriction (IUGR) at term. Retrospective cohort chart review of women diagnosed with foetal growth restriction at term in Reina Sofia Hospital, Cordoba, Spain from January 2014 to December 2015. Registration of baseline characteristics and method of induction was made. The main outcome was time from induction to delivery. Obstetric and perinatal outcomes were also collected. A total of 99 women were diagnosed with IUGR in the mentioned period. Of them, 21 women were induced with dinoprostone [dinoprostone group (DG)], 20 with misoprostol (MG) and in 58 with Cook's balloon (CG). Groups were homogeneous regarding pre-induction Bishop score and parity. The CG required more time (24.36 vs. 19.23 h; p = 0.02) and more oxytocin dose for conduction of labour from induction to delivery (6.75 vs. 1.24 mUI; p women with IUGR at term, with a similar safety profile.

Transport and biodistribution of dendrimers across human fetal membranes: implications for intravaginal administration of dendrimer-drug conjugates.

Science.gov (United States)

Menjoge, Anupa R; Navath, Raghavendra S; Asad, Abbas; Kannan, Sujatha; Kim, Chong J; Romero, Roberto; Kannan, Rangaramanujam M

2010-06-01

Dendrimers are emerging as promising topical antimicrobial agents, and as targeted nanoscale drug delivery vehicles. Topical intravaginal antimicrobial agents are prescribed to treat the ascending genital infections in pregnant women. The fetal membranes separate the extra-amniotic space and fetus. The purpose of the study is to determine if the dendrimers can be selectively used for local intravaginal application to pregnant women without crossing the membranes into the fetus. In the present study, the transport and permeability of PAMAM (poly (amidoamine)) dendrimers, across human fetal membrane (using a side by side diffusion chamber), and its biodistribution (using immunofluorescence) are evaluated ex-vivo. Transport across human fetal membranes (from the maternal side) was evaluated using Fluorescein (FITC), an established transplacental marker (positive control, size approximately 400 Da) and fluorophore-tagged G(4)-PAMAM dendrimers (approximately 16 kDa). The fluorophore-tagged G(4)-PAMAM dendrimers were synthesized and characterized using (1)H NMR, MALDI TOF MS and HPLC analysis. Transfer was measured across the intact fetal membrane (chorioamnion), and the separated chorion and amnion layers. Over a 5 h period, the dendrimer transport across all the three membranes was less than dendrimer (5.8 x 10(-8) cm(2)/s). The biodistribution showed that the dendrimers were largely present in interstitial spaces in the decidual stromal cells and the chorionic trophoblast cells (in 2.5-4 h) and surprisingly, to a smaller extent internalized in nuclei of trophoblast cells and nuclei and cytoplasm of stromal cells. Passive diffusion and paracellular transport appear to be the major route for dendrimer transport. The overall findings further suggest that entry of drugs conjugated to dendrimers would be restricted across the human fetal membranes when administered topically by intravaginal route, suggesting new ways of selectively delivering therapeutics to the mother

Pregnancy and conception rate after two intravaginal inseminations with dog semen frozen either with 5% glycerol or 5% ethylene glycol.

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Rota, Ada; Milani, C; Romagnoli, S; Zucchini, P; Mollo, A

2010-03-01

The primary goal of this study was to compare the effects of 5% ethylene glycol (EG) and 5% glycerol (G) on fertility of frozen-thawed dog semen following intravaginal insemination. The sperm-rich fraction of the ejaculate of three male dogs was collected, pooled and divided into two aliquots, and then frozen with a Tris-glucose-egg yolk-citric acid extender containing either 5% G or 5% EG. A total of 10 bitches were inseminated twice, five with G-frozen-thawed semen and five with EG-frozen-thawed semen; intravaginal inseminations were performed the 4th and the 5th day after the estimated LH peak; four straws, thawed in a 37 degrees C water bath for 1 min and diluted in a Tris buffer, were used for insemination (200 x 10(6) spermatozoa); the insemination dose was introduced in the cranial vagina of the bitch using a sterile plastic catheter. Ovariohysterectomy was performed in all bitches between days 29 and 31 after the calculated LH surge, and pregnancy status, and the number of conceptuses and corpora lutea were recorded. All bitches were pregnant. Neither the number of conceptuses, nor the ratio of conceptuses to corpora lutea (conception rate) was significantly different between groups. In this first screening, with a limited number of bitches, EG-frozen semen did not show a higher fertility than G-frozen semen when used for two intravaginal inseminations. Irrespective of the semen used, conception rate was 0.50.

Feasibility and effectiveness of unintended pregnancy prevention with low-dose mifepristone combined with misoprostol before expected menstruation.

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Li, Cui-Lan; Chen, Dun-Jin; Deng, Yi-Fan; Song, Li-Ping; Mo, Xue-Tang; Liu, Kai-Jie

2015-12-01

What is the efficacy of maintaining or restoring non-pregnant status with low-dose mifepristone combined with misoprostol administered before expected menstruation? Low-dose mifepristone and misoprostol administered at the time of expected menstruation was effective and safe in maintaining or restoring non-pregnant status, with no obvious menstrual disturbance. Menstrual regulation involves the medical or mechanical stimulation of uterine sloughing in women with up to 2-3 weeks of menstrual delay. Low-dose mifepristone plus misoprostol is efficacious for termination of ultra-early pregnancy (≤ 35 days of amenorrhoea) with no obvious menstrual disturbance. A total of 678 women fulfilled all criteria and were recruited. Seventeen women dropped out after deciding to remain pregnant and 11 others were lost to follow-up. Thus, data from 650 women who completed the procedure were included in analyses. Participants were enrolled at any time during their menstrual cycle and administered medication 1 day before expected menstruation. The end of the study was defined on a per-patient basis as the date of completion of the post-treatment menstrual cycle. The primary outcome was the efficacy of abortion induction (for pregnant women) or menstrual regulation (for non-pregnant women). Women with regular menstrual cycles (25-35 days) were voluntarily recruited for this study between February 2012 and December 2014. Serum β-hCG was measured before mifepristone intake. Mifepristone (50 mg) was administered orally 1 day before expected menstruation and 200 µg misoprostol was administered orally on the day of expected menstruation. Efficacy, disturbance in bleeding patterns in the treatment and post-treatment cycles, satisfaction with the treatment, and subsequent contraception preference were analysed. Retrospective analysis of serum β-hCG levels at admission indicated that 23.3% (158/678) of the women were pregnant. The success rate for pregnancy termination was 98.6% (136

Intravaginal lactic Acid bacteria modulated local and systemic immune responses and lowered the incidence of uterine infections in periparturient dairy cows.

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Qilan Deng

Full Text Available The objective of this investigation was to evaluate whether intravaginal infusion of a lactic acid bacteria (LAB cocktail around parturition could influence the immune response, incidence rate of uterine infections, and the overall health status of periparturient dairy cows. One hundred pregnant Holstein dairy cows were assigned to 1 of the 3 experimental groups as follows: 1 one dose of LAB on wk -2 and -1, and one dose of carrier (sterile skim milk on wk +1 relative to the expected day of parturition (TRT1; 2 one dose of LAB on wk -2, -1, and +1 (TRT2, and 3 one dose of carrier on wk -2, -1, and +1 (CTR. The LAB were a lyophilized culture mixture composed of Lactobacillus sakei FUA3089, Pediococcus acidilactici FUA3138, and Pediococcus acidilactici FUA3140 with a cell count of 108-109 cfu/dose. Blood samples and vaginal mucus were collected once a week from wk -2 to +3 and analyzed for content of serum total immunoglobulin G (IgG, lipopolysaccharide-binding protein (LBP, serum amyloid A (SAA, haptoglobin (Hp, tumor necrosis factor (TNF, interleukin (IL-1, IL-6, and vaginal mucus secretory IgA (sIgA. Clinical observations including rectal temperature, vaginal discharges, retained placenta, displaced abomasum, and laminitis were monitored from wk -2 to +8 relative to calving. Results showed that intravaginal LAB lowered the incidence of metritis and total uterine infections. Intravaginal LAB also were associated with lower concentrations of systemic LBP, an overall tendency for lower SAA, and greater vaginal mucus sIgA. No differences were observed for serum concentrations of Hp, TNF, IL-1, IL-6 and total IgG among the treatment groups. Administration with LAB had no effect on the incidence rates of other transition cow diseases. Overall intravaginal LAB lowered uterine infections and improved local and systemic immune responses in the treated transition dairy cows.

Women's Experiences with and Preference for Induction of Labor with Oral Misoprostol or Foley Catheter at Term

OpenAIRE

Ten Eikelder, Mieke L G; van de Meent, Marieke M; Mast, Kelly; Rengerink, Katrien Oude; Jozwiak, Marta; de Graaf, Irene M; Scholtenhuis, Marloes A G Holswilder-Olde; Roumen, Frans J M E; Porath, Martina M; van Loon, Aren J; van den Akker, Eline S; Rijnders, Robbert J P; Feitsma, A Hanneke; Adriaanse, Albert H; Muller, Moira A

2017-01-01

Objective We assessed experience and preferences among term women undergoing induction of labor with oral misoprostol or Foley catheter.  Study Design In 18 of the 29 participating hospitals in the PROBAAT-II trial, women were asked to complete a questionnaire within 24 hours after delivery. We adapted a validated questionnaire about expectancy and experience of labor and asked women whether they would prefer the same method again in a future pregnancy. Results The questionnaire was completed...

A multinational population survey of intravaginal ejaculation latency time.

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Waldinger, Marcel D; Quinn, Paul; Dilleen, Maria; Mundayat, Rajiv; Schweitzer, Dave H; Boolell, Mitradev

2005-07-01

Intravaginal ejaculation latency time (IELT), defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation, is increasingly used in clinical trials to assess the amount of selective serotonin reuptake inhibitor-induced ejaculation delay in men with premature ejaculation. Prospectively, stopwatch assessment of IELTs has superior accuracy compared with retrospective questionnaire and spontaneous reported latency. However, the IELT distribution in the general male population has not been previously assessed. To determine the stopwatch assessed-IELT distribution in large random male cohorts of different countries. A total of 500 couples were recruited from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States. Enrolled men were aged 18 years or older, had a stable heterosexual relationship for at least 6 months, with regular sexual intercourse. The surveyed population were not included or excluded by their ejaculatory status and comorbidities. This survey was performed on a "normal" general population. Sexual events and stopwatch-timed IELTs during a 4-week period were recorded, as well as circumcision status and condom use. The IELT, circumcision status, and condom use. The distribution of the IELT in all the five countries was positively skewed, with a median IELT of 5.4 minutes (range, 0.55-44.1 minutes). The median IELT decreased significantly with age, from 6.5 minutes in the 18-30 years group, to 4.3 minutes in the group older than 51 years (PIELT varied between countries, with the median value for Turkey being the lowest, i.e., 3.7 minutes (0.9-30.4 minutes), which was significantly different from each of the other countries. Comparison of circumcised (N=98) and not-circumcised (N=261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7-44.1 minutes) in circumcised compared with 6.0 minutes (0.5-37.4 minutes) in not-circumcised men (not significant). The

Gluteo-vaginal fistula after posterior intravaginal slingplasty: a case report.

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Grynberg, Michael; Teyssedre, Jacques; Staerman, Frederic

2009-07-01

In patients with posthysterectomy prolapse of the vaginal vault, the posterior intravaginal slingplasty (posterior IVS, Tyco Healthcare, USA) has been suggested as an alternative to traditional vaginal vault suspensions. The goal of this technique is to recreate the uterosacral ligaments and to reinforce the rectovaginal fascia with the use of prosthetic material. We report the case of a 53-year-old woman with a history of 27 months of perineal suppurative discharge after she underwent a vaginal vault prolapse and rectocele repair using a posterior IVS (Tyco Healthcare, USA). The IVS tape was reinforced by interposing a rectovaginal monofilament polypropylene mesh (Parietex, Sofradim, France). Imaging studies and surgical exploration confirmed infection of the IVS mesh with the formation of a gluteo-vaginal fistula while the rectovaginal mesh was intact.

Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curacao

NARCIS (Netherlands)

Boersma, Adriana A.; Jong, Betty Meyboom-de; Kleiverda, Gunilla

Objective To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curacao, where induced abortion is severely restricted by law. Methods In a prospective study 330 women received 200 mg

Randomized, Placebo-Controlled Phase 2 Trial of a Lactobacillus crispatus Probiotic Given Intravaginally for Prevention of Recurrent Urinary Tract Infection

OpenAIRE

Stapleton, Ann E.; Au-Yeung, Melissa; Hooton, Thomas M.; Fredricks, David N.; Roberts, Pacita L.; Czaja, Christopher A.; Yarova-Yarovaya, Yuliya; Fiedler, Tina; Cox, Marsha; Stamm, Walter E.

2011-01-01

In a double-blind placebo-controlled trial of a Lactobacillus crispatus intravaginal suppository probiotic (LACTIN-VÜ, Osel, Inc.) for prevention of recurrent UTI (rUTI) in pre-menopausal women, LACTIN-V was safe, well tolerated, and associated with a reduction in rUTI.

The 5-HT₁A receptor CG polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K C; van Schaik, R; Zwinderman, Aeilko H; Olivier, Berend|info:eu-repo/dai/nl/073067199; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564

INTRODUCTION: Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and

Qualitative and quantitative analysis of bacteria from vaginitis associated with intravaginal implants in ewes following estrus synchronization

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Carlos Otávio de Paula Vasconcelos

2016-04-01

Full Text Available ABSTRACT: This study evaluated the presence of vaginitis and the bacterial load associated with different intravaginal implants in ewes. Twenty-four Dorper and crossbred ewes were allocated into three groups and received intravaginal implant containing 0.3g progesterone (CIDR(r, 60mg MAP or sponges without progesterone (CONTROL for six days. Then, CIDR and MAP treated-ewes received 12.5mg dinoprost and 300IU eCG. Vaginal mucus samples were collected at four times: before device insertion, at the day of its removal, 24 and 48 hours after. The samples were cultured and the colonies were counted (CFU/mL and identified. The results obtained from the counting of CFU mL-1 were submitted to Kruskal-Wallis H test, with P0.05 in comparison with MAP and CIDR-treated ewes. During the occurrence of vaginitis, the predominant isolates belonged to the coliform group, mainly Escherichia coli (72.7%. Such infection was not determined by the members of the vaginal microbiota that were present before implant insertion and normal microbiota was restored between 24 to 48 hours after insert removal.

Induced abortion among Brazilian female sex workers: a qualitative study.

Science.gov (United States)

Madeiro, Alberto Pereira; Diniz, Debora

2015-02-01

Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes.

The 5-HT₁A receptor CG polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K. C.; van Schaik, R.; Zwinderman, Aeilko H.; Olivier, Berend; Waldinger, Marcel D.

2014-01-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and 5-HT₂C

Intravaginal boric acid: is it an alternative therapeutic option for vaginal trichomoniasis?

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Thorley, Nicola; Ross, Jonathan

2017-12-09

Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common curable sexually transmitted infection worldwide. Current guidance in the UK is to treat TV with a nitroimidazole antibiotic. The high prevalence of TV, high rate of antibiotic resistance and limited tolerability to nitroimidazoles suggest that alternative treatment regimens are needed. Intravaginal boric acid (BA) has been used safely for the treatment of candida vulvovaginitis and bacterial vaginosis, and in vitro studies suggest BA is active against TV. We review the evidence for the efficacy of BA in patients with TV. MEDLINE, EMBASE, CINAHL, AMED, HMIC and BNI and Grey literature databases, The Cochrane Library, Trial Registers, conference abstracts and proceedings were searched. Inclusion criteria were women aged 16 years or over with microbiological confirmation of TV infection and using BA as treatment. There were no restrictions on language, publication date or study design. The in vitro evidence for BA activity against TV was also reviewed. No randomised controlled trials or case series were found. Four case reports demonstrated TV clearance with BA using a variety of dose regimens (dose 600 mg alternate nights to 600 mg two times per day; duration 1-5 months). In vitro studies suggest that BA has activity against TV which is independent of its effect on pH. Further evaluation of BA for the treatment of uncomplicated TV is required, but it may be useful when therapeutic options are limited. If shown to be safe and effective, intravaginal BA might provide a well-tolerated alternative anti-infective treatment which reduces community exposure to systemic antibiotics. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism is Associated with the Intravaginal Ejaculation Latency Time in Dutch Men with Lifelong Premature Ejaculation

NARCIS (Netherlands)

Janssen, Paddy K. C.; Bakker, Steven C.; Réthelyi, Janos; Zwinderman, Aeilko H.; Touw, Daan J.; Olivier, Berend; Waldinger, Marcel D.

2009-01-01

Introduction. Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central

Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K C; Bakker, Steven C; Réthelyi, Janos; Zwinderman, Aeilko H; Touw, Daan J; Olivier, Berend; Waldinger, Marcel D

INTRODUCTION: Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central

EVALUACIÓN DE PROGESTERONA INTRAVAGINAL POST INSEMINACIÓN ARTIFICIAL PARA REDUCIR LA MUERTE EMBRIONARIA EN VACAS

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Jorge Ignacio Macias

2014-06-01

Full Text Available El objetivo de esta investigación fue evaluar el efecto de la administración de un dispositivo intravaginal de progesterona post IATF sobre la reducción de la muerte embrionaria, el cual se aplicó siete días después de la inseminación. Se utilizaron 40 vacas de aptitud cárnica de cruza mestiza Senangus x Brahman de dos-cuatro partos. Se realizó ecografía transrectal (Aquilla Vet 7.5 MHZ previo a la sincronización. Se efectuó el inicio de ésta con el dispositivo CIDR 1.38 g progesterona. Después de siete días de la inseminación se colocó el dispositivo usado a 20 animales tratamiento y se lo mantuvo durante 10 días. Se realizó tomas de muestras de sangre para medir los niveles de P4. Estas fueron tomadas a cinco animales del grupo tratamiento en el día que se reinsertó el dispositivo, 5 días después y al retiro. Las muestras revelaron niveles altos de progesterona que oscilaron entre 7.87 hasta 19.4 ng/mL. Se diagnosticó gestación a los 30 y 60 días. Se realizó un análisis costo beneficio al tratamiento. En los resultados se encontró una relación entre los tratamientos y la preñez a los 30 días (p=0.053; la relación del costo beneficio se manifestó económicamente viable con la aplicación de progesterona, ya que por cada dólar invertido se genera como ganancia 23 ctvs de dólar. Se concluye que la aplicación de progesterona reduce la muerte embrionaria hasta los 30 días post inseminación.

Omeprazole and misoprostol for preventing gastric mucosa effects caused by indomethacin and celecoxib in rats Omeprazol e misoprostol na prevenção de lesões de mucosa gástrica causadas por indometacina e celecoxib em ratos

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Míriam Elias Cavallini

2006-06-01

Full Text Available PURPOSE: To evaluate and to compare macro and microscopically the intense injuries of the gastric mucosa of rats which were caused by NSAIDS celecoxib and indomethacin and the gastric cytoprotection with omeprazole and misoprostol. METHODS: The sample is formed by one hundred and fifty Wistar rats with average weight 200 g, distributed in four groups, such as: Group A, subdivided in groups A1 and A2 - pre-treatment with omeprazole (20 mg/rat during seven days and on the 8th day - use of NSAIDS, concerning A1 (20 rats were given celecoxib (1mg/rat and A2 (20 rats were given indomethacin. The Group B, subdivided in group B1 and B2 - pre-treatment with misoprostol (20mg/rat during seven days and on the 8th day use of NSAIDS, concerning B1 (20 rats were given celecoxib (1 mg/ rat and B2 (20 rats were given indomethacin (12.5 mg/rat. The Group C: were not given cytoprotection during seven days, from the 7th to the 8th day - fast of food and water ad libitum, on the 8th day of NSAIDS use, concerning C1 (20 rats were given celecoxib, C2 (20 rats were given indomethacin (12.5 mg/ rat, C3 (20 rats were given celecoxib (200mg/rato, and Group D - control group, concerning 10 rats were observed during seven days ingesting food and water ad libitum. On the 9th day, the stomachs were taken out and were macro and microscopically evaluated for the identification of the gastric injuries. RESULTS: On the macroscopic studies, the groups A2, B2 and C2 presented a remarkable high number of injuries for cm² /animal, respectively 18.55 injuries for cm² /animal, 16.25 injuries for cm² /animal and 13.55 injuries for cm²/animal. On the microscopic studies, the percentage of the injured mucosa, presented expressive difference among the groups A1, B1, C1 when compared to the groups A2, B2, C2 (pOBJETIVO: Avaliar e comparar macro e microscopicamente as lesões agudas da mucosa gástrica de ratos provocadas pelos AINEs celecoxib e indometacina e a citoproteção g

Misoprostol versus ergometrine-oxytocin for preventing postpartum haemorrhage: a systematic review and meta-analysis of randomized controlled trials.

Science.gov (United States)

Tan, Jing; Cao, Qiao; He, Guo-Lin; Cai, Yu-Han; Yu, Jia-Jie; Sun, Xin; Li, You-Ping

2016-11-01

To compare the effects of misoprostol versus ergometrine-oxytocin for postpartum haemorrhage (PPH) prevention, and provide important evidence to choose optimal agents for preventing PPH in developing countries. The Cochrane Central Register of Controlled Trials, PubMed, EMbase, and ClinicalTrails.gov were searched from inception to 1st January 2016. Two authors independently extracted data and assessed risk of bias of studies according to Cochrane Handbook5.1.0. Meta-analysis was performed using RevMan5.2.4 software. A total of 4034 women from six randomized controlled trials (RCTs) were included. Meta-analyses showed that the PPH rate (7.6% vs. 4.2%, RR = 1.81, 95%CI (1.40, 2.35), P oxytocin group, respectively. But there was no significant difference of severe PPH rate between two groups (1.2% vs. 0.76%, RR = 1.55, 95%CI (0.78, 3.07), P = 0.21). The need for manual removal of placenta in misoprostol was only about one-third of ergometrine-oxytocin (0.5% vs. 1.4%, RR = 0.33, 95%CI (0.15, 0.76), P oxytocin could be deemed as alternative agent in low-resource setting due to recognized effect. As a result of limited evidence about these uterotonic agents, the more high-quality RCTs are needed to determine the potentials and harms of various uterotonic agents for preventing PPH in developing countries. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Induced abortion among Brazilian female sex workers: a qualitative study

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Alberto Pereira Madeiro

2015-02-01

Full Text Available Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes.

Intravaginal administration of metformin hydrochloride loaded cationic niosomes amalgamated with thermosensitive gel for the treatment of polycystic ovary syndrome: In vitro and in vivo studies.

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Saini, Neetu; Sodhi, Rupinder Kaur; Bajaj, Lotika; Pandey, Ravi Shankar; Jain, Upendra Kumar; Katare, Om Prakash; Madan, Jitender

2016-08-01

Metformin hydrochloride (MTF-HCl) is extensively recommended by physicians for the treatment of polycystic ovary syndrome (PCOS). Mechanistically, MTF-HCl activates AMP-dependent kinase-α (AMPK-α) pathway to decrease the glucose production, enhances fatty acid oxidation and elevates the uptake of glucose in tissues. However, despite favourable physicochemical properties, oral administration of MTF-HCl is associated with impaired bioavailability (50-60%), lactic-acidosis and frequent dosing (500mg 2-3 times a day) in PCOS that ultimately influence the patient compliance. Therefore, in present investigation, MTF-HCl loaded unmodified and cationic small unilamellar niosomes were separately amalgamated with thermosensitive gel (MTF-HCl-SUNs-Gel and MTF-HCl-C-SUNs-Gel) for the treatment of PCOS through vaginal route of administration. MTF-HCl-SUNs and MTF-HCl-C-SUNs were separately prepared by reverse phase evaporation method. The nanovesicle size and zeta-potential of MTF-HCl-C-SUNs were measured to be 210.3±14.8-nm (Ptreatment of PCOS rats under scheduled dose-dosage regimen with oral MTF-HCl solution, intravaginal MTF-HCl-SUNs-Gel and intravaginal MTF-HCl-C-SUNs-gel exhibited remarkable alterations, recruitment and development of normal follicles in addition to normalization of level of various hormones in PCOS. In conclusion, MTF-C-SUNs-Gel has paved the way for developing intravaginal dosage form of MTF-HCl for the treatment of PCOS. Copyright © 2016 Elsevier B.V. All rights reserved.

Prostaglandin E1 and Its Analog Misoprostol Inhibit Human CML Stem Cell Self-Renewal via EP4 Receptor Activation and Repression of AP-1.

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Li, Fengyin; He, Bing; Ma, Xiaoke; Yu, Shuyang; Bhave, Rupali R; Lentz, Steven R; Tan, Kai; Guzman, Monica L; Zhao, Chen; Xue, Hai-Hui

2017-09-07

Effective treatment of chronic myelogenous leukemia (CML) largely depends on the eradication of CML leukemic stem cells (LSCs). We recently showed that CML LSCs depend on Tcf1 and Lef1 factors for self-renewal. Using a connectivity map, we identified prostaglandin E1 (PGE1) as a small molecule that partly elicited the gene expression changes in LSCs caused by Tcf1/Lef1 deficiency. Although it has little impact on normal hematopoiesis, we found that PGE1 treatment impaired the persistence and activity of LSCs in a pre-clinical murine CML model and a xenograft model of transplanted CML patient CD34 + stem/progenitor cells. Mechanistically, PGE1 acted on the EP4 receptor and repressed Fosb and Fos AP-1 factors in a β-catenin-independent manner. Misoprostol, an FDA-approved EP4 agonist, conferred similar protection against CML. These findings suggest that activation of this PGE1-EP4 pathway specifically targets CML LSCs and that the combination of PGE1/misoprostol with conventional tyrosine-kinase inhibitors could provide effective therapy for CML. Copyright © 2017 Elsevier Inc. All rights reserved.

Achieving community-based postpartum follow up in eastern Uganda: the field experience from the MamaMiso Study on antenatal distribution of misoprostol

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Ditai, James; Frye, Laura J.; Durocher, Jill; Byrne, Meagan E.; Ononge, Sam; Winikoff, Beverly; Weeks, Andrew D.

2017-01-01

Background Advance provision of misoprostol to women during antenatal care aims to achieve broader access to uterotonics for the prevention of postpartum hemorrhage. Studies of this community-based approach usually involve antenatal education as well as timely postpartum follow-up visits to confirm maternal and neonatal outcomes. The MamaMiso study in Mbale, Uganda sought to assess the feasibility of conducting follow-up visits in the postpartum period following advance provision of misoprost...

Ischiorectal abscess and ischiorectal-vaginal fistula as delayed complications of posterior intravaginal slingplasty: a case report.

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Chen, Heidi Wen-Chu; Guess, Marsha K; Connell, Kathleen A; Bercik, Richard S

2009-10-01

Synthetic meshes have been used extensively to augment surgical management of pelvic organ prolapses. Posterior intravaginal sling (IVS) is a technique used for correcting vaginal vault/apical prolapse, posterior vaginal prolapse or rectocele. There are limited data on long-term safety of this procedure. In a subanalysis of the IVS tapes from the SUSPEND trial performed secondary to the large number of patients with complications of suburethral sling erosions after IVS, it was noted that the sling erosion tended to have a delayed presentation secondary to poor incorporation of the mesh. A 48-year-old woman with cystocele, uterine prolapse and rectocele had undergone total vaginal hysterectomy, mesh-augmented anterior repair, posterior colporrhaphy and posterior intravaginal slingplasty (IVS) in July 2005. Thirty months after the surgery, she presented with gradual symptoms of copious vaginal discharge for several weeks followed by constant right buttock pain and swelling. Examination was notable for intact mesh with no signs of erosion and a 3-cm induration deep within the right buttock. Computed tomography suggested a pelvic abscess. Magnetic resonance imaging confirmed a right ischiorectal fossa abscess and a vaginal fistula. The patient underwent sling excision, right ischiorectal fossa exploration and vaginal fistula repair. A fistulous tract was found to extend along the intact sling from the vaginal epithelium toward the right ischiorectal fossa. At 2 months' followup, there were no recurrences or other complications. This is the first report of a delayed complication of an ischiorectal abscess associated with an ischiorectal-vaginal fistula that presented 30 months after the placement of a posterior IVS.

Oxytocin via Uniject (a prefilled single-use injection) versus oral misoprostol for prevention of postpartum haemorrhage at the community level: a cluster-randomised controlled trial

OpenAIRE

Ayisha Diop, MPH; Bocar Daff, MD; Maimouna Sow, MA; Jennifer Blum, MPH; Mamadou Diagne, PhD; Nancy L Sloan, DrPH; Beverly Winikoff, MD

2016-01-01

Background: Access to injectable uterotonics for management of postpartum haemorrhage remains limited in Senegal outside health facilities, and misoprostol and oxytocin delivered via Uniject have been deemed viable alternatives in community settings. We aimed to compare the efficacy of these drugs when delivered by auxiliary midwives at maternity huts. Methods: We did an unmasked cluster-randomised controlled trial at maternity huts in three districts in Senegal. Maternity huts with auxili...

The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy Kc; Schaik, Ron van; Olivier, Berend|info:eu-repo/dai/nl/073067199; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564

2014-01-01

It has been postulated that the persistent short intravaginal ejaculation latency time (IELT) of men with lifelong premature ejaculation (LPE) is related to 5-hydroxytryptamine (HT)2C receptor functioning. The aim of this study was to investigate the relationship of Cys23Ser 5-HT2C receptor gene

Control, communication and monitoring of intravaginal drug delivery in dairy cows.

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Cross, Peter S; Künnemeyer, Rainer; Bunt, Craig R; Carnegie, Dale A; Rathbone, Michael J

2004-09-10

We present the design of an electronically controlled drug delivery system. The intravaginally located device is a low-invasive platform that can measure and react inside the cow vagina while providing external control and monitoring ability. The electronics manufactured from off the shelf components occupies 16 mL of a Theratron syringe. A microcontroller reads and logs sensor data and controls a gascell. The generated gas pressure propels the syringe piston and releases the formulation. A two way radio link allows communication between other devices or a base station. Proof of principle experiments confirm variable-rate, arbitrary profile drug delivery qualified by internal sensors. A total volume of 30 mL was dispensed over a 7-day-period with a volume error of +/- 1 mL or +/- 7% for larger volumes. Delivery was controlled or overridden via the wireless link, and proximity to other devices was detected and recorded. The results suggest that temperature and activity sensing or social grouping determined via proximity can be used to detect oestrus and trigger appropriate responses.

Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal.

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Corinne H Rocca

Full Text Available Expanding access to medication abortion through pharmacies is a promising avenue to reach women with safe and convenient care, yet no pharmacy provision interventions have been evaluated. This observational non-inferiority study investigated the effectiveness and safety of mifepristone-misoprostol medication abortion provided at pharmacies, compared to government-certified public health facilities, by trained auxiliary nurse-midwives in Nepal.Auxiliary nurse-midwives were trained to provide medication abortion through twelve pharmacies and public facilities as part of a demonstration project in two districts. Eligible women were ≤63 days pregnant, aged 16-45, and had no medical contraindications. Between 2014-2015, participants (n = 605 obtained 200 mg mifepristone orally and 800 μg misoprostol sublingually or intravaginally 24 hours later, and followed-up 14-21 days later. The primary outcome was complete abortion without manual vacuum aspiration; the secondary outcome was complication requiring treatment. We assessed risk differences by facility type with multivariable logistic mixed-effects regression.Over 99% of enrolled women completed follow-up (n = 600. Complete abortions occurred in 588 (98·0% cases, with ten incomplete abortions and two continuing pregnancies. 293/297 (98·7% pharmacy participants and 295/303 (97·4% public facility participants had complete abortions, with an adjusted risk difference falling within the pre-specified 5 percentage-point non-inferiority margin (1·5% [-0·8%, 3·8%]. No serious adverse events occurred. Five (1.7% pharmacy and two (0.7% public facility participants experienced a complication warranting treatment (aRD, 0.8% [-1.0%-2.7%].Early mifepristone-misoprostol abortion was as effective and safe when provided by trained auxiliary nurse-midwives at pharmacies as at government-certified health facilities. Findings support policy expanding provision through registered pharmacies by trained auxiliary

Síndrome de Moebius: Genopatía vs efecto teratogénico

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Cecilia Fernández-Ponce

2006-01-01

Full Text Available El Síndrome de Moebius (MBS es una enfermedad rara, caracterizada principalmente por parálisis facial y frecuentemente acompañada de alteraciones oculares asociadas al compromiso del VI nervio craneal. Además es frecuente encontrar anomalías orofaciales y de miembros en estos pacientes. En este artículo se presenta un paciente masculino de nueve meses con el cuadro clínico de Síndrome de Moebius en el cual se discuten los aspectos genéticos y medioambientales asociados a esta patología. Desde la introducción del misoprostol y su uso inadecuado como agente abortivo, se ha observado un incremento en la frecuencia de recién nacidos con Síndrome de Moebius asociados al uso de este medicamento. Al día de hoy, tanto el factor genético como el factor medioambiental se encuentran asociados al Síndrome de Moebius. Finalmente, es importante alertar a la comunidad médica y a la población en general acerca del riesgo teratogénico del misoprostol y de la importancia del consejo genético cuando nace un paciente con Síndrome de Moebius.

Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause.

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Labrie, Fernand; Archer, David F; Koltun, William; Vachon, Andrée; Young, Douglas; Frenette, Louise; Portman, David; Montesino, Marlene; Côté, Isabelle; Parent, Julie; Lavoie, Lyne; Beauregard, Adam; Martel, Céline; Vaillancourt, Mario; Balser, John; Moyneur, Érick

2016-03-01

The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause (GSM). In a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial, the effect of daily intravaginal 0.50% DHEA (6.5 mg) (Prasterone, EndoCeutics) was examined on four coprimary objectives, namely percentage of parabasal cells, percentage or superficial cells, vaginal pH, and moderate to severe pain at sexual activity (dyspareunia) identified by the women as their most bothersome vulvovaginal atrophy symptom. The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups, respectively. After daily intravaginal administration of 0.50% DHEA for 12 weeks, when compared to baseline by the analysis of covariance test, the percentage of parabasal cells decreased by 27.7% over placebo (P < 0.0001), whereas the percentage of superficial cells increased by 8.44% over placebo (P < 0.0001), vaginal pH decreased by 0.66 pH unit over placebo (P < 0.0001), and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo (P = 0.0002). On the other hand, moderate to severe vaginal dryness present in 84.0% of women improved at 12 weeks by 1.44 severity score unit compared to baseline, or 0.27 unit over placebo (P = 0.004). At gynecological evaluation, vaginal secretions, epithelial integrity, epithelial surface thickness, and color all improved by 86% to 121% over the placebo effect (P < 0.0001 for all comparisons with placebo). Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology. The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at

Misoprostol para todxs: objetivos y alcances del activismo lésbico en la lucha por el aborto en Argentina

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Pampin, Ayelen Marina

2014-01-01

La cuestión del aborto se presenta hoy en día en Argentina como un tema absolutamente controversial y encontrar unidad respecto del mismo es difícil. Sin embargo, una de las particularidades que caracterizan el debate es que, visiblemente, está dividido en dos bandos: los que están a favor de la legalización y los que están en contra. Esta división está tan naturalizada que invisibiliza los matices que constituyen la polémica, como por ejemplo, las numerosas y complejas contradicciones que se...

Analytical Method Validation of High-Performance Liquid Chromatography and Stability-Indicating Study of Medroxyprogesterone Acetate Intravaginal Sponges

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Nidal Batrawi

2017-02-01

Full Text Available Medroxyprogesterone acetate is widely used in veterinary medicine as intravaginal dosage for the synchronization of breeding cycle in ewes and goats. The main goal of this study was to develop reverse-phase high-performance liquid chromatography method for the quantification of medroxyprogesterone acetate in veterinary vaginal sponges. A single high-performance liquid chromatography/UV isocratic run was used for the analytical assay of the active ingredient medroxyprogesterone. The chromatographic system consisted of a reverse-phase C18 column as the stationary phase and a mixture of 60% acetonitrile and 40% potassium dihydrogen phosphate buffer as the mobile phase; the pH was adjusted to 5.6. The method was validated according to the International Council for Harmonisation (ICH guidelines. Forced degradation studies were also performed to evaluate the stability-indicating properties and specificity of the method. Medroxyprogesterone was eluted at 5.9 minutes. The linearity of the method was confirmed in the range of 0.0576 to 0.1134 mg/mL ( R 2 > 0.999. The limit of quantification was shown to be 3.9 µg/mL. Precision and accuracy ranges were found to be %RSD <0.2 and 98% to 102%, respectively. Medroxyprogesterone capacity factor value of 2.1, tailing factor value of 1.03, and resolution value of 3.9 were obtained in accordance with ICH guidelines. Based on the obtained results, a rapid, precise, accurate, sensitive, and cost-effective analysis procedure was proposed for quantitative determination of medroxyprogesterone in vaginal sponges. This analytical method is the only available method to analyse medroxyprogesterone in veterinary intravaginal dosage form.

Evaluation of pregnancy rates of Bos indicus cows subjected to different synchronization ovulation protocols using injectable progesterone or an intravaginal device

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Jefferson Tadeu Campos

2016-12-01

Full Text Available This study evaluated the pregnancy rate in Nelore cows (Bos indicus that were subjected to fixed-time artificial insemination (FTAI using different protocols consisting of injectable progesterone (P4 or an intravaginal device (impregnated with P4. Multiparous cows 72-84 months in age, 30-45 days postpartum, were selected on the basis of the absence of a corpus luteum (CL and follicles < 8 mm after transrectal palpation and ultrasound examinations. On a random day of the estrus cycle (D0, the selected animals (n = 135 were randomly assigned to one of three experimental groups (n = 45 each. Group I (injectable P4/FTAI 36 hours received 250 mg of injectable P4 and 2 mg EB on D0; on D7, they received 500 µg of cloprostenol; on D8, 300 IU of eCG and 1 mg of EB were administered; and finally, FTAI was performed 36 hours after the application of EB. Group II (injectable P4/FTAI 48 hours received the same protocol as Group I, except that the FTAI was performed 48 hours after ovulation induction. The animals of Group III (Control/CIDR received a conventional protocol for FTAI using an intravaginal device (D0: P4 and 2 mg EB; D8: device removal, 500 µg cloprostenol, 300 IU eCG, 1 mg EB; and FTAI performed 48 hours after removal of the device. The results showed that cows synchronized with the conventional protocol for FTAI (Control/CIDR had a higher pregnancy rate (60 %, 27/45 than those synchronized with an injectable P4/FTAI 36 hours (33.33 %; 15/45, P = 0.010. However, the group receiving injectable P4 group/FTAI 48 hours had a similar pregnancy rate (48.9 %; 22/45; P = 0.290 when compared to both the group receiving the conventional protocol and that receiving injectable P4/FTAI 36 hours (P = 0.134. Although the injectable P4 may affect pregnancy rate with the FTAI performed in 36 hours, we found similar pregnancy rates from cows inseminated 48 hours after induction ovulation, considering injectable or intravaginal P4. Therefore, we suggest that

Safety and availability of dapivirine (TMC120) delivered from an intravaginal ring.

Science.gov (United States)

Romano, J; Variano, B; Coplan, P; Van Roey, J; Douville, K; Rosenberg, Z; Temmerman, M; Verstraelen, H; Van Bortel, L; Weyers, S; Mitchnick, M

2009-05-01

Vaginal delivery of 200 mg or 25 mg dapivirine from intravaginal rings (IVRs) was evaluated over a 7-day period in two phase 1 safety trials (IPM001 and IPM008, respectively) in a total of 25 healthy women 19 to 46 years of age. The IVR was generally safe and well tolerated with similar adverse events observed in the placebo and dapivirine groups. Across both studies, dapivirine concentrations in vaginal fluids measured at the introitus, cervix, and ring area were within the mean range of 0.7-7.1 microg/ml. Mean dapivirine concentrations in vaginal and cervical tissues on day 7 were 0.3-0.7 microg/g in IPM001 and 1.5-3.5 microg/g in IPM008. Mean plasma concentrations of dapivirine were Dapivirine from both IVRs was successfully distributed throughout the lower genital tract at concentrations >1000x the EC(50) against wild-type HIV-1 (LAI) in MT4 cells suggesting that IVR delivery of microbicides is a viable option meriting further study.

Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

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Justin T Clark

Full Text Available The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

Modalidades terapéuticas en la fase latente prolongada del trabajo de parto Therapeutic modalities in the prolonged latent phase of labor

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Danilo Nápoles Méndez

2012-05-01

Full Text Available En el trabajo de parto, la distocia de fase latente constituye una entidad clínica relacionada con el aumento de la morbilidad y mortalidad materna y perinatal. En este artículo se exponen las modalidades de tratamiento para el trastorno de esta fase del trabajo de parto, a fin de que los obstetras posean alternativas terapéuticas que posibiliten una mayor preparación en la toma de decisiones. Asimismo, se describen tanto las formas de terapia conservadora (reposo terapéutico, como las de la activa. Se concluye que el tratamiento activo no invasivo de base etiológica con misoprostol y la terapia activa con oxitocina y rotura artificial de membranas tardía, son modalidades empleadas en obstetricia con resultados satisfactorios.Dystocia of latent phase constitutes a clinical entity related to the increase of maternal and perinatal morbidity and mortality during labor. The treatment modalities for the disorder of this phase of labor are exposed in this work, so that the obstetricians have therapeutic alternatives which facilitate a greater preparation in the decision-making process. The ways for conservative therapy (therapeutic rest and active therapy are also described. It is concluded that the non-invasive active treatment of etiological basis with misoprostol and the active therapy with oxytocin and late artificial rupture of membranes are the modalities used in obstetrics with satisfactory results.

An intravaginal ring that releases the NNRTI MIV-150 reduces SHIV transmission in macaques.

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Singer, Rachel; Mawson, Paul; Derby, Nina; Rodriguez, Aixa; Kizima, Larisa; Menon, Radhika; Goldman, Daniel; Kenney, Jessica; Aravantinou, Meropi; Seidor, Samantha; Gettie, Agegnehu; Blanchard, James; Piatak, Michael; Lifson, Jeffrey D; Fernández-Romero, José A; Robbiani, Melissa; Zydowsky, Thomas M

2012-09-05

Microbicides may prevent HIV and sexually transmitted infections (STIs) in women; however, determining the optimal means of delivery of active pharmaceutical ingredients remains a major challenge. We previously demonstrated that a vaginal gel containing the non-nucleoside reverse transcriptase inhibitor MIV-150 partially protected macaques from SHIV-RT (simian/HIV reverse transcriptase) infection, and the addition of zinc acetate rendered the gel significantly protective. We test the activity of MIV-150 without the addition of zinc acetate when delivered from either ethylene vinyl acetate (EVA) or silicone intravaginal rings (IVRs). MIV-150 was successfully delivered, because it was detected in vaginal fluids and tissues by radioimmunoassay in pharmacokinetic studies. Moreover, EVA IVRs significantly protected macaques from SHIV-RT infection. Our results demonstrate that MIV-150-containing IVRs have the potential to prevent HIV infection and highlight the possible use of IVRs for delivering drugs that block HIV and other STIs.

Ovarian follicular dynamics and plasma steroid concentrations are not significantly different in ewes given intravaginal sponges containing either 20 or 40 mg of fluorogestone acetate.

Science.gov (United States)

Letelier, C A; Contreras-Solis, I; García-Fernández, R A; Ariznavarreta, C; Tresguerres, J A F; Flores, J M; Gonzalez-Bulnes, A

2009-03-01

Although various progestagens are often used to induce and synchronize estrus and ovulation in ruminants, concerns regarding residues are the impetus to develop alternative approaches, including reduced doses of progestagens. Therefore, the objective was to determine whether ovarian function was affected by halving the dose of fluorogestone acetate in intravaginal sponges for synchronizing ovulation in sheep during the physiologic breeding season. Twenty Manchega ewes, 4-6-year-old, were randomly allocated to receive an intravaginal sponge containing either 20mg (P20, n=10) or 40 mg of fluorogestone acetate (P40, n=10). Cloprostenol (125 microg) was given at sponge insertion, and all sponges were removed after 6d. Ovarian follicular dynamics (monitored by daily ultrasonography) and other aspects of ovarian function did not differ significantly between the two groups. Ovulatory follicles (OF) grew at a similar growth rate (r=0.62; Pprogesterone concentrations (3.8+/-0.35 ng/mL for P20 and 3.9+/-0.38 ng/mL for P40) were similar. In conclusion, reducing the dose of fluorogestone acetate from 40 to 20mg did not affect significantly ovarian follicular dynamics or other aspects of ovarian function.

Determination of Prognostic Factors for Vaginal Mucosal Toxicity Associated With Intravaginal High-Dose Rate Brachytherapy in Patients With Endometrial Cancer

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Bahng, Agnes Y.; Dagan, Avner; Bruner, Deborah W.; Lin, Lilie L.

2012-01-01

Purpose: The objective of this study was to determine the patient- and treatment-related prognostic factors associated with vaginal toxicity in patients who received intravaginal high dose rate (HDR) brachytherapy alone as adjuvant treatment for endometrial cancer. Secondary goals of this study included a quantitative assessment of optimal dilator use frequency and a crude assessment of clinical predictors for compliant dilator use. Methods and Materials: We retrospectively reviewed the charts of 100 patients with histologically confirmed endometrial cancer who underwent total hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection and adjuvant intravaginal brachytherapy between 1995 and 2009 at the Hospital of University of Pennsylvania. The most common treatment regimen used was 21 Gy in three fractions (71 patients). Symptoms of vaginal mucosal toxicity were taken from the history and physical exams noted in the patients’ charts and were graded according to the Common Toxicity Criteria for Adverse Events v. 4.02. Results: The incidence of Grade 1 or asymptomatic vaginal toxicity was 33% and Grade 2–3 or symptomatic vaginal toxicity was 14%. Multivariate analysis of age, active length, and dilator use two to three times a week revealed odds ratios of 0.93 (p = 0.013), 3.96 (p = 0.008), and 0.17 (p = 0.032) respectively. Conclusion: Increasing age, vaginal dilator use of at least two to three times a week, and shorter active length were found to be significantly associated with a decreased risk of vaginal stenosis. Future prospective studies are necessary to validate our findings.

Determination of Prognostic Factors for Vaginal Mucosal Toxicity Associated With Intravaginal High-Dose Rate Brachytherapy in Patients With Endometrial Cancer

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Bahng, Agnes Y.; Dagan, Avner [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Bruner, Deborah W. [University of Pennsylvania School of Nursing, Philadelphia, PA (United States); Lin, Lilie L., E-mail: lin@xrt.upenn.edu [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)

2012-02-01

Purpose: The objective of this study was to determine the patient- and treatment-related prognostic factors associated with vaginal toxicity in patients who received intravaginal high dose rate (HDR) brachytherapy alone as adjuvant treatment for endometrial cancer. Secondary goals of this study included a quantitative assessment of optimal dilator use frequency and a crude assessment of clinical predictors for compliant dilator use. Methods and Materials: We retrospectively reviewed the charts of 100 patients with histologically confirmed endometrial cancer who underwent total hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection and adjuvant intravaginal brachytherapy between 1995 and 2009 at the Hospital of University of Pennsylvania. The most common treatment regimen used was 21 Gy in three fractions (71 patients). Symptoms of vaginal mucosal toxicity were taken from the history and physical exams noted in the patients' charts and were graded according to the Common Toxicity Criteria for Adverse Events v. 4.02. Results: The incidence of Grade 1 or asymptomatic vaginal toxicity was 33% and Grade 2-3 or symptomatic vaginal toxicity was 14%. Multivariate analysis of age, active length, and dilator use two to three times a week revealed odds ratios of 0.93 (p = 0.013), 3.96 (p = 0.008), and 0.17 (p = 0.032) respectively. Conclusion: Increasing age, vaginal dilator use of at least two to three times a week, and shorter active length were found to be significantly associated with a decreased risk of vaginal stenosis. Future prospective studies are necessary to validate our findings.

Resultados preliminares de cultivo intravaginal de ovocitos-inyección intracitoplasmática de espermatozoides (INVO-ICSI), en el centro de fertilidad procrear

OpenAIRE

Hilario, Roly; Dueñas, Julio; Gonzales, Max; García, Javier; Romero, Rocío

2014-01-01

Objetivos: Conocer los resultados preliminares de tasa de embarazo por transferencia en las pacientes en quienes se realizó cultivo intravaginal de ovocitos-inyección intracitoplasmática de espermatozoides (INVO-ICSI) en un centro de fertilidad. Diseño: Estudio descriptivo de una serie de casos. Institución: Centro de Fertilidad Procrear, Lima, Perú. Participantes: Parejas con tratamiento de infertilidad. Intervenciones: Se analizó todos los 13 procedimientos de INVO-ICSI realizados en 12 pac...

prognova compatibility mifepristone and misoprostol treatment missed abortion 150 cases analysis%补佳乐配伍米非司酮、米索前列醇治疗稽留流产150例分析

Institute of Scientific and Technical Information of China (English)

潘静; 张清华

2012-01-01

　　Objective To analyzes prognova compatibility mifepristone and misoprostol on the curative effect of missed abortion. Methods 150 cases of missed abortion patients oral prognova 3 mg three times a day, and at the same time, graded and clothing mifepristone 50 mg a day secondary x3 day, a total of 300 mg, The fourth day meal suit misoprostol 600 ug, after observation abdominal pain, bleeding, organization content discharge and the qing dynasty palace, etc.Results Complete abortion rate 93.07%, incomplete abortion rate 4.6%, not abortion is 2.3%.Conclusion prognova compatibility mifepristone and misoprostol for missed abortion patients safe, effective, convenient.%　　目的：探讨补佳乐配伍米非司酮、米索前列醇对稽留流产的疗效.方法：150例稽留流产患者口服补佳乐3 mg 一日三次,同时分次加服米非司酮50 mg 一日二次 x3天,共计300mg,第4天顿服米索前列醇600ug,用药后观察腹痛、出血、组织物排出及清宫等情况.结果：完全流产率93.07%,不全流产率4.6%,未流产者占2.3%.结论：补佳乐配伍米非司酮、米索前列醇对稽留流产患者安全、有效、方便.

Rationale and Safety Assessment of a Novel Intravaginal Drug-Delivery System with Sustained DL-Lactic Acid Release, Intended for Long-Term Protection of the Vaginal Microbiome.

Science.gov (United States)

Verstraelen, Hans; Vervaet, Chris; Remon, Jean-Paul

2016-01-01

Bacterial vaginosis is a prevalent state of dysbiosis of the vaginal microbiota with wide-ranging impact on human reproductive health. Based on recent insights in community ecology of the vaginal microbiome, we hypothesize that sustained vaginal DL-lactic acid enrichment will enhance the recruitment of lactobacilli, while counteracting bacterial vaginosis-associated bacteria. We therefore aimed to develop an intravaginal device that would be easy to insert and remove, while providing sustained DL-lactic acid release into the vaginal lumen. The final prototype selected is a vaginal ring matrix system consisting of a mixture of ethylene vinyl acetate and methacrylic acid-methyl methacrylate copolymer loaded with 150 mg DL-lactic acid with an L/D-lactic acid ratio of 1:1. Preclinical safety assessment was performed by use of the Slug Mucosal Irritation test, a non-vertebrate assay to evaluate vaginal mucosal irritation, which revealed no irritation. Clinical safety was evaluated in a phase I trial with six healthy nulliparous premenopausal volunteering women, with the investigational drug left in place for 7 days. Colposcopic monitoring according to the WHO/CONRAD guidelines for the evaluation of vaginal products, revealed no visible cervicovaginal mucosal changes. No adverse events related to the investigational product occurred. Total release from the intravaginal ring over 7 days was estimated through high performance liquid chromatography at 37.1 (standard deviation 0.9) mg DL-lactic acid. Semisolid lactic acid formulations have been studied to a limited extent in the past and typically consist of a large volume of excipients and very high doses of lactic acid, which is of major concern to mucosal safety. We have documented the feasability of enriching the vaginal environment with pure DL-lactic acid with a prototype intravaginal ring. Though the efficacy of this platform remains to be established possibly requiring further development, this approach may offer a

An outpatient regimen of combined oral mifepristone 400 mg and misoprostol 400 microg for first-trimester legal medical abortion

DEFF Research Database (Denmark)

Ravn, Pernille; Rasmussen, Ase; Knudsen, Ulla Breth

2005-01-01

AIM: To evaluate the success rate of medical abortion using an outpatient regimen of oral mifepristone 400 mg and oral misoprostol 400 microg for legal abortion in women abortion was defined as an endometrial thickness ... the procedure over a 3-year period and 606 (92%) experienced successful medical abortion. The remaining 8% had vacuum aspiration performed mainly due to uterine retention (70%). Other reasons were vaginal bleeding (25%), vomiting (2%), or pelvic infection (4%). Most women reported no days with severe pain (67......%), 0--1 days with moderate pain (82%), and 0--1 days with light pain (62%). In terms of gastrointestinal side effects, 68% reported nausea, 33% vomiting, and 27% diarrhea. Most women (90%) felt that the information given at the hospital prior to the abortion was sufficient, 74% would prefer medical...

La percepción de los/as estudiantes de la carrera de Medicina de la Universidad de Buenos Aires sobre el tratamiento del aborto en la formación médica

Directory of Open Access Journals (Sweden)

Ana Mines-Cuenya

2015-07-01

Full Text Available El objetivo del siguiente artículo es indagar cómo es el tratamiento del aborto y su atención, en la Carrera de Medicina de la UBA. Para ello, se hará hincapié en tres dimensiones. La primera, consiste en el análisis de los emergentes de la mencionada Carrera a la luz de las legislaciones, y regulaciones que promueven Derechos Sexuales como parte fundamental de los derechos humanos (DDHH. La segunda estriba en el análisis de tales emergentes en relación a discontinuidades y rupturas con lo que se definirá como Modelo Médico Hegemónico (MMH. Por último, se indagará en las políticas, representaciones y prácticas respecto al misoprostol. Esta investigación es de carácter cualitativo. El corpus analizado consiste en entrevistas semi-estructuradas a 24 estudiantes de la mencionada carrera y en regulaciones vigentes emitidas tanto por organismos médicos nacionales, latinoamericanos e internacionales. Como resultados preliminares, primero, se destacan la escasa permeabilidad en la carrera de las regulaciones vigentes, los conocimientos y actualizaciones farmacológicas expresadas en los documentos emitidos por organismos médicos nacionales, latinoamericanos e internacionales en los últimos 10 años. En segundo lugar, resalta la predominancia de un silencio o vacío en el currículo en relación al aborto. Este silencio no es inocuo, sino que tiene efectos concretos: no garantizar el cumplimiento con el marco de DDHH vigentes en Argentina. Por último, el desconocimiento sobre el misoprostol y su amplia utilidad en el campo gineco-obstétrico refuerza la asimetría en la relación médico/a-paciente y una idea de aborto medicalizado que, por lo tanto, robustece al MMH.

Concentrations of Dapivirine in the Rhesus Macaque and Rabbit following Once Daily Intravaginal Administration of a Gel Formulation of [14C]Dapivirine for 7 Days▿

OpenAIRE

Nuttall, Jeremy P.; Thake, Daryl C.; Lewis, Mark G.; Ferkany, John W.; Romano, Joseph W.; Mitchnick, Mark A.

2007-01-01

Dapivirine is a nonnucleoside reverse transcriptase inhibitor being developed as a topical microbicide for the prevention of human immunodeficiency virus infection. The distribution of radioactivity and drug in plasma and in vaginal, cervical, and draining lymph node tissues was investigated after daily application of a vaginal gel formulation of [14C]dapivirine to rhesus macaques. This was preceded by a preliminary study with rabbits. Following the intravaginal administration of [14C]dapivir...

Uso de misoprostol retal para indução do parto em gestantes com amniorrexe prematura: ensaio clínico fase II Use of rectal misoprostol for induction of labor in patients with premature rupture of membranes: a phase II clinical trial

Directory of Open Access Journals (Sweden)

Francisco Carlos Nogueira Arcanjo

2003-08-01

Full Text Available OBJETIVO: avaliar se o misoprostol por via retal constitui método efetivo para indução do parto em gestantes com amniorrexe prematura a termo. MÉTODOS: realizou-se estudo piloto, incluindo 32 gestantes com amniorrexe prematura entre 36 e 41 semanas, feto vivo e único, em apresentação cefálica, escore de Bishop 18 horas receberam antibiótico (penicilina cristalina para profilaxia de infecção estreptocócica. Analisaram-se desfechos diversos como intervalo entre indução e início do trabalho de parto, entre indução e parto, incidência de taquissistolia, tipo de parto, incidência de corioamnionite e resultados neonatais. A análise estatística foi realizada no programa de domínio público Epi-Info 2002, calculando-se médias com os respectivos desvios-padrão, além de distribuições de freqüência. Realizou-se análise de sobrevivência para determinação do percentual de partos em função do tempo transcorrido (em horas desde a administração do primeiro comprimido. RESULTADOS: os intervalos (média ± desvio padrão entre indução e início das contrações e entre indução e parto foram de, respectivamente, 299,8±199,9 e 681±340,5 minutos. Observou-se freqüência de 9,4% de taquissistolia. Cerca de 72% das pacientes evoluíram para parto vaginal. Diagnosticou-se corioamnionite em 12,5% dos casos. As medianas dos escores de Apgar foram de 8 e 9 no primeiro e quinto minuto, respectivamente. Não houve nenhum caso de Apgar PURPOSE: to investigate whether rectally administered misoprostol is an effective method for induction of labor in patients with premature ruptured membranes at term. METHODS: a pilot trial was conducted, enrolling 32 women with alive, singleton, cephalic fetus and ruptured membranes between 36 and 41 weeks of pregnancy, with Bishop score 18 h received antibiotics (crystalline penicillin for prophylaxis of streptococcal infeccion. Outcomes included time from induction to labor and induction to

Static and dynamic MRI of a urinary control intra-vaginal device

International Nuclear Information System (INIS)

Maubon, A.J.; Boncoeur-Martel, M.P.; Juhan, V.; Rouanet, J.P.; Courtieu, C.R.; Thurmond, A.S.; Aubas, P.; Mares, P.

2000-01-01

The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 ± 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 ± 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 ± 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 ± 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

Static and dynamic MRI of a urinary control intra-vaginal device

Energy Technology Data Exchange (ETDEWEB)

Maubon, A.J. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Department of Radiology, CHU Dupuytren, Limoges (France); Boncoeur-Martel, M.P. [Department of Radiology, CHU Dupuytren, Limoges (France); Juhan, V.; Rouanet, J.P. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Courtieu, C.R. [Department of Gynecology, C. M. C. Beausoleil, Montpellier (France); Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France); Thurmond, A.S. [Women' s Imaging, Meridian Park Hospital, Portland, OR (United States); Aubas, P. [Department of Medical Information, Hopital Arnaud de Villeneuve, F-34295 Montpellier (France); Mares, P. [Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France)

2000-06-01

The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 {+-} 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 {+-} 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 {+-} 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 {+-} 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

Changes in the prostacyctin sensitivity of thrombocytes after intravaginal radium irradiation of patients with corpus carcinoma

International Nuclear Information System (INIS)

Schneider, A.

1987-01-01

The goal of this work was to investigate, to what extent the platelet sensitivity in comparison to prostacyclin (PGI 2 ) should be seen as a responsible factor in the increase of the thrombosis rate. For this blood was examined from 22 patients with corpus carcinoma who had received an intravaginal Radium implant with a radiation dose of 960 mgeh to over 24 h. These patients were compared to a control group of 21 clinically healthy women. Even before the radiation therapy there was an increased aggregation rate of the thrombocytes in the carcinoma patients as well as a reduced sensitivity to PGI 2 . Under irradiation there was an even greater decrease in the sensitivity of the thrombocytes to PGI 2 . The aggregation speed increase statistically significantly and the number of thrombocytes decreased during the Radium irradiation. After the giving of heparin the sensitivity of the thrombocytes to PGI 2 sank strongly. (orig./MG) [de

Development of polyether urethane intravaginal rings for the sustained delivery of hydroxychloroquine

Science.gov (United States)

Chen, Yufei; Traore, Yannick Leandre; Li, Amanda; Fowke, Keith R; Ho, Emmanuel A

2014-01-01

Hydroxychloroquine (HCQ) has been shown to demonstrate anti-inflammatory properties and direct anti-HIV activity. In this study, we describe for the first time the fabrication and in vitro evaluation of two types of intravaginal ring (IVR) devices (a surfaced-modified matrix IVR and a reservoir segmental IVR) for achieving sustained delivery (>14 days) of HCQ as a strategy for preventing male-to-female transmission of HIV. Both IVRs were fabricated by hot-melt injection molding. Surface-modified matrix IVRs with polyvinylpyrrolidone or poly(vinyl alcohol) coatings exhibited significantly reduced burst release on the first day (6.45% and 15.72% reduction, respectively). Reservoir IVR segments designed to release lower amounts of HCQ displayed near-zero-order release kinetics with an average release rate of 28.38 μg/mL per day for IVRs loaded with aqueous HCQ and 32.23 μg/mL per day for IVRs loaded with HCQ mixed with a rate-controlling excipient. Stability studies demonstrated that HCQ was stable in coated or noncoated IVRs for 30 days. The IVR segments had no significant effect on cell viability, pro-inflammatory cytokine production, or colony formation of vaginal and ectocervical epithelial cells. Both IVR systems may be suitable for the prevention of HIV transmission and other sexually transmitted infections. PMID:25336923

Intravaginal metronidazole gel versus metronidazole plus nystatin ovules for bacterial vaginosis: a randomized controlled trial.

Science.gov (United States)

Sanchez, Sixto; Garcia, Patricia J; Thomas, Katherine K; Catlin, Mary; Holmes, King K

2004-12-01

We compared metronidazole 0.75% gel (containing 37.5 mg metronidazole per dose) with ovules containing metronidazole 500 mg and nystatin 100,000 U, for intravaginal treatment of bacterial vaginosis (BV). In a single-blinded trial, symptomatic women with BV by both Amsel and Nugent criteria were randomly assigned to gel or ovules, once nightly for 5 nights, and asked to return 3 times after treatment. Analyses were intent-to-treat. Of 151 women with BV by both criteria at enrollment, 138 (91%) returned at least once. Product limit estimates for persistence or recurrence of BV at 14, 42, and 104 days were 20% (95% CI 10%-29%), 38% (95% CI 25%-48%), and 52% (95% CI 37%-63%) after gel treatment, and 4% (95% CI 0%-9%), 17% (95% CI 7%-26%), and 33% (95% CI 21%-46%) after ovule treatment ( P = .01). Among women without BV at first follow-up, subsequent intercourse without condoms independently predicted subsequent recurrence ( P Metronidazole/nystatin ovules were significantly more effective than metronidazole gel. Unprotected sex predicted recurrence after initial improvement.

Is there a correlation between intravaginal ejaculatory latency time and enuresis? An exploratory study.

Science.gov (United States)

Koyuncu, Hakan; Serefoglu, Ege Can; Karacay, Safak; Ozdemir, Ahmet Tunc; Kalkan, Mehmet; Yencilek, Faruk

2014-01-01

Premature ejaculation (PE) is the most common male sexual dysfunction. Monosymptomatic enuresis (ME) is nocturnal bed wetting, without any daytime symptoms. Recent clinical studies report an association between lifelong PE and ME. The purpose of this study was to compare the intravaginal ejaculatory time (IELT) between lifelong PE in men with and without ME. The goal was to determine if there is an association between the severity of ME and of IELT. A total of 137 men with lifelong PE were included in this study. Subjects were asked if they had childhood ME. The characteristics and mean IELTs of patients with and without ME were compared using the student's t-test, and the correlation between severity of ME and IELT was assessed with trend test. Of the 137 lifelong PE patients, 57 reported ME. There was a strong negative correlation in patients with ME between the severity of enuresis and IELT, with IELT being shorter in patients with severe ME. A strong correlation between IELT and the severity of ME suggests a common underlying mechanism. Further studies are required to confirm these findings and elucidate the exact pathophysiology.

Training traditional birth attendants on the use of misoprostol and a blood measurement tool to prevent postpartum haemorrhage: lessons learnt from Bangladesh.

Science.gov (United States)

Bell, Suzanne; Passano, Paige; Bohl, Daniel D; Islam, Arshadul; Prata, Ndola

2014-03-01

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs' knowledge, attitudes, and practices. Acknowledgeing TBAs' important role in the community and in home deliveries and

Morphological Findings in Trophozoites during Amoebic Abscess Development in Misoprostol-Treated BALB/c Mice

Directory of Open Access Journals (Sweden)

Andrés Aceves-Cano

2015-01-01

Full Text Available During amoebic liver abscess (ALA formation in susceptible animals, immune response is regulated by prostaglandin E2 (PGE2 dependent mechanisms. The aim of this study was to analyze the effect of misoprostol (MPL, a PGE1 analogue, on ALA formation in BALB/c mice. Male mice from BALB/c strain were intrahepatically infected with 7.5×105 trophozoites of E. histolytica strain HM1:IMSS and treated with 10−4 M of MPL daily until sacrifice at 2, 4, and 7 days postinfection (p.i.. ALA formation was evaluated at 2, 4, and 7 days postinfection; trophozoite morphology was analyzed using immunohistochemistry and image analysis. Results showed an increase in frequency of ALA formation in infected and MPL-treated mice only at 2 days p.i. (P=0.03. A significant diminution in the size of trophozoites was detected in abscesses from mice independently of MPL treatment (from 5.8±1.1 µm at 2 days p.i. to 2.7±1.9 µm at 7 days p.i. compared with trophozoites dimensions observed in susceptible hamsters (9.6±2.7 µm (P<0.01. These results suggest that MPL treatment may modify the adequate control of inflammatory process to allow the persistence of trophozoites in the liver; however, natural resistance mechanisms cannot be discarded.

Somatotropina bovina recombinante en sincronización de estros y prolificidad de ovejas Pelibuey

OpenAIRE

Sosa-Pérez, G; Pérez-Hernández, P.; Vaquera-Huerta, H.; Salazar-Ortiz, J.; Sánchez-del-Real, C.; Cadena-Villegas, S.; Gallegos-Sánchez, J.

2014-01-01

Con la finalidad de estudiar si la administración de la Somatotropina Bovina Recombinante (bST) dos días antes del retiro del progestágeno, tiene efecto en la sincronización de estros, inicio del estro, fertilidad, prolificidad y tipo de parto en ovejas Pelibuey, a 180 ovejas de 4,0 ± 0,32 años de edad, se les inserto un dispositivo intravaginal impregnado con progesterona (CIDR P4 0,3 g), por nueve días. Dos días antes del retiro del dispositivo, las ovejas se asignaron aleatoriamente a uno ...

Clinical Observation on Termination of Early Pregnancy of 213 Cases after Caesarian Section with Repeated Use of Mifepristone and Misoprostol

Institute of Scientific and Technical Information of China (English)

高佩佩; 汪平

1999-01-01

Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.

Segmented polyurethane intravaginal rings for the sustained combined delivery of antiretroviral agents dapivirine and tenofovir.

Science.gov (United States)

Johnson, Todd J; Gupta, Kavita M; Fabian, Judit; Albright, Theodore H; Kiser, Patrick F

2010-02-19

Dual segment polyurethane intravaginal rings (IVRs) were fabricated to enable sustained release of antiretroviral agents dapivirine and tenofovir to prevent the male to female sexual transmission of the human immunodeficiency virus. Due to the contrasting hydrophilicity of the two drugs, dapivirine and tenofovir were separately formulated into polymers with matching hydrophilicity via solvent casting and hot melt extrusion. The resultant drug loaded rods were then joined together to form dual segment IVRs. Compression testing of the IVRs revealed that they are mechanically comparable to the widely accepted NuvaRing IVR. Physical characterization of the individual IVR segments using wide angle X-ray scattering and differential scanning calorimetry determined that dapivirine and tenofovir are amorphous and crystalline within their polymeric segments, respectively. In vitro release of tenofovir from the dual segment IVR was sustained over 30 days while dapivirine exhibited linear release over the time period. A 90 day accelerated stability study confirmed that dapivirine and tenofovir are stable in the IVR formulation. Altogether, these results suggest that multisegment polyurethane IVRs are an attractive formulation for the sustained vaginal delivery of drugs with contrasting hydrophilicity such as dapivirine and tenofovir. 2009 Elsevier B.V. All rights reserved.

A quality assessment of patient leaflets on misoprostol induced labour – does written information adhere to international standards for patient involvement and informed consent?

DEFF Research Database (Denmark)

Clausen, Jette Aaroe; Juul, Mette; Rydahl, Eva

Objectives: The need for thorough patient information is increasing as maternity care becomes more medicalised. The aim was to assess the quality of written patient information on labour induction. In most Danish hospitals misoprostol is the first-choice drug for induction in low-risk pregnancies......). Design: Patient leaflets were evaluated according to a validated scoring tool (IPDAS), core elements in The Danish Health Act, and items regarding off-label use and non-registered medication. Two of the authors scored all leaflets independently. Outcome measures: Women’s involvement in decision making......, and information on benefits and harms associated with the treatment, other justifiable treatment options, and non-registered treatment. Results: Generally, the hospitals scored low on the IPDAS checklist. No hospitals encouraged women to consider their preferences. Information on side-effects and adverse outcomes...

Qualitative and quantitative intravaginal targeting: key to anti-HIV-1 microbicide delivery from test tube to in vivo success.

Science.gov (United States)

Pillay, Viness; Mashingaidze, Felix; Choonara, Yahya E; Du Toit, Lisa C; Buchmann, Eckhart; Maharaj, Vinesh; Ndesendo, Valence M K; Kumar, Pradeep

2012-06-01

The past decade has seen several effective anti-HIV-1 agent discoveries, yet microbicides continue to disappoint clinically. Our review expounds the view that unsatisfactory microbicide failures may be a result of inefficient delivery systems employed. We hereby propose a thorough scientific qualitative and quantitative investigation of important aspects involved in HIV-1 transmission as a prerequisite for microbicide delivery. Intravaginal targeting of HIV-1 increases the chances of microbicide success, wherein vaginal microenvironmental factors including pH should be maintained at HIV-1 prohibitive acidic levels simultaneously to ward off other sexually transmitted diseases, which compromise vaginal epithelial barrier properties. Furthermore, choice of receptors to target both on HIV-1 and on target cells is vital in deterring transmission. Appropriate modeling of virus-target cell interactions as well as targeting early stages of the HIV-1 infection accompanied by computation and delivery of appropriate microbicide quantities could revolutionize microbicide research, ultimately delivering a female-controlled HIV-1 prevention modality appropriately. Copyright © 2012 Wiley Periodicals, Inc.

Achieving community-based postpartum follow up in eastern Uganda: the field experience from the MamaMiso Study on antenatal distribution of misoprostol.

Science.gov (United States)

Ditai, James; Frye, Laura J; Durocher, Jill; Byrne, Meagan E; Ononge, Sam; Winikoff, Beverly; Weeks, Andrew D

2017-10-26

Advance provision of misoprostol to women during antenatal care aims to achieve broader access to uterotonics for the prevention of postpartum hemorrhage. Studies of this community-based approach usually involve antenatal education as well as timely postpartum follow-up visits to confirm maternal and neonatal outcomes. The MamaMiso study in Mbale, Uganda sought to assess the feasibility of conducting follow-up visits in the postpartum period following advance provision of misoprostol for postpartum hemorrhage prevention. MamaMiso recruited women during antenatal care visits. Participants were asked to contact the research team within 48 h of giving birth so that postpartum follow-up visits could be carried out at their homes. Women's baseline and delivery characteristics were collected and analyzed with respect to follow-up time ('on time' ≤ 7 days, 'late' > 7 days, and 'lost to follow up'). Every woman who was followed up late due to a failure to report the delivery was asked for the underlying reasons for the delay. When attempts at following up participants were unsuccessful, a file note was generated explaining the details of the failure. We abstracted data and identified themes from these notes. Of 748 recruited women, 700 (94%) were successfully followed up during the study period, 465 (62%) within the first week postpartum. The median time to follow up was 4 days and was similar for women who delivered at home or in facilities and for women who had attended or unattended births. Women recruited at the urban hospital site (as opposed to rural health clinics) were more likely to be lost to follow up or followed up late. Of the women followed up late, 202 provided a reason. File notes explaining failed attempts at follow up were generated for 164 participants. Several themes emerged from qualitative analysis of these notes including phone difficulties, inaccurate baseline information, misperceptions, postpartum travel, and the condition of the mother

ECTOPIA CORDIS TORÁCICA EN EMBRIÓN HUMANO DE 8 SEMANAS / Thoracic ectopia cordis in a human embryo of eight weeks

Directory of Open Access Journals (Sweden)

María A. Vila Bormey

2013-10-01

Full Text Available Resumen Los defectos de la pared corporal ventral se producen en el tórax, el abdomen y la pelvis; cuando afectan la región torácica, con desplazamiento total o parcial del corazón fuera de la cavidad, dan origen a la ectopia cordis torácica. Se presenta el caso de un embrión humano de 22 mm de longitud cráneo-raquis, semana 8, estadio 21 del desarrollo embrionario según Carnegie; proveniente de aborto voluntario por misoprostol. En el examen morfológico externo se constató como detalle anormal la presencia de un ápex cardíaco expuesto en la región ventral del tórax, lo que llevó al planteamiento diagnóstico de ectopia cordis torácica. El estudio morfológico de especímenes embrionarios abortados puede poner en evidencia anomalías del desarrollo que usualmente no son diagnosticadas por la pequeñez del producto y la precocidad de la pérdida. / Abstract Defects of the ventral body wall occur in the thorax, abdomen and pelvis, and when they affect the thoracic region, with total or partial displacement of the heart outside the cavity, they give rise to thoracic ectopia cordis. The case of a human embryo of 22 mm skull-spine, week 8, stage 21 of embryonic development according to Carnegie, from voluntary abortion with misoprostol, is presented. As abnormal feature, in the external morphological examination the presence of an exposed cardiac apex in the ventral region of the chest was noted, which led to the diagnosis of thoracic ectopia cordis. The morphological study of aborted embryonic specimens may reveal developmental abnormalities that are not usually diagnosed due to the smallness of the product and the precocity of the loss.

MIV-150-containing intravaginal rings protect macaque vaginal explants against SHIV-RT infection.

Science.gov (United States)

Ouattara, Louise A; Barnable, Patrick; Mawson, Paul; Seidor, Samantha; Zydowsky, Thomas M; Kizima, Larisa; Rodriguez, Aixa; Fernández-Romero, José A; Cooney, Michael L; Roberts, Kevin D; Gettie, Agegnehu; Blanchard, James; Robbiani, Melissa; Teleshova, Natalia

2014-05-01

Recent studies demonstrated that intravaginal rings (IVRs) containing 100 mg of the nonnucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 significantly protect macaques against a chimeric simian-human immunodeficiency virus that expresses the HIV-1 HxB2 reverse transcriptase (SHIV-RT) when present before and after vaginal challenge. The objectives of this study were to (i) evaluate the pharmacodynamics (PD) of MIV-150 in vaginal fluids (VF) and in ectocervical and vaginal tissues following 100-mg MIV-150 IVR exposure and to (ii) gain more insight whether pharmacokinetics (PK) of MIV-150 can predict PD. MIV-150 in VF collected at 1 day and 14 days post-MIV-150 IVR insertion inhibited ex vivo SHIV-RT infection in vaginal biopsy specimens from untreated animals (not carrying IVRs) in a dose-dependent manner. Previous PK studies demonstrated a significant increase of ectocervical and vaginal tissue MIV-150 concentrations 14 days versus 1 day post-IVR insertion, with the highest increase in vaginal tissue. Therefore, we tested PD of MIV-150 in tissues 14 days post-MIV-150 IVR insertion. Ex vivo SHIV-RT infection of vaginal, but not ectocervical, tissues collected 14 days post-MIV-150 IVR insertion was significantly inhibited compared to infection at the baseline (prior to MIV-150 IVR exposure). No changes in vaginal and ectocervical tissue infection were observed after placebo IVR exposure. Overall, these data underscore the use of the ex vivo macaque explant challenge models to evaluate tissue and VF PK/PD of candidate microbicides before in vivo animal efficacy studies. The data support further development of MIV-150-containing IVRs.

Gluteo-vaginal sinus formation complicating posterior intravaginal slingplasty followed by successful IVS removal. A case report and review of the literature.

Science.gov (United States)

Mikos, Themistoklis; Tsalikis, Tryfon; Papanikolaou, Alexios; Pournaropoulos, Fotios; Bontis, John N

2008-03-01

Posterior intravaginal slingplasty (IVS) is a technique used for the treatment of apical prolapse. Type III meshes have been mostly used with this technique. In this article, a case of bilateral gluteo-vaginal sinus tract formation that complicated a posterior vaginal slingplasty with a type III mesh is presented. At 3 months follow-up, the patient complained for bulking through the vagina, continuous offensive vaginal discharge, and constant pain at the buttocks. She had prolapse recurrence, and there was defective healing at the gluteal entry points of the posterior IVS. Ten months after the initial surgery, she underwent a laparotomic subtotal hysterectomy and sacrocervicopexy with prolene type I mesh. At the same time, the posterior mesh was removed allowing the surgeon to discover communication of the canal of the mesh extending from gluteal incisions to the vagina epithelium. The sinus tract was managed surgically with excision of the surrounding tissues. There was no recurrence or other complications at 2 months follow-up.

Safety and pharmacokinetics of dapivirine delivery from matrix and reservoir intravaginal rings to HIV-negative women.

Science.gov (United States)

Nel, Annalene; Smythe, Shanique; Young, Katherine; Malcolm, Karl; McCoy, Clare; Rosenberg, Zeda; Romano, Joseph

2009-08-01

Vaginal microbicides for the prevention of HIV transmission may be an important option for protecting women from infection. Incorporation of dapivirine, a lead candidate nonnucleoside reverse transcriptase inhibitor, into intravaginal rings (IVRs) for sustained mucosal delivery may increase microbicide product adherence and efficacy compared with conventional vaginal formulations. Twenty-four healthy HIV-negative women 18-35 years of age were randomly assigned (1:1:1) to dapivirine matrix IVR, dapivirine reservoir IVR, or placebo IVR. Dapivirine concentrations were measured in plasma and vaginal fluid samples collected at sequential time points over the 33-day study period (28 days of IVR use, 5 days of follow-up). Safety was assessed by pelvic/colposcopic examinations, clinical laboratory tests, and adverse events. Both IVR types were safe and well tolerated with similar adverse events observed in the placebo and dapivirine groups. Dapivirine from both IVR types was successfully distributed throughout the lower genital tract at concentrations over 4 logs greater than the EC50 against wild-type HIV-1 (LAI) in MT4 cells. Maximum concentration (Cmax) and area under the concentration-time curve (AUC) values were significantly higher with the matrix than reservoir IVR. Mean plasma concentrations of dapivirine were <2 ng/mL. These findings suggest that IVR delivery of microbicides is a viable option meriting further study.

Effect of body condition score and reuse of progesterone-releasing intravaginal devices on conception rate following timed artificial insemination in Nelore cows.

Science.gov (United States)

Pereira, L L; Ferreira, A P; Vale, W G; Serique, L R; Neves, Kal; Morini, A C; Monteiro, B M; Minervino, Ahh

2018-06-01

This study had the aim of investigating the efficiency of timed artificial insemination (TAI) through the progesterone-releasing intravaginal device (PRID), used in new condition and for the second and third times in Nelore cows. The effects of device reuse and body condition score (BCS) on the conception rate (CR) were evaluated in 1,122 multiparous Nelore cows (mean BCS of 2.7 ± 0.4), which were randomly distributed into three groups that received new (n = 330), once (n = 439) and twice used (n = 353) PRID. Among the 1,122 females that underwent TAI, 573 became pregnant, thus representing an overall CR of 51.06%. Cows with BCS between 2.75 and 4.0 had greater (p conditions, animals with BCS greater than 2.5 had a higher CR, and the CR decreased proportionally with the number of times that the PRID had been used. © 2018 Blackwell Verlag GmbH.

Radioimmunoassay of serum d-Norgestrel in women following oral and intravaginal administration

International Nuclear Information System (INIS)

Stanczyk, F.Z.; Hiroi, M.; Goebelsmann, U.; Brenner, P.F.; Lumkin, M.E.; Mishell, D.R. Jr.

1975-01-01

A radioimmunoassay (RIA) method for measuring d-Norgestrel (d-Ng) in serum has been developed utilizing petroleum ether extraction, an antiserum raised against d-Norgestrel-3-(0-carboxymethyl) oxime-epsilon-aminocaproic acid--boxine serum albumin, d-Norgestrel-3-(0-carboxymethyl) imino-[ 125 I]-iodohistamine, and dextran-coated charcoal separation. Control serum blanks were undetectable, 6 pg of d-Ng was measurable in 0.1 ml of serum with a high reliability, and intra- and interassay coefficients of variation were 4.4 and 4.9 percent, respectively. d-Ng added to control serum was quantitatively recovered. This RIA proved to be highly specific for d-Ng, cross-reacting less than 0.01 percent with 1-Ng and some 4 to 8 percent with 5α- and 5β-tetrahydro-d-Ng. Serum d-Ng levels measured in 3 women after ingestion of 75 μg of dl-Ng rose to 1.5 to 2 ng/ml within 1/2 to 2-3 hours after oral intake and fell rapidly thereafter to 0.2 to 0.4 ng/ml within 24 hours. Insertion of Silastic intravaginal rings (IVRs), containing 50 or 100 mg of dl-Ng, into 3 women for periods of 3 weeks resulted in a rapid rise of serum d-Ng after insertion. Serum d-Ng levels were highest 24 to 48 hours after the first insertion of each IVR, reaching peak levels of about 5 and 7 to 11 ng/ml, respectively, and declined gradually during the ensuing 15 to 20 days to some 30 to 40 percent of the peak serum d-Ng concentration. Serum d-Ng levels attained after IVR reinsertion remained relatively constant at 1 to 3 ng/ml during each subsequent cycle in all subjects and fell rapidly after each IVR removal. Serum estradiol and progesterone concentrations, measured about 3 times a week in these patients, indicated that ovulation was consistently inhibited

A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy.

Science.gov (United States)

Ugaonkar, Shweta R; Wesenberg, Asa; Wilk, Jolanta; Seidor, Samantha; Mizenina, Olga; Kizima, Larisa; Rodriguez, Aixa; Zhang, Shimin; Levendosky, Keith; Kenney, Jessica; Aravantinou, Meropi; Derby, Nina; Grasperge, Brooke; Gettie, Agegnehu; Blanchard, James; Kumar, Narender; Roberts, Kevin; Robbiani, Melissa; Fernández-Romero, José A; Zydowsky, Thomas M

2015-09-10

Women urgently need a self-initiated, multipurpose prevention technology (MPT) that simultaneously reduces their risk of acquiring HIV-1, HSV-2, and HPV (latter two associated with increased risk of HIV-1 acquisition) and prevents unintended pregnancy. Here, we describe a novel core-matrix intravaginal ring (IVR), the MZCL IVR, which effectively delivered the MZC combination microbicide and a contraceptive. The MZCL IVR contains four active pharmaceutical ingredients (APIs): MIV-150 (targets HIV-1), zinc acetate (ZA; targets HIV-1 and HSV-2), carrageenan (CG; targets HPV and HSV-2), and levonorgestrel (LNG; targets unintended pregnancy). The elastomeric IVR body (matrix) was produced by hot melt extrusion of the non-water swellable elastomer, ethylene vinyl acetate (EVA-28), containing the hydrophobic small molecules, MIV-150 and LNG. The solid hydrophilic core, embedded within the IVR by compression, contained the small molecule ZA and the macromolecule CG. Hydrated ZA/CG from the core was released by diffusion via a pore on the IVR while the MIV-150/LNG diffused from the matrix continuously for 94 days (d) in vitro and up to 28 d (study period) in macaques. The APIs released in vitro and in vivo were active against HIV-1ADA-M, HSV-2, and HPV16 PsV in cell-based assays. Serum LNG was at levels associated with local contraceptive effects. The results demonstrate proof-of-concept of a novel core-matrix IVR for sustained and simultaneous delivery of diverse molecules for the prevention of HIV, HSV-2 and HPV acquisition, as well as unintended pregnancy. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Intravaginal rings as delivery systems for microbicides and multipurpose prevention technologies

Directory of Open Access Journals (Sweden)

Thurman AR

2013-10-01

Full Text Available Andrea Ries Thurman, Meredith R Clark, Jennifer Hurlburt, Gustavo F Doncel CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA Abstract: There is a renewed interest in delivering pharmaceutical products via intravaginal rings (IVRs. IVRs are flexible torus-shaped drug delivery systems that can be easily inserted and removed by the woman and that provide both sustained and controlled drug release, lasting for several weeks to several months. In terms of women's health care products, it has been established that IVRs effectively deliver contraceptive steroids and steroids for the treatment of postmenopausal vaginal atrophy. A novel application for IVRs is the delivery of antiretroviral drugs for the prevention of human immunodeficiency virus (HIV genital infection. Microbicides are antiviral drugs delivered topically for HIV prevention. Recent reviews of microbicide IVRs have focused on technologies in development and optimizing ring design. IVRs have several advantages, including the ability to deliver sustained drug doses for long periods of time while bypassing first pass metabolism in the gut. IVRs are discreet, woman-controlled, and do not require a trained provider for placement or fitting. Previous data support that women and their male sexual partners find IVRs highly acceptable. Multipurpose prevention technology (MPT products provide protection against unintended/mistimed pregnancy and reproductive tract infections, including HIV. Several MPT IVRs are currently in development. Early clinical testing of new microbicide and MPT IVRs will require a focus on safety, pharmacokinetics and pharmacodynamics. Specifically, IVRs will have to deliver tissue concentrations of drugs that are pharmacodynamically active, do not cause mucosal alterations or inflammation, and do not change the resident microbiota. The emergence of resistance to antiretrovirals will need to be investigated. IVRs should not

Labour induction at term - a randomised trial comparing Foley ...

African Journals Online (AJOL)

More analgesia was used in the Foley catheter/misoprostol group than in the misoprostol group (64/172 v. 46/175). Side effects and neonatal complications were similar for the three groups. Conclusions. Use of extra-amniotic Foley catheter placement showed no measurable benefits over the use of oral misoprostol alone, ...

Intravaginal ring delivery of the reverse transcriptase inhibitor TMC 120 as an HIV microbicide.

Science.gov (United States)

Woolfson, A David; Malcolm, R Karl; Morrow, Ryan J; Toner, Clare F; McCullagh, Stephen D

2006-11-15

TMC 120 (Dapivirine) is a potent non-nucleoside reverse transcriptase inhibitor that is presently being developed as a vaginal HIV microbicide. To date, most vaginal microbicides under clinical investigation have been formulated as single-dose semi-solid gels, designed for application to the vagina before each act of intercourse. However, a clear rationale exists for providing long-term, controlled release of vaginal microbicides in order to afford continuous protection against heterosexually transmitted HIV infection and to improve user compliance. In this study we report on the incorporation of various pharmaceutical excipients into TMC 120 silicone, reservoir-type intravaginal rings (IVRs) in order to modify the controlled release characteristics of the microbicide. The results demonstrate that TMC 120 is released in zero-order fashion from the rings over a 28-day period and that release parameters could be modified by the inclusion of release-modifying excipients in the IVR. The hydrophobic liquid excipient isopropyl myristate had little effect on steady-state daily release rates, but did increase the magnitude and duration of burst release in proportion to excipient loading in the IVR. By comparison, the hydrophobic liquid poly(dimethylsiloxane) had little effect on TMC 120 release parameters. A hydrophilic excipient, lactose, had the surprising effect of decreasing TMC 120 burst release while increasing the apparent steady-state daily release in a concentration-dependent manner. Based on previous cell culture data and vaginal physiology, TMC120 is released from the various ring formulations in amounts potentially capable of maintaining a protective vaginal concentration. It is further predicted that the observed release rates may be maintained for at least a period of 1 year from a single ring device. TMC 120 release profiles and the mechanical properties of rings could be modified by the physicochemical nature of hydrophobic and hydrophilic excipients

Preventive efficacy and safety of rebamipide in nonsteroidal anti-inflammatory drug-induced mucosal toxicity.

Science.gov (United States)

Kim, Jeong Ho; Park, Soo-Heon; Cho, Chul-Soo; Lee, Soo Teik; Yoo, Wan-Hee; Kim, Sung Kook; Kang, Young Mo; Rew, Jong Sun; Park, Yong-Wook; Lee, Soo Kon; Lee, Yong Chan; Park, Won; Lee, Don-Haeng

2014-07-01

The use of proton pump inhibitors or misoprostol is known to prevent the gastrointestinal complications of nonsteroidal anti-inflammatory drugs (NSAIDs). Rebamipide is known to increase the mucosal generation of prostaglandins and to eliminate free oxygen radicals, thus enhancing the protective function of the gastric mucosa. However, it is unknown whether rebamipide plays a role in preventing NSAID-induced gastropathy. The aim of this study was to determine the effectiveness of rebamipide compared to misoprostol in preventing NSAID-induced gastrointestinal complications in patients requiring continuous NSAID treatment. We studied 479 patients who required continuous NSAID treatment. The patients were randomly assigned to groups that received 100 mg of rebamipide three times per day or 200 μg of misoprostol three times per day for 12 weeks. The primary endpoint of the analysis was the occurrence rate of gastric ulcers, as determined by endoscopy after 12 weeks of therapy. Of the 479 patients in the study, 242 received rebamipide, and 237 received misoprostol. Ultimately, 44 patients (18.6%) withdrew from the misoprostol group and 25 patients (10.3%) withdrew from the rebamipide group. There was a significant difference in withdrawal rate between the two groups (p=0.0103). The per protocol analysis set was not valid because of the dropout rate of the misoprostol group; thus, the intention to treat (ITT) analysis set is the main set for the efficacy analysis in this study. After 12 weeks, the occurrence rate of gastric ulcers was similar in the rebamipide and misoprostol groups (20.3% vs 21.9%, p=0.6497) according to ITT analysis. In addition, the therapeutic failure rate was similar in the rebamipide and misoprostol groups (13.6% vs 13.1%, p=0.8580). The total severity score of the gastrointestinal symptoms was significantly lower in the rebamipide group than in the misoprostol group (p=0.0002). The amount of antacid used was significantly lower in the rebamipide

A long-acting integrase inhibitor protects female macaques from repeated high-dose intravaginal SHIV challenge.

Science.gov (United States)

Andrews, Chasity D; Yueh, Yun Lan; Spreen, William R; St Bernard, Leslie; Boente-Carrera, Mar; Rodriguez, Kristina; Gettie, Agegnehu; Russell-Lodrigue, Kasi; Blanchard, James; Ford, Susan; Mohri, Hiroshi; Cheng-Mayer, Cecilia; Hong, Zhi; Ho, David D; Markowitz, Martin

2015-01-14

Long-acting GSK1265744 (GSK744 LA) is a strand transfer inhibitor of the HIV/SIV (simian immunodeficiency virus) integrase and was shown to be an effective preexposure prophylaxis (PrEP) agent in a low-dose intrarectal SHIV (simian-human immunodeficiency virus) rhesus macaque challenge model. We examined the pharmacokinetics and efficacy of GSK744 LA as PrEP against repeat high-dose intravaginal SHIV challenge in female rhesus macaques treated with Depo-Provera (depot medroxyprogesterone acetate), which promotes viral transmission vaginally. When Depo-Provera-treated female rhesus macaques were dosed with GSK744 LA (50 mg/kg) monthly, systemic and tissue drug concentrations were lower than previously observed in male rhesus macaques. GSK744 concentrations were fivefold lower on average in cervical tissues than in rectal tissues. Eight female rhesus macaques were treated with GSK744 LA at week 0, and four female rhesus macaques served as controls. All animals received a high-dose challenge of SHIV162P3 at week 1. No infection was detected in GSK744 LA-treated rhesus macaques, whereas viremia was detected 1 to 2 weeks after SHIV challenge in all control animals. The GSK744 LA-treated rhesus macaques were given a second administration of drug at week 4 and further challenged at weeks 5 and 7. GSK744 LA treatment protected six of eight female rhesus macaques against three high-dose SHIV challenges, whereas all control animals became infected after the first challenge (P = 0.0003, log-rank test). These results support further clinical development of GSK744 LA for PrEP. Copyright © 2015, American Association for the Advancement of Science.

TropJrnal Vol 28 No1&2 4Intnet publicatn

African Journals Online (AJOL)

Administrator

Misoprostol is used for cervical ripening and control of post partum haemorrhage among 24.4% and 50% of the .... What do you use for IOL in your institution? Misoprostol. 8. 19.0. Oxytocin. 4. 9.5. Both. 30. 71.5. Misoprostol used with previous caesarean section. Yes. 8 .... for the control of postpartum haemorrhage, while.

Premature ejaculation results from partners' mismatch: development and validation of index of intra-vaginal ejaculation latency time.

Science.gov (United States)

Cai, L; Wen, Y; Jiang, M; Zeng, M; Zhang, B

2016-05-01

Mismatch of partners in premature ejaculation (PE) regarding intra-vaginal ejaculation latency time (IELT) is usually neglected. Here we proposed the concept and evaluated the use of index of IELT (IIELT) as an objective diagnostic tool for PE. Data from 103 self-reporting PE patients and 59 normal controls were collected. The expected IELTs of both the male and female partners were provided by each participating couple in two questionnaires. IIELT=stopwatch IELT/(1/2 the male's expected IELT+1/2 the female's expected IELT). The stopwatch IELTs were 1.74±1.4 min (PE group) and 14.45±11.0 min (control group), PIELTs were 15.65±8.7 min (men) and 14.16±6.9 min (women) in the PE group, and 21.3±16.1 min (men) and 20.04±13.47 min (women) in the control group, P<0.05. The calculated IIELTs were 0.14±0.12 (PE group) and 0.83±0.60 (control group), P<0.05. The best cut-off point was 0.658, the Youden index was 0.652, sensitivity was 0.991, specificity was 0.661, positive predictive probability was 83.46% and negative predictive probability was 97.6%. We concluded that IIELT was an integrated measurement of the couples' sexual equilibrium and demonstrated that it provided a simple and objective screening indicator for diagnosing self-reported PE.

Peces del Noroeste del Ecuador

OpenAIRE

Barriga, Ramiro

1994-01-01

La ictiofauna del occidente del Ecuador es poco conocida. Los peces del noroccidente son diferentes a los del suroccidente del Ecuador. 34 familias y 82 especies fueron colectadas que equivale al 11 % de las especies de peces continentales registradas en el Ecuador. Icteogeográficamente se sabe que la costa ecuatoriana posee dos provincias: la del Pacifico Norte y la del Guayas, se determinó que el límite de las dos provincias es el río Santiago ya que las especies del mencionado río so...

Intravaginal cytomegalovirus (CMV challenge elicits maternal viremia and results in congenital transmission in a guinea pig model

Directory of Open Access Journals (Sweden)

Schleiss Mark R

2011-03-01

Full Text Available Abstract Background The objective of this study was to compare intravaginal (ivg and subcutaneous (sc administration of the guinea pig cytomegalovirus (GPCMV in pregnant and non-pregnant guinea pigs. These studies tested the hypotheses that ivg infection would elicit immune responses, produce maternal viremia, and lead to vertical transmission, with an efficiency similar to the traditionally employed sc route. Results Four groups of age- and size-matched guinea pigs were studied. Two groups were pregnant, and two groups were not pregnant. Animals received 5x105 plaque-forming units (PFU of a GPCMV reconstituted from an infectious bacterial artificial chromosome (BAC construct containing the full-length GPCMV genome. Seroconversion was compared by IgG ELISA, and viremia (DNAemia was monitored by PCR. In both pregnant and non-pregnant animals, sc inoculation resulted in significantly higher serum ELISA titers than ivg inoculation at 8 and 12 weeks post-infection. Patterns of viremia (DNAemia were similar in animals inoculated by either sc or ivg route. However, in pregnant guinea pigs, animals inoculated by both routes experienced an earlier onset of DNAemia than did non-pregnant animals. Neither the percentage of dead pups nor the percentage of GPCMV positive placentas differed by inoculation route. Conclusions In the guinea pig model of congenital CMV infection, the ivg route is as efficient at causing congenital infection as the conventional but non-physiologic sc route. This finding could facilitate future experimental evaluation of vaccines and antiviral interventions in this highly relevant animal model.

Investigating the feasibility of temperature-controlled accelerated drug release testing for an intravaginal ring.

Science.gov (United States)

Externbrink, Anna; Clark, Meredith R; Friend, David R; Klein, Sandra

2013-11-01

The objective of the present study was to investigate if temperature can be utilized to accelerate drug release from Nuvaring®, a reservoir type intravaginal ring based on polyethylene vinyl acetate copolymer that releases a constant dose of contraceptive steroids over a duration of 3 weeks. The reciprocating holder apparatus (USP 7) was utilized to determine real-time and accelerated etonogestrel release from ring segments. It was demonstrated that drug release increased with increasing temperature which can be attributed to enhanced drug diffusion. An Arrhenius relationship of the zero-order release constants was established, indicating that temperature is a valid parameter to accelerate drug release from this dosage form and that the release mechanism is maintained under these accelerated test conditions. Accelerated release tests are particularly useful for routine quality control to assist during batch release of extended release formulations that typically release the active over several weeks, months or even years, since they can increase the product shelf life. The accelerated method should therefore be able to discriminate between formulations with different release characteristics that can result from normal manufacturing variance. In the case of Nuvaring®, it is well known that the process parameters during the extrusion process strongly influence the polymeric structure. These changes in the polymeric structure can affect the permeability which, in turn, is reflected in the release properties. Results from this study indicate that changes in the polymeric structure can lead to a different temperature dependence of the release rate, and as a consequence, the accelerated method can become less sensitive to detect changes in the release properties. When the accelerated method is utilized during batch release, it is therefore important to take this possible restriction into account and to evaluate the accelerated method with samples from non

Prevention of postpartum hemorrhage at home birth in Afghanistan.

Science.gov (United States)

Sanghvi, Harshadkumar; Ansari, Nasratullah; Prata, Ndola J V; Gibson, Hannah; Ehsan, Aftab T; Smith, Jeffrey M

2010-03-01

To test the safety, acceptability, feasibility, and effectiveness of community-based education and distribution of misoprostol for prevention of postpartum hemorrhage at home birth in Afghanistan. A nonrandomized experimental control design in rural Afghanistan. A total of 3187 women participated: 2039 in the intervention group and 1148 in the control group. Of the 1421 women in the intervention group who took misoprostol, 100% correctly took it after birth, including 20 women with twin pregnancies. Adverse effect rates were unexpectedly lower in the intervention group than in the comparison group. Among women in the intervention group, 92% said they would use misoprostol in their next pregnancy. In the intervention area where community-based distribution of misoprostol was introduced, near-universal uterotonic coverage (92%) was achieved compared with 25% coverage in the control areas. In Afghanistan, community-based education and distribution of misoprostol is safe, acceptable, feasible, and effective. This strategy should be considered for other countries where access to skilled attendance is limited.

EP3 receptors inhibit antidiuretic-hormone-dependent sodium transport across frog skin epithelium

DEFF Research Database (Denmark)

Rytved, Klaus A.; Nielsen, Robert

1999-01-01

Antidiuretic hormone; tight epithelium; prostaglandin receptors; sulprostone; misoprostol; cAMP; cellular Ca2+......Antidiuretic hormone; tight epithelium; prostaglandin receptors; sulprostone; misoprostol; cAMP; cellular Ca2+...

The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature.

Science.gov (United States)

van den Berg, Joyce; Gordon, Bernardus B M; Snijders, Marcus P M L; Vandenbussche, Frank P H A; Coppus, Sjors F P J

2015-12-01

Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation rates between 53% and 87%. Some reports suggest that sequential treatment with mifepristone and misoprostol leads to higher success rates than misoprostol alone. To evaluate the added value of mifepristone to current non-surgical treatment regimens in women with EPF we performed a systematic literature search. Electronic databases were searched: PubMed, Cochrane Library, Current Controlled Trials, and ClinicalTrials.gov. Clinical studies, both randomised and non-randomised trials, reporting on the added value of mifepristone to current non-surgical treatment regimens in women with EPF were included. Data of sixteen studies were extracted using a data extraction sheet (based on the Cochrane Consumers and Communication Review Group's data extraction template). The methodological quality was assessed using the Cochrane Collaboration Risk of Bias tool. In five randomised and eleven non-randomised trials, success rates of sequential treatment with mifepristone and misoprostol in case of EPF varied between 52% and 95%. Large heterogeneity existed in treatment regimens and comparators between studies. The existing evidence is insufficient to draw firm conclusions about the added value of mifepristone to misoprostol alone. A sufficiently powered randomised, double blinded placebo-controlled trial is urgently required to test whether, in EPF, the sequential combination of mifepristone with misoprostol is superior to misoprostol only. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

INFLUENCIA DE LOS ÓRGANOS REPRODUCTORES SOBRE LA FERTILIDAD EN VAQUILLONAS MESTIZAS INSEMINADAS A TIEMPO FIJO

Directory of Open Access Journals (Sweden)

Gustavo Adolfo Hidalgo Bravo

2012-12-01

Full Text Available El propósito de esta investigación fue evaluar el peso corporal y las influencias de las diferentes caracterizaciones del tracto reproductivo de vaquillonas y su relación con la tasa de preñez en programas de inseminación artificial en tiempo fijo (IATF. Las vaquillonas (n=38 utilizadas fueron cruza mestizas, condición corporal de 3 a 4 (Escala 1 al 5 de 20 a 30 meses de edad, las que tenían un peso corporal de 320 a 400 kg. El día pre sincronización todas las vaquillonas fueron examinadas por ecógrafo transrectal Aquila Vet 7.5 MHz, donde se determinó el diámetro uterino (cm, área ovárica (cm², área de estructuras ováricas (cm². Día cero se colocó dispositivo intravaginal 0.5 mg progesterona, conjunto con una inyección intramuscular de 1 mg de Benzoato Estradiol; día 8 retiro del dispositivo más administración intramuscular de 500 µg de D (+ Cloprostenol; día 9 aplicación intramuscular de 0.75 mg de benzoato estradiol. Inseminando 54-57 h de retirado el dispositivo intravaginal. Se diagnosticó gestación 60 días post IATF. No se registraron diferencias significativas (P>0.05, entre peso corporal, útero, ovario izquierdo, y estructuras ováricas, solo encontrándose diferencias significativas en el ovario derecho. Se concluye que el área del ovario derecho influye positivamente sobre la tasa de preñez, en cuanto al mejor umbral en pronóstico de la preñez para seleccionar una vaquillona mestiza en función del ovario derecho el estándar 4.80 cm², es el apropiado.

Embryo yield in llamas synchronized with two different intravaginal progesterone-releasing devices and superovulated with eCG

Energy Technology Data Exchange (ETDEWEB)

Aller, J.F.; Abalos, M.C.; Acuña, F.A.; Virgili, R.; Requena, F.; Cancino, A.K.

2015-07-01

The objectives of this study were to compare the effects of two intravaginal devices (ID) containing the same dose (0.5 g) of progesterone (P4) on subsequent ovarian response, embryo production and circulating P4 concentration profile in llamas (Lama glama) treated with equine chorionic gonadotropin (eCG) for ovarian superstimulation. Female llamas were randomly assigned (n = 10 llamas per group) to one of the following groups and treated (Day 0) with an ID containing 0.5 g of vegetal P4 to synchronize the emergence of a new follicular wave: i) DIB 0.5® and ii) Cronipres M15®. On Day 3 llamas were intramuscularly treated with 1000 IU of eCG. The IDs were removed on Day 7. Llamas were naturally mated (Day 9) and treated with GnRH analogue to induce ovulation. A second mating was allowed 24 h later. Embryos were collected between 7 and 8 days after the first mating. Blood samples were taken every day from Day 0 to Day 7 to measure circulating P4 concentrations. The results indicated that DIB device maintained greater plasma P4 levels as compared to Cronipres until Day 2. However, the mean (± SD) number of corpora lutea and recovered embryos was not affected (p < 0.05) by the type of ID (5.3 ± 2.6 vs 4.2 ± 2.2 and 3.5 ± 2.7 vs 2.6 ± 3.0 for DIB and Cronipres, respectively). In conclusion, both DIB and Cronipres devices can be successfully used to synchronize the emergence of follicular wave prior to a single dose of eCG in superovulation protocol in llamas. (Author)

The diagnostic value of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time.

Science.gov (United States)

Kam, Sung Chul; Han, Deok Hyun; Lee, Sung Won

2011-03-01

Premature ejaculation (PE) is the most prevalent male ejaculation disorder. The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the DSM-IV-TR criteria in diagnostic PE. To evaluate the diagnostic value of the PEDT and its association with intravaginal ejaculatory latency time (IELT). (i) Korean validation of PEDT: data was collected from men interviewed by one of the two clinical experts, who made a diagnostic of present or absence of PE, using DSM-IV-TR criteria. A total of 103 patients with PE and 100 men without PE were enrolled into the study and requested to complete the PEDT; and (ii) The correlation between IELT and PEDT: 200 participants were enrolled and each participant was asked to make out PEDT. All participants were requested to measure IELT. Validity and reliability of the PEDT and its association with IELT. The geometric mean IELT of the PE group was 115.37 ± 78.14 seconds. The number of men reporting IELTs of 2 minutes were 28 (28.6%), 29 (29.6%), and 41 (41.8%), respectively. The Cronbach's alpha score was calculated as 0.93, showing adequate internal consistency. The test-retest correlation coefficients of each item were higher than 0.72 and the correlation coefficients of the total score was 0.88. (P IELT showed an adequate negative correlation. (ρ = -0.77, P IELT ≤ 2 minutes) and IELT showed a negative correlation. (ρ = -0.6, P < 0.0001) The PEDT was highly effective in detecting the presence of PE. The result of our study supports its validity as a diagnostic tool in the clinical setting. © 2010 International Society for Sexual Medicine.

Pharmacokinetics and Preliminary Safety of Pod-Intravaginal Rings Delivering the Monoclonal Antibody VRC01-N for HIV Prophylaxis in a Macaque Model.

Science.gov (United States)

Zhao, Chunxia; Gunawardana, Manjula; Villinger, Francois; Baum, Marc M; Remedios-Chan, Mariana; Moench, Thomas R; Zeitlin, Larry; Whaley, Kevin J; Bohorov, Ognian; Smith, Thomas J; Anderson, Deborah J; Moss, John A

2017-07-01

The broadly neutralizing antibody (bNAb) VRC01, capable of neutralizing 91% of known human immunodeficiency virus type 1 (HIV-1) isolates in vitro , is a promising candidate microbicide for preventing sexual HIV infection when administered topically to the vagina; however, accessibility to antibody-based prophylactic treatment by target populations in sub-Saharan Africa and other underdeveloped regions may be limited by the high cost of conventionally produced antibodies and the limited capacity to manufacture such antibodies. Intravaginal rings of the pod design (pod-IVRs) delivering Nicotiana -manufactured VRC01 (VRC01-N) over a range of release rates have been developed. The pharmacokinetics and preliminary safety of VRC01-N pod-IVRs were evaluated in a rhesus macaque model. The devices sustained VRC01-N release for up to 21 days at controlled rates, with mean steady-state VRC01-N levels in vaginal fluids in the range of 10 2 to 10 3 μg g -1 being correlated with in vitro release rates. No adverse safety indications were observed. These findings indicate that pod-IVRs are promising devices for the delivery of the candidate topical microbicide VRC01-N against HIV-1 infection and merit further preclinical evaluation. Copyright © 2017 American Society for Microbiology.

Relationship between non-genital tender point tenderness and intra-vaginal muscle pain intensity: Ratings in women with provoked vestibulodynia and implications for treatment

Science.gov (United States)

PHILLIPS, Nancy; BROWN, Candace; BACHMANN, Gloria; WAN, Jim; WOOD, Ronald; ULRICH, Dagny; BACHOUR, Candi; FOSTER, David

2016-01-01

Background Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder; both of unknown etiology. Association of these conditions is well documented. Intra-vaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps to define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these two conditions. Objective 1) correlate pain intensity during the non-genital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, 2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. Study Design Ninety-two subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (Numerical rating scale> 1) in at least 11 sites of the 18-point non-genital tender point tenderness exam. Vaginal pain sensitivity was measured using an intra-vaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm2 forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of non-genital and those of iliococcygeus regions and the posterior vaginal wall. Independent t-tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance

La superaci??n del modelo del ??ngel del hogar:

OpenAIRE

Hurtado Mu??oz, M??nica

2012-01-01

La Tesis Doctoral titulada "La superaci??n del modelo del "??ngel del hogar". Recuperaci??n de la escritora Leonor Canalejas y Fustegueras (1869-1945)" aborda, en primer lugar, un an??lisis sociol??gico de las circunstancias que rodearon a la mujer espa??ola en el cambio de siglo en el ??mbito social y educativo, en un intento de esclarecer las caracter??sticas propias del contexto en el que la mujer accede a la intelectualidad en general y a la literatura en particular. Esta parte concluye q...

Increasing Access to Prevention of Postpartum Hemorrhage ...

African Journals Online (AJOL)

AJRH Managing Editor

Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could .... estimated 15% rate of refusal to participate in the.

Cytotec e aborto: a polícia, os vendedores e as mulheres Cytotec and abortion: the police, the vendors and women

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Debora Diniz

2012-07-01

Full Text Available Este artigo analisa o comércio ilegal do medicamento abortivo misoprostol no Brasil, com base no estudo de dez casos que alcançaram o Ministério Público do Distrito Federal e Territórios entre 2004 e 2010. Os dados foram assim organizados: 1. história das mulheres; 2. perfil dos vendedores; 3. casos de morte materna. Os resultados mostram que: 1. mulheres jovens, em relacionamento afetivo, fazem uso doméstico do misoprostol sozinhas ou com auxílio dos vendedores. Das sete mulheres indiciadas, três foram denunciadas ao chegar ao hospital público para finalização do aborto; 2. os vendedores são funcionários de farmácias e referências locais para o comércio do misoprostol. Eles informam as mulheres sobre uso do medicamento e prevenção de infecções, mas se recusam a socorrê-las em caso de emergência. Os traficantes atuam pela internet e possuem um estoque mais amplo de medicamentos; 3. houve duas mortes maternas por métodos invasivos combinados ao misoprostol. As principais causas de óbito são a demora em buscar auxílio médico por medo de denúncia policial e o uso combinado do misoprostol com métodos de alto risco.This paper analyzes the illegal trade in misoprostol, the medication predominantly used for abortion in Brazil. The study analyzed ten cases that came to the attention of the Public Prosecution Service for the Federal District between 2004 and 2010. The cases were organized into three categories: 1. women's stories; 2. profile of the vendors; 3. maternal mortality cases. The research was reviewed by an ethics committee. The main outcomes were: 1. young women in steady relationships use misoprostol in the home or with the assistance of drug vendors. Of the seven women indicted, three were reported on arrival at the public hospital to finalize abortion; 2. the drug vendors work at the community drugstore and are local agents for the sale of misoprostol. They instruct women on how to use the drug and how to

Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection.

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Stapleton, Ann E; Au-Yeung, Melissa; Hooton, Thomas M; Fredricks, David N; Roberts, Pacita L; Czaja, Christopher A; Yarova-Yarovaya, Yuliya; Fiedler, Tina; Cox, Marsha; Stamm, Walter E

2011-05-01

Urinary tract infections (UTIs) are common among women and frequently recur. Depletion of vaginal lactobacilli is associated with UTI risk, which suggests that repletion may be beneficial. We conducted a double-blind placebo-controlled trial of a Lactobacillus crispatus intravaginal suppository probiotic (Lactin-V; Osel) for prevention of recurrent UTI in premenopausal women. One hundred young women with a history of recurrent UTI received antimicrobials for acute UTI and then were randomized to receive either Lactin-V or placebo daily for 5 d, then once weekly for 10 weeks. Participants were followed up at 1 week and 10 weeks after intervention and for UTIs; urine samples for culture and vaginal swabs for real-time quantitative 16S ribosomal RNA gene polymerase chain reaction for L. crispatus were collected. Recurrent UTI occurred in 7/48 15% of women receiving Lactin-V compared with 13/48 27% of women receiving placebo (relative risk [RR], .5; 95% confidence interval, .2-1.2). High-level vaginal colonization with L. crispatus (≥10(6) 16S RNA gene copies per swab) throughout follow-up was associated with a significant reduction in recurrent UTI only for Lactin-V (RR for Lactin-V, .07; RR for placebo, 1.1; P < .01). Lactin-V after treatment for cystitis is associated with a reduction in recurrent UTI. Larger efficacy trials of this novel preventive method for recurrent UTI are warranted. CLINICAL TRIALS REGISTRATION. NCT00305227.

Embryo yield in llamas synchronized with two different intravaginal progesterone-releasing devices and superovulated with eCG

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Juan F. Aller

2015-09-01

Full Text Available The objectives of this study were to compare the effects of two intravaginal devices (ID containing the same dose (0.5 g of progesterone (P4 on subsequent ovarian response, embryo production and circulating P4 concentration profile in llamas (Lama glama treated with equine chorionic gonadotropin (eCG for ovarian superstimulation. Female llamas were randomly assigned (n = 10 llamas per group to one of the following groups and treated (Day 0 with an ID containing 0.5 g of vegetal P4 to synchronize the emergence of a new follicular wave: i DIB 0.5® and ii Cronipres M15®. On Day 3 llamas were intramuscularly treated with 1000 IU of eCG. The IDs were removed on Day 7. Llamas were naturally mated (Day 9 and treated with GnRH analogue to induce ovulation. A second mating was allowed 24 h later. Embryos were collected between 7 and 8 days after the first mating. Blood samples were taken every day from Day 0 to Day 7 to measure circulating P4 concentrations. The results indicated that DIB device maintained greater plasma P4 levels as compared to Cronipres until Day 2. However, the mean (± SD number of corpora lutea and recovered embryos was not affected (p < 0.05 by the type of ID (5.3 ± 2.6 vs 4.2 ± 2.2 and 3.5 ± 2.7 vs 2.6 ± 3.0 for DIB and Cronipres, respectively. In conclusion, both DIB and Cronipres devices can be successfully used to synchronize the emergence of follicular wave prior to a single dose of eCG in superovulation protocol in llamas.

Provision of menstrual regulation with medication among pharmacies in three municipal districts of Bangladesh: a situation analysis.

Science.gov (United States)

Huda, Fauzia Akhter; Mahmood, Hassan Rushekh; Alam, Anadil; Ahmmed, Faisal; Karim, Farzana; Sarker, Bidhan Krishna; Al Haque, Nafis; Ahmed, Anisuddin

2018-02-01

The objective was to assess the provision of the combination of mifepristone-misoprostol for menstrual regulation (MR) in randomly selected urban pharmacies in Bangladesh. We conducted a cross-sectional survey among 553 pharmacy workers followed by 548 mystery client visits to the same pharmacies in 3 municipal districts during July 2014-December 2015. The survey found that 99% of pharmacy workers visited had knowledge of MR procedures but only two-thirds (67%) could state the legal time limit correctly; they mentioned misoprostol (86%) over mifepristone-misoprostol combination (78%) as a procedure of MR with medication (MRM); 36% reported knowing the recommended dosage of mifepristone-misoprostol combination; 70% reported providing information on effectiveness of the medicines; 50% reported recommending at least one follow-up visit to them; 63% reported explaining possible complications of using the medications; and 47% reported offering any post-MR contraception to their clients. In contrast, mystery client visits found that the mifepristone-misoprostol combination (69%) was suggested over misoprostol (51%) by the pharmacy workers; 54% provided the recommended dosage of mifepristone-misoprostol combination; 42% provided information on its effectiveness; 12% recommended at least one follow-up visit; 11% counseled on possible complications; and only 5% offered post-MR contraceptives to the mystery clients. We found knowledge gaps regarding recommended dosage for MRM and inconsistent practice in informing women on effectiveness, follow-up visits, possible complications and provision of post-MR contraceptives among the pharmacy workers, particularly during the mystery client visits. Pharmacy workers in Bangladesh need to be trained on legal time limits for MR services provision, on providing accurate information on disbursed medicine, and on proper referral mechanisms. A strong monitoring and regulatory system for pharmacy provision of MRM in pharmacies should be

Helping rural women in Pakistan to prevent postpartum hemorrhage: A quasi experimental study

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Mir Ali

2012-10-01

Full Text Available Abstract Background According to the Pakistan Demographic and Health Survey from 2006–2007, the maternal mortality ratio in rural areas is 319 per 100,000 live births. Postpartum hemorrhage is the leading cause of maternal deaths in Pakistan. The objectives of the study were to document the feasibility of distribution of misoprostol tablets by community-based providers mainly traditional birth attendants and acceptability and use of misoprostol by women who gave birth at home. Methods A quasi-experimental design, comprising intervention and comparison areas, was used to document the acceptability of providing misoprostol tablets to pregnant women to prevent postpartum hemorrhage in the rural community setting in Pakistan. Data were collected using structured questionnaires administered to women before and after delivery at home and their birth attendants. Results Out of 770 women who delivered at home, 678 (88% ingested misoprostol tablets and 647 (84% ingested the tablets after the birth of the neonate but prior to the delivery of the placenta. The remaining women took misoprostol tablets after delivery of the placenta. Side effects were experienced by 40% of women and were transitory in nature. Among women who delivered at home, 80% said that they would use misoprostol tablets in the future and 74% were willing to purchase them in the future. Conclusions Self-administration of misoprostol in the home setting is feasible. Community-based providers, such as traditional birth attendants and community midwives with proper training and counseling, play an important role in reducing postpartum hemorrhage. Proper counseling and information exchange are helpful for introducing new practices in resource-constrained rural communities. Until such a time that skilled birth attendance is made more universally available in the rural setting, alternative strategies, such as training and using the services of traditional birth attendants to provide safe

Prostaglandin E2 EP2 activation reduces memory decline in R6/1 mouse model of Huntington's disease by the induction of BDNF-dependent synaptic plasticity.

Science.gov (United States)

Anglada-Huguet, Marta; Vidal-Sancho, Laura; Giralt, Albert; García-Díaz Barriga, Gerardo; Xifró, Xavier; Alberch, Jordi

2016-11-01

Huntington's disease (HD) patients and mouse models show learning and memory impairment even before the onset of motor symptoms. Deficits in hippocampal synaptic plasticity have been involved in the HD memory impairment. Several studies show that prostaglandin E2 (PGE2) EP2 receptor stimulates synaptic plasticity and memory formation. However, this role was not explored in neurodegenerative diseases. Here, we investigated the capacity of PGE2 EP2 receptor to promote synaptic plasticity and memory improvements in a model of HD, the R6/1 mice, by administration of the agonist misoprostol. We found that misoprostol increases dendritic branching in cultured hippocampal neurons in a brain-derived neurotrophic factor (BDNF)-dependent manner. Then, we implanted an osmotic mini-pump system to chronically administrate misoprostol to R6/1 mice from 14 to 18weeks of age. We observed that misoprostol treatment ameliorates the R6/1 long-term memory deficits as analyzed by the T-maze spontaneous alternation task and the novel object recognition test. Importantly, administration of misoprostol promoted the expression of hippocampal BDNF. Moreover, the treatment with misoprostol in R6/1 mice blocked the reduction in the number of PSD-95 and VGluT-1 positive particles observed in hippocampus of vehicle-R6/1 mice. In addition, we observed an increase of cAMP levels in the dentate ` of WT and R6/1 mice treated with misoprostol. Accordingly, we showed a reduction in the number of mutant huntingtin nuclear inclusions in the dentate gyrus of R6/1 mice. Altogether, these results suggest a putative therapeutic effect of PGE2 EP2 receptor in reducing cognitive deficits in HD. Copyright © 2016. Published by Elsevier Inc.

Historia del Pádel = History of Padel

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Bernardino Javier Sánchez-Alcaraz Martínez

2013-10-01

Full Text Available El presente trabajo resume la historia del deporte del pádel. Existen dos versiones sobre el origen del pádel. La primera versión relaciona los antecedentes del pádel con los de otros deportes de raqueta como el tenis o el bádminton, siendo su origen común el jeu de la paume francés. Posteriormente, surgen variantes en Estados Unidos como el Paddle Tennis y el Platform Tennis, siendo versiones reducidas del tenis, pero con elementos muy comunes al pádel actual. La segunda versión, aprobada por la Federación Internacional de Pádel, afirma que este deporte nació en México, en 1969, a través del empresario Enrique Corcuera.--------------------------------------------------------------------This research summarizes the history of paddle sport. There are two versions about the origin of paddle. The first version relates the history of paddle with other racket sports like tennis or badminton, and its common origin of the Jeu de Paume French. Later, in in the United States, appear two sports called Paddle Tennis and Platform Tennis, which are reduced versions of tennis sport, but these have lot of common characteristics with paddle. The second version, approved by the International Padel Federation, said the sport was born in Mexico in 1969, through the businessman Enrique Corcuera.

Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment.

Science.gov (United States)

Phillips, Nancy; Brown, Candace; Bachmann, Gloria; Wan, Jim; Wood, Ronald; Ulrich, Dagny; Bachour, Candi; Foster, David

2016-12-01

Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder, both of unknown etiology. Association of these conditions is well documented. Intravaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these 2 conditions. We sought to: (1) correlate pain intensity during the nongenital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, and (2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. In all, 92 subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (numeric rating scale >1) in at least 11 sites of the 18-point nongenital tender point tenderness exam. Vaginal pain sensitivity was measured using an intravaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm 2 forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of nongenital and those of iliococcygeus regions and the posterior vaginal wall. Independent t tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance level was at P pain

Potencial del Agua del suelo

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Bustamante Heliodoro

1986-12-01

Full Text Available La energía potencial del agua presenta diferencias de un punto del suelo a otro; esas diferencias son las que originan el movimiento del agua de acuerdo a la tendencia universal de la materia en el sentido de moverse de donde la energía potencial es mayor a donde dicha energía es menor. En el suelo el agua en consecuencia se mueve hacia donde su energía decrece hasta lograr su estado de equilibrio. Se desprende entonces que la cantidad de energía potencial absoluta contenida en el agua, no es importante por sí misma, sino por su relación con la energía en diferentes lugares dentro del suelo. El concepto Potencial de agua del suelo es un criterio para esta energía.

Premature ejaculation: bother and intravaginal ejaculatory latency time in Iran.

Science.gov (United States)

Zargooshi, Javaad

2009-12-01

Complaints of premature ejaculation (PE) and its repercussions are culture-dependent. To report the measured intravaginal ejaculatory latency time (IELT) and the impact of PE in Kermanshah, Iran. From November 1996 through October 2008, 3,458 patients presented to us with self-diagnosed PE. In the first visit, after obtaining a psychosocial and sexual history, PE-specific bother was self-rated by the patients and the patients were advised to measure their IELTs over the next 2-3 weeks. In the second visit, the measured IELTs were reported by the patients. Patients' measured IELT and bother score. Age range was 17-80 years (mean 34.1, standard deviation [SD] 9.1, median 32). Sixty-five percent were married. Primary and secondary PE was reported by 2,105 (60.8%) and 1,353 (39.1%) patients, respectively. Occasional PE was reported by 36 (0.01%). Of those with multiple partners, 6% had partner-specific PE. IELT distribution was positively skewed. Anteportal ejaculation was reported by 97 (2.8%). In 3,458 self-reported PE patients, IELT was 1-15 seconds in 542 (15.7%), 16-30 seconds in 442 (12.8%), 31-60 seconds in 978 (28.3%), > 1 2 5 minutes in 136 (3.9%). IELTs of IELT and bother (r = -0.607) was highly negative, with shorter IELTs being correlated with more bother. Six hundred forty-three patients (18.6%) always consumed opium to lengthen their IELTs. All 21 patients who started to use Tramadol as a PE treatment became addicted to it. Of 168 divorced couples due to PE, 23 divorced because the sexually dissatisfied wives became involved in extramarital affairs. Applying the Diagnostic and Statistical Manual of Mental Disorders criteria for PE and a cutoff IELT point of IELTs of longer than 2 minutes, the patients with occasional PE, and the patients who reported no personal bother, of 3,458 self-reported PE patients, 2,571 (74.3%) had PE. Including the 97 patients with anteportal ejaculation, arithmetic mean IELT in 2,571 patients was 45.87 seconds, SD 36.1, median

Prevention of postpartum haemorrhage by community-based auxiliary midwives in hard-to-reach areas of Myanmar: a qualitative inquiry into acceptability and feasibility of task shifting.

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Than, Kyu Kyu; Mohamed, Yasmin; Oliver, Victoria; Myint, Theingi; La, Thazin; Beeson, James G; Luchters, Stanley

2017-05-17

In Myanmar, postpartum haemorrhage is the leading cause of maternal mortality and contributes to around 30% of all maternal deaths. The World Health Organization recommends training and supporting auxiliary midwives to administer oral misoprostol for prevention of postpartum haemorrhage in resource-limited settings. However, use of misoprostol by auxiliary midwives has not formally been approved in Myanmar. Our study aimed to explore community and provider perspectives on the roles of auxiliary midwives and community-level provision of oral misoprostol by auxiliary midwives. A qualitative inquiry was conducted in Ngape Township, Myanmar. A total of 15 focus group discussions with midwives, auxiliary midwives, community members and mothers with children under the age of three were conducted. Ten key informant interviews were performed with national, district and township level health planners and implementers of maternal and child health services. All audio recordings were transcribed verbatim in Myanmar language. Transcripts of focus group discussions were fully translated into English before coding, while key informants' data were coded in Myanmar language. Thematic analysis was done using ATLAS.ti software. Home births are common and auxiliary midwives were perceived as an essential care provider during childbirth in hard-to-reach areas. Main reasons provided were that auxiliary midwives are more accessible than midwives, live in the hard-to-reach areas, and are integrated in the community and well connected with midwives. Auxiliary midwives generally reported that their training involved instruction on active management of the third stage of labour, including use of misoprostol, but not all auxiliary midwives reported using misoprostol in practice. Supportive reasons for task-shifting administration of oral misoprostol to auxiliary midwives included discussions around the good relationship and trust between auxiliary midwives and midwives, whereby midwives felt

Choosing early pregnancy termination methods in Urban Mozambique

NARCIS (Netherlands)

Mitchell, Ellen M. H.; Kwizera, Amata; Usta, Momade; Gebreselassie, Hailemichael

2010-01-01

Little is known about who chooses medication abortion with misoprostol and why. Women seeking early abortion in 5 public hospitals in Maputo, Mozambique were recruited in 2005 and 2006 to explore decision-making strategies, method preferences and experiences with misoprostol and vacuum aspiration

Efecto del silicio y plaguicidas en la fertilidad del suelo y rendimiento del arroz

OpenAIRE

Furcal-Beriguete, Parménides; Herrera-Barrantes, Alejandra

2013-01-01

Efecto del silicio y plaguicidas en la fertilidad del suelo y rendimiento del arroz. El objetivo de este trabajo fue evaluar el efecto del silicio en la fertilidad del suelo, la incidencia de enfermedades y plagas insectiles, el rendimiento y la calidad de granos del cultivo de arroz. El estudio se realizó en La Vega, Florencia, San Carlos, Costa Rica entre mayo y octubre en los años 2010 y 2011, en el mismo lote con la variedad CR 4477. Se establecieron cinco tratamientos: silicio al suelo, ...

Determinantes del trabajo infantil y la escolaridad: el caso del Valle del Cauca en Colombia

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Sebastián Urueña Abadía

2009-10-01

Full Text Available Colombia, al igual que la mayoría de países latinoamericanos, consciente de las repercusiones sociales y económicas negativas del trabajo infantil, se ha comprometido en la lucha por la erradicación de este fenómeno. Prueba de ello es la ratificación por parte del gobierno colombiano en el año 2007, del Convenio 182 de la OIT sobre la Prohibición de las Peores Formas de Trabajo Infantil y la Acción Inmediata para su Eliminación. En el plano regional, como parte del Plan de Desarrollo del Departamento del Valle del Cauca 2008-2011, se está implementando actualmente una estrategia territorial de erradicación del trabajo infantil en sus 42 municipios. Considerando este panorama, este trabajo indaga cuáles son los determinantes del trabajo infantil y la escolaridad en el departamento del Valle a partir de los datos de la Encuesta Nacional de Calidad de Vida del año 2003. Para el análisis se emplea un modelo econométrico Probit Bivariado, que permite el estudio conjunto e interrelacionado de decisiones diferentes, en este caso la asistencia escolar y el trabajo.

La superación del modelo del ángel del hogar:

OpenAIRE

Hurtado Muñoz, Mónica

2013-01-01

La Tesis Doctoral titulada "La superación del modelo del "ángel del hogar". Recuperación de la escritora Leonor Canalejas y Fustegueras (1869-1945)" aborda, en primer lugar, un análisis sociológico de las circunstancias que rodearon a la mujer española en el cambio de siglo en el ámbito social y educativo, en un intento de esclarecer las características propias del contexto en el que la mujer accede a la intelectualidad en general y a la literatura en particular. Esta parte concluye que la cr...

[Off-label drug use of the misoprostol in gynecology & obstetrics: From a medico-economics benefit to a potential legal risk].

Science.gov (United States)

Decamps-Mini, D; Pelofi, J; Treisser, A

2015-06-01

The scandal of the Mediator® case led the legislature to take measures in order to regulate off-label drugs prescriptions. Indeed the law issued in December 29th, 2011 on strengthening the safety of drugs and all derivative health products came to pave the way for an "over-cautious" practice of medicine in line with the precautionary principle erected as a constitutional principle. The supervision of off-label prescribing has had a direct impact on the exercise of the medical profession and has resurrected the issues related to the freedom of prescription, the obligation to provide information to patients and in general their whole responsibility. It is important to mention that the prescribing act is part of the freedom and the strict prerogative of those skilled in the art: the physician in this case. The off-label prescription is commonly accepted in certain specialties, such as anesthesia and intensive care, oncology or pediatrics where it is even subject of a memorandum of use because of concerns regarding the availability of forms adapted to children. However, the physician must ensure that no appropriate therapeutic alternative is available and inform the patient, fundamental principle of the right to respect for the will of the person. Off-label use of the prostaglandin-E1 analogue misoprostol in obstetrics and gynecology is a good example. In fact, this drug obtained a marketing authorization for the treatment or prevention of peptic ulcers and other stomach disorders, is commonly used off-label when inducing labour or intrauterine device insertion. These are the issues that need to be clarify and carefully assessed in order to help physicians to understand the impact of the law and the state of the jurisprudence on the exercise of their profession. Copyright © 2015. Published by Elsevier SAS.

Increasing Access to Prevention of Postpartum Hemorrhage Interventions for Births in Health Facilities and at Home in Four Districts of Rwanda.

Science.gov (United States)

Dao, Blami; Ngabo, Fidele; Zoungrana, Jeremie; Rawlins, Barbara; Mukarugwiro, Beata; Musoni, Pascal; Favero, Rachel; MacDowell, Juliet; Eugene, Kanyamanza

2015-12-01

To assess coverage, acceptability, and feasibility of a program to prevent postpartum hemorrhage (PPH) at community and facility levels, a study was conducted in 60 health facilities and their catchment areas in four districts in Rwanda. A total of 220 skilled birth attendants at these facilities were trained to provide active management of the third stage of labor and 1994 community health workers (ASMs) were trained to distribute misoprostol at home births. A total of 4,074 pregnant women were enrolled in the program (20.5% of estimated deliveries). Overall uterotonic coverage was 82.5%: 85% of women who delivered at a facility received a uterotonic to prevent PPH; 76% of women reached at home at the time of birth by an ASM ingested misoprostol--a 44.3% coverage rate. Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could further increase coverage.

Culturas del Mundo

DEFF Research Database (Denmark)

Benwell, Ann Fenger; Costa, Alberto; Waehle, Espen

2006-01-01

’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39......’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39...

Preoperative ripening of the cervix before operative hysteroscopy.

Science.gov (United States)

Al-Fozan, Haya; Firwana, Belal; Al Kadri, Hanan; Hassan, Samar; Tulandi, Togas

2015-04-23

Hysteroscopy is an operation in which the gynaecologist examines the uterine cavity using a small telescopic instrument (hysteroscope) inserted via the vagina and the cervix. Almost 50% of hysteroscopic complications are related to difficulty with cervical entry. Potential complications include cervical tears, creation of a false passage, perforation, bleeding, or simply difficulty in entering the internal os (between the cervix and the uterus) with the hysteroscope. These complications may possibly be reduced with adequate preparation of the cervix (cervical ripening) prior to hysteroscopy. Cervical ripening agents include oral or vaginal prostaglandin, which can be synthetic (e.g misoprostol) or natural (e.g. dinoprostone) and vaginal osmotic dilators, which can be naturally occurring (e.g. laminaria) or synthetic. To determine whether preoperative cervical preparation facilitates cervical dilatation and reduces the complications of operative hysteroscopy in women undergoing the procedure for any condition. In August 2014 we searched sources including the Menstrual Disorders and Subfertility Group (MDSG) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, ClinicalTrials.gov and reference lists of relevant articles. We searched for published and unpublished studies in any language. Two review authors independently selected randomised controlled trials (RCTs) of cervical ripening agents used before operative hysteroscopy in pre- and postmenopausal women. Cervical ripening agents could be compared to each other, placebo or no treatment. Data extraction and quality assessment were conducted independently by two review authors. The primary review outcomes were effectiveness of cervical dilatation (defined as the proportion of women requiring mechanical cervical dilatation) and intraoperative complications. Secondary outcomes were mean time required to dilate the cervix, preoperative pain, cervical width

Determinación del requerimiento hídrico del pimentón en el municipio de Candelaria, departamento del Valle del Cauca

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Estrada Salazar Edgar Iván

2010-12-01

Full Text Available Se realizó un ensayo con el fin de determinar el requerimiento hídrico del pimentón Capsicum annuum variedad Unapal-Serrano, en la zona de Candelaria-Valle del Cauca (Colombia. Se determinó que el pimentón requiere 425mm de agua durante su ciclo vegetativo, obteniendo una eficiencia del uso del agua de 5.32 kg/m3 de fruto fresco y de 0.5 kg/m3 en términos de materia seca. Además, se comprobó la eficiencia del microevaporímetro "MIEVHR" como herramienta para programación del riego y estudios hidrológicos.

ORIGINAL ARTICLES Can the outcome of induction of labour with ...

African Journals Online (AJOL)

ORIGINAL ARTICLES. Can the outcome of induction of labour with oral misoprostol be predicted? A M Mbele, J D Makin, R C Pattinson. Objective. To determine predictors of outcome for induction of labour using oral misoprostol. Setting. Labour ward at Kalafong Hospital in Atteridgeville,. Pretoria, that serves an indigent ...

Las fluctuaciones del nivel del mar durante el Cuaternario

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Pousa, Jorge Lorenzo; Isla, Federico Ignacio; Schnack, Enrique Jorge

2002-01-01

Los cambios del nivel del mar han ejercido una fuerte influencia en la evolución del planeta y en la historia de la humanidad. En una escala de tiempo geológico, las variaciones de los niveles oceánicos han dejado un registro ampliamente distribuido en la forma de depósitos sedimentarios. El descenso del nivel del mar durante la Ultima Glaciación, que alcanzó unos 120 metros hace 18.000 años, permitió la emergencia del estrecho de Bering y la migración humana desde Eurasia hacia América. Se e...

EFECTO DEL SILICIO Y PLAGUICIDAS EN LA FERTILIDAD DEL SUELO Y RENDIMIENTO DEL ARROZ

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Parm\\u00E9nides Furcal-Beriguete

2013-01-01

Full Text Available El objetivo de este trabajo fue evaluar el efecto del silicio en la fertilidad del suelo, la incidencia de enfermedades y plagas insectiles, el rendimiento y la calidad de granos del cultivo de arroz. El estudio se realizó en La Vega, Florencia, San Carlos, Costa Rica entre mayo y octubre en los años 2010 y 2011, en el mismo lote con la variedad CR 4477. Se establecieron cinco tratamientos: silicio al suelo, silicio al suelo más plaguicidas (alternativas químicas, silicio foliar, silicio foliar más plaguicidas y testigo comercial. Como fuente se utilizaron si- licio en polvo al 70% de SiO2, aplicado quince días antes de siembra en dosis de 100 kg SiO2/ha, y líquido concentrado 40% SiO2 y 36% MgO, aplicado al follaje en dosis de 4 l/ha a los 17 y 30 días después de la siembra. El suelo del orden inceptisol de formación aluvial, al inicio del experimento tenía pH 4,9, valores de P y Si disponibles de 29 ppm y 44,7 ppm, respectivamente, acidez intercambiable 1,2 cmol(+/l y suma de bases 19,11 cmol(+/l. No hubo diferencia estadística significativa del silicio en la fertilidad del suelo, la incidencia de plagas y enfermedades, y en la calidad molinera; sin embargo, la combinación del silicio aplicado al suelo y el uso de plaguicidas incrementaron el contenido de zinc y cobre en el suelo, y del zinc y magnesio en las hojas de arroz, pero este efecto no se tradujo en rendimiento y calidad de granos. La aplicación de plaguicidas influyó positivamente en el peso y rendimiento del arroz en granza (p≤0,05.

Catàleg dels Miridae (Heteroptera) del Massís del Garraf

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Goula Goula, Marta

1989-01-01

Per a la redacció d'aquest catàleg, s'aporten dades d'observació pròpia al llarg dels anys 1980-1984, així com les troballes publicades per CUNI (1889a,1889b,1889c,1891) i per RIBES (1978a,1978b,1980,1984). Totes aquestes observacions s'han fet en localitats del Massis del Garraf, que será objecte d'una curta descripció.

La Orden de Medidas Provisionales del Tribunal Internacional del Derecho del Mar en el caso del buque de guerra ARA Libertad

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Martin Cabrera Mirassou

2013-06-01

Full Text Available El presente comentario tiene por finalidad describir la reciente orden de medidas provisionales emitida por el Tribunal Internacional del Derecho del Mar en el caso relativo a la detención de la Fragata ARA Libertad. La controversia contiene un complejo trasfondo político, económico y jurídico, en el cual se destaca el alcance de la inmunidad de los buques de guerra, el funcionamiento del sistema de solución de controversias de la Convención de Naciones Unidas sobre Derecho del Mar y, en particular, la competencia del Tribunal. Con la finalidad de lograr un entendimiento más profundo de su jurisprudencia se abordan los principales aspectos que permitan comprender el valor de la decisión para los actores del régimen de los océanos.

Funciones del estilo personal del terapeuta en profesionales del campo de las adicciones

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Leandro Casari

2017-01-01

Full Text Available Objetivo. Comparar el estilo personal del terapeuta entre dos grupos de profesionales, uno dedicado a la atención de pacientes drogodependientes (grupo adicciones y otro a la atención clínica en general (grupo clínico. Método. La muestra estuvo formada por 100 psicoterapeutas que trabajan en instituciones públicas y privadas de tres provincias del interior de Argentina, pareados por las variables socioprofesionales (sexo, edad, años de experiencia profesional, enfoque teórico, grupo etario de trabajo, tipo de abordaje predominante, duración del tratamiento y grado de especialización. El instrumento empleado fue el Cuestionario de Estilo Personal del Terapeuta. Resultados. Para el análisis de datos se emplearon pruebas de comparación de medias y se analizó su tamaño del efecto. Se obtuvieron diferencias signifi cativas en la función expresiva: grupo clínico (M = 40.36 y grupo adicciones (M = 29.86; así como también en la función instruccional: grupo clínico (M = 28.01 y grupo adicciones (M = 32.67. Esto indica una mayor distancia emocional y un incremento en la rigidez del encuadre terapéutico en los terapeutas de pacientes adictos. Conclusión. Se discuten estos resultados en función de postulados previos que señalan la complejidad del vínculo terapéutico y el énfasis en las características del encuadre terapéutico, tal como la puesta de límites.

Calidad del servicio de taxis del municipio Maracaibo

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Joheni A. Urdaneta G.

2011-05-01

Full Text Available El presente trabajo tiene como objetivo describir la calidad del servicio de los taxis en el municipio Maracaibo, ya que los mismos forman parte del sistema de transporte urbano de la ciudad, y es un servicio público fundamental para la convivencia de la sociedad; para lograr este objetivo se realizó una adaptación del modelo SERVPERF, diseñando un instrumento tipo cuestionario, con 32 ítems en 6 dimensiones, adecuado a las características propias del servicio de taxi, con la finalidad de confirmar que los ítems de los instrumentos se correspondían con las dimensiones adaptadas se aplicó la técnica de análisis factorial resultando un nuevo instrumento con 24 ítems en 3 dimensiones. Se utilizó la escala de Likert con tres (3 alternativas de respuesta. La investigación es de tipo descriptiva y aplicada, bajo diseño no experimental de tipo transeccional descriptiva y de campo. La población quedó conformada por los usuarios de las líneas de taxis del municipio Maracaibo. Se aplicó muestreo aleatorio por conglomerado. La confiabilidad del instrumento se midió a través del coeficiente alfa de Cronbach resultando de 0,82 lo cual se considera aceptable. Los resultados revelan que la calidad del servicio de taxis del municipio Maracaibo es mediana por lo tanto este servicio es susceptible a mejoras, las cuales son necesarias para elevar la calidad de vida de los marabinos. Este resultado se obtuvo con el instrumento originalmente adaptado de 32 ítems y con el cuestionario resultante del análisis factorial, de 24 ítems; esto confirma lo apropiado de esta técnica, ya que se redujo el número de ítems y de las dimensiones originalmente adaptadas y no se encontraron diferencias significativas en los resultados con ambos instrumentos; de esta manera se puede medir la calidad del servicio de taxis en el municipio Maracaibo a través de las dimensiones: confiabilidad del servicio, socialización y responsabilidad.

En busca del concepto de gerencia del cuidado

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Ligia Teresa Mora-Delgado

2005-12-01

Full Text Available Este articulo, presenta los conceptos de gerencia del cuidado de enfermería, desarrollado por las enfermeras profesionales que laboran en le Empresa social del estado Hospital Universitario Erasmo Meoz de las Ciudad de Cúcuta, desde su desempeño en la asistencia, administración y docencia. Se pretende además precisar los elementos gerenciales, sociales, humanísticos y éticos que deben hacer parte del concepto de gerencia del cuidado.

Ruptura del projecte parental i disposició dels preembrions

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Farnós Amorós, Esther

2010-01-01

La tesi doctoral "Ruptura del projecte parental i disposició dels preembrions" analitza els efectes del consentiment a les tècniques de reproducció assistida prestat en el marc d'un projecte parental. La tesi ofereix una resposta als conflictes que enfronten exesposos o exconvivents en relació al destí dels preembrions sobrants d'un cicle de fecundació "in vitro" iniciat durant la relació. Aquests conflictes constitueixen un grup de casos al voltant del qual no hi ha solucions legislatives qu...

Impact of management protocols of intrauterine fetal death on perceived stress: A comparative study

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Mita Mandal

2017-01-01

Full Text Available Background: Pregnancy loss is a distressing problem and retention of dead fetus in utero has its own ill effects on physical, psychological, and social aspects, and hence, it is better to recommend medical induction, provided this can be safely undertaken. Aims: The aim of this study is to compare the efficacy, tolerability, induction-delivery interval, and perceived stress scores between induction methods in late intrauterine fetal death (IUFD with misoprostol alone and mifepristone with misoprostol combination in a rural population of Eastern India. Materials and Methods: This pilot study was conducted on 125 patients after taking institutional ethical clearance and informed consent of the patients in a time span of 1 year. Group 2 patients received 200 mg of mifepristone per orally and observed for 48 h, followed by 50 μg misoprostol administered in the posterior vaginal fornix, and repeated 6th hourly up to a maximum of four doses. Group 1 received 50 μg misoprostol per vaginally 6 hourly for four doses. Induction-delivery interval was calculated. Perceived stress level was calculated on admission and before discharge. Results: Significantly lower induction-delivery interval was observed in Group 2 as compared to Group 1 with P < 0.001. There was no significant difference of Cohen's perceived stress scores on admission, but the difference was significantly lower in Group 2 on discharge with the value of P = 0.03. Group 1 had significantly lower hospital stay in days as compared to Group 2 of patients with P < 0.001. Conclusions: Patients with IUFD administered misoprostol per vaginally only may require shorter hospital stay as compared to patients administered with oral mifepristone followed by misoprostol vaginally but the delivery induction time increases significantly and may increase perceived stress levels which may have short- and long-term negative psychological impact.

Determinantes del ingreso y del gasto corriente de los hogares

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Muñoz C., Manuel

2004-01-01

Este ensayo de investigación empírica analiza los determinantes del ingreso y del gasto en los hogares colombianos. Utilizando un modelo del ciclo de vida con datos de la encuesta de hogares de 1994 y 1995, muestra que el comportamiento del ingreso está afectado principalmente por las características demográficas del hogar y los rasgos socio ocupacionales de sus miembros. El comportamiento del gasto está determinado ante todo por el ingreso y, en menor medida, por las características sociales...

Gestión del riesgo del cambio (segunda parte)

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Zorrilla Salgador, Juan Pablo

2004-01-01

Segunda parte del artículo acerca del uso de futuros sobre el tipo de cambio. Esta continuación abarca estrategias, definiciones, metodología y explicaciones sobre todo lo relacionado con el Ratio de cobertura de los futuros y la aparición del riesgo base.Segunda parte del artículo acerca del uso de futuros sobre el tipo de cambio. Esta continuación abarca estrategias, definiciones, metodología y explicaciones sobre todo lo relacionado con el Ratio de cobertura de los futuros y la aparición d...

Understanding motives for intravaginal practices amongst Tanzanian and Ugandan women at high risk of HIV infection: The embodiment of social and cultural norms and well-being☆

Science.gov (United States)

Lees, Shelley; Zalwango, Flavia; Andrew, Bahati; Vandepitte, Judith; Seeley, Janet; Hayes, Richard J.; Francis, Suzanna C.

2014-01-01

Some types of intravaginal practices (IVP) may increase the risk for HIV acquisition. This is particularly worrisome for populations with dual high prevalence of HIV and IVP. Women involved in transactional sex are at increased risk for HIV infection in sub-Saharan Africa. Social, cultural and economic influences are strong drivers of IVP in this population. To explore this, we carried out a qualitative research study to investigate the drivers and motivations for using IVP within a large observational study of women at high risk of HIV in Tanzania and Uganda from September 2008 to September 2009. Of the 201 women selected, 176 women took part in a semi-structured in-depth interview. Additionally, in Tanzania, eight focus group discussions among study participants and community members were carried out to obtain information on community norms and expectations. IVP were motivated by overlapping concerns with hygiene, morality, sexual pleasure, fertility, relationship security, and economic security. These motives were driven by the need to meet cultural and social expectations of womanhood, and at the same time attend to personal well-being. Among women involved in transactional sex in East Africa, interventions aimed at modifying or eliminating IVP should attend to local cultural and social norms as well as the individual as an agent of change. PMID:24565154

HACIA UNA CONCEPTUALIZACIÓN DEL LEGADO DEL TRADUCTOR

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María Constanza Guzmán

2009-06-01

Full Text Available Este artículo se propone investigar el aporte de perspectivas traductológicas para el estudio de la figura del traductor y su legado. Se centra en enfoques teóricos contemporáneos, principalmente aquellos basados en perspectivas postestructuralistas, que consideran el papel del sujeto traductor como un aspecto crucial en la traducción y los estudios literarios, y proponen maneras interesantes de abordarlo. A lo largo del artículo se cuestionan nociones como la idea de un original sacralizado, la relación entre autoría y propiedad, el ideal del significado transparente, y la tensión entre la traducción y la escritura del "original". Se presta especial atención a la importancia de ubicar históricamente la práctica del traductor, reconocer su papel como agente visible, y conceptualizar la traducción como una forma de escritura que se desarrolla en medio de complejas interacciones y negociaciones.

HACIA UNA CONCEPTUALIZACIÓN DEL LEGADO DEL TRADUCTOR

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María Constanza Guzmán

2009-01-01

Full Text Available Este artículo se propone investigar el aporte de perspectivas traductológicas para el estudio de la figura del traductor y su legado. Se centra en enfoques teóricos contemporáneos, principalmente aquellos basados en perspectivas postestructuralistas, que consideran el papel del sujeto traductor como un aspecto crucial en la traducción y los estudios literarios, y proponen maneras interesantes de abordarlo. A lo largo del artículo se cuestionan nociones como la idea de un original sacralizado, la relación entre autoría y propiedad, el ideal del significado transparente, y la tensión entre la traducción y la escritura del "original". Se presta especial atención a la importancia de ubicar históricamente la práctica del traductor, reconocer su papel como agente visible, y conceptualizar la traducción como una forma de escritura que se desarrolla en medio de complejas interacciones y negociaciones.

Componente Cultura del Agua del PMGRH: plan de trabajo

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Autoridad Nacional del Agua; Proyecto de Modernización de la Gestión de Recursos Hídricos

2012-01-01

Describe el plan de trabajo del Componente Cultura del Agua del Proyecto de Modernización de la Gestión de Recursos Hídricos (PMGRH) en relacion a dos aspectos estructurales del proyecto: 1. Mejora de la capacidad de la Gestión Integrada de Recursos Hídricos (GIRH) a nivel nacional y 2. Fortalecimiento de las capacidades de GIRH en las cuencas.

Determinantes del ingreso y del gasto corriente de los hogares

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Muñoz C., Manuel

2004-06-01

Full Text Available Este ensayo de investigación empírica analiza los determinantes del ingreso y del gasto en los hogares colombianos. Utilizando un modelo del ciclo de vida con datos de la encuesta de hogares de 1994 y 1995, muestra que el comportamiento del ingreso está afectado principalmente por las características demográficas del hogar y los rasgos socio ocupacionales de sus miembros. El comportamiento del gasto está determinado ante todo por el ingreso y, en menor medida, por las características sociales del hogar y el gasto de otros hogares con características similares. También examina la influencia de la incertidumbre acerca de los ingresos en el gasto de los hogares para comprobar si estos actúan con motivos de precaución.

A cross-sectional study of bacterial vaginosis, intravaginal practices and HIV genital shedding; implications for HIV transmission and women's health.

Science.gov (United States)

Alcaide, Maria L; Chisembele, Maureen; Malupande, Emeria; Arheart, Kristopher; Fischl, Margaret; Jones, Deborah L

2015-11-09

Bacterial vaginosis (BV) is associated with an increased risk of HIV transmission, and intravaginal practices (IVP) are an important risk factor for developing BV. The relationship between IVP, BV and HIV lower genital shedding, responsible for HIV transmission, has not been examined in women receiving antiretrovirals in Zambia. Cross-sectional study. Community Health Center in Lusaka, Zambia. Participants were HIV-infected women receiving antiretroviral therapy and engaging in IVP (n=128). Participants completed audio computer-administered self-interviews to assess IVP and underwent a vaginal examination. BV was diagnosed using Nugent criteria. HIV-1 lower genital shedding was assessed by measuring HIV-1 RNA in cervicovaginal lavages. Most women engaged in IVP daily (114, 89.0%) and 81 (63.3%) of the participants had BV. HIV-1 genital shedding was detected in 18 (14.2%) participants. BV was associated with daily use of IVP (prevalence ratio, PR=4.58, CI 1.26 to 16.64, p=0.02) and weekly use of traditional medicines for IVP (PR=1.33, CI 1.05 to 1.68, p=0.02). The only factor associated with HIV-1 lower genital shedding was plasma viraemia (PR=4.61, CI 2.02 to 10.54, pHIV shedding. Despite the frequency of IVP and high prevalence of BV, plasma viraemia was the primary factor associated with HIV lower genital shedding. These findings support early initiation of antiretrovirals as an HIV prevention tool. Given adverse health outcomes associated with BV, the association between frequent IVP and BV, and the powerful local norms and traditions encouraging IVP, there is a need for studies assessing culturally tailored interventions to decrease BV in high-prevalence settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Análisis del "Curso sobre la Evolución del Pensamiento Juslaboralista" del Profesor Emérito Héctor-Hugo Barbagelata (El espejo retrovisor del Derecho del Trabajo y los Principios del Dr. H. H. Barbagelata

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Helios Sarthou

2014-01-01

Full Text Available Los que sabíamos que el profesor Emérito de “Derecho del Trabajo y de la Seguridad Social" Dr. Hector Hugo Barbagelata, tenía en preparación un libro sobre Evolución del pensamiento Juslaboralista –de algún modo en la senda del Curso que había fundado en nuestra Facultad de Derecho- lo considerábamos de altísima importancia, no sólo en el plano técnico-jurídico, sino también por las implicancias históricas, sociales y políticas que la temática implicaba.- Y esto es así en esta época, en que el pensamiento neoliberal no obstante el camino ya recorrido, continúa buscando incidir en el Derecho del Trabajo, recurriendo a excusas para el retorno al Derecho Civil, o para alcanzar la flexibilidad con mengua del respeto a los principios de tuitividad y justicia social que debe garantizar el Derecho del Trabajo o, en otros casos directamente promoviendo la irrelevancia técnica de la disciplina en beneficio del Derecho Civil o del Derecho Procesal, en su caso.-

RASGOS GEOGRÁFICOS DEL VALLE DEL RIO AGRIO INFERIOR.

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Celia Torren

1993-12-01

Full Text Available El presente artículo es una síntesis del trabajo "Rasgos Geográficos del Valle del Río Agrio Inferior, el cual es un estudio de base para el conocimiento de la geografía de la región: - apoyando el esfuerzo que está realizando la población del área para lograr una identidad propia y una definitiva integración al contexto provincial; - aportando al proyecto "Rescate Arqueológico en Quili Malal, Neuquén" (subsidiado por CONICET y UNESCO, cuya dirección está a cargo de la profesora Susana Rodríguez de la U.N.C., a través de la confección del mapa geomorfológico del área; y - contribuyendo a los estudios que resultan necesarios ante la construcción de una obra hidroeléctrica de la magnitud de "El Chihuido I", emprendimiento que será llevado a cabo por Agua y Energía eléctrica de la Nación. Los límites del área estudiada fueron establecidos teniendo en cuenta el área del valle inferior del Río Agrio que será completamente inundada por el futuro embalse de la represa "El Chihuido I", a emplazarse 5,5 Km aguas abajo de la confluencia de los ríos Agrio y Neuquén. Además de esta área de afectación directa se tomó también una zona de perilago estrechamente vinculada a la anterior. De esta manera los límites este y oeste quedaron establecidos por la confluencia de los ríos antes mencionados y la localidad de Bajada del Agrio, respectivamente.

Memòries del santuari del Mont (final s. XVIII-1953)

OpenAIRE

Gifre i Ribas, Pere; Puig Pla, Santi; Tremoleda Trilla, Joaquim

2011-01-01

Transcripció del text inèdit de memòries del santuari del Mont. El text va ser escrit, bàsicament, pels preveres custodis i administradors del santuari. Es recull, primerament, els costums litúrgics de la parròquia de Sous, a la manera de les consuetes. A partir de 1791 s’anoten els fets més importants, a parer del custodi administrador, ocorreguts al santuari: obres de reforma i restauració del santuari i les seves dependències, adquisicions de mobiliari i parament de la casa, donacions al s...

Más allá del telar: el mundo del trabajo femenino en la Asturias del siglo XVIII

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Patricia Suárez Álvarez

2011-06-01

Full Text Available En el Siglo de la Razón proliferaron los tratados dónde, por primera vez en la historia, se ponía de relieve la necesidad de educar de forma conveniente a las mujeres. Sin embargo, a pesar del reconocimiento que los Ilustrados otorgaron al sexo femenino, siguieron relegando a éstas a las paredes del hogar, exhortándoles a quedarse fuera del mundo del trabajo extra-doméstico, reservado sólo para los hombres de la familia. No obstante, la necesidad obligaba, y cuando los recursos u hombres de una casa escaseaban, la mujer tenía que salir a buscarse el sustento. Este es el caso de cientos de mujeres del Principado de Asturias, dónde, a mediados del siglo XVIII, la realidad femenina difería de lo que lo que se consideraba ideal. Este trabajo arrojará pues luz, en un campo hasta ahora desconocido: el del mundo profesional de las mujeres asturianas del Setecientos, dónde comprobaremos cómo en ocasiones llegaban a adquirir, gracias a su status profesional, papeles relevantes dentro de la sociedad.

Examen del fenómeno del turismo contemporáneo y la Competitividad en la Frontera del Conocimiento

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Carlos Mario Amaya Molinar

2015-01-01

Full Text Available A partir del inicio del presente siglo, el estudio de la competitividad turística es un tema que ha llamado la atención tanto de académicos del área como de organizaciones públicas y privadas de diversas categorías, con la expectativa de que su comprensión permita a países y destinos turísticos obtener ventajas en captación de visitantes, ingresos y sostenibilidad de su operación turística, de cara a la intensa contienda internacional por la preferencia del turista. El presente trabajo se deriva de la discusión que tuvo lugar en el Panel Competitividad y Turismo, en el marco de la 5ª Cátedra Patrimonial en Turismo Sergio Molina-Estrategias del Turismo en la Frontera del Conocimiento, organizado por el Departamento de Ciencias Administrativas del Instituto de Ciencias Sociales y Administración de la Universidad Autónoma de Ciudad Juárez, efectuado en el mes de abril del año 2013. Para este fin, se analizaron un conjunto de trabajos académicos e institucionales, a fin de identificar sus marcos de referencia, definiciones y modelos teóricos, con la perspectiva de obtener una visión panorámica del estado del arte en la materia.

Fractura triple del complejo suspensorio del hombro

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Eraclio Delgado Rifá

2015-06-01

Full Text Available El complejo suspensorio del hombro es una estructura sumamente importante, compuesta por un anillo de huesos y tejidos blandos. Las lesiones aisladas de este complejo anatómico son frecuentes y no afectan su estabilidad. La interrupción doble conduce a la inestabilidad de esta estructura y usualmente requiere tratamiento quirúrgico. La triple interrupción, por su parte, es sumamente rara y es encontrada en casos de trauma de alta energía a menudo en asociación con otras lesiones. Se presenta una triple lesión del complejo suspensorio del hombro en un paciente de 46 años de edad, con una fractura de la glenoides, del acromion tipo III de Kuhn y de la coracoides tipo II de Ogawa. En este caso, la fractura del acromion fue tratada con fijación percutánea con alambres de Kirschner, por tener asociado lesiones de partes blandas que contraindicaron la reducción abierta. La fractura de la glenoides y de la apófisis coracoides fueron tratadas conservadoramente. Después de 6 meses de evolución, el paciente tuvo un resultado funcional aceptable, con una abducción de 90 grados, los 30 grados de rotación externa y 70 de rotación interna, además asintomático y consolidación de todas las fracturas. A pesar de ser catalogada de una lesión grave del cinturón escapular y estar asociada a otras lesiones se obtuvo un resultado satisfactorio al final del tratamiento.

OBJETIVO DEL DESARROLLO DEL MILENIO 7

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Margarita M. Pérez O.

2013-10-01

Full Text Available Los Objetivos de Desarrollo del Milenio, también conocidos como los Objetivos del Milenio, constituyeron las metas finales que aprobaron los dirigentes mundiales, 189 jefes de estado y de gobierno en la Cumbre del Milenio de las Naciones Unidas celebrada en Nueva York en el año 2000, en la cual los Estados miembros de la organización reafirmaron su compromiso de luchar por un mundo en el que el desarrollo sostenible y la eliminación de la pobreza tuvieran máxima prioridad1 . En la cumbre se definió la Declaración del Milenio, la cual detalla los objetivos, principios, valores, metas y acciones para erradicar la pobreza Mundial hacia el año 2015, todos ellos ratificados con alto interés y acción estratégica de carácter global, como marco para la medición de los progresos en materia de desarrollo.

Estrategias del Teatro del Oprimido para la formación permanente del profesorado

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Tomás Motos-Teruel

2012-01-01

Full Text Available Este artículo relata una experiencia y su valoración de formación permanente del profesorado basada en el aprendizaje vivencial utilizando como estrategia metodológica el Teatro del Oprimido (TO para estimular y favorecer la reflexión sobre la práctica educativa. Sus objetivos básicos fueron dar a conocer la formulación teórica y la metodología del TO y hacer la transferencia de las estrategias metodológicas vivenciadas a la práctica docente. El estudio se ha planteado desde una óptica cualitativa con el estudio de caso único. Y como resultados más destacables hay que reseñar el interés y la percepción de la utilidad personal y profesional del TO como instrumento de reflexión sobre la acción y generador de clima positivo. El Teatro del Oprimido es una formulación teórica y un método estético cuya teoría y praxis están inspiradas en la Pedagogía del Oprimido de Paulo Freire, utiliza las técnicas dramáticas como un instrumento eficaz para la comprensión y la búsqueda de alternativas a problemas sociales, interpersonales e individuales.

DelPhi: a comprehensive suite for DelPhi software and associated resources

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Li Lin

2012-05-01

Full Text Available Abstract Background Accurate modeling of electrostatic potential and corresponding energies becomes increasingly important for understanding properties of biological macromolecules and their complexes. However, this is not an easy task due to the irregular shape of biological entities and the presence of water and mobile ions. Results Here we report a comprehensive suite for the well-known Poisson-Boltzmann solver, DelPhi, enriched with additional features to facilitate DelPhi usage. The suite allows for easy download of both DelPhi executable files and source code along with a makefile for local installations. The users can obtain the DelPhi manual and parameter files required for the corresponding investigation. Non-experienced researchers can download examples containing all necessary data to carry out DelPhi runs on a set of selected examples illustrating various DelPhi features and demonstrating DelPhi’s accuracy against analytical solutions. Conclusions DelPhi suite offers not only the DelPhi executable and sources files, examples and parameter files, but also provides links to third party developed resources either utilizing DelPhi or providing plugins for DelPhi. In addition, the users and developers are offered a forum to share ideas, resolve issues, report bugs and seek help with respect to the DelPhi package. The resource is available free of charge for academic users from URL: http://compbio.clemson.edu/DelPhi.php.

Hacia una conceptualización del legado del traductor

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Guzmán María Constanza

2009-06-01

Full Text Available Este artículo se propone investigar el aporte de perspectivas traductológicas para el estudio de la figura del traductor y su legado. Se centra en enfoques teóricos contemporáneos, principalmente aquellos basados en perspectivas postestructuralistas, que consideran el papel del sujeto traductor como un aspecto crucial en la traducción y los estudios literarios, y proponen maneras interesantes de abordarlo. A lo largo del artículo se cuestionan nociones como la idea de un original sacralizado, la relación entre autoría y propiedad, el ideal del significado transparente, y la tensión entre la traducción y la escritura del "original". Se presta especial atención a la importancia de ubicar históricamente la práctica del traductor, reconocer su papel como agente visible, y conceptualizar la traducción como una forma de escritura que se desarrolla en medio de complejas interacciones y negociaciones.

La equinoterapia en las distintas alteraciones del desarrollo del menor.

OpenAIRE

Chamorro González, Mireya

2015-01-01

La equinoterapia consiste en la utilización del caballo como un método terapéutico para rehabilitar a personas con discapacidad. Esta terapia es considerada una gran alternativa para aumentar el autoestima de los que sufren algún tipo de discapacidad, también a través de esta terapia se mejora y fortalece el estado emocional, así del mismo modo ayuda a mejorar la manera de desenvolverse en su entorno social. Esta terapia se realiza a través de la trasmisión del calor corporal del caballo, del...

Gestión del talento humano y competencias laborales del personal del hospital Hermilio Valdizán 2016

OpenAIRE

Serpa Reyes, Elisa Soledad

2016-01-01

La presente investigación tuvo como objetivo general, Conocer la relación que existe entre gestión del talento humano y las competencias laborales del personal del hospital Hermilio Valdizán en el año 2016. El tipo de investigación es no experimental, de diseño descriptivo correlacional. La población fue de 709 trabajadores, y la muestra de 217 trabajadores del hospital Hermilio Valdizán, la muestra es probabilística aleatoria simple. Se aplicó el cuestionario de gestión del...

Seccional del Lago Lleu Lleu extracto del resumen ejecutivo del estudio

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Manuel Durán

2000-08-01

Full Text Available En el siguiente reportaje se presentan los estudios contratados por el MINVU Planes Seccionales del Lago Lleu Lleu y del Lago Pangue; realizados por las oficinas de Manuel Durán y Lira y Peña Asoc. A continuación entrevistamos al Sr. Tito Rojas, ex Director Regional de SERNATUR y actual Gobernador de la Provincia de Arauco, y a Patricio Aguirre, Director de la Carrera de Turismo del DUOC-UC sede Concepción. Mientras que los instrumentos de planificación desarrollan estrategias específicas para potenciar el turismo aprovechando las potencialidades del recurso lacustre; los entrevistados nos dan su opinión en cuanto a diversos aspectos relacionados con el turismo y los lagos de esta zona: el delicado equilibrio entre turismo y protección de los recursos; las potencialidades de las áreas aledañas a los lagos Pangue y Lleu Lleu; el patrimonio paisajístico y cultural de la provincia de Arauco, entre otros, son los aspectos que se exponen en las próximas páginas.

Comportamiento del servicio Diselin en la Gestión del Conocimiento de la Delegación del CITMA, en el. período 2003- octubre del 2005

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Matilde Palacios Jiménez

2005-01-01

Full Text Available Se aborda el comportamiento del servicio Diselin durante el período 2003 hasta octubre del 2005, en la Gestión del Conocimiento de la Delegación del CITMA, a partir de los contenidos cuantitativos y cualitativos generados en la base de datos Diselin, correspondientes a la estadística general del servicio, relacionada con los indicadores de desempeño bibliotecario: suministro de documentos y satisfacción del cliente a través del talón de retroacoplamiento, como indicadores de desempeño bibliotecario que permiten hacer una valoración más exhaustiva de la evolución de este servicio tradicional con modalidad electrónica que es lo novedoso, aprovechando las tecnologías de información instaladas. Se presentan tablas y gráficos que demuestran la gestión y el impacto del servicio desde el punto de vista organizacional.

Turkish validation of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time.

Science.gov (United States)

Serefoglu, E C; Cimen, H I; Ozdemir, A T; Symonds, T; Berktas, M; Balbay, M D

2009-01-01

There are uncertain issues on the diagnostic methods of premature ejaculation (PE). The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria in diagnosing PE and the aim of this study is to carry out the Turkish validation of the PEDT and to evaluate its association with intravaginal ejaculatory latency time (IELT). A total of 94 patients with a self-reported complaint of PE and 88 men without PE were enrolled into the study and requested to complete the nine-item PEDT, which was translated into Turkish. The patients were also requested to measure IELT. All participants were requested to come for a second visit to assess the PEDT's retest reliability; data from 78 men in the PE group and 69 men in the control group were collected. The IELT data of 35 patients were also recorded. The mean age of the PE group and the control group were 39.4+/-9.7 (24-65) and 30.1+/-5.7 (20-56), respectively, (P=0.068). Among the patients in the PE group, 24 (68.5%) reported life-long PE, whereas 11 (31.5%) reported acquired PE. The geometric mean IELT of the PE group was 59.7+/-46.2 (6.5-197.7) s. The number of men reporting IELTs of 2 min were 20 (57.1%), 11 (31.5) and 4 (11.4%), respectively. The factor analysis assessment showed that the five-item combination (questions 1, 2, 3, 4 and 8) explained 74.4% of the variance, there were no other combinations that explained the variance more effectively. Cronbach's alpha score of five-item combination was calculated as 0.77, showing adequate internal consistency. The overall Cronbach's alpha score did not increase if any item combination was deleted. The test-retest correlation coefficients of each item were higher than 0.80 and the correlation coefficient of the total score was 0.90. The PEDT and IELT showed an adequate correlation (rho=0.44). As a conclusion, the validated five-item Turkish version of PEDT is a

Sobre el significado del descubrimiento del gen FOXP2

OpenAIRE

Longa Martínez, Víctor Manuel

2006-01-01

El reciente descubrimiento del gen FOXP2 ha ofrecido la primera evidencia clara de la base genética del lenguaje, mostrando una correlación inequívoca desde la perspectiva genética entre una versión mutada de F0XP2 y los trastornos lingüísticos de diferente tipo sufridos por una familia inglesa, conocida como KE. El objetivo central del presente trabajo es discutir diferentes aspectos relacionados con tal descubrimiento; especialmente, la discusión del significado de FOXP2 con ...

Entrenamiento funcional del core: eje del entrenamiento inteligente

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Iván Dario Pinzón Ríos

2015-06-01

Full Text Available Antecedentes: La evolución del entrenamiento físico busca la optimización de la salud y el bienestar, como piedra angular de todo programa de ejercicio. El Entrenamiento Funcional (EF es recomendable para optimizar el control postural del core, mejorando el balance y la ejecución de actividades de la vida diaria.  Objetivo: Revisar la definición, elementos constitutivos, características e implicaciones del EF del core en el movimiento corporal humano (MCH y la salud desde la perspectiva del fisioterapeuta. Metodología: Se incluyeron artículos en inglés y español de las bases Pubmed, Scielo y Ebsco; adicionalmente se incluyeron fuentes electrónicas e impresas y libros. Resultados: 56 documentos cumplieron los criterios de inclusión. La definición más adoptada de EF fue entrenar con un propósito buscando obtener un efecto positivo en la aptitud física. Las implicaciones del EF en el MCH, se relacionan con la ganancia y mejoría de la estabilidad. La propuesta de EF enfocada a las actividades de la vida diaria incluye fases que permiten adquirir la estabilidad hasta lograr el desarrollo de movimiento que demanden más agilidad. En la planificación del EF se deben estructurar los procesos a ejecutar considerando el criterio de funcionalidad. Para organizar la sesión del EF, el fisioterapeuta cuenta con tres maneras de planificar la sesión: globales, por hemisferios y por grupos musculares. Conclusión: La fundamentación teórica sobre el EF permite al fisioterapeuta comprender y determinar cómo esta modalidad de intervención repercute de manera positiva sobre el desempeño funcional y calidad de vida de los sujetos.

Desarrollo de la Habilidad de Administración del Tiempo en directivas del primer nivel del MITRANS.

OpenAIRE

García Remus, Mayelín

2009-01-01

Valoración de cómo administran el tiempo las mujeres directivas del sector del transporte en Ciudad de La Habana. Establece las competencias individuales que pueden influir en el desarrollo de la habilidad de administración del tiempo.

LAS NEURONAS DEL SEPTUM LATERAL MODIFICAN LA ACTIVIDAD DE LAS NEURONAS DEL NUCLEO TUBEROMAMILAR DEL HIPOTALAMO

OpenAIRE

FARIAS RODRIGUEZ, PAULA ANDREA; FARIAS RODRIGUEZ, PAULA ANDREA

2012-01-01

El septum lateral (SL), es un núcleo del cerebro anterior, que, procesa la información sensorial afectiva procedente del hipocampo y dirige sus respuestas, importantes para la supervivencia, hacia las zonas del hipotálamo importantes para la motivación, como lo es el núcleo tuberomamilar del hipotálamo (TMN). El TMN contiene las neuronas histaminérgicas en el cerebro, la cual relacionamos con la vigilia y alerta en conductas motivadas y así puede dirigir y reforzar el comportamiento. El TM...

Effect of a prostaglandin - given rectally for prevention of radiation-induced acute proctitis - on late rectal toxicity. Results of phase III randomized, placebo-controlled, double-blind study

International Nuclear Information System (INIS)

Kertesz, Tereza; Herrmann, Markus K.A.; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F.; Hille, Andrea; Zapf, Antonia; Pradier, Olivier; Schmidberger, Heinz

2009-01-01

Background and purpose: to assess the late effect of a prostaglandin, given rectally during irradiation, on late rectal toxicity. In the acute treatment setting no significant differences in reducing the incidence of acute proctitis symptoms in patients receiving misoprostol, however, significantly more rectal bleeding had been reported. Patients and methods: a total of 100 patients who had undergone radiotherapy for prostate cancer had been entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. The toxicity was evaluated yearly after cessation of irradiation by the RTOG/LENT-SOMA scale. Results: the median follow-up was 50 months. 20 patients suffered from grade 1, four patients from grade 2 as well, and three patients only from grade 2 toxicity. Frequency, bleeding and urgency were the most commonly reported symptoms. In keeping with other studies and clinical experience, the symptoms peaked within the first 2 years with a median for grade 1 of 13 months and for grade 2 of 15 months. The presence of acute toxicity grade 2 showed a correlation with the development of any late toxicity (p = 0.03). Any acute rectal bleeding was significant correlated with any late rectal bleeding (p = 0.017). Conclusion: misoprostol given as once-daily suppository for prevention of acute radiation-induced proctitis does neither influence the incidence and severity of radiation-induced acute nor late rectal toxicity. Misoprostol has no negative impact on the incidence and severity of late rectal bleeding, in contrast to acute rectal bleeding. The routine clinical use of misoprostol suppositories cannot be recommended. (orig.)

Effect of a prostaglandin - given rectally for prevention of radiation-induced acute proctitis - on late rectal toxicity. Results of phase III randomized, placebo-controlled, double-blind study

Energy Technology Data Exchange (ETDEWEB)

Kertesz, Tereza; Herrmann, Markus K.A.; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F.; Hille, Andrea [Dept. of Radiotherapy and Radiooncology, Univ. of Goettingen (Germany); Zapf, Antonia [Dept. of Medical Statistics, Univ. of Goettingen (Germany); Pradier, Olivier [Dept. of Radiotherapy and Radiooncology, Univ. of Brest (France); Schmidberger, Heinz [Dept. of Radiotherapy and Radiooncology, Univ. of Mainz (Germany)

2009-09-15

Background and purpose: to assess the late effect of a prostaglandin, given rectally during irradiation, on late rectal toxicity. In the acute treatment setting no significant differences in reducing the incidence of acute proctitis symptoms in patients receiving misoprostol, however, significantly more rectal bleeding had been reported. Patients and methods: a total of 100 patients who had undergone radiotherapy for prostate cancer had been entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. The toxicity was evaluated yearly after cessation of irradiation by the RTOG/LENT-SOMA scale. Results: the median follow-up was 50 months. 20 patients suffered from grade 1, four patients from grade 2 as well, and three patients only from grade 2 toxicity. Frequency, bleeding and urgency were the most commonly reported symptoms. In keeping with other studies and clinical experience, the symptoms peaked within the first 2 years with a median for grade 1 of 13 months and for grade 2 of 15 months. The presence of acute toxicity grade 2 showed a correlation with the development of any late toxicity (p = 0.03). Any acute rectal bleeding was significant correlated with any late rectal bleeding (p = 0.017). Conclusion: misoprostol given as once-daily suppository for prevention of acute radiation-induced proctitis does neither influence the incidence and severity of radiation-induced acute nor late rectal toxicity. Misoprostol has no negative impact on the incidence and severity of late rectal bleeding, in contrast to acute rectal bleeding. The routine clinical use of misoprostol suppositories cannot be recommended. (orig.)

Understanding motives for intravaginal practices amongst Tanzanian and Ugandan women at high risk of HIV infection: the embodiment of social and cultural norms and well-being.

Science.gov (United States)

Lees, Shelley; Zalwango, Flavia; Andrew, Bahati; Vandepitte, Judith; Seeley, Janet; Hayes, Richard J; Francis, Suzanna C

2014-02-01

Some types of intravaginal practices (IVP) may increase the risk for HIV acquisition. This is particularly worrisome for populations with dual high prevalence of HIV and IVP. Women involved in transactional sex are at increased risk for HIV infection in sub-Saharan Africa. Social, cultural and economic influences are strong drivers of IVP in this population. To explore this, we carried out a qualitative research study to investigate the drivers and motivations for using IVP within a large observational study of women at high risk of HIV in Tanzania and Uganda from September 2008 to September 2009. Of the 201 women selected, 176 women took part in a semi-structured in-depth interview. Additionally, in Tanzania, eight focus group discussions among study participants and community members were carried out to obtain information on community norms and expectations. IVP were motivated by overlapping concerns with hygiene, morality, sexual pleasure, fertility, relationship security, and economic security. These motives were driven by the need to meet cultural and social expectations of womanhood, and at the same time attend to personal well-being. Among women involved in transactional sex in East Africa, interventions aimed at modifying or eliminating IVP should attend to local cultural and social norms as well as the individual as an agent of change. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impacto de la asesoría sobre anticoncepción en la selección de métodos hormonales combinados en Colombia

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Pío Gómez Sánchez

2015-06-01

Full Text Available OBJETIVO: Determinar el impacto de la asesoría anticonceptiva informada sobre la elección de método anticonceptivo. MÉTODOS: Estudio descriptivo multicéntrico de evaluación antes y después en nueve ciudades de Colombia. Se invitó a participar mujeres que consideraban usar métodos hormonales combinados de autoadministración al momento de la consulta. Se indagó sobre el uso y preferencia de método anticonceptivo, previa firma del consentimiento informado. En una etapa posterior, se brindó asesoría médica estandarizada en anticoncepción y, a continuación, se preguntó nuevamente por la preferencia de método anticonceptivo y las motivaciones para su elección. RESULTADOS: Ingresaron 858 mujeres al estudio. Al inicio del estudio, 538 (62,7% mujeres usaban píldora combinada y 281 (32,8% no utilizaban ningún método anticonceptivo. Antes de recibir asesoría, las mujeres mostraron una preferencia por la píldora (62,7%, seguida por el anillo intravaginal (28,4% y el parche transdérmico (14%. Luego de la asesoría, la preferencia fue la siguiente: píldora (40,8%, anillo intravaginal (31,5% y parche transdérmico (11,3%. También luego de la asesoría, 32,5 %, 26,8% y 7,5% de las que consideraban usar píldora, parche y anillo, respectivamente, cambiaron su intención de uso. La región de origen, el estatus laboral, el deseo de concebir un hijo en el futuro y tener una relación estable presentaron una relación estadística con la selección del método, pero la edad, el número de hijos o el grado de escolaridad no fueron factores determinantes. CONCLUSIONES: La asesoría médica tiene impacto en la selección del anticonceptivo hormonal combinado autoadministrado, lo que ayuda a las mujeres a utilizar el método de su preferencia y presentar una mejor adherencia al método acorde a sus condiciones particulares.

Caracterización del mercado laboral del sector hotelero del estado Mérida, Venezuela

OpenAIRE

Villasmil R., María A.; Andrade, Henry

2009-01-01

Esta investigación trata sobre modelos que permiten caracterizar Mercados Laborales Locales (MLL), ya que en Venezuela el manejo de los mismos es casi inexistente. En este sentido, se plantea como objetivo caracterizar al mercado laboral del sector hotelero del estado Mérida-Venezuela en función del conocimiento de las particularidades económicas, institucionales, políticas, sociales, educativas y culturales de la zona así como las condiciones que se tengan en materia de empleo, oferta de for...

CONSIDERACIONES SOBRE EL ESTADO DEL ARTE DEL DESARROLLO ECONÓMICO

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Néstor Juan Sanabria

2003-07-01

Full Text Available Este artículo ofrece una síntesis del estado del arte sobre los temas del desarrollo y es parte integrante de la investigación sobre los pymes y el desarrollo económico. Desde los enfoques clásicos hasta los modelos contemporáneos se ha debatido ampliamente la relación entre crecimiento y desarrollo económico. Para muchos autores el desarrollo está vinculado a los problemas de distribución. Para otros el desarrollo es sinónimo de disminución y eliminación de la pobreza o se resuelve a través de aumentar la producción. Otros enfoques se centran en la importancia de minimizar los costos de transacción o en la generación de una mejor calidad de vida. Ahora bien, las teorías del desarrollo predominantes hasta la década de los ochenta, asumen que el proceso del desarrollo no es más que la ruta de homogenización de los mercados duales. Para otros autores el problema se explica por la diferencia de tecnologías, capital social, capital intelectual y humano. Esta síntesis revisa entre otros enfoques los modelos con los que se ha intentado explicar la peculiaridad del desarrollo en los países del tercer mundo, en las economías en proceso de industrialización y la complejidad del caso particular del desarrollo en Latinoamérica y su modelo de sustitución de importaciones.

High resolution MR imaging of the anal sphincter using an intravaginal surface coil; Hochaufloesende Magnetresonanztomographie des Analsphinkters mit einer intravaginalen Oberflaechenspule

Energy Technology Data Exchange (ETDEWEB)

Mueller-Schimpfle, M. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany); Franz, H. [Frauenklinik, Tuebingen Univ. (Germany); Lobinger, B. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany); Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany)

1995-06-01

MR imaging was performed using a 1.0 T unit. In 10 females (6 nullipara, one primipara without and three primipara with postpartum faecal incontinence) a surface coil, originally designed for endorectal use, was placed into the vagina. Transverse oblique T{sub 1}-weighted spin echo and double echo turbo spin echo sequences with T{sub 2}- and proton density-weighting were acquired parallel to the puborectal, rectococcygeal and anorectal planes. Three readers analysed the images in consensus. The anatomic structures of the external and internal sphincter as well as the mucosa were differentiated in all cases with a good contrast. The best results were yielded by the proton density weighting. In one case of faecal incontinence a sphincter defect after repair of a complete rupture of the anal sphincter was shown. In another case irregularities in the structure of the external sphincter and perineum were visualised. (orig./MG) [Deutsch] Die Magnetresonanztomographie (MRT) wurde an einem 1,0-Tesla-Geraet durchgefuehrt. Bei 10 Frauen (6 Nulliparae, eine Primipara ohne und drei Primiparae mit postpartaler Stuhlinkontinenz) wurde eine Oberflaechenspule, die urspruenglich zur endorektalen Anwendung konzipiert war, intravaginal eingefuehrt. Es wurden T{sub 1}-gewichtete Spin-Echo-Sequenzen sowie Doppel-Echo-Turbo-Spin-Echo-Sequenzen mit T{sub 2}- und Protonendichtegewichtung parallel zur puborektalen, rektokokzygealen und anorektalen Ebene akquiriert. Drei Auswerter analysierten die Aufnahmen im Konsensmodus. Die anatomischen Strukturen des Musculus sphincter ani externus und internus sowie die Mukosa konnten in allen Faellen gut differenziert werden. Das beste Ergebnis wurde mit der Protonendichte-Gewichtung erzielt. In einem Fall von Stuhlinkontinenz zeigte sich ein kombinierter Defekt des M. sphincter ani internus und externus nach Naht eines Dammrisses III. Grades. In einem weiteren Fall waren Irregularitaeten im Perineum und externen Sphinkteranteil darzustellen. (orig./MG)

Los métodos de fijación del salario en el Uruguay y los particularismos del Derecho del Trabajo

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Álvaro Rodríguez Azcúe

2014-01-01

Full Text Available El salario y la jornada de trabajo han sido en nuestro país, seguramente, los dos temas que forjaron el nacimiento del Derecho del trabajo1. Dentro del primero, el método de fijación del salario predominante, generalmente, refleja algo mucho más amplio que la política salarial de un gobierno. En realidad pone de manifiesto un eje central de la política laboral, o, más aún, una determinada forma de abordar la cuestión social.Por ese motivo nos proponemos analizar el tema a partir de su evolución histórica y de algunos de los particularismos que, en la concepción de Barbagelata, posee el Derecho del trabajo: la subyacencia del conflicto en las relaciones laborales y la significación del tiempo social.En esa perspectiva se confirma, según enseña Ermida Uriarte, el indudable papel protagónico que han desempeñado los Consejos de Salarios en el Derecho del trabajo y el sistema laboral uruguayo.Presentación. Referencia a los particularismos del Derecho del Trabajo. Los métodos teóricos de fijación del salario. Evolución histórica de los métodos a la luz de los particularismos. Algunas reflexiones finales

Ensayo del lisado de amebocitos del Limulus (LAL

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Rolando Perdomo Morales

2004-04-01

Full Text Available En los últimos años, los principales organismos reguladores de productos farmacéuticos (Farmacopeas exigen cada vez más en sus monografías la aplicación del método del lisado de amebocitos de Limulus (LAL para la liberación de pirógenos en productos terminados parenterales. El análisis de pirógenos constituye uno de los principales ensayos en el control de calidad de la fabricación de inyectables por su repercusión en la salud humana, puesto que la presencia y administración de los mismos, es capaz de provocar una serie de respuestas fisiológicas, en su mayoría de carácter perjudicial y en casos extremos, la muerte del paciente. Por las razones anteriores, existe un creciente interés en el conocimiento y dominio de estos métodos. El presente trabajo muestra una revisión bibliográfica del método del LAL, se tratan aspectos como su descubrimiento y estandarización, aparición en la industria farmacéutica y razones para su triunfo, y los basamentos de los principales métodos o variaciones comerciales del LAL (gelificación, turbidimétricos y cromogénicos que se describen en las Farmacopeas.

Ensayo del lisado de amebocitos del Limulus (LAL

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Rolando Perdomo Morales

Full Text Available En los últimos años, los principales organismos reguladores de productos farmacéuticos (Farmacopeas exigen cada vez más en sus monografías la aplicación del método del lisado de amebocitos de Limulus (LAL para la liberación de pirógenos en productos terminados parenterales. El análisis de pirógenos constituye uno de los principales ensayos en el control de calidad de la fabricación de inyectables por su repercusión en la salud humana, puesto que la presencia y administración de los mismos, es capaz de provocar una serie de respuestas fisiológicas, en su mayoría de carácter perjudicial y en casos extremos, la muerte del paciente. Por las razones anteriores, existe un creciente interés en el conocimiento y dominio de estos métodos. El presente trabajo muestra una revisión bibliográfica del método del LAL, se tratan aspectos como su descubrimiento y estandarización, aparición en la industria farmacéutica y razones para su triunfo, y los basamentos de los principales métodos o variaciones comerciales del LAL (gelificación, turbidimétricos y cromogénicos que se describen en las Farmacopeas.

Indicadores de desempeño del sistema de riego del Rio Dulce, Santiago del Estero, Argentina

NARCIS (Netherlands)

Prieto, D.; Angella, G.; Angueira, M.C.; Pérez Carrera, A.; Moscuzza, C.

2005-01-01

Mucha atención se ha puesto en el estudio del desempeño de los sistemas de riego a partir de la década de 1990, al tomarse conciencia de los bajos resultados de muchos de ellos, y su impacto ambiental negativo. El Sistema de Riego del Río Dulce en Santiago del Estero (PRD), no es la excepción,

La motivación del veredicto en la jurisprudencia del Tribunal Supremo

OpenAIRE

Vegas Torres, Jaime

2006-01-01

1. Introducción. 2. Alcance de la exigencia de motivación del veredicto. 2.1. Extensión de la motivación. 2.1.1. Hechos no controvertidos. 2.1.2. Hechos que el jurado encuentra no probados. 2.2. Profundidad de la motivación. 2.2.1. Admisibilidad de la explicación conjunta de todas las respuestas del jurado a las cuestiones del objeto del veredicto. 2.2.2. Contenido de la motivación. 3. Motivación del veredicto y prueba por indicios. 3.1. Motivación del veredicto basado en prueba de indicios. ...

Del Charco del Agua Amarga (Alcañiz

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Tomás MAIGI

2009-10-01

Full Text Available En agosto de 1947, habiendo llegado a la excelentísima Diputación Provincial de Teruel rumores de recientes deterioros en el friso pintado del abrigo rupestre del "Charco del Agua Amarga", nos fué requerida oficialmente, por dicha Corporación, la presentación de un informe sobre la realidad de los hechos expuestos, así como el planeamiento de las medidas adecuadas para salvaguardar en forma eficaz, en el futuro, las referidas pinturas.

Concentraciones del activador tisular del plasminógeno y del inhibidor del activador del plasminógeno en pacientes con homocistinuria clásica

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Beatriz Meneses

2001-04-01

Full Text Available El aumento moderado o severo de Homocisteína (Hcy en sangre y las alteraciones en el sistema fibrinolítico, se asocian con enfermedad vascular que afecta venas y arterias de todos los calibres. Los pacientes con homocistinuria clásica padecen con mucha frecuencia eventos tromboembólicos, que son su principal causa de mortalidad. El objetivo de este estudio fue determinar las concentraciones de Hcy, Inhibidor del Activador del Plasminógeno tipo 1 (PAI-1 y Activador tisular del Plasminógeno (tPA en pacientes con homocistinuria clásica, en familiares de éstos y en población control sana.

Gestión del riesgo del cambio (primera parte

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Juan Pablo Zorrilla

2007-07-01

Full Text Available A partir de la desaparición del sistema Bretton-Woods, y la libre flotación del tipo de cambio, el mundo se volvió más susceptible a todo tipo de riesgos. El presente artículo pretende explicar a los gestores financieros o empresarios interesados en el tema de instrumentos financieros derivados, a conocer lo más relevante y necesario acerca del uso de futuros sobre el tipo de cambio, instrumento útil para cubrir riesgos derivados del tipo de cambio para las empresas que se dedican a importar, exportar o para protegerse de un crédito otorgado en moneda extranjera.

Calculo del valor en riesgo del futuro de energia e internacionalizacion del sector energetico en Colombia

OpenAIRE

Esquivel Fonseca, Leidy Gioanna

2013-01-01

El presente trabajo de grado busca definir cuál es el mejor método para determinar el valor en riesgo del contrato de futuro de energía eléctrica que se transa en Colombia, para cumplir con este objetivo se toma como referencia el marco histórico del VaR y de los futuros seguido de las características de la fijación de precios, la estructura del contrato, que políticas y métodos hay para cubrirse del riesgo y como se realiza en otros países, realizando algunos cálculos de los modelos más trad...

EFECTO DEL SILICIO Y PLAGUICIDAS EN LA FERTILIDAD DEL SUELO Y RENDIMIENTO DEL ARROZ

OpenAIRE

Parm\\u00E9nides Furcal-Beriguete; Alejandra Herrera-Barrantes

2013-01-01

El objetivo de este trabajo fue evaluar el efecto del silicio en la fertilidad del suelo, la incidencia de enfermedades y plagas insectiles, el rendimiento y la calidad de granos del cultivo de arroz. El estudio se realizó en La Vega, Florencia, San Carlos, Costa Rica entre mayo y octubre en los años 2010 y 2011, en el mismo lote con la variedad CR 4477. Se establecieron cinco tratamientos: silicio al suelo, silicio al suelo más plaguicidas (alternativas químicas), silicio foliar, silicio fol...

Competitividad sectorial internacional. Caso: sector del cuero y del calzado

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Diana Carolina Villegas Álvarez

2007-01-01

Full Text Available El presente escrito se origina en un trabajo de investigación cuya pretensión fue indagar sobre el nivel de competitividad internacional (C.I, del sector del cuero y del calzado colombiano, mediante la aplicación de indicadores que, a partir de la información estadística de las variables de comercio exterior permiten establecer ciertas relaciones que dan cuenta de la importancia del producto en los mercados de los países de la Comunidad Andina de Naciones (CAN, seleccionados para la comparación.

Sobre el fragment dels Catasterismes d'Eratòstenes del manuscrit Parisinus Graecus 1310: el nom dels planetes Saturn i Júpiter

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Pàmias i Massana, Jordi

1998-01-01

El ms. Parisinus Graecus 1310 inclou un breu fragment de l'Epítom dels Catasterismes, obra atribuïda a Eratòstenes. A banda d'alguna variant respecte del textus receptus, presenta un capítol (43) del tot reelaborat, en què l'excepcional irregularitat de l'Epítom dels Catasterismes, pel que fa a les correspondències divines dels dos primers planetes de la nòmina de cinc, ha estat corregida per tal d'adequar els noms dels planetes Faiuou i Faethou a Saturn i a Júpiter respectivament. The man...

Factores de riesgo implicados en el comportamiento agresivo del perro y del gato

OpenAIRE

Amat Grau, Marta

2011-01-01

El presente trabajo se centra en el estudio de algunos aspectos de la agresividad del perro y del gato. El estudio de la agresividad canina y felina es importante por varios motivos. En primer lugar, los problemas de agresividad del perro y del gato son muy frecuentes y, al menos en los centros de referencia, son el principal problema de comportamiento. La agresividad del perro y del gato también es importante, porque constituye una de las principales causas de eutanasia y abandono de perros ...

Enfermedad del virus del Ébola (Ebola Virus Disease)

Centers for Disease Control (CDC) Podcasts

Este podcast proporciona información general sobre la enfermedad del virus del Ébola y el brote en África Occidental. El programa contiene declaraciones del director de los CDC, Dr. Tom Frieden, así como una breve descripción de las actividades de respuesta de los CDC.

LA LEY DEL SUELO DEL PAÍS VASCO: UN PASO MÁS HACIA LA PROTECCIÓN DEL SUELO RURAL

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J.C. Alberdi Collantes

2011-01-01

Full Text Available La Ley del suelo del País Vasco del 2007 nace con el objeto de favorecer el acceso a una vivienda digna. Sin embargo, en la medida en que apuesta por frenar la especulación y la sostenibilidad del medio legisla sobre el tratamiento que se le ha de aportar al suelo no urbanizable. En este caso, no altera sustancialmente la regulación del suelo rural pero sí incorpora nuevas obligaciones dirigidas a frenar la intensidad de la urbanización en este suelo. Se regula la construcción de nueva vivienda, el desarrollo urbanístico de núcleos y barrios rurales y se obliga a profundizar en la calificación del suelo no urbanizable. La aplicación de los nuevos contenidos quedan en manos de los municipios e instituciones sectoriales y los primeros resultados parecen denotar un cambio de tendencia en municipios que han observado la pérdida de calidad paisajística del medio rural, la creciente especulación y la desagrarización de este entorno.

Evolución del desarrollo del color en sistema modelo de composición similar al dulce de leche. Influencia del tiempo de calentamiento y del Ph

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Analía Rodríguez Blanco

2013-01-01

Full Text Available El color es un atributo importante en la elección del producto dulce de leche por parte del consumidor. El mismo se desarrolla en el proceso de elaboración debido principalmente a las reacciones de pardeamiento no enzimático, las cuales se ven influenciadas por varios factores. En este trabajo se evaluó el desarrollo de color, con el tiempo de tratamiento térmico y el pH inicial como variables tecnológicas, en un sistema modelo compuesto de caseinato, lactosa, sacarosa y agua destilada cuya composición fue similar a la del dulce de leche comercial. El estudio del color se realizó utilizando los parámetros de medición de color del sistema CIELAB y el índice de Kubelka Munk (K/S. Con ambos métodos se constató un aumento significativo del dE*ab y del K/S con el tiempo de tratamiento térmico y el pH inicial. Con el sistema CIELAB además se observó una tendencia a disminuir la luminosidad con el tiempo y el aumento del pH inicial, y el aumento de a* con el tiempo.

In vivo evaluation of a mucoadhesive polymeric caplet for intravaginal anti-HIV-1 delivery and development of a molecular mechanistic model for thermochemical characterization.

Science.gov (United States)

Ndesendo, Valence M K; Choonara, Yahya E; Meyer, Leith C R; Kumar, Pradeep; Tomar, Lomas K; Tyagi, Charu; du Toit, Lisa C; Pillay, Viness

2015-01-01

The aim of this study was to develop, characterize and evaluate a mucoadhesive caplet resulting from a polymeric blend (polymeric caplet) for intravaginal anti-HIV-1 delivery. Poly(lactic-co-glycolic) acid, ethylcellulose, poly(vinylalcohol), polyacrylic acid and modified polyamide 6, 10 polymers were blended and compressed to a caplet-shaped device, with and without two model drugs 3'-azido-3'-deoxythymidine (AZT) and polystyrene sulfonate (PSS). Thermal analysis, infrared spectroscopy and microscopic analysis were carried out on the caplets employing temperature-modulated DSC (TMDSC), Fourier transform infra-red (FTIR) spectrometer and scanning electron microscope, respectively. In vitro and in vivo drug release analyses as well as the histopathological toxicity studies were carried out on the drug-loaded caplets. Furthermore, molecular mechanics (MM) simulations were carried out on the drug-loaded caplets to corroborate the experimental findings. There was a big deviation between the Tg of the polymeric caplet from the Tg's of the constituent polymers indicating a strong interaction between constituent polymers. FTIR spectroscopy confirmed the presence of specific ionic and non-ionic interactions within the caplet. A controlled near zero-order drug release was obtained for AZT (20 d) and PSS (28 d). In vivo results, i.e. the drug concentration in plasma ranged between 0.012-0.332 mg/mL and 0.009-0.256 mg/mL for AZT and PSS over 1-28 d. The obtained results, which were corroborated by MM simulations, attested that the developed system has the potential for effective delivery of anti-HIV-agents.

Acerca del moho

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El moho forma parte del medio ambiente natural. Afuera del hogar, el moho juega un papel en la naturaleza al desintegrar materias organicas tales como las hojas que se han caido o los arboles muertos. El moho puede crecer adentro del hogar cuando las espor

La teoria del ciclo vitale del risparmio di Modigliani cinquant’anni dopo

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Mauro Baranzini

2005-06-01

Full Text Available Nei primi anni ’50 Franco Modigliani, insieme a Richard Brumberg e ad Albert Ando, formulò lateoria del ciclo vitale del consumo e del risparmio, che ha riscosso un enorme e indiscussosuccesso per almeno tre decenni. Tuttavia, a partire dai primi anni ’80 la teoria del ciclo vitale èstata criticata in modo sempre più serrato, per almeno quattro ragioni. La prima consistenell’esistenza di una significativa trasmissione intergenerazionale della ricchezza, da ricondurre acause esogene al modello del ciclo vitale. La seconda ragione è rappresentata dalla crescenteevidenza che i ricchi continuano a risparmiare in misura maggiore rispetto ai meno fortunati,come, in effetti, Keynes sosteneva. Il terzo motivo è che vi sono prove sempre più evidenti,almeno nell’Europa occidentale e in Giappone, che le famiglie giovani, durante i venti e i trentaanni di età, risparmiano una quota positiva e crescente del proprio reddito, e ciò si pone indeciso contrasto con la versione originaria della teoria del ciclo vitale. Infine, numerosi lavoriempirici hanno rilevato che i pensionati accantonano una parte elevata del proprio reddito. Ciòimpone un serio ripensamento dell’approccio della teoria del ciclo vitale, che interessa sia l’analisieconomica sia la politica economica.

Knowledge of medical abortion among Brazilian medical students.

Science.gov (United States)

Fernandes, Karayna Gil; Camargo, Rodrigo Pauperio Soares; Duarte, Graciana Alves; Faúndes, Anibal; Sousa, Maria Helena; Maia Filho, Nelson Lourenço; Pacagnella, Rodolfo Carvalho

2012-09-01

To assess the knowledge of Brazilian medical students regarding medical abortion (MA) and the use of misoprostol for MA, and to investigate factors influencing their knowledge. All students from 3 medical schools in São Paulo State were invited to complete a pretested structured questionnaire with precoded response categories. A set of 12 statements on the use and effects of misoprostol for MA assessed their level of knowledge. Of about 1260 students invited to participate in the study, 874 completed the questionnaire, yielding a response rate of 69%. The χ(2) test was used for the bivariate analysis, which was followed by multiple regression analysis. Although all students in their final year of medical school had heard of misoprostol for termination of pregnancy, and 88% reported having heard how to use it, only 8% showed satisfactory knowledge of its use and effects. Academic level was the only factor associated with the indicators of knowledge investigated. The very poor knowledge of misoprostol use for MA demonstrated by the medical students surveyed at 3 medical schools makes the review and updating of the curriculum urgently necessary. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Max Weber o el enigma emocional del origen del capitalismo

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EDUARDO BERICAT ALASTUEY

2001-01-01

Se analiza el trabajo clave de Max Weber, La ética protestante y el espíritu del capitalismo, desde la perspectiva de la Sociología de las Emociones. Aunque la inclusión de las emociones de los fenómenos sociales es clave para entender la idea de Weber sobre el dogma de la predestinación, los sociólogos han trivializado el papel de la emoción. Tras detallar la creencia de Weber en que el espíritu del capitalismo parte del conocimiento de que el destino del hombre está predeterminado (la ética...

Produccion Gaseosa del Cometa Halley: Erupciones Y Fotodisociacion del Radical OH

Science.gov (United States)

Silva, A. M.; Mirabel, I. F.

1990-11-01

RESUMEN:En este trabajo informamos la detecci6n de 20 erupciones en la li'nea de =18cm (1667MHz) del radical OH en el Cometa Halley.Las observaciones incluyen todos los monitoreos existentes y se extienden desde 120 dias antes del perihelio hasta 90 dias despues.Se detectan bruscos crecimientos en el flujo medido,hasta un factor 1O,seguidos por decaimientos lentos asociados con la fotodisociaci6n del OH. Se obtuvieron valores para el tiempo de vida fotoquimico del OH y del H2O basandose en el modelo desarrollado previamente por Silva(1988). Esos tiempos de vida estan de acuerdo con predicciones teoricas y con las observaciones en el Ultravioleta, y los resultados, los que son fuertemente dependientes de la velocidad heliocentrica del Coineta (variando hasta un factor 6), han sido calculados para varios rangos de velocidad entre +28 y -28 km/seg. Key wo'L :

DIAGNÓSTICO DEL SECTOR TURÍSTICO DEL CANTÓN BOLÍVAR

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Johnny Patricio Bayas Escudero

2013-12-01

Full Text Available Con el propósito de realizar el diagnóstico del sector turístico del cantón Bolívar, se partió, inicialmente, de la identificación de los recursos y atractivos turísticos existentes, asi como su nivel de incidencia en el desarrollo de esta jurisdicción, para posteriormente, proponer los potenciales productos turísticos que permitan la implementación de planes y programas de desarrollo del turismo. Para el cumplimiento de estos objetivos, se realizó una caracterización general del territorio, identificando e inventariando los recursos y atractivos turísticos del cantón, basándose en las fichas de inventario del Ministerio de Turismo y una propuesta de valoración de atractivos que dejaron como resultado un nuevo inventario de atractivos turísticos; se analizó la superestructura turística y la política turística cantonal; se caracterizó la infraestructura y servicios relativos al turismo; se analizó la oferta y demanda turística actual del cantón, determinando y analizando a su vez, la competencia directa que tiene el cantón para el desarrollo de esta actividad, se realizó el análisis FODA del componente turismo del cantón, que permitió proponer estrategias de desarrollo turístico para Bolívar. Se establecieron 13 potencialidades turísticas del cantón, cuantificando y cualificando su carácter y atributos; de los cuales, cuatro se consideran como las más significativas; en base a las potencialidades determinadas se caracterizaron las actividades turísticas potenciales a desarrollarse en base a categorías, redes de producto y niveles de intervención.

Elementos del sistema electoral del Congreso Mexicano

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Aldo Medina García

2013-08-01

Full Text Available El presente artículo es un estudio de los componentes del sistema electoral, diseñado por el legislador mexicano para integrar al parlamento federal. Estudio desarrollado a sabiendas de la importancia que reviste el sistema electoral como un medio que permite a los ciudadanos convertir su voto expresado en las urnas en escaños a favor de determinado candidato o partido. En dicho análisis tomamos en cuenta la evolución constitucional del sistema electoral mexicano, la participación de las fuerzas minoritarias en la integración del Senado y de la Cámara de Diputados, la división que se hace del territorio en circunscripciones electorales, la barrera electoral que se fija a los partidos políticos para acceder a la representación en el Parlamento, la fórmula de asignación que se aplica a la votación obtenida, para finalmente concluir que el sistema electoral mexicano es esencialmente mayoritario aun cuando se vista de proporcional.

Dimensión integral e interdisciplinaria del concepto de comportamiento del consumidor

OpenAIRE

Gil Hernández, Cleysi Yumara; Torres Estrada, Isabel Cristina; López Torres, Zulima Azeneth

2013-01-01

Este artículo busca analizar el aporte teórico que la economía, la antropología,la psicología, la sociología y la estética hacen al estudio del concepto decomportamiento del consumidor.El estudio del comportamiento del consumidor debe buscar una miradaintegral, que permita, desde diferentes saberes y disciplinas, comprender alsujeto, su entorno y sus prácticas de consumo.El estudio del consumidor no debe supeditarse exclusivamente a los momentosdel consumo; su comprensión implica un análisis ...

Identificación del genotipo del virus del papiloma humano en pacientes portadoras de lesiones cérvico uterinas

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Alexander Morales Fontaine

2016-02-01

Full Text Available Fundamento: en los últimos años se ha observado un elevado predominio de mujeres infestadas por genotipos del  Virus del Papiloma Humano considerados de alto riesgo por su elevada oncogenicidad.Objetivo: identificar los genotipos del Virus del Papiloma Humano en pacientes portadoras de este con lesiones cervicales, cuyas biopsias fueron analizadas en el departamento de anatomía patológica, perteneciente al Hospital General Docente ¨Ernesto Guevara de la Serna¨, en el período comprendido entre enero de 2013 a diciembre de 2014.Métodos: se realizó un estudio descriptivo, de corte transversal, en 45 pacientes cuyas biopsias fueron tomadas de forma aleatoria de un total de 456 casos en los que se encontraron evidencias histopatológicas de infección por el  Virus del Papiloma Humano, en el período referido período de estudio. Las biopsias fueron enviadas al Laboratorio de Biología Molecular del departamento de Virología del Instituto de Medicina Tropical ´´Pedro Kourí´, a fin de aislar e identificar los tipos de este virus, involucrados en la patogénesis de las lesiones premalignas en estudio. Se utilizaron fuentes secundarias dadas por los resultados de la identificación del genotipo del virus aislado enviados desde dicha institución. Los datos se procearon según la estadística descriptiva, mediante el análisis porcentual.Resultados: en el 88,8 % de la muestra se obtuvo infestación por el Virus del Papiloma Humano, de alto riesgo de oncogenicidad, de ellos hay una preponderancia del genotipo 16, con 26 casos (57,7 % seguido del 31 con 12 aislamientos (26,6 % y 2 pacientes presentaron el genotipo 52 para el 4,4 %. El 6,6 % de la muestra resultó estar infestadas por el genotipo 11, el cual es considerado de bajo riesgo y en 2 casos no fue posible realizar la tipificación.Conclusiones: Existió gran predominio de pacientes afectadas por Virus de Papiloma Humano de alto riesgo de oncogenicidad.

Estudio de la relación del ascenso del nivel del Mar Caspio con el regadio en la Cuenca del Mar de Aral

OpenAIRE

Vidal Cruz, Rafael

2004-01-01

El nivel del Mar Caspio ha venido subiendo desde mediados de los años 60. Se plantea la conjetura de que este ascenso sea debido al augmento de las extensiones de cultivo situadas en las cuencas de regadío del Mar de Aral. Ello provoca un aumento de humedad atmosférica, que es transportada hacia la cuenca del Mar Caspio. El objetivo de la tesina es estudiar dicha conjetura.

POTENCIAL ENERGÉTICO DE RESIDUOS AGROINDUSTRIALES DEL DEPARTAMENTO DEL CAUCA, A PARTIR DEL PODER CALORÍFICO INFERIOR

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DEYANIRA MUÑOZM

2013-12-01

Full Text Available Se determinaron los valores energéticos de los residuos agroindustriales del departamento del Cauca, mediante análisis del poder calorífico, datos técnicos reportados en las tablas estadísticas del Anuario Estadístico del Sector Agropecuario y Pesquero 2011 y con las expresiones simples presentadas en la metodología de Antolín G.G para el cálculo de variables energéticas.Los valores obtenidos del poder caloríficoen base seca fueron: 116187,97kJ/kgpara bagacillo de caña, 15419,95kJ/kg para polvillo de fique y 15262,18kJ/kg para afrecho de yuca.El valor promediodelas mezcla fue de 15623,35kJ/kg.Se concluye que 15623,35 kJ/kg representa la energía promedio que puede liberarse en un proceso de combustión deestos residuos y es comparable con la energía liberada por otras fuentes de biomasa. El potencial energético del bagacillo de caña con el valor de 163.45TJ/año, contribuye con el 35.73% de la energía, por lo cual ofrece mayores ventajas energéticas en comparación alvalor del afrecho de yuca,que tiene un potencial de 0.91 TJ/año. La mezcla con la mejor característica energética esta compuesta por 33.3% bagacillo de caña, 33.3% polvillo de fique y 33.3% afrecho de yuca y tiene un potencial energético de 48.39 TJ/año.

Habermas y Parsons: La búsqueda del reencantamiento del mundo

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JOSÉ ENRIQUE RODRÍGUEZ IBÁÑEZ

1981-01-01

Full Text Available Se comparan las tradiciones críticas y analíticas a través de un análisis del concepto de Habermas sobre el "universal pragmático" (Comunicación y la evolución de la sociedad y la noción de Talcott Parson del "paradigma de la condición humana" (Teoría de la Acción y la condición humana. Habermas y Parsons insisten fuertemente en el elemento simbólico del lenguaje en la sociedad, tendente al misterio y el reencantamiento de las categorías epistemológicas fundamentales. Sus posiciones deben su identidad y sentido del futuro a la sociedad industrial avanzada. La recuperación por parte de Habermas del diálogo entre las esferas teórica ("universal pragmático" e histórica ("paradigma reconstructivo", rompiendo con las posiciones del marxismo y los creadores de la Escuela de Frankfurt, abren un camino esperanzador para la investigación. Se analiza el normativismo epistemológico oculto del "paradigma de la condición humana" de Parson a través de sus primeros trabajos. El conflicto entre las tradiciones analítica y crítica se atribuye a diferentes grados de énfasis normativo-subjetivos y generativo-intersubjetivos.

The 5-HT₁A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation.

Science.gov (United States)

Janssen, Paddy K C; van Schaik, R; Zwinderman, Aeilko H; Olivier, Berend; Waldinger, Marcel D

2014-06-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and 5-HT₂C hypofunction. To investigate the relationship between 5-HT₁A receptor gene (HTR₁A)-C(1019)G promoter polymorphism and IELT in men with LPE. This polymorphism is known to increase 5-HT1A receptor expression. A prospective study was conducted in 54 Dutch Caucasian men with LPE. Baseline IELT during coitus was assessed by stopwatch over a 1-month period. All men were genotyped for HTR₁A gene polymorphism. Allele frequencies and genotypes of C and G variants of HTR₁A polymorphism were determined. Association between CC, CG, and GG genotypes and the IELT in men with LPE were investigated. IELT measured by stopwatch, HTR₁A polymorphism. In this cohort of men with LPE, the geometric mean IELT was 23.8 s. Of the 54 men, the CC, CG and GG genotype frequency for the C(1019)G polymorphism of the 5-HT₁A gene was 33%, 43% and 24%, respectively. The geometric mean IELT for the CC, CG and GG genotypes were 14.5, 27.7 and 36.0 s, respectively (p=0.019). Compared to GG and CG genotypes, men with CC genotype had a 250% and 190% shorter ejaculation time, respectively. HTR₁A gene polymorphism is associated with the IELT in men with LPE. Men with CC genotype have shorter IELTs than men with GG and CG genotypes. Copyright © 2014 Elsevier Inc. All rights reserved.

Recombinant polymorphic membrane protein D in combination with a novel, second-generation lipid adjuvant protects against intra-vaginal Chlamydia trachomatis infection in mice.

Science.gov (United States)

Paes, Wayne; Brown, Naj; Brzozowski, Andrzej M; Coler, Rhea; Reed, Steve; Carter, Darrick; Bland, Martin; Kaye, Paul M; Lacey, Charles J N

2016-07-29

The development of a chlamydial vaccine that elicits protective mucosal immunity is of paramount importance in combatting the global spread of sexually transmitted Chlamydia trachomatis (Ct) infections. While the identification and prioritization of chlamydial antigens is a crucial prerequisite for efficacious vaccine design, it is likely that novel adjuvant development and selection will also play a pivotal role in the translational potential of preclinical Ct vaccines. Although the molecular nature of the immuno-modulatory component is of primary importance, adjuvant formulation and delivery systems may also govern vaccine efficacy and potency. Our study provides the first preclinical evaluation of recombinant Ct polymorphic membrane protein D (rPmpD) in combination with three different formulations of a novel second-generation lipid adjuvant (SLA). SLA was rationally designed in silico by modification of glucopyranosyl lipid adjuvant (GLA), a TLR4 agonistic precursor molecule currently in Phase II clinical development. We demonstrate robust protection against intra-vaginal Ct challenge in mice, evidenced by significantly enhanced resistance to infection and reduction in mean bacterial load. Strikingly, protection was found to correlate with the presence of robust anti-rPmpD serum and cervico-vaginal IgG titres, even in the absence of adjuvant-induced Th1-type cellular immune responses elicited by each SLA formulation, and we further show that anti-rPmpD antibodies recognize Ct EBs. These findings highlight the utility of SLA and rational molecular design of adjuvants in preclinical Ct vaccine development, but also suggest an important role for anti-rPmpD antibodies in protection against urogenital Ct infection. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

La psicología del ejercicio y del deporte en Brasil y América del Sur

OpenAIRE

Becker Júnior, Benno

2001-01-01

Es difícil determinar el inicio exacto de la Psicología del Ejercicio y Deporte en un país, mayormente en América del Sur, sin correr el riesgo de cometer varias injusticias, pues estos eventos tienen poca o ninguna divulgación. Los registros oficiales realizados por Feige (1977) muestran que la Psicología del Ejercicio y Deporte, en América del Sur, se inició en Brasil, en 1954 en el Departamento de Árbitros de la Federación Paulista de Fútbol. Ahora está en su quinta década, con 47 anos. Es...

Factores psicosociales del presentismo en trabajadores del Sistema de Salud chileno

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Aldo Vera-Calzaretta

2015-01-01

Full Text Available Este estudio analizó los factores psicosociales que explicaban el presentismo o deterioro laboral autopercibido asociado a trabajar enfermo. La muestra fue de 676 trabajadores del sistema de salud chileno (84% de mujeres, M = 35.9 anos, en su mayoría enfermeras y técnicos paramédicos. Se aplicó un cuestiona- ˜ rio sociodemográfico, el Job Content Questionnaire, el Effort-Reward Imbalance, el Health Performance Questionnaire y una escala de interferencia del trabajo en la vida familiar. La regresión lineal explicó el 21% de la varianza del deterioro laboral percibido. Este último se asoció a asistir a trabajar enfermo. Los resultados sugieren que el deterioro del desempeno y asistir a trabajar enfermo son dos aspectos del ˜ mismo proceso. El ausentismo por razones de salud, la interferencia del trabajo en la vida familiar y la sintomatología emocional predijeron el deterioro laboral. Éste último se asoció negativamente a trabajar en turnos, controlando edad y salario. Los resultados sugieren que el presentismo es explicado por factores del contexto de trabajo y el conflicto trabajo-familia.

Acciones intersectoriales en la estimulación temprana del desarrollo del lenguaje

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Déborah Magaly López Salas

Full Text Available Se realizó un análisis del proyecto "Acciones intersectoriales en la estimulación temprana del desarrollo del lenguaje" con el objetivo propiciar un estudio social sobre la gestión del conocimiento y la innovación tecnológica en la dirección de programas para la estimulación del desarrollo de menores en edad preescolar, desde la visión de ciencia, tecnología y sociedad. Se muestran conceptos afines al tema, necesarios en la comprensión de la idea de reorganización de los servicios vinculados a la estimulación y atención temprana del desarrollo del lenguaje desde la comunidad, con la participación de profesionales de diferentes instituciones, y se demuestra la necesidad de comprender los estudios de Ciencia, Tecnología y Sociedad como un campo de acción en la actualidad en Cuba.

Eficacia del difusor de feromona de procesionaria del pino Pherocon PPM®

OpenAIRE

Durán, María; Rodrigo Santamalia, Mª Eugenia; Pérez Laorga, Eduardo; Mas i Gisbert, Hugo

2012-01-01

Los resultados de este trabajo forman parte del trabajo de fin de carrera presentado en la Universidad Politecnica de Valencia por Maria Duran Lázaro y dirigido por la Dra. Eugenia Rodrigo Santamalia y Eduardo Perez Laorga con el titulo "Influencia del tipo de trampa en la captura de mariposas de la procesionaria del pino (Thaumetopoea pityocampa Schiff.) en la sierra Calderona" [ES] Se ha ensayado la eficacia de un difusor de la feromona de la procesionaria del pino fabricado por la em...

La luz del origen del universo

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Casas, Alberto

2015-10-01

Full Text Available Penzias and Wilson discovered the cosmic microwave background, a luminous echo of the Big Bang, in 1965. The amount of information encoded in this relic of the early universe is truly extraordinary. At present, the most precise data about the origin and structure of the universe comes from the study of this primordial light, the full potential of which has yet to be explored.En 1965 se descubrió el fondo de radiación de microondas, un eco luminoso de la Gran Explosión (Big Bang. La cantidad de información contenida en esta reliquia del universo primitivo es verdaderamente extraordinaria. En la actualidad los datos más precisos sobre el origen y estructura del universo provienen del estudio de esta luz primigenia, que aún no ha sido explorada en todo su potencial.

Diámetro transverso del cerebelo fetal en la restricción del crecimiento intrauterino

OpenAIRE

Salazar de Dugarte, Guillermina

2011-01-01

Objetivo: Evaluar el comportamiento de la biometría del cerebelo fetal en su diámetro transverso, en los casos con restricción del crecimiento intrauterino. Ambiente: Servicio de Perinatología, Hospital "Dr. Adolfo Prince Lara", Puerto Cabello. Métodos: Estudio transversal, de correlación. En 1 569 fetos se realizó la biometría del diámetro transverso del cerebelo, para la construcción del nomograma del mismo. Se estableció una comparación entre los valores del diámetro transverso del cerebel...

Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

Science.gov (United States)

Smith, James M; Moss, John A; Srinivasan, Priya; Butkyavichene, Irina; Gunawardana, Manjula; Fanter, Rob; Miller, Christine S; Sanchez, Debbie; Yang, Flora; Ellis, Shanon; Zhang, Jining; Marzinke, Mark A; Hendrix, Craig W; Kapoor, Amita; Baum, Marc M

2017-01-01

Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs) delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs) can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2) to prevent HIV, acyclovir (ACV) to prevent HSV, and etonogestrel (ENG) in combination with ethinyl estradiol (EE), FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6) over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1) for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing) 0.63; and ENG (low releasing) 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1) may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high-risk populations.

Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

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James M Smith

Full Text Available Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2 to prevent HIV, acyclovir (ACV to prevent HSV, and etonogestrel (ENG in combination with ethinyl estradiol (EE, FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6 over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1 for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing 0.63; and ENG (low releasing 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1 may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high

Medical treatment of second-trimester fetal miscarriage; A retrospective analysis

OpenAIRE

Niinimaki, Maarit; Mentula, Maarit; Jahangiri, Reetta; Mannisto, Jaana; Haverinen, Annina; Heikinheimo, Oskari

2017-01-01

Abstract Objectives: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. Materials and methods: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1–21+6. Primary outcome...

Identificación del genotipo del virus del papiloma humano en pacientes portadoras de lesiones cérvico uterinas

OpenAIRE

Alexander Morales Fontaine; Odalys Rufina Peña Pérez; Alicia María Yabor Palomo; Vicente de Jesús Alvarez Yabor

2016-01-01

Fundamento: en los últimos años se ha observado un elevado predominio de mujeres infestadas por genotipos del  Virus del Papiloma Humano considerados de alto riesgo por su elevada oncogenicidad.Objetivo: identificar los genotipos del Virus del Papiloma Humano en pacientes portadoras de este con lesiones cervicales, cuyas biopsias fueron analizadas en el departamento de anatomía patológica, perteneciente al Hospital General Docente ¨Ernesto Guevara de la Serna¨, en el período comprendido entre...

Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation.

Science.gov (United States)

Janssen, Paddy K C; Bakker, Steven C; Réthelyi, Janos; Zwinderman, Aeilko H; Touw, Daan J; Olivier, Berend; Waldinger, Marcel D

2009-01-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central serotonin (5-hydroxytryptamine [5-HT]) neurotransmission and 5-HT receptor functioning. To investigate the relationship between 5-HT transporter gene-linked polymorphism (5-HTTLPR) and short IELTs in men with lifelong PE. A prospective study was conducted in 89 Dutch Caucasian men with lifelong PE. IELT during coitus was assessed by stopwatch over a 1-month period. Controls consisted of 92 Dutch Caucasian men. All men with LPE were genotyped for a 5-HTT-promoter polymorphism. Allele frequencies and genotypes of short (S) and long (L) variants of 5-HTTLPR polymorphism were compared between patients and controls. Association between LL, SL, and SS genotypes, and the natural logarithm of the IELT in men with LPE was investigated. IELT measured by stopwatch, 5-HTTLPR polymorphism. In men with lifelong PE, the geometric mean, median, and natural mean IELTs were 21, 26, and 32 seconds, respectively. There were no significant differences in the 5-HTT polymorphism alleles and genotypes between 89 Dutch Caucasian men with LPE (S 47%, L 53%/LL 29%, SL 48%, SS 22%) and 92 Dutch Caucasian controls (S 48%, L 52%/LL 29%, SL 45%, SS 26%). In men with lifelong PE there was a statistically significant difference between LL, SL, and SS genotypes in their geometric mean IELT (P IELTs than the SS and SL genotypes. The 5-HTTLPR polymorphism is associated with significant effects on the latency to ejaculate in men with lifelong PE. Men with SS and SL genotypes have 100% and 90% longer ejaculation time, respectively than men with LL genotypes.

[Medical induced abortion].

Science.gov (United States)

Bettahar, K; Pinton, A; Boisramé, T; Cavillon, V; Wylomanski, S; Nisand, I; Hassoun, D

2016-12-01

Updated clinical recommendations for medical induced abortion procedure. A systematic review of French and English literature, reviewing the evidence relating to the provision of medical induced abortion was carried out on PubMed, Cochrane Library and international scientific societies recommendations. The effectiveness of medical abortion is higher than 95% when the protocols are adjusted to gestational age (EL1). Misoprostol alone is less effective than a combination of mifepristone and misoprostol (EL1). Gemeprost is less effective than misoprostol (EL2). The dose of 200mg of mifepristone should be preferred to 600mg (NP1, Rank A). Mifepristone can be taken at home (professional agreement). The optimum interval between mifepristone and misoprostol intake should be 24 to 48 hours (EL1, grade A). Before 7 weeks LMP, the dose of 400μg misoprostol should be given orally (EL1, grade A) eventually repeated after 3hours if no bleeding occurs. For optimal effectiveness between 7 and 14 LMP, the interval between mifepristone and misoprostol should not be shortened to less than 8hours (grade 1). An interval of 24 to 48hours will not affect the effectiveness of the method provided misoprostol dosage is 800μg (EL1). Vaginal, sublingual or buccal routes of administration are more effective and better tolerated than the oral route, which should be abandoned (EL1). An amount of 800μg sublingual or buccal misoprostol route has the same effectiveness than the vaginal route but more gastrointestinal side effects (EL1, grade A). Between 7 and 9 LMP, it does not seem necessary to repeat misoprostol dose whereas it should be repeated beyond 9 SA (grade B). Between 9 and 14 LMP, the dose of 400μg misoprostol given either vaginally, buccally or sublingually should be repeated every 3hours if needed (with a maximum of 5 doses) (EL2, grade B). There is no strong evidence supporting routine antibiotic prophylaxis for medical abortion (professional agreement). Rare contraindications

Liderazgo del director y el compromiso organizacional de los docentes del nivel secundario de las Instituciones Educativas del distrito de Chancay, 2014

OpenAIRE

Velásquez García, Luis Alberto

2015-01-01

El presente estudio se centra en describir cómo se relaciona el liderazgo del director y el compromiso organizacional de los docentes del nivel secundario de las Instituciones Educativas del distrito de Chancay, 2014. El nivel de la presente investigación es cuantitativo de tipo descriptivo correlacional. La muestra es probabilística de 117 docentes del nivel secundario de las Instituciones Educativas del distrito de Chancay, 2014. Los instrumentos utilizados para observar ...

Consideraciones preliminares entorno del pensamiento pedagógico del Profesor

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JEFFER HARVEY CABEZAS

2011-01-01

Full Text Available El pensamiento pedagógico del profesor, como un mar insondable, es hoy en día, un referente primordial dentro del devenir propio de la Educación, adquiere sentido a partir de lo que el profesor siente, piensa, dice y hace. Por eso, esta reflexión surge como producto de la necesidad de establecer un miramiento entorno del pensamiento pedagógico del profesor desde algunas tipologías pedagógicas que en marcan la práctica pedagógica del profesor, las cuales sugieren una manera de cómo el profesor asume la pedagogía, y por tanto, se visibiliza en las acciones de aula, en donde ella se piensa desde las posibilidades individuales y colectivas del profesor. En donde la pedagogía es la oportunidad de la reflexión, para aminorar la brecha existente entre la teoría y la práctica, para tejer las relaciones que se enmarcan en los ambientes de aprendizaje; es decir, en ese espacio conceptual, donde estudiantes y profesores son sujetos epistemológicos, éticos y políticos que conforman parte activa de la sociedad.

Evaluación de diferentes tratamientos hormonales para la sincronización del estro en cabras criollas serranas durante el verano

OpenAIRE

Ruiz, Rodrigo; Fernández, Jorge L; de la Vega, Adolfo C; Rabasa, Alicia E

2002-01-01

El objetivo de este trabajo fue evaluar la eficiencia de dos tratamientos hormonales en la sincronización de celos en cabras Criollas Serranas durante el verano. El mismo se realizó con 79 hembras, con un diseño completamente aleatorizado, con los siguientes tratamientos: T1, Prostaglandina F2µ (n = 27): dos aplicaciones de 325 mg/cabra (sc) de cloprostenol, espaciadas 12 días una de otra; T2, Progestágeno (n =26): esponja intravaginal con 60 mg de acetato de medroxiprogesterona, durante 12 d...

Análisis del efecto del fuego y de la presencia de contaminantes sobre la actividad y biodiversidad microbiana del suelo

OpenAIRE

Turmero Hidalgo, Adriana Isabel

2013-01-01

La salud de un suelo se puede definir como la capacidad del mismo para funcionar como un sistema vivo dentro de un ecosistema, sustentar la productividad biológica, promover la calidad ambiental y mantener la salud de plantas, animales y del hombre. El concepto de salud del suelo se relaciona, por tanto, con las características biológicas, químicas y físicas del mismo, que son esenciales para una productividad agrícola sostenible a largo plazo, con un mínimo impacto ambiental. El estudio del...

Efectividad del uso del mate de coca en la reducción del estrés laboral en

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Rivera-Encinas, María Teresa

2016-01-01

Objetivo: Evaluar la efectividad del uso del mate de coca en la reducción del estrés laboral en administrativos de una universidad y determinar sus principales características sociodemográficas.Material y métodos: Se aplicó el cuestionario para la detección del estrés laboral de la OIT/OMS a dos grupos de trabajadores, experimental (10) y control (10), empleando randomización simple. Se hizo un experimento cruzado en 31 días, utilizando mate de coca y agua para cada grupo. Se utilizó el análi...

Microempresas del sector formal de comercio en Cuernavaca, Morelos, y contratación del capital humano (2000-2006. El aprovechamiento del régimen del riesgo

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Philippe Dautrey

2009-01-01

Full Text Available Las transformaciones del entorno, como la apertura comercial y la difusión de las nuevas tecnologías de la información y de la comunicación (TIC pueden explicar las prácticas nuevas de contratación en las microempresas del sector formal de comercio, el más dinámico en la zona metropolitana de Cuernavaca, capital del estado de Morelos. ¿Cuál es entonces e nivel educativo que requiere el capital humano para ser contratado?, ¿son la competencia comercial y el uso de la informática los únicos factores explicativos de dichas prácticas? De hecho, la extensión del régimen del riesgo global, esto es, el incremento de la precariedad laboral y del desempleo hace que se contrate a personas que sean "empleables" de inmediato, y que parte de la capacitación en el trabajo sea externa, limitándola así a ciertas categorías de trabajadores.

L'ampliamento della teoria del linguaggio letterario e l'analisi del fatto letterario

OpenAIRE

Albaladejo Mayordomo, Tomás; Chico Rico, Francisco

2010-01-01

El presente estudio aborda el problema de la ampliación de la teoría del lenguaje literario hacia lo que podemos llamar una «teoría del hecho literario» a lo largo del siglo XX. Dicha ampliación ha tenido lugar gracias al desarrollo de la Poética lingüística como teoría del texto literario de amplitud semiótica y abarcadora, por tanto, del conjunto del hecho literario y mediante el empleo de otras perspectivas teórico-críticas de raigambre no lingüístico-inmanentista que potencian la atención...

Reconstrucción del enfoque del aumento y generación del efectivo para la Pyme de manufactura

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Igor Rivera González

2011-01-01

Full Text Available Este artículo parte de la hipótesis de que el aumento continuo del efectivo es el objetivo principal dentro de las pequeñas y medianas empresas privadas de manufactura3. Nuestra finalidad es realizar una propuesta teórica acerca de cómo definir la paramétrica referida al aumento del efectivo en un periodo a través del análisis de la forma en que se genera el efectivo dentro de las pequeñas y medianas empresas (Pyme de trasformación; para ello, se resalta la importancia de tres elementos clave que intervienen en la generación del efectivo: a el proceso de transformación, b la optimización del flujo de materiales y de información y c la creación de valor.

del alcoholismo

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Rodrigo Arias Duque

2005-01-01

Full Text Available Desde el punto de vista farmacológico, es importante comprender qué es el alcohol y cómo actúa en el organismo. No existe una causa simple, sino una interacción complicada de factores neuroquímicos, fisiológicos, psicológicos y sociales que originan y desarrollan esta grave enfermedad fármaco-dependiente. La acción psicofisiológica y farmacodinámica del alcohol es fundamentalmente depresiva, por la reducción de la transmisión sináptica en el sistema nervioso humano. Es un hecho conocido que el consumo excesivo de alcohol causa una disfunción aguda y crónica del cerebro, produciendo trastornos en el sistema nervioso central, presentando alteraciones en la memoria y en las funciones intelectuales como cálculo, comprensión y aprendizaje. A nivel hepático tiene lugar, en su mayoría, el metabolismo del alcohol, produciéndose un hígado graso alcohólico, aumentando el tamaño, terminando en necrosis e inflamación grave del hígado; esto se llama hepatitis alcohólica, y si se sigue consumiendo alcohol se desarrollará la cirrosis. El alcohol también ha estado relacionado con alteraciones del miocardio; se ha constatado en animales de experimentación sanos que tanto la velocidad de contracción del músculo cardiaco y su máxima tensión disminuyen en presencia del alcohol, como consecuencia, la fuerza de cada contracción y el aumento de presión en el ventrículo izquierdo son menores, perdiendo eficacia el corazón como bomba.

La aplicación del principio del equilibrio económico a contratos estatales sometidos al régimen normativo del derecho privado

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Manuela Canal-Silva

2016-06-01

Full Text Available En vista de la importancia del equilibrio económico del contrato dentro del marco de la contratación pública, el presente artículo pretende demostrar la procedencia de su aplicación a los contratos estatales sometidos al régimen del derecho privado. Mediante la reflexión y el estudio de la jurisprudencia sobre el tema se presentarán los principales motivos expuestos por las providencias que apoyan la tesis planteada. Se exponen así los temas del interés colectivo y los preceptos constitucionales como bases de este principio del equilibrio económico. Para luego examinar la conmutatividad del contrato y el debate frente a la consideración del equilibrio económico como un principio transversal al derecho público y privado.

Imaginarios persistentes en las narrativas sobre la invasión del Tawantinsuyu : estudio del caso del secuestro y magnicidio del Hanan Inka Atawallpa, ocurridos en Cajamarca (Perú: 1532 y 1533)

OpenAIRE

Ontiveros, Asunción

2014-01-01

Ontiveros, Asunción. (2015). Imaginarios persistentes en las narrativas sobre la invasión del Tawantinsuyu. Estudio del caso del secuestro y magnicidio del Hanan Inka Atawallpa, ocurridos en Cajamarca (Perú: 1532 y 1533) (Tesis de posgrado). Universidad Nacional de Quilmes, Bernal, Argentina: Repositorio Institucional Digital de Acceso Abierto. Disponible en: http://ridaa.demo.unq.edu.ar La producción de narrativas y o formas simbólicas relacionadas a los acontecimientos del secuestro y m...

Determinantes del acceso al internet: Evidencia de los hogares del Ecuador

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Botello-Peñaloza, Héctor Alberto

2015-01-01

El objetivo del artículo se centra en investigar los determinantes del uso de Iinternet en los hogares ecuatorianos en 2013, incorporando sus características socioeconómicas dentro de un modelo de elección discreta que realiza estimaciones sobre la probabilidad del uso de internet dentro del hogar con base en los microdatos de la encuesta de uso de TIC. Los principales hallazgos sugieren que el ingreso y el grado de educación de los individuos ejercen las mayores influencias positivas en el u...

DIAGNÓSTICO DEL SECTOR TURÍSTICO DEL CANTÓN BOLÍVAR

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Johnny Patricio Bayas Escudero; Carmen Adriana Álvarez Bermúdez; David Reinaldo García Moreira; José Rafael Vera Vera

2013-01-01

Con el propósito de realizar el diagnóstico del sector turístico del cantón Bolívar, se partió, inicialmente, de la identificación de los recursos y atractivos turísticos existentes, asi como su nivel de incidencia en el desarrollo de esta jurisdicción, para posteriormente, proponer los potenciales productos turísticos que permitan la implementación de planes y programas de desarrollo del turismo. Para el cumplimiento de estos objetivos, se realizó una caracterización general del territorio, ...

Alcance del principio de eficacia directa del derecho comunitario andino en el ámbito de la propiedad industrial y del derecho del consumidor en el ordenamiento jurídico colombiano

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Pachón Guerrero, Juan Sebastián

2017-01-01

Tesis sobre el alcance del principio de eficacia directa del derecho comunitario andino en el ámbito de la propiedad industrial y del derecho del consumidor en el ordenamiento jurídico colombiano Thesis related to the scope of the principle of direct effectiveness of andean community law in the field of industrial property and consumer law in the Colombian legal system

Acerca del nombre del Perú en la actual Colombia

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Juan Friede

1962-03-01

Full Text Available Como es sabido, la adaptación del nombre "Perú" al Imperio Incaico es de origen netamente español. Los indios del Perú no llamaban así a su territorio, como lo confirman Valera, Cieza de León, Montesinos, Garcilaso y otros. Tenían nombres para designar las distintas provincias pero no para la totalidad del imperio de los incas.

Consistencia interna del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Trastornos del Eje II del DSM-IV*

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Campo-Arias, Adalberto; Díaz-Martínez, Luis Alfonso; Barros-Bermúdez, Jaider Alfonso

2008-01-01

Introducción: Es infrecuente identificar posibles casos de trastornos de personalidad en la población general, debido a la carencia de instrumentos autoadministrados con buena validez y confiabilidad. Hasta la fecha no se ha explorado la confiabilidad del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Diagnósticos del eje II (SDID-II) del DSM-IV en la población colombiana. Objetivo: Determinar la consistencia interna de las subescalas del cuestionario autoadministrad...

Determinantes en el proceso del despliegue del valor para la innovación

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Juan Mejía Trejo

2016-03-01

Full Text Available El estudio tiene como objetivo hallar las determinantes en el proceso del despliegue del valor para la innovación de productos. la metodología, basada en investigación documental, descubre tres áreas: I: qfd modificado, donde se consideran las percepciones ponderadas del consumidor de necesidades, satisfacción y desempeño de los diferentes atributos y características de los productos y servicios a través de voces denominadas: del consumidor, la mercadotecnia, la tecnología, los requerimientos y la firma; área II: valorprecio y costo de retención del consumidor, en la que se calcula el precio justo del producto objetivo a innovar respecto de sus competidores y costo de retener al consumidor; área III: difusión de la innovación, que permite visualizar el mercado de adoptadores del producto objetivo a innovar. El proceso es posible visualizarlo en un solo plano, por lo que se propone su denominación como despliegue del valor para la innovación de productos (dvip.

Análisis del documental “Las raices del conflicto: Palestina- Israel”

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Espinosa Seguí, Ana

2011-01-01

El documental "Las raices del conflicto: Palestina- Israel" nos va a servir para analizar diversos elementos del conflicto entre Israel y Palestina, como la evolución histórica del conflicto, las fronteras exteriores e interiores de Israel y Palestina, los conflictos de Israel con los países vecinos, el conflicto por el agua, la creación del estado de Israel y su crecimiento posterior o el problema de los refugiados palestinos.

Vigencia del Darwinismo

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Lessa, Enrique P

2009-01-01

En este ensayo se presenta una revisión histórica del signifcado y legado del darwinismo, con énfasis en el último siglo. La principal conclusión es que la visión darwiniana de la evolución, con las modifcaciones requeridas para dar cuenta de los grandes desarrollos de la disciplina, se ha impuesto y mantiene vigencia en nuestros días. En particular, el papel del azar, la evolución como proceso de “descendencia con modifcación” a lo largo de diversas ramas del árbol de la vida, el pensamiento...

Determinantes del acceso al internet: Evidencia de los hogares del Ecuador

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Héctor Alberto Botello-Peñaloza

2015-01-01

Full Text Available El objetivo del artículo se centra en investigar los determinantes del uso de Iinternet en los hogares ecuatorianos en 2013, incorporando sus características socioeconómicas dentro de un modelo de elección discreta que realiza estimaciones sobre la probabilidad del uso de internet dentro del hogar, con base en los microdatos de la encuesta de uso de TIC. Los principales hallazgos sugieren que el ingreso y el grado de educación de los individuos ejercen las mayores influencias positivas en el uso de internet, al igual que se evidencian brechas significativas de género, con un asentamiento en las áreas rurales más que en las urbanas, especialmente por la falta de infraestructura. Estos resultados destacan la importancia de la intervención pública en el aumento del acceso a las nuevas tecnologías, a la vez que el papel del capital humano en la reducción de las brechas sociales en Ecuador.

SISTEMA INFORMÁTICO PARA LA GESTIÓN DEL TALENTO HUMANO DEL GOBIERNO MUNICIPAL DEL CANTÓN BOLÍVAR

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Angel Cristian Mera Macías; Daniela Vera Vélez

2016-01-01

Esta investigación tuvo como objetivo la creación e implementación de un sistema informático para la gestión del talento humano del Gobierno Autónomo Descentralizado Municipal del cantón Bolívar. Durante el estudio se determinó cómo la organización en mención gestiona la información del talento humano y la manera en la que se podría mejorar dicha tarea, es así que mediante la aplicación de encuestas a los clientes internos y externos se determinó que existían dificultades en dicho pr...

El movimiento estudiantil chileno del 2011 en intervenciones discursivas del Presidente Piñera

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Claudio Araya Seguel

2014-06-01

Full Text Available Este artículo muestra evidencia lingüístico-discursiva del intento del Presidente Piñera por acallar las influencias sociales del movimiento estudiantil chileno del año 2011. Desde una mirada crítica se da cuenta del comportamiento discursivo de este hablante en el marco del primer conflicto social que enfrentó el nuevo gobierno de derecha en Chile. El valor teórico-metodológico de este estudio radica en la mirada triangular a las intervenciones discursivas. A través del análisis de un corpus de cuatro intervenciones presidenciales desde las perspectivas de las funciones estratégicas del discurso político, la teoría de la valoración y la lingüística de corpus se observa cómo Piñera deslegitima al movimiento social asociando las demandas referidas a educación con la violencia y el desorden público generado en el contexto de las crecientes marchas a lo largo del país.

Vigilando la Calidad del Agua de los Grandes Rios de la Nacion: El Programa NASQAN del Rio Grande (Rio Bravo del Norte)

Science.gov (United States)

Lurry, Dee L.; Reutter, David C.; Wells, Frank C.; Rivera, M.C.; Munoz, A.

1998-01-01

La Oficina del Estudio Geologico de los Estados Unidos (U.S. Geological Survey, 0 USGS) ha monitoreado la calidad del agua de la cuenca del Rio Grande (Rio Bravo del Norte) desde 1995 como parte de la rediseiiada Red Nacional para Contabilizar la Calidad del Agua de los Rios (National Stream Quality Accounting Network, o NASOAN) (Hooper and others, 1997). EI programa NASOAN fue diseiiado para caracterizar las concentraciones y el transporte de sedimento y constituyentes quimicos seleccionados, encontrados en los grandes rios de los Estados Unidos - incluyendo el Misisipi, el Colorado y el Columbia, ademas del Rio Grande. En estas cuatro cuencas, el USGS opera actualmente (1998) una red de 40 puntos de muestreo pertenecientes a NASOAN, con un enfasis en cuantificar el flujo en masa (la cantidad de material que pasa por la estacion, expresado en toneladas por dial para cada constituyente. Aplicacando un enfoque consistente, basado en la cuantificacion de flujos en la cuenca del Rio Grande, el programa NASOAN esta generando la informacion necesaria para identificar fuentes regionales de diversos contaminantes, incluyendo sustancias qui micas agricolas y trazas elementos en la cuenca. EI efecto de las grandes reservas en el Rio Grande se puede observar segun los flujos de constituyentes discurren a 10 largo del rio. EI analisis de los flujos de constituyentes a escala de la cuenca proveera los medios para evaluar la influencia de la actividad humana sobre las condiciones de calidad del agua del Rio Grande.

Resultados del tratamiento a pacientes con tríada terrible del codo

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Héctor Gabriel Díaz Carrillo

2015-04-01

Full Text Available La luxación del codo, asociada a la fractura del proceso coronoideo y a la fractura de la cabeza radial, es denominada “tríada terrible del codo”, debido a la complejidad al abordar el tratamiento correcto y lo desalentador de los resultados que se obtienen con el mismo. Se realizó un estudio prospectivo, donde se recogen los resultados postoperatorios, obtenidos en cuatro pacientes con inestabilidad traumática aguda del codo, tratados entre enero de 2012 y mayo de 2013, que acudieron inicialmente al cuerpo de guardia del Hospital General Docente “Dr. Ernesto Guevara de La Serna” y tuvieron un seguimiento medio de ocho meses. El proceder consistió en reparación de la coronoides, del ligamento lateral externo, reparación de la cúpula radial, cupulectomía y colocación de pin endomedular; la técnica operatoria a emplear se definió por los estudios radiográficos realizados y los hallazgos en el transcurso del proceder. Los pacientes, tres hombres y una mujer, tuvieron cinco codos lesionados y un promedio de edad de 34 años. Como resultado del tratamiento la flexión fue normal entre 130-135° en 4 codos y limitada en uno a 110°, la extensión se encontró limitada de 8 a 21° en todos los pacientes, la pronosupinación se mantuvo limitada en todos los casos entre 5 y 22°. La intervención quirúrgica mediante fijación y reparación de los estabilizadores del codo proporcionó a corto plazo una funcionabilidad del codo cercana a la normalidad, los pacientes evolucionaron positivamente. Las complicaciones fueron: reluxación, infección local y aflojamiento de la osteosíntesis

Gerencia del cuidado-gerencia del servicio

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Marta Palmet Jiménez

2016-01-01

Full Text Available La gerencia de este siglo debe estar plenamente identificada con la administración para planear, organizar, decidir y obtener resultados definidos, evaluados y alcanzados a través de las personas. Para poder gerenciar el cuidado se debe saber administrar. El objetivo de enfermería es cuidar; el objetivo de la gerencia es la conducción de la producción de bienes o servicios en las organizaciones. La gerencia del cuidado implica: motivación, creatividad, responsabilidad y ética por parte del cuidador y de quien cuida, claridad de actitud frente al ser y al qué hacer por parte del cuidador. Se puede concluir que la gerencia (administración, el cuidado (producto de calidad, el servicio (valor intangible, querer servir son un trinomio que deben ir de la mano de manera integrada para el logro de los objetivos propuestos por la organización de salud y de enfermería.

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article

Science.gov (United States)

Park, Yoo Jin

2017-01-01

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC. PMID:29354612

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

Science.gov (United States)

Kim, Jun-Mo; Park, Yoo Jin

2017-12-01

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter , Escherichia coli , Candida , and Gardnerella ). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

LA GESTIÓN DEL SUPERMERCADO VIRTUAL: TIPIFICACIÓN DEL COMPORTAMIENTO DEL CLIENTE ONLINE

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Marimon Viadiu, Frederic

2011-01-01

Full Text Available Este artículo analiza diferentes elementos que influyen en el comportamiento de compra del cliente de un supermercado online. Estos elementos están relacionados tanto con aspectos estéticos del sitio web, como con los procesos que tienen lugar en el momento de realizar la compra. A partir de este análisis, se estudian los distintos grupos de consumidores con comportamientos homogéneos y se posicionan en función de sus actitudes. El análisis también permite definir la calidad del servicio prestado por este tipo de establecimientos, así como las principales dimensiones en que se despliega. En las conclusiones se citan aspectos en los que el gestor de un supermercado online debe incidir para mejorar la calidad de su servicio.

Guía del investigador americanista para San Luís del Potosí novohispano

OpenAIRE

Montoya, Ramón Alejandro

2012-01-01

El trabajo aborda uno de los temas menos abarcados por la historiografía del norte de la Nueva España : la familiarización de la heurística sobre una región minera septentrional del México Colonial. El objetivo del trabajo es dar a conocer las vetas documentales para los estudiosos del norte de la Nueva España y no necesariamente de la jurisdicción de San Luis Potosí. Para eso proponemos una enumeración detallada de acervos y colecciones documentales del interior del país y del extranjero con...

Agendas visuales y procesos, elementos básicos en la vida del alumnado con Trastorno del Espectro del Autismo

OpenAIRE

Rodríguez Molino, Joana

2014-01-01

Este Trabajo Fin de Grado comienza haciendo un repaso de las definiciones y características asociadas a los Trastornos del Espectro del Autismo para poder considerar las pautas de intervención más acertadas a seguir con este alumnado. También se hace hincapié en los Sistemas Alternativos y Aumentativos de Comunicación como medio de comunicación y aprendizaje para estos niños/as. Se presenta una propuesta de intervención educativa llevada a cabo con un niño con Trastorno del Espectro del A...

Asociación del trastorno del desarrollo de la coordinación con otros trastornos del desarrollo infantil en la ciudad de Cali

OpenAIRE

Riascos Alpala, Alexander; Velez Correa, Diana Lizeth; Acosta Alvarez, Yuri Andrea

2016-01-01

INTRODUCCION. El trastorno del Desarrollo de la Coordinación TDC en la infancia es una problemática importante desde la salud pública, ya que tiene repercusiones importantes desde las diferentes esferas del desarrollo: motora, cognitiva, psicosocial y emocional, por lo mismo, es frecuente la presencia de comorbilidad con otros trastornos del desarrollo infantil. Se presenta un estudio multicéntrico que caracteriza la asociación del TDC con otros trastornos del desarrollo. OBJETIVO. Determ...

Antonio Zambrana Lara, docente y pintor. Técnica y procedimientos dentro del Realismo Sevillano del último tercio del siglo XX

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Domínguez Moreno, Gustavo

2012-01-01

El trabajo que aquí se presenta, cuyo título es Antonio Zambrana Lara, docente y pintor. Técnica y procedimiento dentro del Realismo Sevillano del último tercio del siglo XX, procurará analizar en profundidad las cuestiones relacionadas con la personalidad artística de Antonio Zambrana, a través de diversos asuntos, como por ejemplo su contextualización, intentando profundizar en un momento apasio nante del arte sevillano y especialmente en aquellos apartados que de manera más concreta se ref...

El sentido cultural del cuidado en casa del enfermo

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Marina Sánches-Sanabria

2008-12-01

Full Text Available Esta investigación tiene un diseño cualitativo descriptivo, transversal para comprender las diferencias existentes en los conocimientos, actitudes y prácticas influidas por la percepción o sentido cultural de cuidar del cuidador primario, como elemento básico para caracterizar elementos culturales presentes en el ambiente de cuidado al enfermo o discapacitado que está en casa a través de la indagación profunda de la percepción y sentimientos que tiene tanto el cuidador primario como el ser cuidado en casa. Se realizó con los usuarios inscritos del Programa de Promoción y Prevención de la indagación profunda de la percepción y sentimientos Universidad Popular del Cesar (IPS-UPC de los enfermos crónicos y discapacitados a nivel comunitario del grupo extramural de la comuna cinco y del Hospital Eduardo Arredondo Daza de la ciudad de Valledupar, Colombia. El valor de realizar este proyecto, está en desocultar los múltiples significados que en la realidad vivida por los seres cuidadores primarios y en los seres cuidados; son esas distintas formas de percibir la existencia, influido por el conocimiento de lo ancestral, los sentimientos y la sabiduría de la cultura que cada uno posee para expresarse en las múltiples formas que el cuidado lo acontece y lo requiere para dar el sentido cultural característico y diferenciado que se percibe en el modo de cuidar y la satisfacción de quien lo recibe y lo ofrece. Este aspecto fue valioso para la comunidad académica del programa de enfermería, porque ubicó epistémicamente la transculturalidad del cuidado como una mirada y forma de enseñar transdisciplinariamente, enseñando y ofreciendo el cuidado desde la cultura, sentimientos y pensamientos del ser cuidado para el mantenimiento de la vida y la salud, en la que estudiantes de enfermeria desde sus primeras experiencias formativas deben incursionar en la intervención holística que se requiere en el cuidado de la salud y de la vida.

Las reformas del Estado, de las políticas sociales y de salud: Un balance del final del milenio

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Gerschman Silvia

1999-01-01

Full Text Available El presente trabajo se propone reflexionar sobre las reformas de los sistemas de salud y de políticas sociales en el marco de las así llamadas reformas del Estado. Com esta finalidad, se busca como punto de partida condensar distintas visiones explicativas de la crisis del Estado de Bienestar, presentes en la bibliografía produzida en la década de los 90. En el corazón de la crisis, las políticas sociales se encuentran profundamente cuestionadas. Lo que pretendemos mostrar es que este argumento posee una función específica, que es la de introducir mudanzas de carácter neoliberal en la política económica y para las cuales los instrumentos económicos utilizados van a generar la abstención del Estado en el plano social, la desregulación de las economías nacionales en favor del libre mercado y, fundamentalmente, el papel sobredimensionado del mercado financiero internacional. En este contexto, son analizadas las reformas de la seguridad social y de los sistemas de salud. La última parte del trabajo tuvo por objetivo enfrentar las dificultades que las políticas sociales presentan en el contexto actual, trayendo al centro del debate un mapeamiento de las alternativas posibles para el desarrollo de las políticas sociales y de salud.

Psicodrama del duelo.

OpenAIRE

José Antonio Espina Barrio; Marisol Filgueira Bouza

1997-01-01

La pérdida de rituales agrava y alarga la reacción del duelo. Se define el Psicodrama Antropológico y su intervención en el proceso del duelo. El Psicodrama Focal del Duelo es una psicoterapia breve centrada en el proceso de Duelo. Se comentan varios casos y resultados. Se concluye con un programa sencillo para el duelo en Atención Primaria.

La Cultura del Vino, motor del desarrollo sostenible de las regiones vitivinícolas

Directory of Open Access Journals (Sweden)

Luisa González-SanJosé Ma

2017-01-01

Full Text Available Existen bastantes evidencias para vincular la cultura del vino con el entorno y el desarrollo sostenible. En primer lugar, destaca que la cultura del vino es el reflejo del aprovechamiento vitivinícola del medio y, por tanto, refleja su efecto sobre el desarrollo social y económico de las regiones, lo que es plausible a través del devenir histórico de las mismas. Más recientemente, el aprovechamiento de la cultura del vino para su explotación a través de las experiencias enoturísticas, ha supuesto una revalorización de muchos territorios, impulsando el desarrollo social y económico. La cultura del vino no es sólo el eje temático de la actividad enoturística, sino que es su base y pilar esencial, por tanto, se relaciona directamente con la sostenibilidad ambiental, económica y social que subyace tras el enoturismo. Además, es importante tener en cuenta que gran parte de la importancia de la cultura del vino se centra en las señas de entidad asociadas a cada territorio, que aportan características distintivas y singulares, contribuyendo a la sostenibilidad cultural. En España, ACEVIN y el Rutas del Vino de España son claros ejemplos de como la cultura del vino es un motor del desarrollo sostenible de las regiones vitivinícolas.

Ecuador y los objetivos del milenio : inversiones para la conservación del agua

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Fabián Rodríguez

2013-09-01

Full Text Available El presente estudio analiza si se justifica la inversión en la protección del Sistema Nacional de Áreas Protegidas (SNAP. El nivel de inversión del Estado ecuatoriano fue estimado a partir de las necesidades de financiamiento del SNAP. Los beneficios económicos fueron estimados a partir de la oferta de agua de las áreas protegidas que se encuentran a lo largo de la Cordillera de los Andes. La metodología para evaluar si es conveniente o no la inversión del Estado en la protección del SNAP fue la relación beneficio - costo (B/C. Los resultados del estudio demuestran que solo los valores piso de la relación B/C justifican la inversión del Estado.

Determinación del requerimiento hídrico del pimentón en el municipio de Candelaria, departamento del Valle del Cauca Water requeriments of pepper in Candelaria, Valle del Cauca, Colombia

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Adriana Gómez Enríquez

2010-10-01

Full Text Available Se realizó un ensayo con el fin de determinar el requerimiento hídrico del pimentón Capsicum annuum variedad Unapal-Serrano, en la zona de Candelaria-Valle del Cauca (Colombia. Se determinó que el pimentón requiere 425mm de agua durante su ciclo vegetativo, obteniendo una eficiencia del uso del agua de 5.32 kg/m³ de fruto fresco y de 0.5 kg/m³ en términos de materia seca. Además, se comprobó la eficiencia del microevaporímetro 'MIEVHR' como herramienta para programación del riego y estudios hidrológicos.A trial was carried out in order to determining the water requirement of the pepper Capsicum annuum variety UNAPAL- Serrano in the zone of Candelaria -Valley of the Cauca (Colombia and to evaluate the efficiency of the microevaporímeter 'MIEVHR' as estimator of the evaporation. It was determined that the pepper requires 425mm of water during the cycle vegetative obtaining an efficiency of the use of the water of 5.32 Kg/m³ of fresh fruit and 0.5 kg/m³ in terms of dry matter. Besides, it was verified the microevaporímeter efficiency 'MIEVHR' as tool for programming of the irrigation.

Detección, transmisión y caracterización del fitoplasma asociado a la enfermedad del decaimiento del peral

OpenAIRE

Garcia i Chapa, Meritxell

2004-01-01

Consultable des del TDX Títol obtingut de la portada digitalitzada Se ha realizado una prospección en 1500 parcelas de cultivo de peral, para evaluar la extensión de la enfermedad del Decaimiento del peral (PD) en el Nordeste de España. Un 7% de las parcelas observadas presentaron síntomas de la enfermedad. Paralelamente, se ha evaluado la incidencia de la enfermedad en 45 de estas parcelas, por inspección visual de 500 árboles, en cada una de ellas. La presencia del fitoplasma fue conf...

Gestión del subsistema Activos Fijos Tangibles del sistema Cedrux.

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Larisa González Álvarez

2009-12-01

Full Text Available En aras del fortalecimiento de la gestión de entidades y la informatización de la sociedad, Cuba se encuentra inmersa en la creación del producto Cedrux, basado en los principios de independencia tecnológica y en las particularidades de la economía cubana. Esta solución nacional incluye un subsistema para el control de los activos fijos tangibles (AFT, que pretende servir de apoyo a la toma de decisiones en las entidades. El subsistema es capaz de gestionar activos de forma dinámica, tributa mediante operaciones al sistema contable de la empresa y estandariza el tratamiento de los AFT a nivel nacional. Incluye además temas como la multimoneda, la agrupación de activos y la generación de documentos, prestaciones del sistema que responden a necesidades del país, actualmente no satisfechas de manera conjunta por los sistemas existentes. A partir de la puesta en marcha del sistema, la economía del país se verá favorecida y el control de los AFT será confiable, estable y legalmente correcto.

Estado del Medio Ambiente Marino y Costero del Pacífico Sudeste.

OpenAIRE

Andrade V., Héctor; Guitiérres S., Sixto; Andrade C., Héctor

2014-01-01

El presente documento contiene los antecedentes sistematizados sobre el Estado del Medio Ambiente Marino Costero del Pacífico Sudeste en base a los informes nacionales de consultoría elaborados entre 2011 y 2012 en Panamá, Colombia, Ecuador, Perú y Chile y cuya finalidad fue establecer un estado actualizado del medio marino a nivel regional, en el marco del Programa CONPACSE III de la Comisión Permanente de Pacífico Sur. Los principales contaminantes presentes en las aguas marinas costeras de...

Caracterización del potencial de abuso del flunitracepam

OpenAIRE

Martí de la Llave, Cecilia

1997-01-01

Con el presente estudio se pretende caracterizar el potencial de abuso del flunitracepam. La pauta de administración del flunitracepam está ajustada para alcanzar concentraciones máximas plasmáticas similares entre los dos regímenes de administración del fármaco activo, aunque a diferente velocidad; con la dosis única se alcanza la concentración máxima plasmática más rápidamente que con la dosis dividida. Cuando el voluntario recibe el fármaco activo a dosis única toma cinco cápsulas que ...

Historia del desarrollo institucional turístico del Meta

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Ramón Vergel

2002-11-01

el primer plan de desarrollo turístico departamental, se comienza a visualizar diferentes tipologías de turismo que se podían desarrollar como el Ecoturismo y a trabajar en pro de ello. Surge luego el segundo Plan Sectorial del Meta visualizando al turismo como producto. Posteriormente se realiza un Estudio Exploratorio sobre el Potencial Turístico del Meta y la promoción turística del departamento comienza a surgir con la participación en ferias y vitrinas turísticas importantes logrando así fijar un mercado turístico: Bogotá.

ESTUDIOS MACRO Y MICROSCOPICO DEL SACO ANAL DEL COIPO (Myocastor coypus)

OpenAIRE

Rafasquino, Marta E.; Ramos, Pablo A.; Alonso, Cristina R.; Idiart, Julio R.

1998-01-01

RESUMEN:Fue realizada la disección del saco anal de 44 coipos, de ambos sexos, de distintas edades y procedencias, observándose algunas características similares a los sacos anales del perro y gato, aunque es impar y está ubicado en ventral del ano. Es ovoídeo o piriforme, siendo más grande en los adultos y, entre éstos, más aún en los machos que en las hembras; posee un conducto que desemboca en el canal anal a un centímetro del ano y que se exterioriza en el momento de secretar el producto ...

Fenomenología del prejuicio

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Montero Moliner, Fernando

1992-05-01

Full Text Available Not available.

Este trabajo expone la defensa del «prejuicio » llevada a cabo por Gadamer, mostrando su efectividad histórica y confrontándola con la crítica husserliana del «prejuicio» desde el apriorismo. Se pone de relieve, además, la historicidad del «mundo de la vida» y su incidencia en la teoría del a priori, para terminar con un estudio de la racionalidad del a priori y la facticidad del prejuicio.

La crisi del diritto del lavoro

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Alessandro Garilli

2012-01-01

Full Text Available Riassunto - L’Autore ripercorre in chiave critica l’evoluzione delle politiche legislative in materia di lavoro, alla luce dell’attuale fase di crisi economico finanziaria. Nell’esaminare i principali interventi normativi attuati da inizio secolo, l’Autore mette in evidenza le scelte di metodo e gli elementi di continuità che accomunano i vari provvedimenti, individuandoli nell’affannosa ricerca del punto di equilibrio tra flessibilità e garantismo. La riflessione si chiude con alcuni interrogativi sulle ultime linee di riforma del mercato del lavoro e con l’auspicio che, anche al cospetto delle imprescindibili ragioni dell’economia, il diritto del lavoro possa continuare a svolgere il proprio tradizionale ruolo di disciplina di tutela della persona.   Abstract - The author analyzes, with a critically oriented approach, the development of the employment law, in the light of the current economic and financial crisis. In examining the main regulatory measures implemented since the beginning of the century, the author highlights the methodological choices and the elements of continuity that unite the various measures, focusing them in a hard research of a point of balance between flexibility and security. The discussion concludes with some questions about the last lines of the reform of the labor market and with the hope that, even in the face of compelling reasons of economy, labor law can continue to play its traditional role of governing the protection of person.

Il dono del racconto

DEFF Research Database (Denmark)

Polito, Paola

1998-01-01

L'articolo indaga a vari livelli strutturali del romanzo "Il coraggio del pettirosso" (rete metaforica, dialogismo diegetico, dialogismo come fenomeno di voce, strategie discorsive messe in atto dalla voce narrante, stile colloquiale) la complessa realizzazione testuale del genere narrativo...

COMPOSICIÓN DEL ENSAMBLE DE INSECTOS DEL DOSEL DE BOSQUES SUBTROPICALES SECOS DEL CHACO SEMIÁRIDO, ARGENTINA

OpenAIRE

Liliana Diodato; Andrea Fuster

2016-01-01

El dosel arbóreo constituye un complejo hábitat con gran diversidad de insectos. Los estudios sobre insectos del dosel están mayormente concentrados en bosques húmedos tropicales y son escasos en bosques secos subtropicales. El propósito de este trabajo fue caracterizar la entomofauna del dosel de bosques secos subtropicales, analizando su diversidad regional y localmente. Para ello se muestrearon cinco sitios localizados en la región fitogeográfica del Chaco Semiárido Argentino. Las recolecc...

Reconstrucción del límite superior del bosque en la parte norte del Ecuador: algunos resultados del proyecto RUFLE

NARCIS (Netherlands)

Sevink, J.; Tonneijck, F.; Jansen, B.; Hooghiemstra, H.; Cuesta, F.; Sevink, J.; Llambí, L.D.; De Bièvre, B.; Posner, J

2014-01-01

Resumen Se estudiaron los suelos, los registros de polen y los marcadores biológicos en transectos entre bosque y páramo en la reserva natural Guandera al norte del Ecuador para reconstruir el límite superior del bosque y establecer sus características y dinámicas. Se encontró que los suelos estaban

Dirección del proyecto para la construcción del casco habitable del edificio multifamiliar Pramin, aplicando estándares del PMI

OpenAIRE

Cabrejos Canevaro, Omar; Garrido Lovón, Johan; Herrera Stoll, Alberto; Ramírez Apón, Ernesto

2017-01-01

La presente tesis tiene como objetivo principal el desarrollo de la Dirección de un proyecto para la construcción del Casco Habitable del Edificio Multifamiliar Pramin, ejecutado por la empresa Construcciones Corbus S.A., aplicando los estándares de la Guía del PMBOK, quinta edición, se busca lograr una ventaja competitiva sostenible en el tiempo a través de un modelo de dirección eficiente en sus procesos que sirva como base actualizable para la ejecución de cada proyecto de la empresa a fin...

Del internacionalismo al nacionalismo: rumbos del conflicto armado en Colombia

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Mónica Zuleta P.

2003-10-01

Full Text Available Este ensayo tiene por propósito sugerir una interpretación del desarrollo del conflicto armado colombiano durante la última década del siglo XX mediante el uso de la concepción de poder de Michel Foucault. Ello con miras a presentar alternativas analíticas frente a la relación entre lo global y lo local donde se consideren algunas de las hipótesis contemporáneas sobre la cuestión del nacionalismo. El ensayo utiliza el término nacionalismo como sustantivo (lo que es en lugar de como adjetivo (lo que debe ser y ordena los conjuntos de acciones que, en torno al proyecto de lo nacional, han sido puestos en práctica por las guerrillas en Colombia.

Gestión del marketing sensorial sobre la experiencia del consumidor

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Leonardo Ortegón-Cortázar

2016-01-01

Full Text Available El rápido desarrollo de mercados con productos competitivos de difícil diferenciación y consumidores mejor informados que demandan experiencias memorables, justifican estudiar los elementos sensoriales que pueden potenciar e influir positivamente sobre dichas experiencias. El objetivo de este artículo es analizar el estado del arte respecto a la gestión y uso del marketing sensorial sobre la experiencia del consumidor. El diseño de investigación es no experimental documental, con un tipo de estudio descriptivo, empleando fuentes de recolección de información secundarias, mediante un arqueo bibliográfico de revistas de impacto que figuran en bases de datos de libre acceso. Los resultados revelan la dominancia del sentido de la visión sobre la persuasión y las actividades de marketing, mientras que el sentido del olfato demuestra mayor influencia sobre el nivel de recuerdo y evocación de información. Se concluye la utilidad de jerarquizar por nivel de influencia las actividades de estimulación sensorial en marketing a partir del funcionamiento y participación de los sentidos humanos y poder combinar dichas estimulaciones como medio para maximizar la experiencia del consumidor y distinguir la oferta de valor, considerando el grado de diferenciación, la favorabilidad y la fuerza de la actividad sensorial basada en planeación estratégica empresarial.

Avances del mejoramiento genético participativo del frijol en Cuba

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Rodobaldo Ortiz-P\\u00E9rez

2006-01-01

Full Text Available Las actividades de Fitomejoramiento Participativo fueron conducidas con agricultores del municipio de San Antonio de los Baños de la provincia La Habana y campesinos de la comunidad la Palma de la provincia de Pinar del Río durante 2001 al 2004. En la fase de diagnóstico en las áreas de intervención del proyecto, más del 80 % de los agricultores no utilizaban la semilla del sistema formal; por lo tanto, las variedades obtenidas por los programas de mejoramiento no llegaban a la mayoría de los agricultores. Se buscó un mecanismo alternativo para introducir diversidad genética a las localidades mediante las ferias de diversidad, cuyo objetivo principal ha estado dirigido a facilitar el flujo de semilla de los institutos de investigaciones hacia el agricultor y viceversa. Posterior al desarrollo de las ferias de diversidad se continúa con la experimentación campesina en fincas y cooperativas, desarrollándose una amplia red experimental difícil de lograrse sin la participación de los productores. La experimentación campesina, el aumento de la eficiencia en la finca, incluyendo el aumento del rendimiento de sus parcelas, el aumento de la diversidad por el uso de mayor número de variedades, y una mayor proporción de área dedicada a estas variedades; todo lo cual redunda en un mejoramiento de la vida del campesino y su familia

Variedades del voto: hacia una sociología plural del sufragio particular

OpenAIRE

Sonnleitner, Willibald

2017-01-01

Resumen En México, las relaciones inestables entre las bases socio-territoriales del desarrollo socio-económico y del voto desafían las teorías clásicas de la modernización. Para comprender el comportamiento contradictorio de la participación electoral hay que explorar las variedades del sufragio en distintos contextos, niveles y escalas, y considerar la diversidad de formas de movilización ciudadana. Como lo muestra la sociología empírica del voto, éste puede apoyarse en dispositivos de tipo...

VALORACIÓN Y EFECTOS PUZOLÁNICOS DEL MATERIAL VOLCÁNICO DEL PURACÉ

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Diana Marcela Burgos Galindo

Full Text Available En este artículo se presentan los resultados experimentales de caracterización y evaluación puzolánica del material volcánico del Puracé (MVP. El MVP fue analizado mediante microscopía electrónica de barrido, fluorescencia de rayos X, difracción de rayos X, petrografía de secciones delgadas, análisis termo-gravimétricos, entre otros. La reactividad puzolánica fue evaluada por medio del Índice de Actividad Puzolánica y el ensayo de Frattini. Además, se evaluó el efecto de la incorporación del MVP en la resistencia a compresión de morteros donde el cemento Portland se remplazó por MVP en un rango del 0-40 %. Los resultados demostraron que el MVP presentó todas las características para ser considerado una puzolana natural y su porcentaje óptimo de incorporación como puzolana en remplazo del cemento es del 10 %, pero el diseño demostró que puede incorporarse hasta un 20 % con una pequeña desviación en la resistencia media reportada por el diseño.

Hacia una caracterización del lugar y el perfil del elector colombiano

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Víctor Arteaga Villa

2011-01-01

Full Text Available El artículo presenta una aproximación a la caracterización del lugar que se le ha dado y del perfil con que se ha configurado el elector colombiano. A partir de la metodología del estado de arte, analiza la literatura más relevante que se ha producido en torno a la relación elecciones-partidos políticos-elector y señala las categorías de énfasis que se han privilegiado. Además, a partir del establecimiento de las razones de la decisión y de la orientación del voto, enlista algunos de los factores que, desde motivaciones muy particulares -cívicas (deber ser del ciudadano, cínicas (ser de la contraprestación-, inducen al elector a su participación.

Las implicaciones del imaginario dominante “Barrios del Sur” en la producción del espacio urbano

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Roberto Villalobos Vega

2016-07-01

Full Text Available La ciudad y lo que se entiende como su realidad, es una dinámica de producción territorial compleja e infinita que se teje recíprocamente entre su dimensión imaginaria (memoria, ideas, sentidos, emociones, etc., su dimensión empírica (edificaciones, infraestructura, acontecimientos, y la manera en que sus ciudadanos, tanto la sociedad civil como quienes ostentan el poder, amalgaman las distintas variables que la componen para simbolizarla y construirla constantemente (dimensión social. Ante esta premisa, el presente artículo esboza, como problemática urbana, la construcción mediática del territorio, desde el fenómeno de las representaciones de los “Barrios del Sur”, un imaginario dominante que se designa bajo generalizaciones negativas del territorio sur del casco central de la ciudad de San José, Costa Rica (Distrito Hospital y Catedral; y su profundo impacto en la producción de la ciudad a nivel de organización territorial (ubicación de miedos y culpas en la urbe, planificación, diseño e inversión urbana, y vivencia socio-espacial del entorno designado.

Una caza del tesoro para aprender la pronunciación del español

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Xose Padilla García

2012-08-01

Full Text Available El grupo Pronuncia bien surgió en el seno del Máster de Enseñanza de español einglés como L2/LE de la Universidad de Alicante bajo la dirección del profesor Xose A.Padilla. El objetivo de nuestro grupo es elaborar instrumentos de aprendizaje quepermitan mejorar la pronunciación de estudiantes de E/LE de manera eficaz y divertida.A día de hoy, el grupo ha creado materiales didácticos dirigidos especialmente aestudiantes cuya lengua de origen sea el inglés o el italiano. La creación de lasherramientas didácticas y de evaluación propiamente dichas se basa en los principios delMétodo Verbo-Tonal (MVT, en las propuestas del enfoque comunicativo, y en el usode las nuevas tecnologías (TICs. Tenemos en cuenta, asimismo, las directrices delMarco Común Europeo de Referencia para las lenguas (MCER y los consejos del PlanCurricular del Instituto Cervantes (PCIC sobre la enseñanza del español.

Una alabarda procedente del valle del Manzanares (Madrid

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Miguel Ángel de BLAS CORTINA

2009-12-01

Full Text Available RESUMEN: Se estudia una alabarda metálica procedente —sin datos precisos de su localización— del valle del Manzanares (Madrid. Posiblemente apareciera con otros materiales (¿puntas Palmela?, pero el hecho no pudo ser comprobado. Fundida en un molde monovalvo que proporciona un acabado homogéneo a una sola de las caras, se integra metalúrgicamente en el grupo E 01 (cobres arsenicales propio de la Península Ibérica durante el Calcolítico y el Bronce Antiguo. Tipológicamente puede ser clasificada como integrante del grupo Carrapatas al que pertenecen un conjunto de alabardas procedentes del N.E. de Portugal (Bragança y Tras os Montes del que se conocen escasos testimonios fuera del área característica. Especialmente significativo es el hallazgo de la finca de la Paloma (Pantoja, Toledo que muestra la asociación entre las alabardas Carrapatas y elementos propios del campaniforme tardío de España y Portugal, circunstancia que permite fechar el tipo entre el 1700-1500 a. de J.C., datación similar a las fechas admitidas para las alabardas irlandesas con las que algunos autores ven posibles relaciones. La existencia de alabardas grabadas en estelas más tardías o en rocas al aire libre plantea el problema de su perduración. No obstante, el carácter simbólico de las armas grabadas puede hacer que sea solamente la imagen representada la que superviva, aunque el arma como tal haya perdido vigencia. La alabarda del Manzanares, junto con las de Pantoja, señala la presencia en la Meseta Sur de elementos metalúrgicos propios del N.W. de la Península en un momento sincrónico con las fases finales del campaniforme.ABSTRACT: We study a metallic halberd found in an indeterminate place in the valley of the river Manzanares (Madrid. It might have appeared with other materials (Palmela Points?, although this fact could not be confirmed. Made in a single-faced mould which allows a homogeneous finish to only one of the sides, it belongs from

Influencia del yeso sobre la velocidad de hidratación del cemento portland

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Yamaguchi, G.

1961-12-01

Full Text Available Not availablePara esclarecer la Influencia del yeso sobre el fraguado y endurecimiento del cemento, los autores estudiaron el grado de hidratación de los cuatro principales minerales del clínker de cemento Portland y el efecto del yeso sobre ellas. Haciendo uso del análisis cuantitativo de rayos X, se determinó la porción no hidratada. Simultáneamente, se determinaron los tiempos de fraguado y las resistencias. Los ensayos se llevaron a cabo sobre tres clínkeres sintéticos de diferentes composiciones y sobre dos clínkeres de cemento Portland comerciales.

El legado del Movimiento Moderno. Conjuntos de vivienda masiva en ciudades europeas del Oeste y del Este. No tan diferentes…

Directory of Open Access Journals (Sweden)

Javier Monclús

2015-05-01

Full Text Available El objetivo de este artículo es comparar y contrastar algunos conjuntos de vivienda modernos en ciudades europeas del Oeste (“capitalistas” y del Este (“socialistas”. Nuestro trabajo se centra en conjuntos de vivienda masiva construidos en el periodo de crecimiento urbano acelerado que tuvo lugar en Europa principalmente en las décadas de los años 60 y 70 del pasado siglo. El punto de partida más obvio es que las ciudades socialistas son diferentes de las europeas occidentales por la distinta naturaleza de sus políticas urbanas, el sistema de planificación económica socialista centralizada, la ausencia de un mercado del suelo libre, el impacto de la industrial­ización en el sector de la construcción, etc. Sin embargo, hay muchos conceptos en urbanismo, así como en los procesos urbanos, que fueron compartidos en ambos sistemas políticos e ideológicos. El artículo ofrece una perspectiva comparada de la naturaleza de esos conjuntos residenciales modernos construidos a ambos lados del Telón de Acero –Housing Es­tates en UK, Grands Ensembles en Francia, Großsiedlungen en Alemania, Polígonos en España o los grandes conjuntos residenciales socialistas en los países del Bloque del Este– con el fin de entender mejor si –y hasta qué punto– las formas urbanas de dichos conjuntos son el resultado de la cultura internacional del urbanismo moderno.

Practical synthesis of methyl 7-(3-hydroxy-5-oxocyclopent-1-en-1-yl-heptanoate

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Xinpeng Jiang

2017-07-01

Full Text Available The key intermediate of misoprostol, methyl 7-(3-hydroxy-5-oxocyclopent-1-en-1-yl-heptanoate was prepared from commercially available suberic acid in 40% yield over five steps. The key step involved a ZnCl2 catalyzed Friedel-Crafts reaction between furan and 2,9-oxonanedione. Sulfuric acid catalyzed methylation of 8-(furan-2-yl-8-oxooctanoic acid followed by sequential reduction and ZnCl2 catalyzed Piancatelli rearrangement resulted in the formation of the key intermediate of misoprostol.

Gestión del talento humano y compromiso organizacional de los docentes del nivel primario en las instituciones educativas del Cercado de Huaral, 2014

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Huapalla Paredes, Javier Mitchel

2015-01-01

El presente estudio se centra en describir cómo se relaciona Gestión del talento humano y compromiso organizacional de los docentes del nivel primario en las Instituciones Educativas del Cercado de Huaral, 2014. El nivel de la presente investigación es cuantitativo de tipo descriptivo correlacional. La muestra es probabilística de 125 docentes del nivel primario de las Instituciones Educativas del Cercado de Huaral. Los instrumentos utilizados para observar y recabar inform...

Gestión del riesgo

OpenAIRE

Duque Escobar, Gonzalo

2014-01-01

Documento Anexo del Manual de Geología para Ingenieros, con temas asociados a la gestión integral del riesgo de interés para la ecorregión cafetera y Colombia. Parte de los temas ha sido tomada del módulo “Diálogos con el Territorio y Gestión del Riesgo Natural, a mi cargo en la Especialización en Geografía, Ordenamiento Territorial y Manejo del Riesgo Natural en la Universidad de Caldas. Otros, provienen del compendio de temas sobre la materia, elaborado en el marco de mis actividades académ...

LA MATEMÁTICA ELEMENTAL DEL PROCESO DE VALORIZACIÓN DEL CAPITAL

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Henry Manuel Mora Jiménez

2011-09-01

Full Text Available La economía es (o aspira a ser una ciencia social que, por su particular objeto de estudio, permite y requiere la cuantificación de las expresiones objetivadas de los procesos sociales en que centra su interés; y aunque probablemente se han cometido (y se siguen cometiendo muchos abusos en este campo, no podemos renunciar a una tarea que es requisito para el desarrollo de una teoría científica del capitalismo.Se pretende en este trabajo, utilizar instrumentos de la matemática elemental para formalizar importantes tesis marxianas, relacionadas con la teoría del plusvalor absoluto. Aunque la matemática que se utiliza es simple, el planteamiento es sugestivo, y se centra en formalizar con ayuda del álgebra y del cálculo elemental, los principales resultados teóricos de la sección tercera (especialmente el capítulo nueve del Libro I de El Capital de Karl Marx, susceptibles de tratamiento cuantitativo.Nuestra pretensión es aclarar la teoría del proceso de valorización del capital (creación de nuevo valor mediante el consumo productivo de fuerza de trabajo y de medios de producción, como un requisito parcial para entender mejor lo que en un artículo posterior denominaremos “proceso de desvalorización del capital”, el cual se desarrolla paralelamente y se entrecruza con el primero. La exposición se centra en el método de producción de plusvalor conocido como plusvalor absoluto, por ser la forma general y básica de creación capitalista de excedente.

Combined vesicovaginal and rectovaginal fistulas associated with a ...

African Journals Online (AJOL)

Long-duration intravaginal foreign bodies are a rare entity, but may cause serious complications to the bladder or rectum. We describe a 22-year-old woman who presented with a calcified pelvic mass caused by a long-duration intravaginal foreign body complicated by perforation into the bladder and rectum.

Combined Vesicovaginal and Rectovaginal Fistulas Associated with ...

African Journals Online (AJOL)

Long-duration intravaginal foreign bodies are a rare entity, but may cause serious complications to the bladder or rectum. We describe a 22-year-old woman who presented with a calcified pelvic mass caused by a long-duration intravaginal foreign body complicated by perforation into the bladder and rectum.

DE LA MUERTE DEL AUTOR A LA MUERTE DEL ARTISTA: REFLEXIÓN CRÍTICA PARA UN DEBATE EN TORNO A LA FIGURA DEL AUTOR

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Ricardo Arcos-Palma

2011-04-01

Full Text Available La "muerte del autor" se ha convertido en el paradima de la postmodernidad. El siguiente ensayo realiza un análisis crítico de tal expresión y las consecuencias de su aplicación en el mundo del arte contemporáneo. La tesis planteada es la siguiente: la muerte del autor trae consigo la muerte del artista y del crítico, figuras representativas de la autoridad. Tales muertes generan el nacimiento de una nueva figura de poder que es el curador. Con este texto se pretende aportar elementos de reflexion para un debate, que apenas comienza, en torno a la figura del curador.

Circulating progesterone dynamics after intravaginal instillation of prostaglandin-F2α to lactating dairy cows.

Science.gov (United States)

Wijma, R; Stangaferro, M L; Giordano, J O

2016-06-01

Our objectives were to evaluate circulating progesterone (P4) concentration dynamics and test the feasibility of inducing luteal regression after intravaginal (IVG) instillation of the PGF2α analogue dinoprost (PGF) in lactating dairy cows. In two experiments, cows were synchronized using the Ovsynch protocol to induce the formation of a corpus luteum (CL). Cows with at least one functional (P4 ≥1 ng/mL) CL ≥15 mm 7.5 days after Ovsynch remained in the studies. In experiment 1, cows (n = 31) were stratified by parity group and received 5 mL of saline IVG (SAL-IVG, n = 6), 25 mg of PGF intramuscular (IM) (PGF25-IM, n = 7), 25 mg of PGF IVG (PGF25-IVG, n = 6), 50 mg of PGF IVG (PGF50-IVG, n = 6), and 125 mg of PGF IVG (PGF125-IVG, n = 6). Experiment 2 was conducted to test the hypothesis that IVG instillation of two 25 mg doses of PGF 12 hours apart would be more effective than a 25- or 50-mg dose in a single application. Cows (n = 32) were stratified by parity and received SAL-IVG (n = 7), PGF25-IM (n = 7), PGF25-IVG (n = 6), and PGF50-IVG (n = 6) as in experiment 1, whereas another group received two IVG instillations of 25 mg of PGF 12 hours apart (PGF25-2X-IVG, n = 6). Blood was collected at -1 hour, every 6 hours from 0 hour to 24 hours, and every 12 hours up to 96 hours after treatment (trt). In experiment 1, there was an effect of trt (P cows in the SAL-IVG group from 12 to 96 hours after trt. Although an initial decline in P4 concentrations was induced in all PGF-treated cows, some cows in the IVG-treated groups presented a rebound in plasma P4, indicating CL recovery. More cows in the PGF25-IVG and PGF125-IVG groups than in the PGF50-IVG and PGF25-IM groups presented CL recovery, suggesting that greater doses of PGF may not necessarily improve CL regression. In experiment 2, there was an effect of trt (P Cows in the PGF25-2X-IVG group had a P4 profile that was similar to that of cows in the PGF25-IM group and

Consideraciones alrededor del Libro del Almismo, el Libro del Pensar.

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MartaLucía Tamayo Fernandez

1999-12-01

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La doctora MarthaLucía Tamayo comparte muchas inquietudes alrededor del Libro del Almismo, el Libro del Pensar; de dónde salió ese nombre; de juntar en medicina y en genética a tres escritores como lo son Jorge Luis Borges, Macedonio Fernández y Julio Cortázar. Su conferencia dice así:

El término almismo fue ideado por Macedonio Fernández porque defendía mucho el ensimismamiento y el pensamiento hacia el interior, mirar hacia adentro; cada uno somos un “sí mismo” que nos hace diferentes aunque al mismo tiempo podemos ser iguales. Todos tenemos esa parte interior que la medicina debe trabajar y que no puede olvidar.

“El Libro del Almismo, el libro del pensar” nos lleva a replantear y a repensar un poco la medicina que queremos, una medicina vuelta a pensar.

Quiero contarles la historia de cómo se llegó a este libro y por qué y para qué se sigue trabajando en estos temas: Después de mi internado y de un trabajo un poco triste de rural, volví al Instituto de Genética y a la Universidad Javeriana en donde encontré al doctor Bernal y un espacio que estaba buscando para esa medicina diferente que quería, con un grupo de personas que me permitía no sólo ver la medicina sino ver muchas otras cosas más; había espacio para la literatura, para Mafalda, para hablar de niños, de locos, había incluso tiempo para hablar de medicina dentro del golf, de carros antiguos y de todo eso fui aprendiendo.

Eso era lo que estaba buscando. Una medicina que diera espacios diferentes, que fuera más humanizada. Rápidamente me ubiqué y me quedé! No me arrepiento en lo absoluto de haberme quedado porque fue, ha sido y sigue siendo, una experiencia enriquecedora, de muchas vivencias importantes. Sabía exactamente dónde estaba y sabía que había que seguir rápido y había que trabajar muchos aspectos de esa medicina que estábamos buscando y de esa genética especial.

Rápidamente empezamos a trabajar

Las guerras olvidadas del Perú: formación del Estado e imaginario nacional

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Cecilia Méndez G.

2012-06-01

Full Text Available A diferencia de otros países americanos, el Perú carece de una memoria nacional de sus guerras civiles decimonónicas. Estas han sido opacadas por la avasalladora memoria de la Guerra del Pacífico, que el Perú y Bolivia perdieron ante Chile (1879-1883. El presente ensayo se propone rescatar del olvido a las guerras civiles peruanas del siglo XIX, empezando por las guerras de la independencia. Las preguntas que planteamos están motivadas por la guerra reciente que desató el Sendero Luminoso entre 1980 y fines de la década de 1990, en la que los campesinos andinos asumieron las funciones represivas del Estado al tomar las armas para derrotar a la insurgencia senderista. Esta situación exhibe interesantes paralelos con las guerras civiles del siglo XIX. Proponemos que el estudio de las guerras civiles decimonónicas del Perú, a la luz de la reciente guerra interna, ofrece una oportunidad fecunda para discutir las nociones de ciudadanía y pertenencia, la relación entre guerra y la constitución del Estado, así como los alcances y límites del concepto weberiano del Estado como el ente que monopoliza la violencia legítima. Subrayamos la importancia de la organización civil de las poblaciones rurales en el devenir de la guerra y, más ampliamente, en la construcción del Estado.

Medición del valor agregado del hogar: nuevos enfoques para el caso peruano

OpenAIRE

Arlette Beltrán; Pablo Lavado

2013-01-01

Aun cuando las diferentes medidas convencionales del Producto Bruto Interno (PBI) muestran el desempeño económico del país, el cálculo de éstas no considera el significativo valor de los bienes y servicios producidos dentro del hogar. A través de la Encuesta Nacional del Uso de Tiempo (ENUT) 2010, la presente investigación trata de estimar el valor asociado al tiempo dedicado a las labores del hogar en el Perú bajo distintos enfoques discutidos en la literatura académica. Los resultados arroj...

Objeto de aprendizaje abierto de la Competencia del manejo del idioma inglés

OpenAIRE

Baltazar Gutierrez, Alejandro; Flores Carrillo, Cristina; Garcia Moran, Gregory Alfonso; Macias Acosta, Paulina; Campa Mariño, Maria Alejandra

2011-01-01

1. Portada 2. Resumen 3. Información General a. Introducción b. Objetivos c. Temario 4. Evaluación Diagnóstica 5. Temas a. Tema 1. ¿Qué significa la competencia del manejo del inglés? i. Actividad Inicial ii. Contenido iii. Actividad Final iv. Recursos del TEMOA b. Tema 2. ¿Por qué es relevante para mi formación que adquiera la competencia del idioma inglés? i. Actividad Inicial ii. Contenido iii. Actividad Final iv. Recursos del TEMOA c. ...

SISTEMA INFORMÁTICO PARA LA GESTIÓN DEL TALENTO HUMANO DEL GOBIERNO MUNICIPAL DEL CANTÓN BOLÍVAR

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Angel Cristian Mera Macías

2016-06-01

Full Text Available Esta investigación tuvo como objetivo la creación e implementación de un sistema informático para la gestión del talento humano del Gobierno Autónomo Descentralizado Municipal del cantón Bolívar. Durante el estudio se determinó cómo la organización en mención gestiona la información del talento humano y la manera en la que se podría mejorar dicha tarea, es así que mediante la aplicación de encuestas a los clientes internos y externos se determinó que existían dificultades en dicho proceso, por otra parte también se determinó la predisposición y la necesidad de implementar un sistema informático para mejorar la gestión del talento humano. Una vez conocida la problemática se planteó como solución, dinamizar la gestión del talento humano mediante un sistema informático desarrollado, utilizando la metodología de “Desarrollo Rápido de Aplicaciones” que integre los datos del personal en un banco de datos central, donde la información que se genere se vaya registrando de forma organizada para agilizar el acceso a la misma y de esta manera optimizar los recursos de la entidad, llegando a la conclusión de que con el trabajo planificado y ordenado es posible construir un sistema informático lo suficientemente robusto para gestionar el talento humano en los gobiernos municipales en el Ecuador.

El análisis económico del derecho de autor y del copyright, un estudio del equilibrio entre los intereses público y privado

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Ana María Pérez Gómez Tétrel

2007-01-01

Full Text Available La propiedad intelectual ha sido concebida para responder, tanto a la necesidad de protección del autor de una obra del intelecto, como al beneficio que la sociedad pueda sacar del acceso a dichas creaciones intelectuales, generando así un equilibrio entre los diferentes actores. Los sistemas digitales de comunicación han puesto en jaque dicho equilibrio. Conviene preguntarse ¿es capaz la protección otorgada por el derecho a la creación intelectual, de establecer un equilibrio en las relaciones entre creador (autor y la sociedad (consumidor? ¿En qué medida el análisis económico comparado del derecho de autor y del copyright puede contribuir al modelo económico de este equilibrio? ¿Hasta qué punto, el rol desempeñado por las industrias de la comunicación está rompiendo este equilibrio? El objetivo de este artículo es analizar diversos aspectos del derecho de autor y del copyright, a la luz del análisis económico del derecho.

El análisis económico del derecho de autor y del copyright, un estudio del equilibrio entre los intereses público y privado

Directory of Open Access Journals (Sweden)

Ana María Pérez Gómez Tétrel

2007-11-01

Full Text Available La propiedad intelectual ha sido concebida para responder, tanto a la necesidad de protección del autor de una obra del intelecto, como al beneficio que la sociedad pueda sacar del acceso a dichas creaciones intelectuales, generando así un equilibrio entre los diferentes actores. Los sistemas digitales de comunicación han puesto en jaque dicho equilibrio. Conviene preguntarse ¿es capaz la protección otorgada por el derecho a la creación intelectual, de establecer un equilibrio en las relaciones entre creador (autor y la sociedad (consumidor? ¿En qué medida el análisis económico comparado del derecho de autor y del copyright puede contribuir al modelo económico de este equilibrio? ¿Hasta qué punto, el rol desempeñado por las industrias de la comunicación está rompiendo este equilibrio? El objetivo de este artículo es analizar diversos aspectos del derecho de autor y del copyright, a la luz del análisis económico del derecho.

Epidemiologia del parasitismo intestinal infantil en el Valle del Guadalquivir

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Pérez Armengol Cristina

1997-01-01

Full Text Available FUNDAMENTO: Las parasitosis intestinales en los niños constituyen un problema de salud pública que debe ser valorado periódicamente en cada región. En este trabajo se aborda, por primera vez en la región natural del Valle del Guadalquivir, un estudio amplio sobre la prevalencia del parasitismo intestinal en la población infantil de la zona. MÉTODOS: Durante el período 1994-1996, mediante análisis coprológico y método de Graham, se ha estudiado a 1.917 niños y niñas asintomáticos, con edades comprendidas entre seis y diez años, residentes en veinte localidades del Valle del Guadalquivir. RESULTADOS: El índice global de parasitación ha sido del 27,12 %. Las especies parásitas detectadas, así como sus prevalencias fueron: Enterobius vermicularis (20,44%, Giardia lamblia (5,05%, Entamoeba coli (2,45%, Endolimax nana (1,61%, Entamoeba histolytica (0,31%, Entamoeba hartmanni (0,05%, Iodamoeba bütschlii (0,05%. CONCLUSIONES: La prevalencia global encontrada es similar a la de otras regiones españolas, aunque quizás pueda considerarse algo más favorable. No se detectan geohelmintos, debido posiblemente a la mejora de la infraestructura higiénico-sanitaria y a los efectos de la prolongada sequía en la zona. La giardiasis, a diferencia de las restantes protozoosis, mantiene una prevalencia relativamente alta.

Descripción del funcionamiento del sector eléctrico colombiano

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Santiago Alvarez Sierra

2006-04-01

Full Text Available Se ha considerado el comportamiento del sector eléctrico como un factor de gran trascendencia en desenvolvimiento de la economía de un país. Sin embargo, es notable el desconocimiento de algunas personas no especialistas es esta temática, de los conceptos básicos y de la organización intrínseca de este sector. Por lo tanto, resulta conveniente la realización de un artículo que informe de manera descriptiva sobre la naturaleza y funcionamiento del sector eléctrico en Colombia, como punto de partida para posteriores estudios y profundos análisis de temas relacionados con este sector. Entre los aspectos básicos que una persona debe conocer para estar en capacidad de entender y argumentar sobre el comportamiento del sector eléctrico en Colombia podemos citar, entre otros, los siguientes: antecedentes e historia del sector, agentes e instituciones del mercado, variables importantes en la toma de decisiones, contratos de corto y largo plazo, y finalmente algunos procedimientos que actualmente se encuentran en discusión, los cuales podrían cambiar el funcionamiento del Mercado de Energía Mayorista en Colombia

Panorama europeo del control de calidad del hormigón

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García Meseguer, Álvaro

1974-02-01

Full Text Available The present state of the problem is presented with some detail, taking into account the work in course of the Editorial Committee CEB-CIB-FIP-RILEM on Statistical Quality Control of Concrete. In a comparative way the modus operandi, recently introduced in Spain through the new Code of Concrete EH 73, is also presented. The paper concludes commenting on the influence which the decrease of concrete strength has on the safety of the structure, a problem which is more complicated than it might appear at first sight.Se presenta con cierto detalle el estado actual del tema, a partir de los trabajos en curso del Comité Editorial CEB-CIB-FIP-RILEM sobre Control Estadístico de Calidad del Hormigón. De forma comparativa, se presenta también el modus operandi recientemente introducido en España por la nueva Instrucción del Hormigón EH 73. El artículo termina comentando la influencia que tiene un descenso de resistencia del hormigón en la seguridad de la estructura, tema éste más complejo de lo que puede parecer a primera vista.

Prevalencia de helmintos intestinales en caninos del departamento del Quindío.

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María Isabel Giraldo

2005-09-01

Full Text Available Introducción. Los helmintos intestinales son agentes patógenos que afectan animales domésticos y que a través de ellos pueden infectar humanos. Objetivo. El objetivo del trabajo fue determinar la prevalencia de helmintos intestinales en perros con dueño del departamento del Quindío. Materiales y métodos. Estudio descriptivo prospectivo. Se aplicó una encuesta epidemiológica a los propietarios de los perros. Se recolectaron muestras de heces de los caninos registrados en la jornada de vacunación antirrábica del 2003 en el departamento del Quindío. Las muestras de materia fecal frescas fueron analizadas utilizando la técnica de diagnóstico de Ritchie. Resultados. Se analizaron 324 muestras de heces caninas; el 67,6% de los perros eran de razas puras y el 32,4% razas mestizas. Se encontró una prevalencia del 22,2%; Ancylostoma caninum fue el parásito más frecuente, 13,9%. También se observó Trichuris vulpis, 4,3%; Toxocara canis, 2,5%, y Strongyloides stercoralis, 4,0%. El 2,46% de las mascotas se encontraron multiparasitadas. Conclusión. La frecuencia de helmintos intestinales en el departamento del Quindío fue de 22,2% y la presencia de estos parásitos coincide con factores como la edad y la permanencia del canino en la calle, entre otros. Por esta razón, es necesario establecer programas de vigilancia y prevención en la población humana y canina.

el Valle del Cauca

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Carlos Humberto Ortiz

2007-01-01

Full Text Available Este artículo se enfoca en la identi- ficación de aquellos factores estructurales que explican la pérdida de dinamismo económico de largo plazo en Colombia y, en particular, en el Valle del Cauca. Se examina la competitividad del Valle en relación con Colombia y con el resto del mundo. Se cuestiona la insistencia en una estrategia exportadora como dinamizadora del desarrollo económico. Se identifica que una gran parte de la población está excluida de los beneficios del desarrollo económico. Para construir un modelo de desarrollo que incluya a esta población se recomienda recuperar la senda de la industrialización, invertir en el capital humano (educación de alta calidad, salud, salubridad y nutrición, e invertir en infraestructura. La participación del Estado en estas inversiones sociales es necesaria para disminuir la desigualdad y aumentar el crecimiento económico.

DE LA SOCIEDAD DEL CONOCIMIENTO A LA SOCIEDAD DEL RIESGO

OpenAIRE

Abdala Cardona, Alejandro

2013-01-01

El tiempo en el que vivimos: el siglo XXI, presenta a la vez, retos y exigencias al conjunto global de los habitantes del mundo, puesto que, no solo se nos presenta la actualidad como aquella coyuntura histórica en los que el cambio de los acontecimientos gira en torno al rol central del conocimiento, sino también, en torno al potencial que dicho conocimiento trae tras de sí; es decir, el presente siglo impone al conjunto de personas el rótulo de "sociedad del conocimiento" donde se puede enc...

Las Competencias Legales del Racional en la Organización Administrativa y Contable del Municipio de Valencia (Comienzos del Siglo XVII)

OpenAIRE

Francisco Mayordomo García-Chicote

2005-01-01

La organización administrativa y contable de los mayores municipios españoles, a comienzos del XVII, es un tema que apenas ha sido abordado por los investigadores de la historia de la Contabilidad y del Derecho. En este trabajo se estudian los textos legales (Capitols del Quitament y Ordenanzas de la Taula de Canvis) que regulaban aquellas cuestiones en relación con la ciudad de Valencia, y sobre todo se hace un detenido análisis del cargo municipal (el Racional) que se responsabilizaba de la...

Nuevos datos paleontológicos del Pleistoceno en el Valle del Manzanares (Madrid, España: Los micromamíferos del yacimiento del Arenero de Arriaga

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Sesé, Carmen

2013-12-01

Full Text Available The micromammals from the archaeological site of the Arenero de Arriaga from the Manzanares Valley are here described. They are the Soricomorpha: Crocidura sp. and Talpa sp., the Rodentia: Eliomys quercinus quercinus, Apodemus sp., Microtus brecciensis, Microtus arvalis, Microtus duodecimcostatus and Arvicola aff. sapidus, and the Lagomorpha: Oryctolagus cuniculus. The faunal association and the evolutionary state of Microtus brecciensis and Arvicola aff. sapidus, suggest an age of the end of the Middle Pleistocene. It also indicates the existence of different biotopes: riparian, moist and dry meadows, and forest, and a temperate climate similar to the present-day climate of the Meseta.Se describe la asociación de micromamíferos del yacimiento achelense del Arenero de Arriaga del valle del Manzanares constituida por los soricomorfos: Crocidura sp. y Talpa sp., los roedores: Eliomys quercinus quercinus, Apodemus sp., Microtus brecciensis, Microtus arvalis, Microtus duodecimcostatus y Arvicola aff. sapidus, y el lagomorfo: Oryctolagus cuniculus. La asociación faunística y el estadio evolutivo de Microtus brecciensis y Arvicola aff. sapidus, indican una edad del final del Pleistoceno Medio. La asociación de micromamíferos sugiere la existencia de varios biotopos representados: ripícola, praderas húmedas y secas, y bosque, y un clima templado similar al actual de la Meseta.

RESPIRACIÓN DEL SUELO EN UNA COMUNIDAD SUCESIONAL DE PASTIZAL DEL BOSQUE ALTOANDINO EN LA CUENCA DEL RÍO PAMPLONITA, COLOMBIA

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MURCIA-RODRÍGUEZ MIGUEL ANTONIO

2008-12-01

Full Text Available Se determinó la respiración del suelo (RS en una comunidad sucesional de pastizal de Holcus lanatus y Anthoxanthum odoratum en la franja altoandina de la cuenca del río Pamplonita, Norte de Santander, Colombia. Las medias mensuales de la RS fueron unimodales de día y de noche; la anual diurna fue de 118,44 mg CO2 m-2 h-1; y la nocturna, de 140,57 mg CO2 m-2 h-1. La diferencia entre estos dos valores se atribuyó a un incremento del brillo solar y a una disminución del recorrido del viento entre septiembre y diciembre de 2006 que condujo a un aumento de la tasa de evaporación. La RS nocturna se correlacionó con la humedad relativa y la temperatura máxima del aire y la diurna con el recorrido del viento. La RS acumulada (diurna y nocturna mostró una tendencia lineal con respecto al tiempo. La producción anual diurna de carbono, con base en la RS acumulada anual, se estimó entre 32,67 y 40,73 y la nocturna entre 35,65 y 43,02 g de C m-2.

RESPIRACIÓN DEL SUELO Y CAÍDA DE HOJARASCA EN EL MATORRAL DEL BOSQUE ALTOANDINO (CUENCA DEL RÍO PAMPLONITA, COLOMBIA

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Murcia Miguel

2012-06-01

Full Text Available Se estudiaron la respiración del suelo (RS y la caída de hojarasca (CH en un matorral de Hypericum phellos y Monochaetum strigosum en la franja altoandina del Nororiente de Colombia. Los muestreos mensuales de la RS se realizaron entre enero y diciembre de 2006; la CH se recolectó entre agosto de 2004 y diciembre de 2006. El comportamiento de la respiración del suelo diurna (RSD fue bimodal con picos en mayo y septiembre (177,65-172,73 mg CO2 m-2 h-1, relacionándose exponencialmente con la temperatura media del aire (R2=0,48; p=0,013 y la humedad relativa (R2=0,40; p=0,028. La respiración del suelo nocturna (RSN fue trimodal con valores máximos en octubre, agosto y mayo (268,87-181,49-162,79 mg CO2 m-2 h-1. Las tasas anuales de la respiración del suelo diurnas y nocturnas se estimaron entre 35,14 - 39,28 g C m-2 y entre 42,48 - 47,42 g C m-2, respectivamente. Con base en el área del matorral (9,1 ha, la liberación de carbono edáfico se calculó entre 3,08 y 3,72 Mg C año-1 para el periodo diurno y nocturno. Las fluctuaciones mensuales de la temperatura media del aire y de la caída de detritus (Dt determinaron (R2=0,66; p<0,001 la dinámica de la respiración diurna (RSD=77,94TMEDIA+36,45Dt-1142,8 y nocturna (RSN=99,05TMEDIA+57,44Dt-1470,3, permitiendo retroinferir que las tasas de respiración en 2005 podrían ser 50% mayores que en 2006. El catabolismo edáfico del matorral dependió menos de las oscilaciones de las variables meteorológicas que el del pastizal.

Anfibios y reptiles del valle del Mezquital, Hidalgo, México Amphibians and reptiles from the Valle del Mezquital, Hidalgo, Mexico

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Leonardo Fernández-Badillo

2010-12-01

Full Text Available El valle del Mezquital, Hidalgo, México, es un área de gran riqueza biológica; sin embargo, se desconoce mucho sobre su herpetofauna, por lo que se realizó una lista de anfibios y reptiles de 3 zonas del valle. Se analizó su distribución por tipo de vegetación, se registraron los microhábitats utilizados, así como la abundancia relativa. Se llevaron a cabo 12 salidas mensuales durante 1 año, con 108 días de muestreo. Se realizaron recorridos sobre transectos, en 9 tipos de vegetación. La herpetofauna del área de estudio está integrada por 37 especies (7 anfibios y 30 reptiles, de las cuales 8 se registran por primera vez para el valle del Mezquital. La mayoría de las especies se presentaron en las zonas de cultivo (26, 14 especies en los de la zona templada y 13 en los de la zona de riego. La herpetofauna del valle del Mezquital utiliza un total de 27 tipos de microhábitats, siendo "bajo roca" donde se registró el mayor número de especies (22. La mayoría de las especies tanto de anfibios como de reptiles fueron consideradas raras.Valle del Mezquital Hidalgo, Mexico is known for its high biological richness, but little is known about its herpetofauna. A study to list the amphibians and reptiles of 3 different zones at the Valle del Mezquital was carried out. We analyzed their distribution in different types of vegetation, their microhabitat and relative abundance in 12 monthly trips during 1 year for a total of 108 days. We sampled transects over 9 types of vegetation. Thirty species have been reported for this area (7 amphibians, 30 reptiles, 8 reported for the first time from Valle del Mezquital. Most of the species were present within crops (26, 14 within the temperate zone and 13 within the irrigation zone. The herpetofauna at Valle del Mezquital uses 27 different microhabitat, being "under rock" the most used by 22 species. Most of the species, both amphibians and reptiles were considered rare.

Una caza del tesoro para aprender la pronunciación del español

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Xose Padilla García

2009-01-01

Full Text Available El grupo Pronuncia bien surgió en el seno del Máster de Enseñanza de español e inglés como L2/LE de la Universidad de Alicante bajo la dirección del profesor Xose A.Padilla. El objetivo de nuestro grupo es elaborar instrumentos de aprendizaje que permitan mejorar la pronunciación de estudiantes de E/LE de manera eficaz y divertida.A día de hoy, el grupo ha creado materiales didácticos dirigidos especialmente a estudiantes cuya lengua de origen sea el inglés o el italiano. La creación de las herramientas didácticas y de evaluación propiamente dichas se basa en los principios del Método Verbo-Tonal (MVT, en las propuestas del enfoque comunicativo, y en el uso de las nuevas tecnologías (TICs. Tenemos en cuenta, asimismo, las directrices del Marco Común Europeo de Referencia para las lenguas (MCER y los consejos del Plan Curricular del Instituto Cervantes (PCIC sobre la enseñanza del español.

PROBLEMÁTICA ESPACIAL DEL SUR DEL DEPARTAMENTO DEL ATLÁNTICO Y LA PLANEACIÓN TERRITORIAL ESTRATÉGICA

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Efraín Llanos Henríquez

2017-06-01

Full Text Available Una parte considerable de los problemas espaciales que afectan a muchos entes territoriales en Colombia se debe en gran medida a la inexistencia de adecuadas políticas de ordenamiento y planeación del territorio. En este trabajo se hace una caracterización de los principales problemas espaciales de los municipios del sur del Atlántico, se analizan los factores que han incidido en su surgimiento y continuidad y se plantean algunas alternativas de solución, desde la Nueva Planeación Territorial Estratégica. El trabajo se sustenta en una amplia utilización de fuentes secundarias (investigación bibliográfica, uso de cartografía -mapas, planos, fotografías e imágenes satelitales- y estadísticas económicas, políticas y sociales, entre otras, así como en la realización de entrevistas y encuestas a habitantes de los municipios del área, en trabajos de campo y en la experiencia personal del autor en la zona estudiada. El trabajo se soporta teóricamente en la concepción del espacio como construcción social, planteada, entre otros, por Santos (2000, en los análisis y métodos de la Geografía Histórica (Tovar, 1986, y en especial en el llamado por Harvey (2003 Materialismo Histórico Geográfico y en los aportes de la Nueva Planeación Territorial Estratégica. Es una investigación de tipo descriptivo y explicativo.

Monitorización del proceso emprendedor a través del modelo de negocio

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Rosa M. Batista-Canino

2017-01-01

Full Text Available El presente trabajo aborda un doble objetivo: desde un punto de vista teórico, profundizar en el conocimiento del proceso emprendedor en la fase incipiente y, desde un punto de vista metodológico, evidenciar el potencial del modelo de negocio como herramienta de prospección y estudio del proceso emprendedor en dicha fase. Con este fin se propone la adaptación del marco teórico sobre modelos de negocio, al tiempo que se desarrolla una metodología para el análisis longitudinal en esta primera etapa de la vida de una empresa, utilizando un caso revelador. Ello permite confirmar muchos de los hallazgos teóricos del campo de estudio e identificar nuevas cuestiones de investigación. Así, se pone de manifiesto la importancia de desvelar qué factores influyen en la evolución del proceso emprendedor a través del análisis de la evolución del modelo de negocio que subyace, y cómo se ajustan los elementos internos de la empresa con los del entorno para ir configurando un proyecto empresarial en su fase temprana. El trabajo contribuye a mitigar la necesidad de desarrollar estudios de corte longitudinal, al incluir la dimensión temporal en el modelo de negocio, cuestión escasamente abordada en la literatura.

Anexo: Fibras de lino en las piletas del poblado ibérico del Coll del Moro (Gandesa, Terra Alta: estudio paleoetnobotánico

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Alonso i Martínez, Natàlia

1994-12-01

Full Text Available In this paper we offer the results of research on flax fibres discovered in water-bassins of the Iberian settlement of Coll del Moro (Gandesa, Spain

En el presente estudio presentamos los resultados obtenidos en las investigaciones realizadas sobre la funcionalidad de las piletas del poblado ibérico del Coll del Moro (Gandesa, en las cuales detectamos una importante presencia de fibras de lino.

Memorias para armar: Las conmemoraciones del 24 de Marzo en escuelas primarias del conurbano bonaerense

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Amézola, Gonzalo de; D'Achary, Claudia

2009-01-01

Este artículo se ocupa del problema del tratamiento del pasado reciente en la escuela. Describe las distintas representaciones de la última dictadura militar que se encuentran presentes en los discursos pronunciados en las conmemoraciones realizadas en 2008 para recordar el golpe de Estado del 24 de marzo de 1976 en escuelas primarias del partido de Malvinas Argentinas, ubicado en el Conurbano Bonaerense. Se analiza en esos discursos la presencia de distintas narraciones de la memoria colecti...

Identificación del agente causal del anillo rojo del agave tequilero (Agave tequilana Weber var. Azul).

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Mezo Villalobos, Miriam

2014-01-01

El cultivo del agave tequilero es parte de una larga tradición del estado de Jalisco, México. Esta actividad que culmina con la obtención del tequila, un tipo de mezcal tan característico, que se ha legislado su producción bajo la Denominación de Origen. La cadena producto agave-tequila es de suma importancia económica y social, no sólo para la región productora, sino para el país, dadas las elevadas cantidades de tequila que se exportan a todo el mundo. Esta investigación tuvo como objetivo ...

El contrato de agencia comercial. Análisis dentro del contexto del derecho romano

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María Elisa Camacho López

2009-06-01

Full Text Available Sumario: Premisa. Principios derivados del sistema jurídico romano-germánico aplicables al contrato de agencia comercial. i. Algunas figuras de la actividad mercantil en el derecho romano. ii. Cláusulas de no competencia. A. Posibles fuentes de la obligación de no competencia en el derecho romano. 1. Obsequium. 2. Operae iuratae. 3. Operae stipulatae. 4. Stipulatio. 5. Contratos innominados. 6. Lex mancipii. B. Licitud o ilicitud de la obligación de no competencia en el derecho romano. C. Condena por el incumplimiento de la obligación de no competir. iii. Consecuencias de la terminación del contrato. A. Revocación del mandato por parte del mandante. B. Renuncia del mandato por parte del mandatario. iv. Conclusiones

Estudio de asociación del trastorno del desarrollo de la coordinación con otros trastornos del desarrollo infantil en la ciudad de Bucaramanga

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Salinas Velasco, Rossana Iveth; Díaz Plata, Lyda Maritza

2016-01-01

INTRODUCCION. El trastorno del Desarrollo de la Coordinación TDC en la infancia es una problemática importante desde la salud pública, ya que tiene repercusiones importantes desde las diferentes esferas del desarrollo: motora, cognitiva, psicosocial y emocional, por lo mismo, es frecuente la presencia de comorbilidad con otros trastornos del desarrollo infantil. Se presenta un estudio multicéntrico que caracteriza la asociación del TDC con otros trastornos del desarrollo. OBJETIVO. Determ...

Calidad del software: camino hacia una verdadera industria del software

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Saulo Ernesto Rojas Salamanca

1999-07-01

Full Text Available El software es quizá uno de los productos de la ingeniería que más ha evolucionado en muy poco tiempo, pasando desde el software empírico o artesanal hasta llegar al software desarrollado bajo los principios y herramientas de la ingeniería del software. Sin embargo, dentro de estos cambios, las personas encargadas de la elaboración del software se han enfrentado a problemas muy comunes: unos debido a la exigencia cada vez mayor en la capacidad de resultados del software, debido al permanente cambio de condiciones lo que aumenta su complejidad y obsolescencia; y otros, debido a la carencia de herramientas adecuadas y estándares de tipo organizacional encaminados al mejoramiento de los procesos en el desarrollo del software. Hacia la búsqueda de mecanismos de solución de estos últimos problemas se orienta este artículo...

Carta del Editor

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Luis Eladio Proaño

2015-01-01

Full Text Available La millonaria contratación del futbolista David Beckham, un fenómeno del mercado, ha provocado cuestionamientos a los que se busca respuesta. Es tema de análisis el por qué el betseller "Harry Potter" ha causado tanta conmoción en la opinión pública. Respecto al periodista cibernético, se señalan los contornos del presente y atisban las posibilidades del futuro de esta nueva profesión. El tratamiento de los mitos de la prensa, los temores de la Ley mordaza venezolana y la brutalidad de los video juegos e Internet son temas de enorme interés. Se comenta las pocas veces que la prensa reflexiona sobre la comunicación corporal y la anorexia.

Influencia del evento el niño-oscilacion del sur sobre las precipitaciones en cinco ciudades del litoral ecuatoriano

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Espol; Rodriguez Aguilar, Jose Antonio; Luna Rodriguez, Javier Alejandro

2017-01-01

La investigación se realizó con el objetivo de evaluar la influencia del fenómeno enos, caracterizado por los índices oni e icen, sobre las precipitaciones ocurridas en el período de 1975-2016 en ciudades del litoral ecuatoriano, con la finalidad de que contribuya al diseño de lineamientos para mejorar la respuesta de la población ante la posible presencia del evento Guayaquil MAGISTER EN CAMBIO CLIMATICO

El reconocimiento del arte mobilar cantábrico : la aportación del H. Alcalde del Río