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Qiu P, He H, Zhao Y, Yang Z, Li S, Ni P, Guo Y, Ji C, Zhang C, Zhang H, Zhou C, Wang B. Global disease burden attributed to unsafe sex in 204 countries and territories from 1990 to 2019: results from the Global Burden of Disease Study 2019. Sci Rep 2023; 13:12900. [PMID: 37558737 PMCID: PMC10412620 DOI: 10.1038/s41598-023-40001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023] Open
Abstract
Unsafe sex has become a public safety problem that endangers society, and research on deaths and disability-adjusted life years (DALYs) related to unsafe sex is valuable for global policy-making. We aimed to estimate the deaths and DALYs attributable to unsafe sex by country, gender, age group, and sociodemographic status from 1990 to 2019. We extracted data on disease burden from the Global Disease Burden 2019 (GBD 2019) database for unsafe sex, including deaths, DALYs and age-standardized rates (ASRs). Comparative analyses were performed on data about deaths, DALYs and the responding ASRs attributable to unsafe sex in different countries and regions using the Social Demographic Index (SDI). The global age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) attributable to unsafe sex were 11.98 (95% uncertainty intervals (UI): 10.97-13.52) per 100,000 people and 570.78 (95% UI: 510.24-658.10) per 100,000 people, respectively. Both the ASMRs and ASDRs were the highest in southern sub-Saharan Africa and lowest in Australasia and decreased with increasing SDI levels. About unsafe-sex-related disease, HIV/AIDS has the highest ASMR [8.48 (95% UI: 7.62-9.95)/100,000 people] and ASDR [447.44 (95% UI: 394.82-533.10)/100,000 people], followed by Cervical cancer [ASMR: 3.40 (95% UI: 2.90-3.81)/100,000 people and ASDR: 107.2 (95% UI: 90.52-119.43)/100,000 people] and sexually transmitted infections excluding HIV [ASMR: 0.10 (95% UI: 0.08-0.11)/100,000 people and ASDR: 16.14 (95% UI: 10.51-25.83)/100,000 people]. The death and DALY burden caused by these three diseases were more serious in the over 75 years old age group. The 40-44 age group for men and the 35-39 age group for women had the highest population of unsafe sex-related deaths and DALYs, respectively. In addition, the burden of unsafe sex in women was more serious than those in men. Unsafe sex is an important risk factor for global disease burden and a leading cause of substantial health loss. We found that the risk of ASMRs and ASDRs attributable to unsafe sex had negative correlation with SDI levels. These results demonstrate that the need for revised policies that focus on efforts to reduce overall unsafe sex worldwide.
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Affiliation(s)
- Pei Qiu
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zejian Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shouyu Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Peng Ni
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yujie Guo
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chao Ji
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chenchen Zhang
- Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
| | - Can Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
| | - Bo Wang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, China.
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Bernard R. Responding to the Overturning of Roe v. Wade: 6 Immediate Actions for Primary Care Internists. J Gen Intern Med 2023; 38:219-220. [PMID: 36323821 PMCID: PMC9849600 DOI: 10.1007/s11606-022-07869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/21/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Rachel Bernard
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226-3596, USA.
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Laine C. Contraceptive Counseling: An Essential Component of Preventive Health Care. Ann Intern Med 2022; 175:1043-1044. [PMID: 35605237 DOI: 10.7326/m22-1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Farhat SA, Jabbari F, Jabbari P, Rezaei N. Targeting signaling pathways involved in primordial follicle growth or dormancy: potential application in prevention of follicular loss and infertility. Expert Opin Biol Ther 2022; 22:871-881. [PMID: 35658707 DOI: 10.1080/14712598.2022.2086042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Premature ovarian failure (POF) is one of the important causes of infertility in females. To date, no efficient preventive pharmacological treatment has been offered to prevent POF. Therefore, it is necessary to focus on strategies that provide a normal reproductive lifespan to females at risk of developing POF. AREAS COVERED Recently, attention has been drawn to discovering pathways involved in primordial follicle activation, as the inhibition of this process might maintain the stock of primordial follicles and therefore, prevent POF. In vitro and animal studies have resulted in the discovery of several of these pathways that can be used to develop new treatments for POF. These studies show crosstalk of these pathways at different levels. One of the important crossing points of many of these pathways involves anti-Mullerian hormone (AMH). Herein, we discuss different aspects of this topic by reviewing related published articles indexed in PubMed and Web of Science as of December 2021. EXPERT OPINION Although the findings seem promising, most of the studies were conducted on animals, and the interaction between these factors and the possible outcomes of their administration in the long term are still unknown. Therefore, further investigation is necessary to assess these aspects.
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Affiliation(s)
- Sara Ali Farhat
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Forouq Jabbari
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Jabbari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Mann AK, Khoury A, McCartt P, Smith MG, Hale N, Beatty K, Johnson L. Multilevel Influences on Providers' Delivery of Contraceptive Services: A Qualitative Thematic Analysis. WOMEN'S HEALTH REPORTS 2022; 3:491-499. [PMID: 35651999 PMCID: PMC9148650 DOI: 10.1089/whr.2021.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/12/2022]
Abstract
Introduction: Access to a full range of contraceptive services is essential for quality health care. Contraceptive provision practices of primary care providers play an important role in patients' decision-making about their reproductive health care. Understanding the multilevel factors influencing contraceptive care delivery in primary care settings is critical for advancing quality care. This study offers an in-depth examination of influences on providers' delivery of contraceptive services across multiple primary care specialties and practice settings to identify issues and strategies to improve care. Materials and Methods: Twenty-four in-depth face-to-face interviews were conducted in 2017 with primary care providers, including family physicians, gynecologists, pediatricians, and nurse practitioners from academic settings, private practices, and health centers. Interviews were transcribed and analyzed thematically. Results: Providers described a complex set of influences on their provision of contraception across multiple ecological contexts. Seven major themes emerged from the qualitative analysis, including six types of influence on provision of contraception: organizational, individual provider-related, structural and policy, individual patient-related, community, and the lack of influences or barriers. Providers also discussed the sources they access for information about evidence-based contraception counseling. Conclusions: A diverse set of providers described a complex system in which multiple concentric ecological contexts both positively and negatively influence the ways in which they provide contraceptive services to their patients. To close the gaps in contraceptive service delivery, it is important to recognize that both barriers and facilitators to patient-centered contraceptive counseling exist simultaneously across multiple ecological contexts.
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Affiliation(s)
- Abbey K. Mann
- Department of Family Medicine, Quillen College of Medicine, and College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Amal Khoury
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Paezha McCartt
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Michael G. Smith
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Nathan Hale
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Kate Beatty
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Leigh Johnson
- Department of Family Medicine, Quillen College of Medicine, and College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
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Wang ZQ, Liu ZQ, Zhao CH, Zhang K, Kang ZJ, Qu TR, Zeng FS, Guo PY, Tong ZC, Wang CL, Wang KL, Wang HL, Xu YS, Wang WH, Chu ML, Wang L, Qiao ZY, Wang H, Xu W. An Ultrasound-Induced Self-Clearance Hydrogel for Male Reversible Contraception. ACS NANO 2022; 16:5515-5528. [PMID: 35352555 DOI: 10.1021/acsnano.1c09959] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nearly half of pregnancies worldwide are unintended mainly due to failure of contraception, resulting in negative effects on women's health. Male contraception techniques, primarily condoms and vasectomy, play a crucial role in birth control, but cannot be both highly effective and reversible at the same time. Herein, an ultrasound (US)-induced self-clearance hydrogel capable of real-time monitoring is utilized for in situ injection into the vas deferens, enabling effective contraception and noninvasive recanalization whenever needed. The hydrogel is composed of (i) sodium alginate (SA) conjugated with reactive oxygen species (ROS)-cleavable thioketal (SA-tK), (ii) titanium dioxide (TiO2), which can generate a specific level of ROS after US treatment, and (iii) calcium chloride (CaCl2), which triggers the formation of the hydrogel. For contraception, the above mixture agents are one-time injected into the vas deferens, which can transform from liquid to hydrogel within 160 s, thereby significantly physically blocking the vas deferens and inhibiting movability of sperm. When fertility is needed, a noninvasive remedial ultrasound can make TiO2 generate ROS, which cleaves SA-tK to destroy the network of the hydrogel. Owing to the recanalization, the refertility rate is restored to 100%. Meanwhile, diagnostic ultrasound (D-US, 22 MHz) can monitor the occlusion and recanalization process in real-time. In summary, the proposed hydrogel contraception can be a reliable, safe, and reversible male contraceptive strategy that addresses an unmet need for men to control their fertility.
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Affiliation(s)
- Zi-Qi Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhong-Qing Liu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Chang-Hao Zhao
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Kuo Zhang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhi-Jian Kang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Tian-Rui Qu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Fan-Shu Zeng
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Peng-Yu Guo
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhi-Chao Tong
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Chang-Lin Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Ke-Liang Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Hong-Lei Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Yin-Sheng Xu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Wan-Hui Wang
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Mao-Lin Chu
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Lu Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zeng-Ying Qiao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Hao Wang
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Wanhai Xu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
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Abstract
PURPOSE OF REVIEW Issues pertaining to women with epilepsy have advanced with a better understanding of multidirectional influences among hormones, seizures, and antiseizure medications, as well as pregnancy-related concerns around fertility, seizure destabilization, and antiseizure medication-associated teratogenicity. This article highlights important developments in this field and reviews best practices in the management of women with epilepsy. RECENT FINDINGS Important external hormonal influences may impact women with epilepsy particularly in the context of gender-affirming medications, hormonal replacement therapy, and fertility therapies. Fertility for women with epilepsy is influenced by multiple variables; however, in the absence of preexisting fertility issues, epilepsy per se is not associated with significantly impaired fertility. Once women with epilepsy are pregnant, the majority have a stable course. Antiseizure medication use in pregnancy is associated with major congenital malformations 2 to 5 times that of the general population and is highest with high-dose (≥1500 mg or greater total daily) valproate. Carefully considered changes in drug choice and dose may mitigate these risks. Therapeutic drug monitoring plays an important role in pregnancy care, and under expert supervision, women with epilepsy in pregnancy have similar seizure risks as women with epilepsy who are not pregnant. As women with epilepsy age, bone health and menopause may further be impacted by seizures and antiseizure medications. SUMMARY The care of women with epilepsy is a multifaceted discipline that recognizes the life-long impact of sex and gender influences on epilepsy care.
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Matsushita T, Hasegawa T, Noma H, Ota E, Chou VB, Okada Y. Interventions to increase access to long-acting reversible contraceptives. Hippokratia 2021. [DOI: 10.1002/14651858.cd014987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tomomi Matsushita
- Department of Obstetrics and Gynaecology; Showa University School of Medicine; Tokyo Japan
| | - Takeshi Hasegawa
- Showa University Research Administration Center (SURAC); Showa University; Tokyo Japan
| | - Hisashi Noma
- Department of Data Science; The Institute of Statistical Mathematics; Tokyo Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science; St. Luke's International University; Chuo-ku Japan
| | - Victoria B Chou
- Department of International Health; Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland USA
| | - Yoshiyuki Okada
- Department of Obstetrics and Gynecology; Showa University Northern Yokohama Hospital; Kanagawa Japan
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Xie M, Li J, Zhang S, Zhu D, Mei X, Wang Z, Cheng X, Li Z, Wang S, Cheng K. A trifunctional contraceptive gel enhances the safety and quality of sexual intercourse. Bioact Mater 2021; 6:1777-1788. [PMID: 33336110 PMCID: PMC7724154 DOI: 10.1016/j.bioactmat.2020.11.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022] Open
Abstract
Current contraceptive methods come with a number of drawbacks, including low efficacy, in the case of commercial contraceptive gels, and a reduction in the quality of sexual intercourse, in the case of condoms. Adding pharmacologically-active agents to contraceptive gels holds the potential to improve sexual experience, and hardbor safety and hygiene. In this study, we fabricated a Carbomer-based contraceptive gel consisting of three agents: tenofovir, gossypol acetate, and nitroglycerin (TGN), with pH adjusted to 4.5 (to be compatible with the vagina). In vitro, the gossypol component of the contraceptive gel proved to be a significantly effective spermicide. When the concentration of gossypol acetate was 10 mg/ml, the spermicidal ability reached 100% after 30s. In addition, tenofovir in the gel significantly inhibited lentiviral transfection efficiency in cell-containing media. In 6 pairs of rats, the gel successfully prevented all females from conceiving after successful mating. Moreover, increased sexual frequency and enhanced erection, which were promoted by the nitroglycerin in the components, were observed in male rats that had the gel applied to their penises. This novel TGN contraceptive gel yielded a higher contraceptive success rate than that of the commercial contraceptive gel (Contragel®). In addition, it has the added benefits to prevent sexually transmitted diseases and improve male libido and erection function during sexual intercourse. Combining three FDA-approved and marketed agents together, our trifunctional TGN gel has a great potential for further translation and commercialization.
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Affiliation(s)
- Mengjie Xie
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Junlang Li
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Sichen Zhang
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Dashuai Zhu
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Xuan Mei
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Zhenzhen Wang
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Xiao Cheng
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Zhenhua Li
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
| | - Shaowei Wang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Ke Cheng
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, 27607, USA
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, Raleigh, NC, 27607, USA
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Sachdeva M. Contraception in Kidney Disease. Adv Chronic Kidney Dis 2020; 27:499-505. [PMID: 33328066 DOI: 10.1053/j.ackd.2020.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 02/02/2023]
Abstract
Unplanned pregnancies account for a large number of encountered pregnancies. One of the reasons for this is the lack of counseling surrounding contraception and subsequently lack of contraception use. A conversation during a regular CKD office visit of simply asking a woman what her plans are regarding pregnancy can lead to further discussion on timing of pregnancy and contraception and eventually safer outcomes for both the mother and fetus. Individual preference, as well as comorbid conditions, should be taken into account when deciding on optimal contraceptive methods. One must remember that contraception counseling and initiation of contraception should not be wrapped up in a single office visit, and there must be continued follow-up to ensure that the woman is using the contraceptive method correctly to prevent any future unplanned pregnancy.
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Affiliation(s)
- Kunal K Sindhu
- Department of Radiation Oncology, the Icahn School of Medicine, New York, New York
| | - Eli Y Adashi
- Department of Medical Science, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Contraception Use among Women of Childbearing Age in Southern Israel: A Comparison Between Two Ethnic Populations. J Racial Ethn Health Disparities 2020; 8:630-637. [PMID: 32700259 DOI: 10.1007/s40615-020-00822-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/18/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Two populations with different socio-demographic characteristics reside in southern Israel: the traditional Muslim Bedouin population and the Jewish population that leads a western lifestyle. The aim of the study was to assess the rate, pattern, and dynamics of the use of contraception in these two ethnic populations from 2006 to 2016 and to identify factors associated with the practice of effective and safe contraception. METHODS A retrospective study based on a computerized medical database. We recorded actual purchases of different forms of contraception by women of childbearing age (15-49 years) from the two populations in the southern Negev region of Israel. RESULTS Contraceptives were purchased by 7588 Bedouin women and 30,482 Jewish women. The rate of purchase ranged from 5.2 to 9.7% in the Bedouin sector and from 12.9 to 28.2% in the Jewish sector. Oral contraceptives were the most common type. In the Jewish sector, their use remained relatively stable over the years. In the Bedouin sector, in contrast, the rate increased. The only factor that was associated with the use of intrauterine devices was age (OR = 1.063, P < 0.001). Among women who used combined hormonal contraception, Jewish ethnicity (OR = 5.835, P < 0.001), age (OR = 0.926, P < 0.001), and comorbidity (OR = 0.87, P = 0.001) were associated with the use of newer, low-dose estrogen drugs. CONCLUSIONS Our findings, such as the lower rate of contraception practice in the Bedouin sector in general and the use of the new and safer hormonal contraceptives in particular, can help focus the efforts of medical teams in programs for women's health promotion.
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