Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.1 (ERK)
 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Weight gain and psychomotor development of breastfed infants of Egyptian mothers using Norplant, Cu T-380A IUDs, norethisterone enanthate injectables (NET-EN), Depo Provera and a levonorgestrel minipill were compared in 2 trials. First, groups of 120 women using Norplant and NET-EN were compared to a control group using IUDs, beginning 5-7 weeks postpartum. There were no differences in infant weight gain, mid-arm circumference, triceps-skin-fold thickness, or timing of motor milestones. The mean growth curve of all 3 groups were close to that of the 50th percentile for Egyptian infants. While timing of initiation of supplements was similar in the 3 groups, complete weaning occurred first in the IUD group, second in the Norplant group, and last in the NET-EN users. A second trail compared progesterone implants injected with a trocar that resulted in a blood level of 3 ng/ml for 5 months, with Population Council vaginal rings releasing 10 progesterone/24 hours, and CuT-380A IUDs. Serum progesterone in the ring users averaged 5.2 ng/ml for the 1st 2 weeks, then leveled off at about 4 ng/ml for about 2 months, falling to about 3 ng/ml for the last 3 weeks of use. Each women used 4 rings per year. Evidence of ovulation by ultrasonic vaginal probe and assay of estradiol and progesterone was apparent in 25% of vaginal ring users, compared to 55.9% of controls in the 2nd 6 months postpartum. There was 1 pregnancy in a ring users. The continuation rates were 66.6% for rings and 85.5% for IUDs. The reasons for discontinuation in vaginal ring continuation were logistical problems and unfamiliarity.
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PMID:Contraception with progestogens and progesterone during lactation. 183 50

The most effective, convenient, reversible method of birth control is considered to be long-acting progestogen injections. Used by over 90 countries, Depot medroxy-progesterone acetate (DMPA, Depo-Provera, Upjohn) has yet to be approved by the U.S. Food and Drug Administration. The reluctance of the FDA to approve DMPA and much of the controversy surrounding this method revolve around the results of testing done on animals who were given large doses of the progestogen over a long period of time and developed tumors. However, the large body of research and records on this method that have been compiled over the past 30 years is positive. The injectable method works like oral contraceptives, inhibiting ovulation. Changes in menstruation have been the chief complaint of women who use this method; however, the duration and frequency of spotting and bleeding diminish over time. Other side effects of DMPA and Norethindrone enanthate (NET EN, Noristerat, Schering) are discussed. Also discussed is the history of development and testing for the 2 methods and subdermal implants, specifically Norplant.
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PMID:Injectable contraception. 252 77

Irregularity in vaginal bleeding patterns is the most common clinical side effect causing discontinuation of the method reported by the-users of the newer contraceptive methods, especially hormonal ones. An objective assessment of vaginal bleeding pattern is, therefore, critical in evaluation of a new contraceptive method for its acceptance and continued use. The menstrual diary records of women participating in clinical trials of several contraceptive methods undertaken by the Indian Council of Medical Research were analysed. It was observed that the long-acting progestogen-only hormonal contraceptives like levonorgestrel (LNG)-releasing subdermal implants Norplant or intrauterine devices (LNG-IUD) as well as injectable contraceptive NET-EN 200mg given 2 or 3 monthly produced disturbances in bleeding pattern in the majority of their users. Very heavy or prolonged bleeding, a potential health hazard was uncommon and a shift more towards infrequent bleeding was observed. In Norplant-II implants users, 75 to 80% of women had irregularities in bleeding pattern during the first year of use which improved with prolonged use. However, even at 4 years of use, about half of the users of Norplant-II implants continued to have irregular bleeding patterns. The bleeding disturbances occurred in 80% users of 200mg NET-EN injectable contraceptives also during first year of use, however unlike Norplant-II implants users, there was no improvement with prolonged use. Combined monthly injectable contraceptives containing 50mg NET-EN and 5mg estradiol valerate caused less bleeding problems with half of the users experiencing normal pattern during one year of its use. Combined low-dose oral pills, both triphasic and monophasic, produced much better cycle control as compared to any of the other hormonal contraceptive-treated groups; about 90% of combined oral pill users had normal bleeding patterns during one year of method use. The use of copper IUDs was associated with increased bleeding in 18 to 20% of women during the initial period of three months which improved with prolonged use. It was observed that the women having frequent or prolonged bleeding had discontinued the contraceptive method more often as compared to those having delayed bleeding episodes or oligomenorrhoea. However, discontinuation rates due to bleeding irregularities at one year were lower in Norplant-II implants users as compared to other long acting hormonal contraceptive methods such as injectables or IUDs in spite of similar or better bleeding patterns in women using these methods.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Vaginal bleeding patterns of women using different contraceptive methods (implants, injectables, IUDs, oral pills)--an Indian experience. An ICMR Task Force Study. Indian Council of Medical Research. 762 84

After observation and in-depth interviews within the Indonesian Family Planning Service Delivery System, it was concluded that the introduction of new contraceptives such as the injectable Cyclofem administered once a month would be advantageous only if changes were made in operations and program management. Changes were needed in counseling and information provision, technical provision of care, training of staff, supervision, record keeping, logistics and supplies, and policy support. Informed choice was jeopardized in the prior introduction of the new method Norplant, and wide scale introduction of Cyclofem would stretch the ability of the system to respond with assurances of quality of care. Expanding the method mix would be appropriate in settings where the service delivery system is stronger, where injectables are not currently available, and where Cyclofem could replace high-dose injectables already dispensed. This study included observations of 241 individual provider-client interactions and 107 in-depth interviews among national leaders, provincial and district program managers, public and private sector providers, community leaders, and clients in Cyclofem trial and non-trial areas. Promotional activities were not performed for Cyclofem. The introduction of Cyclofem expanded women's options and in a way that included additional information not usually provided. Cyclofem has the advantage of easy reversibility, regular bleeding patterns, and high efficacy. This method, however, was not promoted as a spacing method, in part because spacing methods are generally promoted within the service delivery system. The system already provide two other injectables, DMPA and NET-EN, with very different side effects. The policy and management obstacles to planned expansion of choice in the public sector of the Indonesian Family Planning Program included the following: the emphasis on long-acting methods, charges for injectables and limited supplies, the lack of identification of specific injectables in the record-keeping system, inadequate information dissemination and counseling, and the added burden to staff time. The private sector is more suitable for introduction of all injectables.
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PMID:Contraceptive introduction and the management of choice: the role of Cyclofem in Indonesia. 804 35

This review covers the appropriateness of the use of hormonal contraceptive methods while breast feeding. The introduction notes that exclusive breast feeding is associated with a pregnancy rate of less than 2% during the first 6 months postpartum. While infertility associated with amenorrhea may be extended by breast feeding on demand continually during the day and night, this is often impractical for women in developed countries. Research on progestin-only contraceptives indicates that use of norgestrel may enhance lactation and is associated with no difference in milk content from controls. Use of levonorgestrel was associated with decreased milk volume but no differences in length, weight, or head circumference of subject infants. Injections of NET-EN or depot medroxyprogesterone at 1 and 6 weeks postpartum led to no adverse effects on infants or lactation. In addition, Norplant implants after the 4th week postpartum had no affect other than passing on a small dose to the infant, which is associated with no health risk. Use of a progestin-releasing IUD in comparison with a copper IUD was associated with a slight decrease in milk volume. Nearly all studies have concluded that combined oral contraceptives decrease milk volume and impair a woman's ability to breast feed exclusively. Thus, hormonal contraceptives can be used immediately postpartum and progestin-only contraceptives are preferable during the first 6 months because they have no apparent deleterious effect on breast feeding.
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PMID:Hormonal contraception and lactation. 902 49

Steroids can be administered in at least five different ways: injectables; hormone-releasing intra-uterine devices (IUDs); implants; vaginal rings; and pills. Progestogens which are synthetic steroids, are used as the main bioactive substances. Different progestogens are effective for different periods of time. Progestins in daily oral pills are effective for 24 hours. The effectiveness of a progestogen can be prolonged by incorporating it in a sustained-release system that gradually releases the hormone; therefore they can be effective up to 5 years or more. Two progestogen-only injectables are widely available in the family planning programmes, (DMPA and NET-EN) and two combined injectables, Cyclofem (DMPA + EC), and Mesigyna (NET-EN + EV). The ring is placed by the woman in her vagina, where it gradually releases hormone. Implantable contraceptives are placed just under the skin on the inside of the woman's arm. Implant capsules release the progestogen at a slow, steady rate. There are three implantables available in the market: Implanon; Norplant; and Jadelle. They are effective for 1-5 years, but then must be replaced. Natural and synthetic progestogens were first added to IUDs in the early 1970s. The main problem of long-acting progestogens is the disruption of the menstrual cycle.
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PMID:Long-acting progestogens. 1204 60

New injectable and implantable contraceptives that provide a slow, steady dose of hormone over long periods of time promise convenient, trouble-free contraception not related to intercourse. Like oral progestagen-only contraceptives, they prevent fertilization by impeding sperm penetration through the cervical mucus, and, also like oral progestagens, their major side effects are menstrual disorders. Injectable contraceptives have the advantage that they can be administered by trained health workers and the disadvantage that they cannot be removed. New 90-day injectables that do not release initial high levels of progestagens are being developed. Family Health International is conducting Phase III clinical trials of the NET 90-day injectable, which releases .66 mg progestagen a day. Other 90-day injectables include a levonorgestrel and a progesterone injectable being developed by Stolle, a norgestimate injectable being tested by Ortho Pharmaceutical, and steroid ester injectables being developed by the World Health Organization and the US National Institute of Child Health and Human Development. Combined estrogen-progesterone monthly injectables are used by millions of women in Mexico, Latin America, and China; and 2 monthly combined injectables, HRP112 and HRP102, are being tested by the World Health Organization. 2 injectables, Upjohn's Depo-Provera and Schering's Noristerat, have been available for over a decade. Both are extremely effective, with pregnancy rates of less than 2/100 woman-years of use. Depo-Provera has been approved for use in the UK and West Germany but not in the US, due to the development of breast and endometrial tumors in experimental animals. The longest acting steroid contraceptives are the implantables. Family Health International is conducting Phase III clinical trials of the biodegradable NET pellets, containing 85% norethindrone and 15% cholesterol, developed by Endocon, Inc. Capronor, a biodegradable capsule containing levonorgestrel, developed by the Research Triangle Institute, is currently being tested in animals. The Population Council's Norplant consists of 36 mg levonorgestrel in 6 silicon elastomer capsules, which are not biodegradable. Norplant is effective for 5 years, after which the capsules must be removed. Norplant is highly effective, with a pregnancy rate of less than 1/100 woman-years of use. Its advantages are the lack of estrogen-related side effects and a swift return to fertility. Disadvantages are a higher initial cost and the need for insertion and removal by trained personnel.
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PMID:Long-acting steroids provide new options. 1231 56

"New Era for Injectables," a report published in the most recent issue of the Johns Hopkins University School of Hygiene and Public Health's Population Reports, notes that injectable contraceptives are among the most effective family planning methods. Most clinical trials report less than one pregnancy per 100 women during the first year of use, making injectables as effective as Norplant implants, the best copper IUDs, and voluntary sterilization. Injectables also protect women against ectopic pregnancy, help to prevent endometrial and possibly ovarian cancer, and may help women with anemia and sickle-cell disease. The major side effect of injectable use is changes in menstrual bleeding. Some women also experience weight gain, and a few report headaches, dizziness, abdominal discomfort, acne, and moodiness. The most widely-used injectable is the progestin-only DMPA (depot medroxyprogesterone acetate), known under the brand name Depo-Provera and manufactured by the Upjohn Company. Women receive an injection every 3 months. Another progestin-only injectable, NET EN (norethindrone enanthate), is taken every 2 months. Cyclofem and Mesigyna, two new monthly injectables which combine estrogen and progestin, are currently being introduced in a number of countries. Worldwide, 1.5% of all married women of reproductive age who use some form of family planning use injectables. The highest level of use among such women is in Indonesia and Thailand where 15% and 12%, respectively, use injectables. Donor agencies have been responding to increasing numbers of orders for injectables from family planning programs in developing countries, while the UN Population Fund, the largest supplier, shipped 12 million doses of injectables in 1992 and 20 million in 1994. The 1992 US Food and Drug Administration approval of DMPA has made it possible for the US Agency of International Development to respond to requests for it.
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PMID:Millions of couples to have choice of injectable contraceptive. 1234 10