Objective: To compare the efficacy, side-effects and acceptability of domestic produced implant No. I and No. II with Norplant. Method: A multicentered randomized prospective clinical trial was conducted in ten center...Objective: To compare the efficacy, side-effects and acceptability of domestic produced implant No. I and No. II with Norplant. Method: A multicentered randomized prospective clinical trial was conducted in ten centers in Chi na since 1993. Every center have recruited 100 cases for each of the three types of implants. Results: Altogether l, 001 cases of No. I, 1, 000 cases of No. II and 998 cases of Norplant were recruited. The follow--up rate was 99. 2% at the end of 24 months and 99. 1% at the end of 36 months. One pregnancy in No. I implant occurred & months after insertion and the net cumulative pregnancy rate was 0. 1 per 100 women. Total discontinuation rates were 15. 1, 14. 1, and 12. 9 per 100 women in NO. I, No. II and Norplant groups respectively. Among them about 75% of discontinuation was due to the menstrual problems. The incidence of side-effects were 22. 6%, 19. 0% and 19. 7% respectively at 36 months follow--up. There was no significant differences in efficacy and side effects among these three types of implant. Conclusion: The result of this three-years’ follow--up indicated that the domestic products implant No. I and No. II just as Norplant are long term, highly effective contraceptive and have been accepted in different area by different people. It will be widely selected by women of reproductive age in China.展开更多
In the United States, maternal mortality and unintended pregnancy rates are increasing. There are growing disparities in maternal health between indigent, minority women and Caucasian women of higher socioeconomic sta...In the United States, maternal mortality and unintended pregnancy rates are increasing. There are growing disparities in maternal health between indigent, minority women and Caucasian women of higher socioeconomic status. Family planning has long been viewed as a solution to these problems. As reliance on permanent contraception has diminished, timely access to highly effective contraceptive methods, namely long acting reversible contraceptives, which includes the contraceptive hormonal implant and intrauterine device- has become even more important. For women in the United States and abroad, the time of delivery is the one reliable opportunity for women to receive medical care. Consistently, research has shown that providing contraception in the immediate postpartum period is safe, effective, feasible and cost effective. However, misperceptions, lack of supplies, and reimbursement issues combine to defeat attempts to provide the most effective methods of contraception during that hospitalization. We believe that it is time to tackle the problem of unintended and rapid repeat pregnancy using an evidence-based, patient-centered paradigm and to eradicate systemic barriers blocking access to contraceptive methods during hospital stay. This editorial will outline some of the more compelling evidence supporting this move and will provide insights from successful programs.展开更多
In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well docum...In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well documented. We refined this technique as a mini V-Y advancement flap consisting of two subcutaneous pedicles that vascularize the skin island via subdermal plexus lateral bridges. This technique was used for 21 middle-aged or younger patients with a small benign skin lesion. None of them experienced any postoperative complications. Aesthetically excellent results were found in all patients. This small advancement flap could be attempted as an alternative to fusiform excision of small skin lesions, particularly in younger patients.展开更多
文摘Objective: To compare the efficacy, side-effects and acceptability of domestic produced implant No. I and No. II with Norplant. Method: A multicentered randomized prospective clinical trial was conducted in ten centers in Chi na since 1993. Every center have recruited 100 cases for each of the three types of implants. Results: Altogether l, 001 cases of No. I, 1, 000 cases of No. II and 998 cases of Norplant were recruited. The follow--up rate was 99. 2% at the end of 24 months and 99. 1% at the end of 36 months. One pregnancy in No. I implant occurred & months after insertion and the net cumulative pregnancy rate was 0. 1 per 100 women. Total discontinuation rates were 15. 1, 14. 1, and 12. 9 per 100 women in NO. I, No. II and Norplant groups respectively. Among them about 75% of discontinuation was due to the menstrual problems. The incidence of side-effects were 22. 6%, 19. 0% and 19. 7% respectively at 36 months follow--up. There was no significant differences in efficacy and side effects among these three types of implant. Conclusion: The result of this three-years’ follow--up indicated that the domestic products implant No. I and No. II just as Norplant are long term, highly effective contraceptive and have been accepted in different area by different people. It will be widely selected by women of reproductive age in China.
文摘In the United States, maternal mortality and unintended pregnancy rates are increasing. There are growing disparities in maternal health between indigent, minority women and Caucasian women of higher socioeconomic status. Family planning has long been viewed as a solution to these problems. As reliance on permanent contraception has diminished, timely access to highly effective contraceptive methods, namely long acting reversible contraceptives, which includes the contraceptive hormonal implant and intrauterine device- has become even more important. For women in the United States and abroad, the time of delivery is the one reliable opportunity for women to receive medical care. Consistently, research has shown that providing contraception in the immediate postpartum period is safe, effective, feasible and cost effective. However, misperceptions, lack of supplies, and reimbursement issues combine to defeat attempts to provide the most effective methods of contraception during that hospitalization. We believe that it is time to tackle the problem of unintended and rapid repeat pregnancy using an evidence-based, patient-centered paradigm and to eradicate systemic barriers blocking access to contraceptive methods during hospital stay. This editorial will outline some of the more compelling evidence supporting this move and will provide insights from successful programs.
文摘In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well documented. We refined this technique as a mini V-Y advancement flap consisting of two subcutaneous pedicles that vascularize the skin island via subdermal plexus lateral bridges. This technique was used for 21 middle-aged or younger patients with a small benign skin lesion. None of them experienced any postoperative complications. Aesthetically excellent results were found in all patients. This small advancement flap could be attempted as an alternative to fusiform excision of small skin lesions, particularly in younger patients.
