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American Family Physician Apr 2014
Topics: Contraception, Postcoital; Contraceptives, Postcoital; Emergency Medical Services; Female; Humans; Levonorgestrel; Norpregnadienes
PubMed: 24695612
DOI: No ID Found -
Canadian Family Physician Medecin de... Feb 2023
Topics: Female; Humans; Menorrhagia; Intrauterine Devices; Levonorgestrel; Intrauterine Devices, Medicated
PubMed: 36813509
DOI: 10.46747/cfp.6902113 -
Molecules (Basel, Switzerland) Jun 2023To meet the growing needs of public safety and sustainable development, it is highly desirable to develop flame-retardant polymer materials using a facile and low-cost... (Review)
Review
To meet the growing needs of public safety and sustainable development, it is highly desirable to develop flame-retardant polymer materials using a facile and low-cost method. Although conventional solution chemical synthesis has proven to be an efficient way of developing flame retardants, it often requires organic solvents and a complicated separation process. In this review, we summarize the progress made in utilizing simple ball milling (an important type of mechanochemical approach) to fabricate flame retardants and flame-retardant polymer composites. To elaborate, we first present a basic introduction to ball milling, and its crushing, exfoliating, modifying, and reacting actions, as used in the development of high-performance flame retardants. Then, we report the mixing action of ball milling, as used in the preparation of flame-retardant polymer composites, especially in the formation of multifunctional segregated structures. Hopefully, this review will provide a reference for the study of developing flame-retardant polymer materials in a facile and feasible way.
Topics: Flame Retardants; Levonorgestrel; Polymers; Sustainable Development
PubMed: 37446752
DOI: 10.3390/molecules28135090 -
Contraception Feb 2017Combined hormonal contraceptives (CHCs), containing estrogen and progestin, are associated with an increased risk of venous thromboembolism (VTE) and arterial... (Review)
Review
BACKGROUND
Combined hormonal contraceptives (CHCs), containing estrogen and progestin, are associated with an increased risk of venous thromboembolism (VTE) and arterial thromboembolism (ATE) compared with nonuse. Few studies have examined whether nonoral formulations (including the combined hormonal patch, combined vaginal ring and combined injectable contraceptives) increase the risk of thrombosis compared with combined oral contraceptives (COCs).
OBJECTIVES
The objectives were to examine the risk of VTE and ATE among women using nonoral CHCs compared to women using COCs.
METHODS
We searched the PubMed database for all English language articles published from database inception through May 2016. We included primary research studies that examined women using the patch, ring or combined injectables compared with women using levonorgestrel-containing or norgestimate-containing COCs. Outcomes of interest included VTE (deep venous thrombosis or pulmonary embolism) or ATE (acute myocardial infarction or ischemic stroke). We assessed the quality of each individual piece of evidence using the system developed by the United States Preventive Services Task Force.
RESULTS
Eight studies were identified that met inclusion criteria. Of seven analyses from six studies examining VTE among patch users compared with levonorgestrel- or norgestimate-containing COC users, two found a statistically significantly elevated risk among patch users (risk estimates 2.2-2.3), one found an elevated risk that did not meet statistical significance (risk estimate 2.0), and four found no increased risk. Of three studies examining VTE among ring users compared with levonorgestrel COC users, one found a statistically significantly elevated risk among patch users (risk estimate 1.9) and two did not. Two studies did not find an increased risk for ATE among women using the patch compared with norgestimate COCs. We did not identify any studies examining combined injectable contraceptives.
CONCLUSION
Limited Level II-2 good to fair evidence demonstrated conflicting results on whether women using the patch or the ring have a higher risk of VTE than women using COCs. Evidence did not demonstrate an increased risk of ATE among women using the patch. Overall, any potential elevated risk likely represents a small number of events on a population level. Additional studies with standard methodology are needed to further clarify any associations and better understand mechanisms of hormone-induced thrombosis among users of nonoral combined hormonal contraception.
Topics: Administration, Cutaneous; Adolescent; Adult; Contraceptive Devices, Female; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Estrogens; Female; Humans; Levonorgestrel; Norgestrel; Progestins; Risk Factors; Thromboembolism; Venous Thromboembolism; Young Adult
PubMed: 27771476
DOI: 10.1016/j.contraception.2016.10.005 -
Cleveland Clinic Journal of Medicine Mar 2013
Topics: Contraception, Postcoital; Female; Humans; Levonorgestrel; Practice Patterns, Physicians'; Pregnancy
PubMed: 23456469
DOI: 10.3949/ccjm.80c.03001 -
Lancet (London, England) Feb 2020
Topics: Contraception; Female; HIV Infections; Humans; Incidence; Intrauterine Devices, Copper; Levonorgestrel; Medroxyprogesterone Acetate
PubMed: 32035557
DOI: 10.1016/S0140-6736(19)33107-1 -
Ontario Health Technology Assessment... 2016Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced... (Comparative Study)
Comparative Study Review
BACKGROUND
Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding.
METHODS
We conducted a systematic review of the clinical and economic evidence comparing LNG-IUS with usual medical therapy, endometrial ablation, or hysterectomy. Medline, EMBASE, Cochrane, and the Centres for Reviews and Dissemination were searched from inception to August 2015. The quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also completed an economic evaluation to determine the cost-effectiveness and budget impact of the LNG-IUS compared with endometrial ablation and with hysterectomy. The economic evaluation was conducted from the perspective the Ontario Ministry of Health and Long-Term Care.
RESULTS
Relevant systematic reviews (n = 18) returned from the literature search were used to identify eligible randomized controlled trials, and 16 trials were included. The LNG-IUS improved quality of life and reduced menstrual blood loss better than usual medical therapy. There was no evidence of a significant difference in these outcomes compared with the improvements offered by endometrial ablation or hysterectomy. Mild hormonal side effects were the most commonly reported. The quality of the evidence varied from very low to moderate across outcomes. Results from the economic evaluation showed the LNG-IUS was less costly (incremental saving of $372 per person) and more effective providing higher quality-adjusted life years (incremental value of 0.05) compared with endometrial ablation. Similarly, the LNG-IUS costs less (incremental saving of $3,138 per person) and yields higher quality-adjusted life-years (incremental value of 0.04) compared with hysterectomy. Publicly funding LNG-IUS as an alternative to endometrial ablation and hysterectomy would result in annual cost savings of $3 million to $9 million and $0.1 million to $23 million, respectively, over the first 5 years.
CONCLUSIONS
The 52-mg LNG-IUS is an effective and cost-effective treatment option for idiopathic heavy menstrual bleeding. It improves quality of life and menstrual blood loss, and is well tolerated compared with endometrial ablation, hysterectomy, or usual medical therapies.
Topics: Adolescent; Adult; Endometrial Ablation Techniques; Female; Humans; Hysterectomy; Levonorgestrel; Menorrhagia; Middle Aged; Ontario; Technology Assessment, Biomedical; Young Adult
PubMed: 27990196
DOI: No ID Found -
Journal of Neurochemistry Jan 2016'Norgestrel', a synthetic form of the female hormone progesterone has been identified as potential drug candidate for the treatment of the degenerative eye disease...
'Norgestrel', a synthetic form of the female hormone progesterone has been identified as potential drug candidate for the treatment of the degenerative eye disease retinitis pigmentosa. However, to date, no work has looked at the compound's specific cellular target. Therefore, this study aimed to identify the receptor target of Norgestrel and begin to examine its potential mechanism of action in the retina. In this work, we identify and characterize the expression of progesterone receptors present in the C57 wild type and rd10 mouse model of retinitis pigmentosa. Classical progesterone receptors A and B (PR A/B), progesterone receptor membrane components 1 and 2 (PGRMC1, PGRMC2) and membrane progesterone receptors α, β and γ were found to be expressed. All receptors excluding PR A/B were also found in the 661W photoreceptor cell line. PGRMC1 is a key regulator of apoptosis and its expression is up-regulated in the degenerating rd10 mouse retina. Activated by Norgestrel through nuclear trafficking, siRNA knock down of PGRMC1 abrogated the protective properties of Norgestrel on damaged photoreceptors. Furthermore, specific inhibition of PGRMC1 by AG205 blocked Norgestrel-induced protection in stressed retinal explants. Therefore, we conclude that PGRMC1 is crucial to the neuroprotective effects of Norgestrel on stressed photoreceptors. The synthetic progestin 'Norgestrel' has been identified as a potential therapeutic for the treatment of Retinitis Pigmentosa, a degenerative eye disease. However, the mechanism behind this neuroprotection is currently unknown. In this work, we identify 'Progesterone Receptor Membrane Component 1' as the major progesterone receptor eliciting the protective effects of Norgestrel, both in vitro and ex vivo. This furthers our understanding of Norgestrel's molecular mechanism, which we hope will help bring Norgestrel one step closer to the clinic.
Topics: Animals; Cells, Cultured; Female; Male; Membrane Proteins; Mice; Mice, Inbred C57BL; Mice, Transgenic; Neuroprotection; Norgestrel; Photoreceptor Cells, Vertebrate; Receptors, Progesterone; Signal Transduction
PubMed: 26447367
DOI: 10.1111/jnc.13388 -
Contraception Jan 2022To review published data on the effectiveness of a progestogen-only pill containing norgestrel 75 µg/day which should be under consideration by the FDA in 2022 for sale... (Review)
Review
OBJECTIVES
To review published data on the effectiveness of a progestogen-only pill containing norgestrel 75 µg/day which should be under consideration by the FDA in 2022 for sale over the counter in the US.
STUDY DESIGN
A literature search in MEDLINE, EMBASE, and COCHRANE REVIEWS using specified search terms and adding related cross-references.
RESULTS
We identified a total of thirteen relevant studies of women using norgestrel 75 µg/day. None were reported with the rigor characteristic of trial reporting today. Nevertheless, six studies provided data on 3,184 women who were not breastfeeding, followed for over 35,000 months and reported a range of overall failure rates during typical use of norgestrel 75 µg/day from 0 to 2.4/hundred woman-years giving an aggregate Pearl Index of 2.2. Seven additional studies involved 5,445 women some of whom were breastfeeding for at least part of the period of follow-up. More than 36,000 months of use yielded 12-month life table cumulative pregnancy rates for norgestrel 75 µg/day ranging from 0 to 3.4. We were unable to calculate an aggregate Pearl Index for the breastfeeding studies because of lack of crucial data.
CONCLUSIONS
The data support that norgestrel 75 µg/day is highly effective in clinical use, with similar estimates of failure in breastfeeding and non-breastfeeding women, providing support to the case for approval without the need to see a healthcare provider.
Topics: Breast Feeding; Female; Humans; Norgestrel; Pregnancy; Progestins
PubMed: 34499877
DOI: 10.1016/j.contraception.2021.08.016 -
Cleveland Clinic Journal of Medicine Nov 2012Rates of unintended pregnancy and abortion are high, yet many doctors do not feel comfortable discussing emergency contraception with patients, even in cases of sexual... (Review)
Review
Rates of unintended pregnancy and abortion are high, yet many doctors do not feel comfortable discussing emergency contraception with patients, even in cases of sexual assault. Since the approval of ulipristal acetate (ella) for emergency contraception, there has been even more confusion and controversy. This article reviews various emergency contraceptive options, their efficacy, and special considerations for use, and will attempt to clarify myths surrounding this topic.
Topics: Abortion, Induced; Contraception, Postcoital; Counseling; Crime Victims; Female; Hospitals; Humans; Intrauterine Devices, Copper; Levonorgestrel; Mifepristone; Nonprescription Drugs; Norpregnadienes; Obesity; Practice Patterns, Physicians'; Pregnancy; Pregnancy, Unplanned; Sex Offenses; United States
PubMed: 23125326
DOI: 10.3949/ccjm.79a.12019