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Global Health, Science and Practice Jun 2020The Implants Access Program (IAP) was a partnership between public and private organizations that aimed to increase access to contraceptive implants for women in...
The Implants Access Program (IAP) was a partnership between public and private organizations that aimed to increase access to contraceptive implants for women in low-income countries. The partnership began with 2 volume guarantee agreements that reduced the price of implants by approximately 50% and was complemented by efforts to address supply chain, service delivery, and knowledge and awareness barriers. We conducted a summative evaluation to identify key insights related to the IAP's relevance, effectiveness, and sustainability. We completed a desk review of program materials and published literature, followed by 42 in-depth interviews, including global stakeholders and country stakeholders in 3 case example countries: Kenya, Nigeria, and Uganda. The evaluation found evidence of increased access to implants including a 10-fold increase in procurement between 2010 and 2018 and an increase in prevalence of contraceptive implants during this same period. The IAP leveraged global family planning efforts taking place at the time, and its partnerships offered a business case for manufacturers to support increased access to implants. Enhanced supply chain visibility and coordination helped limit country-level stock-outs, and the IAP built on existing in-country delivery capacity. Although the IAP was able to address key challenges due to its effective collaboration and coordination at global and country levels, sustaining progress requires institutionalized mechanisms to continue global efforts and long-term assurances that the low price of implants will be maintained. Over 6 years, the IAP supported tremendous progress in increasing access to implants for women in low-income countries by building a public- and private-sector collaboration that focused on systems change in the family planning field. This partnership matched a unique response to a unique problem: building tools, systems, and capacity that can inform and support the introduction and scale-up of new and underutilized contraceptive methods.
Topics: Contraception; Contraceptive Agents, Female; Contraceptive Devices; Delayed-Action Preparations; Developing Countries; Drug Implants; Family Planning Services; Female; Health Services Accessibility; Humans; Kenya; Long-Acting Reversible Contraception; Nigeria; Private Sector; Public-Private Sector Partnerships; Uganda
PubMed: 32467126
DOI: 10.9745/GHSP-D-19-00383 -
American Journal of Public Health Jan 1998
Topics: Coercion; Contraceptive Agents, Female; Drug Implants; Female; Humans; Levonorgestrel
PubMed: 9584026
DOI: 10.2105/ajph.88.1.136-c -
Current Biology : CB Feb 2006
Comparative Study
Topics: Animals; Conservation of Natural Resources; Corticosterone; Drug Implants; Female; Male; New Zealand; Quail; Reproduction; Sex Ratio
PubMed: 16506315
DOI: 10.1016/j.cub.2006.01.040 -
The Journal of Family Planning and... Apr 2004
Topics: Abortion, Induced; Contraceptive Agents, Female; Desogestrel; Drug Implants; Female; Humans; Patient Acceptance of Health Care; Pregnancy; Pregnancy, Unwanted
PubMed: 15087011
DOI: 10.1783/147118904322995636 -
The Journal of Family Planning and... Oct 2006
Topics: Adult; Contraceptive Devices, Female; Device Removal; Drug Implants; Female; Humans
PubMed: 17032535
DOI: 10.1783/147118906778586624 -
Contraception Sep 2016This study aims to systematically review evidence published on the safety of Sino-implant (II) [SI (II)] among women with medical conditions or characteristics... (Review)
Review
OBJECTIVES
This study aims to systematically review evidence published on the safety of Sino-implant (II) [SI (II)] among women with medical conditions or characteristics identified by the World Health Organization for eligibility for contraceptive use.
STUDY DESIGN
We searched PubMed, WEIPU, CNKI and Wanfang to identify all relevant evidence published in peer-reviewed journals from 1991 through 2014 regarding the safety of SI (II). We considered studies among women with medical conditions or other characteristics, such as age and parity, as direct evidence and studies among healthy women or a general population of women as indirect evidence.
RESULTS
We identified 108 articles of which 9 met our inclusion criteria. Among women with medical conditions, no evidence was identified for the outcomes of interest, including serious adverse events or outcomes related to medical conditions. Among healthy women, evidence regarding efficacy of SI (II) for women weighing ≥70 kg was conflicting; one study showed an increased pregnancy rate and another showed no relationship. Women with menorrhagia did not experience worsened symptoms and may benefit from SI (II) use. Healthy women using SI (II) were no more likely than users of other methods to gain weight, develop elevated blood pressure, have abnormal liver or bone density tests or develop ovarian cysts or uterine myomas.
CONCLUSIONS
Evidence among healthy women suggests SI (II) is safe and had health outcomes similar to those of other levonorgestrel implants. Studies were limited and conflicting regarding efficacy for women ≥70 kg. All included studies were conducted in China, limiting generalizability.
Topics: Bone Density; China; Contraception Behavior; Contraceptive Agents, Female; Drug Implants; Female; Humans; Leiomyoma; Levonorgestrel; Ovarian Cysts; Patient Satisfaction; Randomized Controlled Trials as Topic; Weight Gain
PubMed: 27217053
DOI: 10.1016/j.contraception.2016.05.004 -
Postgraduate Medical Journal Jan 2004At present there is much excitement about drug-eluting stents, which hold promise for the treatment of coronary artery disease. This ingenious therapy involves coating... (Review)
Review
At present there is much excitement about drug-eluting stents, which hold promise for the treatment of coronary artery disease. This ingenious therapy involves coating the outside of a standard coronary stent with a thin polymer containing medication that can prevent scarring at the site of coronary intervention. Early trials with sirolimus coated stents showed that they might prevent coronary artery restenosis, but later studies, involving more complex coronary lesions, did not show a complete absence of restenosis. Recent studies have demonstrated the long term cost effectiveness of drug-eluting stents as they have reduced the need for revascularisation procedures. At present there are few data on the safety and effectiveness of stents over follow up periods exceeding two years, and data obtained from animal models of stenting might not be completely applicable to humans. There are concerns that drug-eluting stents might delay, rather than inhibit, restenosis. Also there is concern regarding the inflammation caused by the polymer substrate. This article reviews the present data on drug-eluting stents and their benefits, shortcomings, and concerns.
Topics: Antineoplastic Agents, Phytogenic; Clinical Trials as Topic; Coronary Restenosis; Coronary Stenosis; Cost-Benefit Analysis; Drug Implants; Humans; Paclitaxel; Stents
PubMed: 14760171
DOI: 10.1136/pmj.2003.009431 -
Scientific Reports Sep 2023Recently, Ta/Cu nanocomposites have been widely used in therapeutic medical devices due to their excellent bioactivity and biocompatibility, antimicrobial property, and...
Recently, Ta/Cu nanocomposites have been widely used in therapeutic medical devices due to their excellent bioactivity and biocompatibility, antimicrobial property, and outstanding corrosion and wear resistance. Since mechanical yielding and any other deformation in the patient's body during treatment are unacceptable in medicine, the characterization of the mechanical behavior of these nanomaterials is of great importance. We focus on the microstructural evolution of Ta/Cu nanocomposite samples under uniaxial tensile loading conditions at different strain rates using a series of molecular dynamics simulations and compare to the reference case of pure Ta. The results show that the increase in dislocation density at lower strain rates leads to the significant weakening of the mechanical properties. The strain rate-dependent plastic deformation mechanism of the samples can be divided into three main categories: phase transitions at the extreme strain rates, dislocation slip/twinning at lower strain rates for coarse-grained samples, and grain-boundary based activities for the finer-grained samples. Finally, we demonstrate that the load transfer from the Ta matrix to the Cu nanoparticles via the interfacial region can significantly affect the plastic deformation of the matrix in all nanocomposite samples. These results will prove useful for the design of therapeutic implants based on Ta/Cu nanocomposites.
Topics: Humans; Nanocomposites; Corrosion; Drug Implants; Edible Grain; Joint Dislocations
PubMed: 37737499
DOI: 10.1038/s41598-023-43126-6 -
Therapeutic Delivery Nov 2014“Despite limitations associated with every approach, delivery of proteins for an extended duration in a controlled manner is achievable… a clinically acceptable...
“Despite limitations associated with every approach, delivery of proteins for an extended duration in a controlled manner is achievable… a clinically acceptable formulation that delivers proteins over a period of months is largely an unmet need.”
Topics: Absorbable Implants; Chemistry, Pharmaceutical; Drug Carriers; Drug Implants; Forecasting; Polymers; Proteins; Technology, Pharmaceutical
PubMed: 25491667
DOI: 10.4155/tde.14.86 -
Graefe's Archive For Clinical and... May 2023The purpose of this study is to evaluate clinical outcomes of autoimmune retinopathy (AIR) in the patients treated with intravitreal dexamethasone implant (IDI).
PURPOSE
The purpose of this study is to evaluate clinical outcomes of autoimmune retinopathy (AIR) in the patients treated with intravitreal dexamethasone implant (IDI).
METHOD
Twenty-one eyes of 11 AIR patients treated with at least 1 injection of IDI were retrospectively reviewed. Clinical outcomes before and after treatment, including best corrected visual acuity (BCVA), optic coherence tomography (OCT), fundus autofluorescence (FAF), full-field electroretinography (ff-ERG), and visual field (VF) at last visit within 6 and/or 12 months, were recorded.
RESULTS
Among all the patients, 3 had cancer-associated retinopathy (CAR) and 8 had non-paraneoplastic-AIR (npAIR) with mean followed up of 8.52 ± 3.03 months (range 4-12 months). All patients achieved improved or stable BCVA within 6 and/or 12 months after the treatment. Cystoid macular edema (CME) in 2 eyes and significant retinal inflammation in 4 eyes were markedly resolved after single injection. Central retinal thickness (CFT) in all eyes without CME, ellipsoid zone (EZ) on OCT in 71.4% of eyes, ERG response in 55% of eyes, and VF in 50% of eyes were stable or improved within 6 months after treatment. At last visit within 12 months, both BCVA and CFT remained stable in the eyes treated with either single or repeated IDI; however, progression of EZ loss and damage of ERG response occurred in some patients with single IDI.
CONCLUSION
Clinical outcomes, including BCVA and parameters of OCT, ERG, and VF, were stable or improved after IDI in a majority of AIR patients. Local treatment of AIR with IDI was a good option to initiate the management or an alternative for the patients' refractory to the systemic therapy but with limited side effect.
Topics: Humans; Dexamethasone; Glucocorticoids; Autoimmune Diseases; Retinal Diseases; Retrospective Studies; Tomography, Optical Coherence; Macular Edema; Retina; Intravitreal Injections; Drug Implants; Diabetic Retinopathy
PubMed: 36565329
DOI: 10.1007/s00417-022-05941-x