Factors leading to the removal of the intrauterine implant Gynefix.

OBJECTIVE: The objective of this study was to determine the incidence of expulsion of the Gynefix intrauterine implant, to analyze the variables associated with the above and to examine the efficacy of this intrauterine contraceptive model in users at the Municipal Family Planning Center-SERGAS in A Coruña, Spain. METHODS: A prospective observational study was performed on all women (n = 358) who had a Gynefix implant inserted from March 1998 to September 2000. RESULTS: The accumulated incidence of implant expulsion was 6.7% (95% confidence interval (CI) 4.4-9.9) with a pregnancy rate of 0.6% (95% CI 0.09-2.2). The probability of implant removal decreases with the rise in the number of implants that have been inserted by the professional. A multivariate analysis adjusted for age, number of implants and uterine position showed that the position of the uterus was the variable that independently determined the probability of removal. CONCLUSIONS: It is concluded that retroflexion of the uterus increases the probability of removal.

The importance of the removal of the intrauterine device in genital colonization by actinomyces.

OBJECTIVE: To determine whether, in addition to treatment with antibiotics, it is necessary to remove the intrauterine device (IUD) to eliminate genital colonization by Actinomyces. METHODS: A randomized clinical trial was carried out. Patients were divided into two groups. The intervention group did not have their IUDs removed, while the control group did. Both groups were treated with trimethoprim and sulfamethoxazole. A total of 43 patients were included. RESULTS: The patients from the intervention group and the control group proved to be comparable. The post-intervention cytology smear tested negative for Actinomyces in 100% of the patients whose IUD had been removed and in 66.7% of those whose IUD had not been removed (p = 0.005). The probability that colonization by Actinomyces will continue if the IUD is not removed is greater the longer the patient has been exposed to the IUD. After 24 months, relative risk (RR) = 2, after 36 months RR = 2.16 and after 48 months RR = 2.66. CONCLUSIONS: The removal of the IUD has been effective in genital colonization by Actinomyces. The protective effect exerted by the removal of the IUD was found to be greater in proportion to the length of time the patient had used it.

Eight years with the same IUD.

The purpose of this study was to determine the efficacy of the TCu380A (GYNET 380 IUD) in long-term users for periods of > 5 years and to obtain the incidence of Actinomyces as related to length of use and reasons for removal. The report is a retrospective descriptive study of all the clinical cases (n = 370 patients) at the Municipal Family Planning Centre-SERGAS A Coruña, Spain, of women who had a TCu380A IUD inserted during the period 1988-1989 with a September 1997 cutoff date for data analysis. A total of 271 (73.5%) patients had been using the TCu380A IUD for > 5 years with 100% efficacy. The accumulated incidence of Actinomyces was 5.9% (CI 95%: 3.8-8.9). The highest incidence was found between the second and third year of use. There was no increase in the incidence of Actinomyces after 5 years of use. The most common reason for removal of the IUD was the duration of use of 8 years with the same device (32.3%).

PIP: A retrospective study was carried out to determine the efficacy of the long-term use of TCu380A (GYNET 380 IUD) for a period of 5 years. The study also aimed to obtain the incidence of Actinomyces as it related to length of use and reasons for removal. Data were obtained from 370 clinical cases of patients who had been inserted with a TCu380A IUD (GYNET 380) between 1988 and 1989 at the Family Planning Centre-SERGAS A Coruna, Spain. Results revealed that a total of 271 patients had been using the TCu380A IUD for 5 years with 100% efficacy. The accumulated incidence of Actinomyces was 5.9%. Highest incidence was found between the 2nd and 3d year of use. There was no increase in the incidence of Actinomyces after 5 years of use. The duration of use--8 years with the same device--was the most common reason for removal of the IUD (32.3%).

[Epidemiology of Chlamydia trachomatis in a population attending a family planning center]. / Epidemiología de Chlamydia trachomatis en una población que acude a un Centro de Planificación Familiar.

OBJECTIVE: To know the prevalence of Chlamydia trachomatis in a population attending a Family Planning Center, as well as the distribution of said prevalence in relationship with different variables. METHODS: This was a prevalence study, population-based. So all females over 14 years old who consulted the Planning Center were admitted into the study. We used enzyme-immune assay and DNA probe to identify the microorganism. The statistical analysis used chi 2 and Fisher's exact test when needed. For the confidence intervals, Cornfield's test was used. RESULTS: Of the 2,408 female who participated in the study we found a prevalence of 5.1% this percentage was even higher on the 15 to 21 years old segment: 7.47% p < 0.05. Being single and belonging to the group of non-qualify workers yielded a relative risk of 1.49 and 1.66 respectively. CONCLUSIONS: The prevalence we have found is higher to the one found in different publications in our country, a study to determine Chlamydia trachomatis should be performed in all sexually active women between 15 and 30 years old.

[Roxithromycin versus doxycycline in the treatment of Chlamydia trachomatis cervicitis in asymptomatic women]. / Roxitromicina frente a doxiciclina en el tratamiento de la cervicitis por Chlamydia trachomatis en mujeres asintomáticas.

We have performed an experimental open study, non randomized, in a population of women pertaining to a family planning center, and who have been diagnosed of Chlamydia trachomatis infection through EIA and DNA probe. 75 patients were included in the study, 50 of them received roxitromycine; 150 mg every 12 hours during 10 days, the other 25 being treated with doxycycline, 100 mg each 24 hours during 10 days. All women underwent a control after treatment using both techniques a month later, to asses the efficacy of the treatment. Mean age of women treated with roxitromycine was 28.6 years, and 30 years the ones treated with doxycycline. Efficacy in the eradication of Chlamydia trachomatis was 91.7% in the group treated with macrolide, and 92% in the group treated with doxycycline. Comparison through Chi-square did not yield statistical significance with a p < 0.05. Only a patient treated with doxycycline showed gastric intolerance. Roxitromycine shows an in vivo activity similar to doxycycline, and is an alternative to the use of doxycycline, being the first choice in those women in whom tetracycline are contraindicated.

[Rapid diagnosis of Chlamydia trachomatis using a DNA probe in a population with low risk of infection]. / Diagnóstico rápido de Chlamydia trachomatis por sonda ADN-Probe en una problación con bajo riesgo de infección.

BACKGROUND: To assess the efficacy of a newer diagnostic technique for Chlamydia trachomatis and its usefulness as screening method in populations at low-risk for Chlamydia trachomatis infection. METHODS: Open comparative trial between the EIA technique (Abbott Laboratories) and DNA gene probe (Gen Probe Diagnostic). A total of 1683 individuals (1630 women and 53 men) were screened with the two different techniques using samples obtained simultaneously. RESULTS: Among women, 66 give a positive result either by one or another technique. The prevalence was 4.04%. Sensitivity of DNA probe when compared with EIA assay was 64% and specificity was 98.9%. CONCLUSIONS: The DNA probe technique is faster than actual techniques and easy to do without major laboratory equipment. However, its price is high and its sensitivity poor in low-risk populations.