Reports of Two Broken Nexplanon® Rods.

Damage to progestin containing contraceptive implants has been reported for Implanon® rods but there appear to be few reports of damage to Nexplanon® rods. This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear. Evidence based guidelines to inform management of suspected damage to contraceptive implants would be helpful. In the meantime, a shared decision-making process offering removal and replacement of damaged implants would seem reasonable.

Assessing Knowledge and Perceptions Related to Preventive Methods and Treatment of Malaria in the Local Endemic Area of Trujillo, Honduras.

Malaria in Honduras is endemic and accounts for 40% of the total cases in Central America. Our goal was to assess knowledge of preventive methods and current treatment of malaria among the affected community of Trujillo, Honduras. A cross-sectional survey was administered to 71 individuals. Most respondents had a good understanding about common malaria symptoms but not about the complications associated with severe cases. More important, we found that less than 20% of the respondents recognized indoor residual sprays and insecticide-treated nets as effective preventive measures, which are the most efficient preventive methods. Our study highlights the perceptions the people of Trujillo have about malaria. From our observations, we put forward recommendations to implement a comprehensive campaign to educate the Trujillo population about malaria preventive methods and to recruit local and international efforts to distribute insecticide-treated nets.

AA/12-Lipoxygenase Signaling Contributes to Inhibitory Learning in Hermissenda Type B Photoreceptors.

Conditioned inhibition (CI) is a major category of associative learning that occurs when an organism learns that one stimulus predicts the absence of another. In addition to being important in its own right, CI is interesting because its occurrence implies that the organism has formed an association between stimuli that are non-coincident. In contrast to other categories of associative learning that are dependent upon temporal contiguity (pairings) of stimuli, the neurobiology of CI is virtually unexplored. We have previously described a simple form of CI learning in Hermissenda, whereby animals' phototactic behavior is increased by repeated exposures to explicitly unpaired (EU) presentations of light and rotation. EU conditioning also produces characteristic reductions in the excitability and light response, and increases several somatic K(+) currents in Type B photoreceptors. Type B photoreceptors are a major site of plasticity for classical conditioning in Hermissenda. Because arachidonic acid (AA) and/or its metabolites open diverse K(+) channels in many cell types, we examined the potential contribution of AA to CI. Our results indicate that AA contributes to one of the major effects of EU-conditioning on Type B photoreceptors: decreases in light-evoked spike activity. We find that AA increases the transient (I(A)) somatic K(+) current in Type B photoreceptors, further mimicking CI training. In addition, our results indicate that metabolism of AA by a 12-lipoxygenase enzyme is critical for these effects of AA, and further that 12-lipoxygenase metabolites are apparently generated during CI training.