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1.
Sensors (Basel) ; 24(10)2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38793874

RESUMEN

In this study, a p-Si/ALD-Al2O3/Ti/Pt MOS (metal oxide semiconductor) device has been fabricated and used as a hydrogen sensor. The use of such a stack enables a reliable, industry-compatible CMOS fabrication process. ALD-Al2O3 has been chosen as it can be integrated into the back end of the line (BEOL) or in CMOS, post processing. The device response and recovery are demonstrated with good correlation between the capacitance variation and the hydrogen concentration. Detection down to 20 ppm at 140 °C was obtained and a response time of 56 s for 500 ppm was recorded.

2.
AJOG Glob Rep ; 4(1): 100321, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38586611

RESUMEN

Preeclampsia is a syndrome with multiple etiologies. The diagnosis can be made without proteinuria in the presence of dysfunction of at least 1 organ associated with hypertension. The common pathophysiological pathway includes endothelial cell activation, intravascular inflammation, and syncytiotrophoblast stress. There is evidence to support, among others, immunologic causes of preeclampsia. Unlike defense immunology, reproductive immunology is not based on immunologic recognition systems of self/non-self and missing-self but on immunotolerance and maternal-fetal cellular interactions. The main mechanisms of immune escape from fetal to maternal immunity at the maternal-fetal interface are a reduction in the expression of major histocompatibility complex molecules by trophoblast cells, the presence of complement regulators, increased production of indoleamine 2,3-dioxygenase, activation of regulatory T cells, and an increase in immune checkpoints. These immune protections are more similar to the immune responses observed in tumor biology than in allograft biology. The role of immune and nonimmune decidual cells is critical for the regulation of trophoblast invasion and vascular remodeling of the uterine spiral arteries. Regulatory T cells have been found to play an important role in suppressing the effectiveness of other T cells and contributing to local immunotolerance. Decidual natural killer cells have a cytokine profile that is favored by the presence of HLA-G and HLA-E and contributes to vascular remodeling. Studies on the evolution of mammals show that HLA-E, HLA-G, and HLA-C1/C2, which are expressed by trophoblasts and their cognate receptors on decidual natural killer cells, are necessary for the development of a hemochorial placenta with vascular remodeling. The activation or inhibition of decidual natural killer cells depends on the different possible combinations between killer cell immunoglobulin-like receptors, expressed by uterine natural killer cells, and the HLA-C1/C2 antigens, expressed by trophoblasts. Polarization of decidual macrophages in phenotype 2 and decidualization of stromal cells are also essential for high-quality vascular remodeling. Knowledge of the various immunologic mechanisms required for adequate vascular remodeling and their dysfunction in case of preeclampsia opens new avenues of research to identify novel biological markers or therapeutic targets to predict or prevent the onset of preeclampsia.

3.
Nat Commun ; 14(1): 8143, 2023 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-38065951

RESUMEN

Neural networks are powerful tools for solving complex problems, but finding the right network topology for a given task remains an open question. Biology uses neurogenesis and structural plasticity to solve this problem. Advanced neural network algorithms are mostly relying on synaptic plasticity and learning. The main limitation in reconciling these two approaches is the lack of a viable hardware solution that could reproduce the bottom-up development of biological neural networks. Here, we show how the dendritic growth of PEDOT:PSS-based fibers through AC electropolymerization can implement structural plasticity during network development. We find that this strategy follows Hebbian principles and is able to define topologies that leverage better computing performances with sparse synaptic connectivity for solving non-trivial tasks. This approach is validated in software simulation, and offers up to 61% better network sparsity on classification and 50% in signal reconstruction tasks.

4.
Pediatr Dev Pathol ; 26(5): 466-471, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37672728

RESUMEN

INTRODUCTION: In both Canada and the United States, workload measurement for anatomic pathology is mainly based on complexity and clinical significance of specimens, with gross examination being a considerable contributor. While Pathologists' Assistants (PAs) play an increasing role in gross examination, there is little known regarding the time required for PAs to complete grossing tasks. This information is essential for effective staffing and workload management in pathology laboratories. The objective of our study was to determine the time required for PAs to gross second and third trimester singleton placentas in a large tertiary hospital with a significant perinatal pathology service. MATERIALS AND METHODS: For our study, 7 certified PAs each grossed a minimum of 10 second and third trimester singleton placentas using a standard placental grossing protocol, an electronic laboratory information system, and voice recognition dictation software. Placental specimens requiring photography, sampling for ancillary studies, or immediate pathologist's consultation were excluded. We calculated average and standard deviation of grossing times for each PA, overall average grossing time, and 95% confidence interval using a mixed linear regression model. We analyzed the impact of PA job experience, degree obtained, and number of blocks prepared on overall average in a multivariate analysis. RESULTS: The mean grossing times for each PA ranged from 11.0 (standard deviation [sd] = 2.0) to 17.8 (sd = 4.5) minutes. The overall average grossing time was 14.5 minutes, with a 95% confidence interval of 11.7 to 17.3 minutes. In multivariate analysis, an increase in the number of blocks prepared was significantly associated with longer overall average grossing time. If 4 blocks were prepared consistently, the model predicted a slightly lower overall average of 13.3 minutes, with a 95% confidence interval of 10.9 to 15.7 minutes. DISCUSSION: To our knowledge, our study is the first to objectively report time required for PAs to perform gross examinations of routine second and third trimester singleton placentas. The methodology of our study is replicable and can be applied to other specimen types and laboratory settings. Previously, estimated grossing times for specimens were primarily based on retrospective surveys, which were susceptible to recall errors and subjectivity. However, our study demonstrates objective data collection is achievable. Furthermore, the data collected from this study offer valuable insights into the accuracy of previous and current pathology workload models for second and third trimester singleton placentas.


Asunto(s)
Patólogos , Placenta , Embarazo , Humanos , Femenino , Estudios Retrospectivos , Tercer Trimestre del Embarazo , Manejo de Especímenes/métodos
5.
Front Neurosci ; 16: 983950, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36340782

RESUMEN

This study proposes voltage-dependent-synaptic plasticity (VDSP), a novel brain-inspired unsupervised local learning rule for the online implementation of Hebb's plasticity mechanism on neuromorphic hardware. The proposed VDSP learning rule updates the synaptic conductance on the spike of the postsynaptic neuron only, which reduces by a factor of two the number of updates with respect to standard spike timing dependent plasticity (STDP). This update is dependent on the membrane potential of the presynaptic neuron, which is readily available as part of neuron implementation and hence does not require additional memory for storage. Moreover, the update is also regularized on synaptic weight and prevents explosion or vanishing of weights on repeated stimulation. Rigorous mathematical analysis is performed to draw an equivalence between VDSP and STDP. To validate the system-level performance of VDSP, we train a single-layer spiking neural network (SNN) for the recognition of handwritten digits. We report 85.01 ± 0.76% (Mean ± SD) accuracy for a network of 100 output neurons on the MNIST dataset. The performance improves when scaling the network size (89.93 ± 0.41% for 400 output neurons, 90.56 ± 0.27 for 500 neurons), which validates the applicability of the proposed learning rule for spatial pattern recognition tasks. Future work will consider more complicated tasks. Interestingly, the learning rule better adapts than STDP to the frequency of input signal and does not require hand-tuning of hyperparameters.

6.
Microb Pathog ; 173(Pt A): 105873, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36371065

RESUMEN

Brachyspira hyodysenteriae, an etiologic agent of swine dysentery (SD), is known for causing colitis. Although some aspects of colonic defenses during infection have been described previously, a more comprehensive picture of the host and microbiota interaction in clinically affected animals is required. This study aimed to characterize multiple aspects of colonic innate defenses and microbiome factors in B. hyodysenteriae-infected pigs that accompany clinical presentation of hemorrhagic diarrhea. We examined colonic mucus barrier modifications, leukocyte infiltration, cathelicidin expression, as well as microbiome composition. We showed that B. hyodysenteriae infection caused microscopic hemorrhagic colitis with abundant neutrophil infiltration in the colonic lamina propria and lumen, with minor macrophage infiltration. Mucus hypersecretion with abundant sialylated mucus in the colon, as well as mucosal colonization by [Acetivibrio] ethanolgignens, Lachnospiraceae, and Campylobacter were pathognomonic of B. hyodysenteriae infection. These findings demonstrate that B. hyodysenteriae produces clinical disease through multiple effects on host defenses, involving alterations of mucosal innate immunity and microbiota. Given that B. hyodysenteriae is increasingly resistant to antimicrobials, this understanding of SD pathogenesis may lead to future development of non-antibiotic and anti-inflammatory alternative therapeutics.


Asunto(s)
Colitis , Disentería , Infecciones por Bacterias Gramnegativas , Microbiota , Infecciones por Spirochaetales , Enfermedades de los Porcinos , Porcinos , Animales , Enfermedades de los Porcinos/patología , Disentería/veterinaria , Disentería/patología , Inmunidad Innata , Infecciones por Bacterias Gramnegativas/patología
7.
Nanotechnology ; 32(40)2021 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-34167106

RESUMEN

Resistive switching (RS) devices are promising forms of non-volatile memory. However, one of the biggest challenges for RS memory applications is the device-to-device (D2D) variability, which is related to the intrinsic stochastic formation and configuration of oxygen vacancy (VO) conductive filaments (CFs). In order to reduce the D2D variability, control over the formation and configuration of oxygen vacancies is paramount. In this study, we report on the Zr doping of TaOx-based RS devices prepared by pulsed-laser deposition as an efficient means of reducing the VOformation energy and increasing the confinement of CFs, thus reducing D2D variability. Our findings were supported by XPS, spectroscopic ellipsometry and electronic transport analysis. Zr-doped films showed increased VOconcentration and more localized VOs, due to the interaction with Zr. DC and pulse mode electrical characterization showed that the D2D variability was decreased by a factor of seven, the resistance window was doubled, and a more gradual and monotonic long-term potentiation/depression in pulse switching was achieved in forming-free Zr:TaOxdevices, thus displaying promising performance for artificial synapse applications.

9.
Nanotechnology ; 31(44): 445205, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-32674084

RESUMEN

Non-volatile resistive switching devices are considered as prime candidates for next-generation memory applications operating at room temperature and above, such as resistive random-access memories or brain-inspired in-memory computing. However, their operability in cryogenic conditions remains to be mastered to adopt these devices as building blocks enabling large-scale quantum technologies via quantum-classical electronics co-integration. This study demonstrates multilevel switching at 1.5 K of Al2O3/TiO2-x resistive memory devices fabricated with complementary metal-oxide-semiconducto-compatible processes and materials. The I-V characteristics exhibit a negative differential resistance (NDR) effect due to a Joule-heating-induced metal-insulator transition of the Ti4O7 conductive filament. Carrier transport analysis of all multilevel switching I-V curves show that while the insulating regime follows the space charge limited current (SCLC) model for all resistance states, the conduction in the metallic regime is dominated by SCLC and trap-assisted tunneling for low- and high-resistance states respectively. A non-monotonic conductance evolution is observed in the insulating regime, as opposed to the continuous and gradual conductance increase and decrease obtained in the metallic regime during the multilevel SET and RESET operations. Cryogenic transport analysis coupled to an analytical model accounting for the metal-insulator-transition-induced NDR effects and the resistance states of the device provide new insights on the conductive filament evolution dynamics and resistive switching mechanisms. Our findings suggest that the non-monotonic conductance evolution in the insulating regime is due to the combined effects of longitudinal and radial variations of the Ti4O7 conductive filament during the switching. This behavior results from the interplay between temperature- and field-dependent geometrical and physical characteristics of the filament.

11.
Nat Commun ; 10(1): 4322, 2019 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-31541107

RESUMEN

The monolithic integration of III-V compound semiconductor devices with silicon presents physical and technological challenges, linked to the creation of defects during the deposition process. Herein, a new defect elimination strategy in highly mismatched heteroepitaxy is demonstrated to achieve a ultra-low dislocation density, epi-ready Ge/Si virtual substrate on a wafer scale, using a highly scalable process. Dislocations are eliminated from the epilayer through dislocation-selective electrochemical deep etching followed by thermal annealing, which creates nanovoids that attract dislocations, facilitating their subsequent annihilation. The averaged dislocation density is reduced by over three orders of magnitude, from ~108 cm-2 to a lower-limit of ~104 cm-2 for 1.5 µm thick Ge layer. The optical properties indicate a strong enhancement of luminescence efficiency in GaAs grown on this virtual substrate. Collectively, this work demonstrates the promise for transfer of this technology to industrial-scale production of integrated photonic and optoelectronic devices on Si platforms in a cost-effective way.

12.
Sensors (Basel) ; 19(15)2019 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-31382380

RESUMEN

Nowadays, there is an increased demand in integrated sensors for electronic devices. Multi-functional sensors provide the same amount of data using fewer sensors. Carbon nanotubes are non-selectively sensitive to temperature, gas and strain. Thus, carbon nanotubes are perfect candidates to design multi-functional sensors. In our study, we are interested in a dual humidity-temperature sensor. Here, we present a novel method to differentiate at least two sources using the sensor's frequency responses based on multiwall carbon nanotubes sensors. The experimental results demonstrate that there are temperature- or moisture-invariant frequencies of the impedance magnitude, and their values depend on the sensor's geometry. The proposed measurement model shows that source-invariant frequencies of the phase can be also determined. In addition, the source separation method is generalized to other materials or sources enabling multi-functional sensors for environment monitoring.

13.
Nephrol Ther ; 15(6): 413-429, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-30935786

RESUMEN

The role of angiogenic factors in the onset of clinical manifestations of preeclampsia was demonstrated in 2003 by the implication of sFlt-1, PlGF and VEGF, and in 2006 by the implication of soluble endoglin. Placental ischemia and inflammation observed in preeclampsia alter both the production and progression of angiogenic factors during pregnancy. During the first trimester, the combination of PlGF with clinical, biophysical and biological factors results in a better test than the conventional one. However, the clinical value of this method remains to be confirmed. During the second and third trimesters, the sFlt-1/PlGF ratio may be used, with or without pre-existing renal disease, for short-term prediction, diagnosis, and prognosis, and to evaluate the effectiveness of preeclampsia treatment. While a sFlt-1/PlGF ratio<38 and≤33, respectively, rules out the short-term onset and diagnosis of preeclampsia, a sFlt-1/PlGF ratio≥85 between 20 and 34 weeks of pregnancy and≥110 beyond 34 weeks of pregnancy confirms a diagnosis of preeclampsia. Angiogenic and non-angiogenic preeclampsia are identified by a sFlt-1PlGF≥85 and<85, respectively, with the risk of maternal and fetal complications at two weeks differing between the two. Similarly, a sFlt-1/PlGF ratio>665 and>205, respectively, is a good short-term predictor of adverse outcomes of early and late-onset preeclampsia. These values could be incorporated into future guidelines for better clinical management of preeclampsia.


Asunto(s)
Proteínas de la Membrana/sangre , Preeclampsia/sangre , Factor A de Crecimiento Endotelial Vascular/sangre , Receptor 1 de Factores de Crecimiento Endotelial Vascular/sangre , Adulto , Aspirina/uso terapéutico , Biomarcadores/sangre , Endoglina/fisiología , Endotelio Vascular/fisiopatología , Femenino , Humanos , Tolerancia Inmunológica , Inflamación , Enfermedades Renales/sangre , Enfermedades Renales/cirugía , Trasplante de Riñón , Estrés Oxidativo , Placenta/inmunología , Placenta/metabolismo , Preeclampsia/tratamiento farmacológico , Preeclampsia/inmunología , Preeclampsia/fisiopatología , Embarazo , Complicaciones del Embarazo/sangre , Resultado del Embarazo , Trimestres del Embarazo , Pronóstico , Factor de Crecimiento Transformador beta/fisiología , Receptor 1 de Factores de Crecimiento Endotelial Vascular/fisiología
14.
Cell Tissue Res ; 376(3): 433-442, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30788579

RESUMEN

The intestinal mucosa contributes to frontline gut defenses by forming a barrier (physical and biochemical) and preventing the entry of pathogenic microbes. One innate role of the human colonic epithelium is to secrete cathelicidin, a peptide with broad antimicrobial and immunomodulatory functions. In this study, the effect of cathelicidin in the maintenance of epithelial integrity, Toll-like receptor recognition, bacterial invasion and initiation of inflammatory response against Salmonella typhimurium is investigated in cultured human colonic epithelium. We found exogenous human cathelicidin restores the epithelial integrity in S. typhimurium-infected colonic epithelial (T84) cells by mostly post-translational effects associated with reorganization of zonula occludens (ZO)-1 tight junction proteins. Endogenous cathelicidin prevents S. typhimurium internalization as shown in colonic epithelial cells genetically deficient in the only human cathelicidin, LL-37 (shLL-37). Moreover, supplementation of shLL-37 cells with synthetic LL-37 reduces the grade of S. typhimurium internalization in a dose-dependent manner. Mechanistically, shLL-37 cells have lower gene expression of TLR4 and pro-inflammatory cytokine IL-1ß in response to S. typhimurium. Thus, human cathelicidin aids in the early colonic epithelial defenses against enteric S. typhimurium by preventing bacterial invasion and maintaining epithelial barrier integrity, likely to occur due to the production of sensing TLR4 and pro-inflammatory cytokines.


Asunto(s)
Péptidos Catiónicos Antimicrobianos/farmacología , Colon/efectos de los fármacos , Mucosa Intestinal/efectos de los fármacos , Infecciones por Salmonella/prevención & control , Salmonella typhimurium/efectos de los fármacos , Péptidos Catiónicos Antimicrobianos/uso terapéutico , Colon/inmunología , Colon/microbiología , Células HT29 , Humanos , Interleucina-1beta/inmunología , Mucosa Intestinal/inmunología , Mucosa Intestinal/microbiología , Receptor Toll-Like 4/inmunología , Proteína de la Zonula Occludens-1/metabolismo , Catelicidinas
15.
Nanotechnology ; 29(21): 215701, 2018 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-29504511

RESUMEN

Germanium-based nanostructures have attracted increasing attention due to favourable electrical and optical properties, which are tunable on the nanoscale. High densities of germanium nanocrystals are synthesized via electrochemical etching, making porous germanium an appealing nanostructured material for a variety of applications. In this work, we have demonstrated highly tunable electrical conductivity in mesoporous germanium layers by conducting a systematic study varying crystallite size using thermal annealing, with experimental conductivities ranging from 0.6 to 33 (×10-3) Ω-1 cm-1. The conductivity of as-prepared mesoporous germanium with 70% porosity and crystallite size between 4 and 10 nm is shown to be ∼0.9 × 10-3 Ω-1 cm-1, 5 orders of magnitude smaller than that of bulk p-type germanium. Thermal annealing for 10 min at 400 °C further reduced the conductivity; however, annealing at 450 °C caused a morphological transformation from columnar crystallites to interconnecting granular crystallites and an increase in conductivity by two orders of magnitude relative to as-prepared mesoporous germanium caused by reduced influence of surface states. We developed an electrostatic model relating the carrier concentration and mobility of p-type mesoporous germanium to the nanoscale morphology. Correlation within an order of magnitude was found between modelled and experimental conductivities, limited by variation in sample uniformity and uncertainty in void size and fraction after annealing. Furthermore, theoretical results suggest that mesoporous germanium conductivity could be tuned over four orders of magnitude, leading to optimized hybrid devices.

16.
Int J Antimicrob Agents ; 51(6): 813-821, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29476808

RESUMEN

Cathelicidins are a primitive class of host defense peptides and are known for their broad-spectrum antimicrobial activity against bacteria, fungi, and enveloped viruses. These small, cationic, proteolytically-activated peptides are diverse in structure, encompassing a wide range of activities on host immune and inflammatory cell responses. The dual capacity of cathelicidins to directly control infection and regulate host defenses highlights the potential use of these peptides as alternatives to antibiotics and immunomodulators. Cathelicidins are found in many mammalian species; this review focuses on bovine cathelicidins. Eight naturally and two synthetically occurring bovine cathelicidins are described in detail, with a focus on recent advances in their expression, location and biological roles. This review also presents an overview of the bioactive functions of cathelicidins in bovine mastitis, a disease causing economic losses in cattle dairy production. Comparison of the structural, antimicrobial, cytotoxic and mechanistic properties of bovine cathelicidins advances the knowledge needed for the development of these peptides as potential identifiers of infectious diseases (e.g., bovine mastitis) and as novel therapeutic alternatives to antibiotics.


Asunto(s)
Antiinfecciosos/metabolismo , Péptidos Catiónicos Antimicrobianos/metabolismo , Catelicidinas/metabolismo , Mastitis Bovina/inmunología , Animales , Péptidos Catiónicos Antimicrobianos/biosíntesis , Bacterias/inmunología , Catelicidinas/biosíntesis , Bovinos , Femenino , Hongos/inmunología , Mastitis Bovina/microbiología , Virus/inmunología
17.
Nanoscale Res Lett ; 11(1): 481, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27804101

RESUMEN

We propose a novel technique to investigate the gas sensitivity of materials for implementation in field-effect transistor-based gas sensors. Our technique is based on the measurement of the surface charge induced by gas species adsorption, using an electrometer. Platinum sensitivity to hydrogen diluted in synthetic air has been evaluated with the proposed charge measurement technique in the operation temperature range from 80 to 190 °C at constant H2 concentration of 4 % and for different concentrations ranging from 0.5 to 4 % at 130 °C.

18.
Nanoscale Res Lett ; 11(1): 446, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27704487

RESUMEN

We have performed a detailed characterization study of electrochemically etched p-type GaAs in a hydrofluoric acid-based electrolyte. The samples were investigated and characterized through cathodoluminescence (CL), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS). It was found that after electrochemical etching, the porous layer showed a major decrease in the CL intensity and a change in chemical composition and in the crystalline phase. Contrary to previous reports on p-GaAs porosification, which stated that the formed layer is composed of porous GaAs, we report evidence that the porous layer is in fact mainly constituted of porous As2O3. Finally, a qualitative model is proposed to explain the porous As2O3 layer formation on p-GaAs substrate.

19.
Contraception ; 93(4): 303-309, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26708301

RESUMEN

OBJECTIVES: Traditional progestogen-only pills (POPs) have stringent daily timing and missed pill rules that might affect contraceptive reliability. A new-generation oestrogen-free pill has been developed, containing 4-mg drospirenone with a unique regimen of 24 active treatment days followed by four placebo tablets. A previous study showed that this new drospirenone-only pill effectively inhibited ovulation. Clinical efficacy, however, can be affected by compliance, and delayed or forgotten pill intake often occurs in daily life. The aim of this study was to investigate if inhibition of ovulation was maintained after four scheduled 24-h delays in tablet intake. STUDY DESIGN: One hundred thirty healthy women with proven ovulatory cycles were randomized, and 127 were treated with the drospirenone-only pill during two cycles. In treatment Group A (n=62), 24-h delays in tablet intake were scheduled on days 3, 6, 11 and 22 during Cycle 2 and, in treatment Group B (n=65) during Cycle 1, respectively. Ovulation was defined as disappearance or persistence of a large follicle and progesterone levels higher than 5 ng/mL for at least 5 consecutive days. RESULTS: The overall ovulation rate was 0.8%; only one subject in Group A fulfilled the ovulation criteria in Cycle 2. Follicular diameters in the regular-intake and the delayed-intake cycles were similar. CONCLUSION: Despite the 4-day hormone-free period and multiple intentional 24-h delays in tablet intake, ovulation inhibition was maintained. This property distinguishes this new-generation oestrogen-free pill from traditional POPs by allowing the same "safety window" or flexibility in intake as combined oral contraceptives without compromising contraceptive reliability. IMPLICATIONS: Delayed or forgotten pill intake is very common. Ovulation inhibition by the new-generation oestrogen-free pill, containing 4-mg drospirenone for 24 days followed by a 4-day treatment-free period, was maintained despite four 24-h delays in tablet intake, so the impact of delayed intake on contraceptive reliability will be low.


Asunto(s)
Androstenos/administración & dosificación , Anticonceptivos Femeninos , Inhibición de la Ovulación , Progestinas/administración & dosificación , Adulto , Androstenos/efectos adversos , Femenino , Humanos , Folículo Ovárico/anatomía & histología , Folículo Ovárico/efectos de los fármacos , Ovulación/efectos de los fármacos , Placebos
20.
Contraception ; 92(5): 439-44, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26232513

RESUMEN

OBJECTIVES: This study was performed to assess the contraceptive efficacy of the drospirenone (DRSP)-only pill and to provide information regarding its safety and cycle-control profile. STUDY DESIGN: This prospective, multicenter, noncomparative study was conducted at 41 European sites in healthy women at risk of pregnancy, aged 18 to 45 years. The study medication was DRSP 4.0mg daily for 24 days followed by a placebo for 4 days (DRSP 4 mg 24/4, Exeltis, Spain) for thirteen 28-day treatment cycles. The primary efficacy endpoint was the overall Pearl Index (PI). Bleeding patterns, changes in vital signs and changes in laboratory values were also analyzed. RESULTS: A total of 713 participants with 7638 DRSP treatment cycles were analyzed. The overall PI was 0.51 (95% confidence interval, 0.1053-1.4922). The proportion of participants with any bleeding decreased from 72.7% in Cycle 1 to 40% in Cycle 6 and 32.1% in Cycle 13. Unscheduled bleeding decreased from 49.1% in Cycle 1 to 27.8% in Cycle 6 and to 22.8% in Cycle 13. Prolonged bleeding was reported by 6.5% during Cycles 2 to 4 decreasing to 4.2% during Cycles 11 to 13. There were no reports of deep vein thrombosis, pulmonary embolism or hyperkalemia. No relevant changes were observed for laboratory parameters, body weight, body mass index, blood pressure or heart rate. Study drug acceptability was considered as "excellent/good" by over 82% of subjects. CONCLUSION: This new DRSP-only oral contraceptive provides clinical contraceptive efficacy similar to that of the currently marketed Combination estrogen plus progestin Oral Contraceptive, with a good safety profile, and favorable cycle control. IMPLICATIONS: A novel 4-mg DRSP-only pill taken daily for 24 days followed by a placebo for 4 days demonstrated contraceptive efficacy similar to that of currently marketed Combination estrogen plus progestin Oral Contraceptive, with a good safety profile, and favorable cycle control.


Asunto(s)
Androstenos/uso terapéutico , Anticoncepción/métodos , Anticonceptivos Hormonales Orales/uso terapéutico , Adolescente , Adulto , Europa (Continente) , Femenino , Voluntarios Sanos , Humanos , Ciclo Menstrual/efectos de los fármacos , Trastornos de la Menstruación/epidemiología , Trastornos de la Menstruación/etiología , Persona de Mediana Edad , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Embarazo , Estudios Prospectivos , Hemorragia Uterina/epidemiología , Hemorragia Uterina/etiología , Adulto Joven
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