Two oral contraceptives, efficacy, serum proteins, and lipid metabolism. A comparative multicentre study on a triphasic and a fixed dose combination.

A triphasic, combined oral contraceptive containing 30 - 40 - 30 micrograms ethinyloestradiol (EE), and 50 - 75 - 125 micrograms levonorgestrel was compared with a fixed dose combination containing 30 micrograms EE and 150 micrograms desogestrel in a randomized multicentre trial in 193/199 women and 1 063/1 073 cycles, respectively. The duration of the trial was six months. Eleven centres in Denmark, Sweden, and Norway participated. Contraceptive reliability, bleeding control and side effects were evaluated. Influence on serum sex hormone binding globulin (SHBG) and transcortin was assayed as well as lipid metabolism. Three pregnancies occurred in the group using the triphasic regimen but none in the fixed dose regimen. Two of the three pregnancies were considered drug failures and the third a possible interaction. Possible reasons for the triphasic contraceptive failure are discussed with special reference to a British report on eight pregnancies. Bleeding control appeared to be equally good for the two preparations. However, the number of cycles with spotting, breakthrough bleeding and missed withdrawal bleeding were above the levels reported earlier on the triphasic regimen. About 80 per cent of the women completed the planned six months on either combination. Side effects were generally mild and in accordance with earlier reports on low dose oral contraceptives. Metabolically the triphasic levonorgestrel combination increased SHBG 100 per cent versus 200 per cent for the fixed desogestrel combination. Transcortin rose about 98 and 110 per cent, respectively. Both preparations induced similar changes in the levels of lipids and lipoproteins with the exception of a significant increase in the arachidonic content of cholesterol during treatment with the desogestrel-containing preparation.

[Failure of oral contraception--probably because of interaction with phenemal]. / P-pillesvigt--antagelig på grund af interaktion med fenemal.

PIP: A 30-year-old woman was using oral contraceptives (50 mcg ethinyl estradiol and 75 mcg Org. 2969) while simultaneously taking an anorexikum which contained 2 mg of acetfenolisatin, 50 mg caffeine, 20 mg efedrinechloride, 3 mg tiaminchloride, 50 mg ascorbic acid, 50 mg potassium carbonate, and 20 mg phenemal. She became pregnant despite oral contraceptive use; it is possible that the phenemal counteracted the contraceptive effect of the contraceptive.^ieng

Diagnosis of postnatal rubella by the enzyme-linked immunosorbent assay for rubella IgM and IgG antibodies.

A semi-automated enzyme-linked immunosorbent assay (ELISA) was established for the detection of rubella IgM antibodies in non-fractionated sera. A cut-off level between rubella IgM positive and negative sera was determined by a study of sera without rheumatoid factor from 200 blood donors. Testing of 12 donor sera containing rheumatoid factor showed that 5 sera gave a positive result in the rubella IgM assay. Rubella IgM antibodies were quantified by ELISA in a study of 214 serial serum specimens drawn from 16 patients with rubella during a period of up to 10 years after the infection. Peak values of the IgM antibodies were reached approximately 8 days after onset of the rash, and the persistence of the IgM antibodies ranged from 17-90 days, with the exception of one patient with a prolonged IgM response. The rubella IgG antibodies increased slowly after the rash and reached maximum levels about 50-120 days, after which a monor decrease was observed. The results of the present study indicate that ELISA is suitable as a routine procedure for the serodiagnosis of recent rubella.

Epidemiology of urinary tract diseases in general practice.

During a one-year morbidity survey of urinary tract diseases in general practice 741 cases were diagnosed. Only about half of all the patients with symptoms of urinary tract infection had significant bacteriuria. In young women urinary tract infections and symptoms from the urinary tract without bacteriuria-in particular urethritis-were found to predominate. In middle-aged women, the urinary tract symptoms were ascribed increasingly to genital prolapse, while incidence of urolithiasis was the highest in any group, and urinary tract infections became less frequent. The prevalence of urinary tract infection showed another increase in elderly women, and recurrent/chronic pyelonephritis, which occurs with a steadily increasing prevalence throughout all age groups, became common.In younger male urological patients diseases with symptoms of urinary tract infection without bacteriuria were predominant, whereas prostatitis and urinary tract infections were less frequent. In middle-aged men, urolithiasis was especially frequent, while an increasing proportion of elderly men had prostatic hypertrophy, urinary tract infections, and recurrent/chronic pyelonephritis.

Bacterial vaginosis: a double-blind randomized trial of the effect of treatment of the sexual partner.

In a double-blind randomized controlled trial we assessed the effect of metronidazole treatment of the male partner on the recurrence rate of bacterial vaginosis. Women who fulfilled the diagnostic criteria for bacterial vaginosis were treated with metronidazole given in single doses of 2 g on days 1 and 3. The sexual partners were randomized to receive either the same dosage of metronidazole or a placebo. A total of 107 pairs completed the study. One week after the start of treatment 89% of the women considered themselves improved or cured and 93% no longer had the diagnostic criteria for bacterial vaginosis. At assessment 5 weeks after the treatment, 75% reported that they were cured or improved and the diagnostic criteria were not present in 73%. Treatment of the male partner did not affect subjective symptoms, clinical signs and isolation rates of Gardnerella vaginalis at 1 and 5 weeks after treatment.