Efficacy of ondansentron treatment for acute emesis with different dosing schedules 8 vs 32 mg. A randomized study.

The aim of the present randomized study was to evaluate which dose of Ondansentron (OND)(32 versus 8 mg) is appropriate for the antiemetic treatment of a uniform group of patients (pts) with Non Small Cell Lung Cancer (NSCLC) who were treated with Cisplatin (CDDP) 100 mg/m2 in combination with other less emetogenic drugs. One hundred and ten patients, with histologically confirmed NSCLC entered this randomized study. They were between 50 - 70 years old, with no previous Chemotherapy, with a PS (Karnofsky) >60%. They were randomized into two groups; Group A: OND as a 32 mg dose the first 24 hours, followed by 8 mg every 8 hrs for the following four days, combined with dexamethasone, 8 mg i.v. the first day, and 8 mg p.o., in the morning, the following three days. Group B: OND as a 8 mg dose every day for 4 days, combined with dexamethasone 8 mg i.v. and 8 mg p.o. the following three days. In this randomized study, of the 110 patients who entered, 106 were evaluable. Clinical parameters were similar between the examined groups. A higher number of patients of Group A presented complete response (P 0.0001), compared to patients of Group B who failed (P 0.004), during the first 24 hours. In the 3 days that followed, a higher number of pts of Group A presented complete response to the antiemetic therapy (P 0.001, P 0.0001), while Group B failed (P 0.007, P 0.001, P 0.019), or presented minor response (P 0.0001, P 0.004). Patients who had no antiemetic response needed additional therapy and were excluded from the evaluatio (13 pts of Group B). Retches (P 0.0001, P 0.005), and nausea (P 0.0001, P were also frequent in Group B. We concluded that reduced OND doses (8 mg) are inadequate in the prevention of emesis after high dose CDDP (100 mg/m2) and should be avoided.

The relationship between prenatal care and subsequent modern contraceptive use in Bolivia, Egypt and Thailand.

Determinants of modern contraceptive use are usually examined in isolation of the effect of exposure to other aspects of health care systems. Maternal interaction with organised health service provision during post-conception and postpartum stages of reproduction can provide an opportunity to transfer contraceptive service information and counselling. We found that living in a community in which women have widespread health service contact is related to both prenatal care use and subsequent modern contraceptive use. After controlling for effects of living in high health service contact areas and various demographic and background factors, our results suggest that prior use of prenatal care has a strong influence on subsequent use of modern contraception in Bolivia, Egypt and Thailand.

Understanding the proximate determinants of fertility of a Nigerian ethnic group.

"This paper uses data from a 1992/93 sample survey of 1,000 women aged 15-49 in selected areas of Imo State, Nigeria. The purpose of the survey was to get information/data on birth-spacing dynamics of the area. In this paper, we applied the basic Bongaarts model and its extended version to identify the proximate determinants of Igbo fertility. A total fertility rate [of] 6.7 births per woman is estimated from the model compared with a TFR of 7.26 actually observed from the survey. When compared with earlier studies, it is shown that the principal proximate determinant of fertility in the area is no more lactational infecundability, but delayed marriage. Explanations for this change, future research needs and policy implications are discussed." (SUMMARY IN ITA AND FRE)