The contraceptive vaginal ring (NuvaRing) and hemostasis: a comparative study.

This open-label, nonrandomized study compared changes in hemostatic variables during NuvaRing and oral levonorgestrel 150 microg/ethinylestradiol 30 microg (LNG/EE) use for six cycles. Eighty-seven women started the study, 44 with NuvaRing and 43 with the LNG/EE oral contraceptive. For most procoagulation variables, there was no difference between NuvaRing and oral LNG/EE; only Factor VII levels increased in the NuvaRing group and decreased in the LNG/EE group. The majority of assessed variables show that anticoagulation and fibrinolytic activity was comparable between the NuvaRing and oral LNG/EE groups. Antithrombin activity and protein C activity both tended to be higher with NuvaRing. Levels of tissue plasminogen activator decreased in both groups but the reduction was smaller with NuvaRing. There were no significant differences in fibrin turnover between the treatment groups. The data show that both NuvaRing and oral LNG/EE are associated with a minimal effect on hemostatic variables.

Patients' knowledge and attitudes regarding sleep and hypnotics.

OBJECTIVE: To examine attitudes, opinions and knowledge regarding hypnotics and their use, sleep and sleep requirements among patients who have used hypnotics. DESIGN: A mailed questionnaire. SETTING: A primary health care centre serving 18,500 inhabitants. PATIENTS: 143 randomly selected patients for whom hypnotics had been prescribed at the health care centre at any time during the year previous to the study. MAIN OUTCOME MEASURES: Answers to 21 questions about sleep, sleep requirement, use and effect of hypnotics. RESULTS: Regular use of hypnotics over long periods is common. Participants endure sleeping problems before beginning to use hypnotics. Once on pills most patients take hypnotics without first trying to fall asleep. Knowledge about sleeping hygiene was good and household remedies are much used. Feelings of guilt about using hypnotics were not common. Elderly people were less informed than younger about the effects and disadvantages of use of hypnotics. CONCLUSION: Most patients are well informed about the benefits of hypnotics and possible abuse or addictive effects. Most begin using hypnotics after long-standing sleep problems and after trying various household remedies. Doctors have a lot of influence on patients' use of hypnotics and need to inform their patients well when hypnotics are first prescribed.

Age specific prevalence of antibodies against Chlamydia pneumoniae in Iceland.

Chlamydia pneumoniae is a newly recognized common cause of respiratory tract infections. The aim of this study was to examine its prevalence in Iceland. The study was based on 1020 serum samples from individuals 0-99 years old. The samples were divided into 10-year age groups. IgG and IgM antibodies were determined with microimmunofluorescence assay. An IgG titer > or = 32 and IgM titer > or = 16 were considered positive. The prevalence of positive IgG titer in the study population was 53 +/- 16% (mean +/- SD, age group range 14-66%). Neither seasonal nor gender-based difference in IgG antibody prevalence was demonstrated. It was lowest in the youngest group, 0-9 years old (p < 0.001), but rose linearly to age 70 (p < 0.005). 34 samples were IgM positive on initial testing; most from the older age groups. 12 were rheumatoid factor positive as well. After treatment with caprine antihuman IgG antibodies all became negative. The prevalence of C. pneumoniae infections is high in Iceland according to these results and similar to that in neighbouring countries. The presence of IgM rheumatoid factor may cause false positive tests for pathogen-specific IgM by immune complex binding with pathogen-specific IgG, thereby requiring its removal before testing.

[Hypnotics and tranquillisers. Patients' knowledge and attitudes.].

OBJECTIVE: To elicit patients' views and attitudes towards the use of hypnotics and tranquillisers and their knowledge about such drugs and household remedies. MATERIAL AND METHODS: During 1986-1993 a total of 577 individuals in Egilsstaethir district (3029 inhabitants) had used sedatives and/or tranquillisers. Out of this group a stratified randomised sample composing 208 individuals, received a questionnaire with 22 or 24 questions about the use of tranquillisers and hypnotics. RESULTS: The mean age was 55.1 years for users of tranquillisers, 60.1 years for the users of hypnotics. Women were in majority in both groups, most of them were married and working outside the home. Users of tranquillisers were divided into two main categories i.e. daily users and occasional users. Only a few used tranquillisers two or three times daily. Many used tranquillisers only as sleeping medicine. A fourth of the participants began using hypnotics after sleeping problems of less than one month. Doctors usually prescribed the medicines the first time they were used. 55% have tried household remedies against anxiety and sleeping problems. A majority had tried to stop using these medicines. Feelings of guilt because of the use of medicines was not common. Participants were well informed about how much sleep is needed. CONCLUSION: Our results show that most of the patients in the research area had gripped their doctors' message regarding sleeping problems, health promotion and the risk of addiction after continuous use of hypnotics and tranquillisers. It is however likely, that more education in this direction can further increase health promotion and minimise the use of drugs.