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  • 11
    Language: English
    In: Current Women`s Health Reviews, 2014, Vol.10(2), p.66-71
    Description: Use of any form of contraception results in cost-savings compared to non-use of contraception, regardless of payer type. Long-acting reversible contraceptive (LARC) methods are significantly more cost-effective than short-term hormonal and barrier methods, even when LARC methods are not used for their full duration of efficacy. Despite increased contraceptive coverage and reduced patient cost-sharing under the Affordable Care Act, significant barriers remain in addressing the unmet need for effective contraception and fully realizing the decreased health care costs associated with use of contraception in the United States.
    Keywords: Contraception Larc Cost-Effectiveness Affordable Care Act (Aca) Sterilization Emergency Contraception.
    ISSN: 1573-4048
    E-ISSN: 1875-6581
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  • 12
    Language: English
    In: American Journal of Obstetrics and Gynecology, January 2018, Vol.218(1), pp.S245-S246
    Keywords: Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
    Source: ScienceDirect Journals (Elsevier)
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  • 13
    In: Obstetrics & Gynecology, 2018, Vol.132(3), pp.612-618
    Description: OBJECTIVE:: To evaluate whether prophylactic pregabalin reduces pain experienced with medication abortion. METHODS:: We conducted a randomized, double-blind, placebo-controlled trial of women initiating medication abortion with mifepristone and buccal misoprostol up to 70 days of gestation. Participants were randomized to 300 mg oral pregabalin or a placebo immediately before misoprostol. The primary outcome was maximum pain on an 11-point numerical rating scale, reported using real-time electronic surveys over 72 hours. Secondary outcomes included pain at each time point, ibuprofen and narcotic use, side effects, and satisfaction. We estimated that 110 women would be required to have 80% power to detect a difference in pain of 1.3 points. RESULTS:: Between June 2015 and October 2016, 241 women were screened and 110 were randomized (56 pregabalin, 54 placebo). Three were lost to follow-up. The primary outcome of mean maximum pain in the pregabalin group was 5.0±2.6 vs 5.5±2.2 in the placebo group (P=.32). Excluding medication taken before the study capsule, ibuprofen was used by 64% (35/55) of the pregabalin group vs 87% (45/52) placebo (P〈.01). Narcotics were used by 29% (16/55) of the pregabalin group vs 50% (26/52) placebo (P〈.03). More dizziness (P〈.001), sleepiness (P〈.04), and blurred vision (P〈.05) occurred in the pregabalin group. Satisfaction scores for the analgesic regimen were higher in the pregabalin group (very satisfied: 47% vs 22%; P=.006). CONCLUSION:: Compared with placebo, 300 mg pregabalin coadministered with misoprostol during medication abortion did not significantly decrease maximum pain scores. Women who received pregabalin were less likely to require any ibuprofen or narcotic and were more likely to report higher satisfaction with analgesia, despite an increase in dizziness, sleepiness, and blurred vision. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, NCT02782169.
    Keywords: Abortion, Induced -- Adverse Effects ; Analgesics -- Therapeutic Use ; Pain -- Prevention & Control ; Pregabalin -- Therapeutic Use;
    ISSN: 0029-7844
    E-ISSN: 1873233X
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  • 14
    In: Obstetrics & Gynecology, 2017, Vol.130(2), pp.387-392
    Description: OBJECTIVE:: To evaluate the efficacy of a paracervical block to decrease pain during osmotic dilator insertion before second-trimester abortion. METHODS:: In this double-blind, randomized trial, 41 women undergoing Laminaria insertion before a second-trimester abortion received either a paracervical block with 18 mL 1% lidocaine and 2 mL sodium bicarbonate or a sham block. Women were between 14 and 23 6/7 weeks of gestation. The primary outcome was pain immediately after insertion of Laminaria. Women assessed their pain on a 100-mm visual analog scale. Secondary outcomes included assessment of pain at other times during the insertion procedure and overall satisfaction with pain control. To detect a 25-mm difference in pain immediately after Laminaria insertion, at an α of 0.05 and 80% power, we aimed to enroll 20 patients in each arm. RESULTS:: From May 2015 to December 2015, 20 women received a paracervical block and 21 received a sham block. Groups were similar in demographics, including parity, history of surgical abortion, and number of Laminaria placed. The paracervical block reduced pain after Laminaria insertion (median scores 13 mm [interquartile range 2–39] compared with 54 mm [interquartile range 27–61], P=.01, 95% CI −47.0 to −4.0). Women who received a paracervical block also reported higher satisfaction with overall pain control throughout the entire Laminaria insertion procedure (median scores 95 mm [interquartile range 78–100] compared with 70 mm [interquartile range 44–90], P=.05, 95% CI 0.0–37.0). CONCLUSION:: Paracervical block is effective at reducing the pain of Laminaria insertion. Additionally, a paracervical block increases overall patient satisfaction with pain control during Laminaria placement. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, NCT02454296.
    Keywords: Abortion, Induced–Methods ; Adult–Methods ; Anesthesia, Obstetrical–Administration & Dosage ; Double-Blind Method–Administration & Dosage ; Female–Administration & Dosage ; Gestational Age–Administration & Dosage ; Hawaii–Administration & Dosage ; Humans–Administration & Dosage ; Laminaria–Administration & Dosage ; Lidocaine–Administration & Dosage ; Pain Measurement–Administration & Dosage ; Patient Satisfaction–Administration & Dosage ; Pregnancy–Administration & Dosage ; Pregnancy Trimester, Second–Administration & Dosage ; Sodium Bicarbonate–Administration & Dosage ; Abridged ; Sodium Bicarbonate ; Lidocaine;
    ISSN: 0029-7844
    E-ISSN: 1873233X
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  • 15
    In: Cancer, 01 August 2016, Vol.122(15), pp.2408-2417
    Description: The findings of the current randomized controlled trial indicate that, compared with controls, a peer‐counseling intervention significantly improves quality of life and maintains marital adjustment in patients with breast cancer. Having a peer counselor may prevent or improve psychosocial morbidity after diagnosis.
    Keywords: Breast Neoplasms ; Counseling ; Quality Of Life ; Patient‐Navigation ; Posttraumatic Stress
    ISSN: 0008-543X
    E-ISSN: 1097-0142
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  • 16
    Language: English
    In: Gastroenterology, April 2015, Vol.148(4), pp.S-1169-S-1169
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0016-5085(15)33990-1 Byline: Mariam F. Eskander, Lindsay A. Bliss, Susanna W. deGeus, George Baison, Tyler M. Berzin, Sing Chau Ng, Jennifer F. Tseng
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 17
    Language: English
    In: Gastroenterology, April 2015, Vol.148(4), pp.S-1124-S-1124
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0016-5085(15)33828-2 Byline: Ammara A. Watkins, Lindsay A. Bliss, Danielle Cameron, Jennifer F. Tseng, Tara S. Kent
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 18
    Language: English
    In: Cancer Research, 04/15/2012, Vol.72(8 Supplement), pp.2471-2471
    ISSN: 0008-5472
    E-ISSN: 1538-7445
    Source: CrossRef
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  • 19
    Language: English
    In: Gastroenterology, May 2014, Vol.146(5), pp.S-1057-S-1057
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
    Source: ScienceDirect Journals (Elsevier)
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  • 20
    Language: English
    In: Current Obstetrics and Gynecology Reports, 2015, Vol.4(1), pp.53-60
    Description: Adolescent pregnancy rates in the USA have reached an all-time low from their peak in the 1980s and 1990s. However, the USA maintains the highest rate of teenage pregnancy among developed nations. Adolescents experience higher typical use failure rates for user-dependent contraceptives compared to their adult counterparts. Long-acting reversible contraception (LARC), intrauterine devices (IUDs), and implants have failure rates that are both very low and independent of user age. In settings where the most effective methods are prioritized and access barriers are removed, the majority of adolescents initiate LARC. Use of LARC by adolescents significantly reduces rates of overall and repeat teen pregnancy. All methods of contraception are safe for use in teens, including IUDs and depot medroxyprogesterone acetate (DMPA). Dual use of LARC and barrier methods to reduce risk of sexually transmitted infection is the optimal contraceptive strategy for most adolescents. Adolescent access to evidence-based and confidential contraceptive services, provided in a manner that respects autonomy, is a vital public health goal.
    Keywords: Adolescent ; Teen ; IUD ; Implant ; LARC ; Contraception ; Birth control ; Oral contraceptives ; Injectable contraceptive ; DMPA ; Condoms ; Barrier methods ; Emergency contraception ; Dual method ; Pregnancy
    E-ISSN: 2161-3303
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