Knowledge, Attitudes and Barriers to Human Papillomavirus (HPV) Vaccine Uptake Among an Immigrant and Refugee Catch-Up Group in a Western Canadian Province.

Vaccination is a key strategy to prevent cervical cancer in developed countries. Lower uptake of human papillomavirus (HPV) vaccine among new immigrants and refugees has been documented, although exploration of underlying reasons remains an understudied area. Semi-structured interviews with eleven immigrant women (ages 18-26 years) were conducted to understand their knowledge, attitudes and barriers regarding HPV vaccination in a western Canadian province.

Atonic Postpartum Hemorrhage: Blood Loss, Risk Factors, and Third Stage Management.

Objective: Atonic postpartum hemorrhage rates have increased in many industrialized countries in recent years. We examined the blood loss, risk factors, and management of the third stage of labour associated with atonic postpartum hemorrhage.

Methods: We carried out a case-control study of patients in eight tertiary care hospitals in Canada between January 2011 and December 2013.

Recombinant human luteinizing hormone to trigger ovulation: randomized, controlled, dose-finding pilot study in ovulation induction.

Objective: To evaluate recombinant human luteinizing hormone (r-hLH) versus urine-derived human chorionic gonadotropin (u-hCG) to trigger ovulation in women (aged 20-40 years) with WHO Group II anovulatory infertility undergoing ovulation induction (OI) with recombinant human follicle-stimulating hormone (r-hFSH) (150 IU/day starting dose).

Study Design: For this Phase II, open-label, dose-finding pilot study, patients were randomized to doses of 825, 2,750, 5,500, 11,000, or 22,000 IU r-hLH or u-hCG (5,000 IU). Primary endpoints were ovulation and ratio of ruptured follicles/follicle > or = 15 mm (day of r-hLH/ u-hCG administration).

Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial.

We determined the effects of 2 years of exercise training and soy isoflavone supplementation on bone mass and lipids in postmenopausal women provided with calcium and vitamin D. Women were randomized to four groups: exercise training (Ex); isoflavone supplementation (Iso: 165 mg/d [105 mg/d aglycone equivalent]); combined Ex and Iso (ExIso); and placebo (control). Exercise included resistance training (2 days/week) and walking (4 days/week).

Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes.

Background: In previous studies, maternal exposure to folic acid antagonists was associated with increased risks of neural tube defects, cardiovascular defects, oral clefts and urinary tract defects. The objective of the current study was to assess the possible effects of using folic acid antagonists in pregnancy on placenta-mediated adverse outcomes of pregnancy.

Methods: We used data from an administrative database to retrospectively compare the occurrence of placenta-mediated adverse pregnancy outcomes between pregnant women exposed to folic acid antagonists and women without exposure to these agents.

Maternal characteristics associated with pregnancy exposure to FDA category C, D, and X drugs in a Canadian population.

Purpose: To estimate the frequency of exposure to prescription Food and Drug Administration (FDA) category C, D, and X drugs in pregnant women, and to analyze the maternal characteristics associated with such an exposure.

Methods: A 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 was chosen for the study. The rate of exposure to FDA category C, D, or X drugs recorded in the pharmacist database was estimated.

Occurrence and determinants of trimethoprim/sulfamethoxazole use in pregnancy.

Objective: To estimate the rate of prescription trimethoprim/sulfamethoxazole use in pregnancy, and to analyse the association between maternal characteristics and use of trimethoprim/sulfamethoxazole in pregnancy.

Methods: A population-based study was conducted based on a 50% random sample of women who gave a birth in Saskatchewan between 1 January 1997 and 31 December 2000. The rate of trimethoprim/sulfamethoxazole use during pregnancy was estimated.

Effects of oral contraceptives administered at defined stages of ovarian follicular development.

Objective: To elucidate the effects of initiating oral contraceptives (OC) at defined stages of ovarian follicle development.

Design: Prospective longitudinal study.

Setting: Healthy volunteers in an academic research environment.

Selective serotonin reuptake inhibitors and adverse pregnancy outcomes.

Objective: The purpose of this study was to assess the safety of the use of selective serotonin reuptake inhibitors in pregnancy.

Study Design: We carried out a retrospective cohort study of 972 pregnant women who had been given at least 1 selective serotonin reuptake inhibitor prescription in the year before delivery and 3878 pregnant women who did not receive selective serotonin reuptake inhibitors and who were matched by the year of the infant's birth, the type of institute at birth, and the mother's postal code from 1990 to 2000 in the Canadian province of Saskatchewan.

Results: The risks of low birth weight (adjusted odds ratio, 1.

Ovarian follicular dynamics during conventional vs. continuous oral contraceptive use.

Objectives: The purpose of this study was to characterize ovarian follicular and endometrial development during conventional vs. continuous oral contraceptive (OC) dosing regimens, to explore follicular development during the hormone-free interval (HFI) and to examine follicular development following OC discontinuation.

Study Methods: A randomized clinical trial involving 36 clinically normal healthy women between the ages of 18 and 35 years (24.

Quality-of-life analysis in the management of endometrial cancer.

Objective: The purpose of this study was to determine whether and how the quality of life (QL) of patients with stage I endometrial cancer was influenced by different surgical procedures with or without radiation therapy.

Study Design: We conducted a retrospective analysis of 200 women with stage I endometrial cancer at the University of Saskatchewan, Canada in 2001 through 2002. Modified QLQ-C30 Questionnaires were used in evaluating differences in the weighted QL of patients who underwent staged surgery and patients who had nonstaged surgery, the latter of which refers to total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) with or without radiation therapy.

Ultrasound image attributes of human ovarian dominant follicles during natural and oral contraceptive cycles.

Background: Computer-assisted analyses were used to examine ultrasound image attributes of human dominant ovarian follicles that developed during natural and oral contraceptive (OC) cycles. We hypothesized that image attributes of natural cycle follicles would quantitatively differ from those in OC cycles and that OC cycle follicles would possess image attributes indicative of atresia.

Methods: Dominant ovarian follicles of 18 clinically normal women were compared using transvaginal ultrasonography for the 7 days before ovulation during a natural cycle (n = 9) or the 7 days before peak estradiol in women using OC (n = 11).

Magnetic resonance diffusion imaging of ovarian masses: a first experience with 12 cases.

Objective: The objective of the study was to determine the feasibility of using apparent diffusion coefficient (ADC) measurement for the differential diagnosis of malignancy in ovarian masses.

Materials And Methods: Twelve cases involving ovarian masses were imaged using spin echo diffusion magnetic resonance imaging (MRI). Five cases involved malignant ovarian masses, on the basis of postoperative histologic examination, and the rest involved benign masses.

Transvaginal sonography and fiberoptic illumination of uterine vessels for abdominal cervicoisthmic cerclage.

Background: Transabdominal cervicoisthmic cerclage is a procedure carried out to increase the fetal salvage rates in women who are poor candidates for the more usual procedure of transvaginal cerclage or for those with previously failed vaginal procedures. Although several modifications have been applied to the original procedure in an attempt to reduce the morbidity, bleeding arising from trauma to the uterine vessels during suture placement remains problematic.

Case: Our technique involves transilluminating the uterine vessels during placement of the 5-mm-wide Mersilene (Ethicon Inc.

Incorporating sexual and reproductive health care in the medical curriculum in developing countries.

Medical educators have a responsibility to train physicians and other health professionals in the core competencies needed to improve the sexual and reproductive health of their communities. Yet sexual and reproductive health care is significantly under-represented in the basic educational curriculum for medical and other health professionals, as well as in continuing medical education and professional development programmes for practising physicians and other health professionals. The Commonwealth Medical Association Trust is developing a model curriculum on sexual and reproductive health that can be integrated into undergraduate medical education and used with appropriate amendments for continuing medical education.

A randomized controlled trial of outpatient versus inpatient labour induction with vaginal controlled-release prostaglandin-E2: effectiveness and satisfaction.

Background: Outpatient management in obstetrics is expanding, but evidence to support outpatient labour induction is needed.

Objective: To compare the effectiveness, acceptability, duration of hospitalization, and safety of outpatient and inpatient induction of labour with intravaginal controlled-release prosta-glandin-E2 (CR-PGE2).

Methods: A prospective, randomized, controlled trial enrolled 300 women at term with parity < or = 5 and singleton pregnancies in cephalic presentation.

Curriculum reform for reproductive health.

A new model of reproductive health care delivery is unfolding, driven by emerging health issues, expanding technology and increasing public expectations. Additional imperatives in service provision for women's health compel reforms to undergraduate medical education using reproductive health as the basis for restructuring curriculum contents. These developments provide an opportunity for implementing the recommendations from various international conferences through continuing professional development and an evidence-based approach to clinical decision-making.