Desogestrel and gestodene in oral contraceptives: 12 months' assessment of carbohydrate and lipoprotein metabolism
Concerns have been raised over the possible negative effects of oral contraceptives (OCs) on risk factors for cardiovascular disease due to the action of OCs on carbohydrate and lipid metabolism. These concerns have been addressed by the development of new OCs with greatly reduced levels of steroid hormones. Newer pills contain much less estrogen and progestogen than the original pills. Examples of the new gonane progestogens are desogestrel and gestodene, which can be combined with estradiol (an estrogen) in one pill. To determine the effects of these preparations on carbohydrate and lipid metabolism, 34 volunteers were randomly assigned to receive either 20 micrograms of estradiol (ethinyl E2) plus 150 micrograms of desogestrel, or 30 micrograms of estradiol plus 75 micrograms of gestodene for 12 consecutive cycles. Blood samples were analyzed at different points in the study for the content of high- and low-density lipoprotein ('good' and 'bad' cholesterol, respectively). The subjects' glucose tolerance (metabolism) was evaluated as well. Results showed no differences between the two groups in fasting levels of glucose or insulin before or after hormonal intake. However, glucose tolerance became poorer in both groups after three months of hormone treatment; this effect did not persist. In both groups, the levels of high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and triglycerides increased with treatment. In the ethinyl E2-desogestrel group, an increase in the high-density lipoprotein cholesterol/total cholesterol ratio was seen after 12 months. No persistent elevation in low-density lipoprotein cholesterol was observed in either group. Thus, no lasting effects were seen on carbohydrate or lipoprotein metabolism after use of these drugs. A discussion is presented of the metabolic effects of OCs. While the results indicate no adverse effects on certain cardiovascular risk factors, the possibility that these agents affect other risk factors, such as blood coagulation, can not be ruled out. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
War and children
Children are very susceptible to the consequences of war, with many children injured in war-related violence, disrupted health and social services leading to epidemics and starvation, and exposure to traumatic events resulting in long-term traumatic stress reactions, depression and disruptive behavior in children. Physicians and other health care professionals can play a leading role in rehabilitation efforts by providing immediate relief efforts and long-term follow-up care to children.
Publication Name: JAMA, The Journal of the American Medical Association
The role of selenium in iodine metabolism in children with goiter
The authors present research regarding selenium and iodine metabolism interactions investigated in children with iodine deficiencies manifested in goiter. Results indicate differences in free thyroxine concentrations are linked to selenium deficiency, but only in females.
Publication Name: Environmental Health Perspectives
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