Dear Colleagues,

Planned Parenthood of Montana is pleased to announce that the 2014 Montana Sexual Assault Nurse Examiner (SANE) Training will be held May 12-16 in Great Falls, Montana. Registration is now open see the attached brochure.  Travel reimbursements and scholarships are limited so please register early. 

Feel free to pass along this information to others who may be interested in learning more about the training.

Best regards,
 

By Kelly Young

The U.S. Preventive Services Task Force is recommending the use of low-dose aspirin (81 mg/day) to prevent preeclampsia in high-risk women. Previously, the group found insufficient evidence to recommend its routine use.

In a draft recommendation statement, the task force advises daily, low-dose aspirin after 12 weeks' gestation if a woman has one or more high-risk conditions, such as a history of preeclampsia, chronic hypertension, or diabetes, or has several moderate risk factors, including obesity, family history, and an age of 35 years or above.

Clinical trials found that aspirin reduced the risk for preeclampsia by 24%, preterm birth by 14%, and intrauterine growth restriction by 20%.  There was no evidence of maternal or fetal harms with aspirin.

The authors write that aspirin's anti-inflammatory, antiangiogenesis, and antiplatelet properties could help explain its role in preeclampsia prevention.

The USPSTF's draft statement is open to public comment until May 5.

Actavis and Valeant announced that the FDA has approved Metronidazole 1.3% Vaginal Gel for the treatment of bacterial vaginosis. In April 2013, Actavis acquired the rights to Metronidazole 1.3% from Valeant.

Metronidazole, a nitroimidazole antimicrobial, is reduced by metabolically active anaerobes. Studies have demonstrated that this reduced form of the drug interacts with bacterial DNA. The exact intracellular targets of action of metronidazole on anaerobes are unknown.

The FDA approval was based on the results of a Phase 3 randomized, double-blind, placebo-controlled, multicenter clinical trial, which found that the higher concentration Metronidazole 1.3% was well tolerated, safe, and efficacious.

Metronidazole Vaginal Gel 1.3% will be available as a single-dose packaged in a prefilled disposable applicator. The product is expected launch later this year. 

Eleanor Bimla Schwarz, MD, MS reviewing Dinger J et al. Contraception 2014 Apr. Eleanor Bimla Schwarz, MD, MS

Prospective data indicate drospirenone's thromboembolic risk is similar to that of older progestins. Eleanor Bimla Schwarz, MD, MS

Several large epidemiologic studies have raised concern that drospirenone-containing oral contraceptives (OCs) are more likely than levonorgestrel-containing OCs to be associated with thromboembolic events, although the industry-funded European Active Surveillance Study did not find this to be the case. Now, investigators for the industry-funded International Active Surveillance Study of Women Taking Oral Contraceptives have reported outcomes in >85,000 participants (22% of whom were new users of combined hormonal contraception) who were prospectively followed for 2 to 6 years with only 3.3% lost to follow-up.

Whether women used 21- or 24-day regimens of drospirenone-containing combined OCs, rates of thromboembolism were less than 1 per 1000 woman-years of use. In addition, rates of venous and arterial thromboembolism, cancer, death, or severe depression were similar whether women used pills containing drospirenone, levonorgestrel, or any other progestin. In women who stopped all use of hormonal contraception, rates of serious adverse events were more than 80% higher than in women who used hormonal contraception, largely due to pregnancy-related complications.

Comment

This study, which controlled for multiple factors affecting clot risk (e.g., blood pressure, obesity, tobacco use, family history), reinforces my comfort prescribing whichever oral contraceptive pill my patients prefer - especially when it's their least expensive option. - See more at: http://www.jwatch.org/na34124/2014/04/10/contraception-choose-pill-any-pill?query=etoc_jwwomen#sthash.S7anQB52.dpuf