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[WHO updates medical eligibility criteria for contraceptives] OMS reactualizeaza criteriile medicale de eligibilitate pentru utilizarea contraceptivelor.
Targu-Mures, Romania, Institutul Est European de Sanatate a Reproducerii, 2006. 15 p. (Actualitati in planificarea familiala No. 1)The World Health Organization (WHO) has issued new family planning guidance, including the following: Most women with HIV infection generally can use IUDs. Women generally can take hormonal contraceptives while on antiretroviral (ARV) therapy for HIV infection, although there are interactions between contraceptive hormones and certain ARV drugs. Women with clinical depression usually can take hormonal contraceptives. More than 35 experts met at WHO headquarters in Geneva, Switzerland, in October 2003 and developed this and other new guidance. The new guidance updates the 2000 Medical Eligibility Criteria (MEC) for Contraceptive Use. (excerpt)
Geneva, Switzerland, WHO, .  p.This document is one important step in a process for improving access to quality of care in family planning by reviewing the medical eligibility criteria for selecting methods of contraception. It updates the second edition of Improving access to quality care in family planning: medical eligibility criteria for contraceptive use, published in 2000, and summarizes the main recommendations of an expert Working Group meeting held at the World Health Organization, Geneva, 21-24 October 2003. The Working Group brought together 36 participants from 18 countries, including representatives of many agencies and organizations. The document provides recommendations for appropriate medical eligibility criteria based on the latest clinical and epidemiological data and is intended to be used by policy-makers, family planning programme managers and the scientific community. It aims to provide guidance to national family planning/reproductive health programmes in the preparation of guidelines for service deliveryof contraceptives. It should not be seen or used as the actual guidelines but rather as a reference. (excerpt)
Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health Project [INFO], 2004 Aug. 8 p. (INFO Reports No. 1; USAID Grant No. GPH-A-00-02-00003-00)The World Health Organization (WHO) has issued new family planning guidance, including the following: Most women with HIV infection generally can use IUDs. Women generally can take hormonal contraceptives while on antiretroviral (ARV) therapy for HIV infection, although there are interactions between contraceptive hormones and certain ARV drugs. Women with clinical depression usually can take hormonal contraceptives. More than 35 experts met at WHO headquarters in Geneva, Switzerland, in October 2003 and developed this and other new guidance. The new guidance updates the 2000 Medical Eligibility Criteria (MEC) for Contraceptive Use. (excerpt)
In: WHO updates medical eligibility criteria for contraceptives, by Ward Rinehart. Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health Project [INFO], 2004 Aug. 5. (INFO Reports No. 1; USAID Grant No. GPH-A-00-02-00003-00)Considering depressive disorders for the first time, the October 2003 MEC meeting concluded that there is no need for restriction on use of hormonal contraceptives for women with depression. A variety of studies have found no increase in symptoms among depressed women using combined or progestin-only oral contraceptives, DMPA injectable, or Norplant implants. A single study reported that taking fluoxetine (Prozac) for depression did not reduce the effectiveness of combined or progestin- only oral contraceptives. Conclusions cannot be reached concerning postpartum depression or bipolar disorder because current evidence is inadequate. (excerpt)
Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2002.  p. (WHO/FCH/CAH/01.20)Adolescence is a period of rapid development when young people acquire new capacities and are faced with new challenges. It is a time of opportunity but also of vulnerability to risk behaviours which can have lifelong consequences, especially for health. Health risk behaviours may undermine adolescent health and development. For example, unprotected sexual relations may lead to unplanned pregnancy or a sexually transmitted infection, including HIV. So far, programming for adolescent health and development has focused mainly on providing information and services to reduce risk behaviours and mitigate their consequences. But this is not enough. The evidence now shows that enhancing protective factors, in addition to reducing risk, is equally important. Programming strategies need to strike a balance, addressing both risk and protective factors. (excerpt)
ARCHIVES OF GENERAL PSYCHIATRY. 1994 Jan; 51(1):39-49.The WHO Neuropsychiatric AIDS Study project was to assess the prevalence and natural history of HIV-1-associated psychiatric, neuropsychological, and neurological abnormalities in representative subject samples enrolled in the five geographic areas predominantly affected by the HIV-1 epidemic (Sub-Saharan Africa, North America, Latin America, western Europe, and southeast Asia). Assessment was made by a data collection instrument including six modules. The study consisted of a cross-sectional phase and a longitudinal follow-up. The results of psychiatric assessment revealed that the prevalence of current mental disorders was significantly higher in symptomatic (but not in asymptomatic) HIV-1-seropositive subjects, compared with seronegative controls, in Bangkok and Sao Paulo. This difference remained significant when the analysis was restricted to IV drug users in the former center (21.4% vs 2.1%, P <.01) and to homosexuals/bisexuals in the latter (33.3% vs 5.7%, P <.01). Symptomatic HIV-1-seropositive subjects had consistently higher mean scores on the Montgomery-Asberg Depression Rating Scale (MADRS) compared with those of seronegative controls, and the mean global score was always significantly increased in the former. Only two significant differences on individual items (both in Bangkok) were observed between physically asymptomatic HIV-1-seropositive subjects and controls. The mean MADRS global score was significantly higher in women than in men among symptomatic HIV-1 seropositive subjects who were assessed in Kinshasa (p <.05) and in Munich (p <.001). However, no significant sex difference was found among either HIV-1 seronegative or asymptomatic HIV-1-seropositive persons in any center. The effect of the sex-serogroup interaction on the MADRS global score was found to be significant in Munich (F=10.6, df=2, P <.0001), but the effect of the interaction risk group-serogroup did not reach statistical significance. The correlation between the MADRS global score and the CD4 count was significant only in symptomatic seropositive subjects assessed in Kinshasa and Munich (p <.01).
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1990; 68(5):671-3.A consultation on the neuropsychiatric aspects of HIV-1 infection was held at the World Health Organization (WHO) headquarters January 11-13, 1990. Of topics discussed, participants concluded that a group of conditions characterized by cognitive and motor impairment can be described. New terminology was suggested accordingly. Participants found that otherwise health HIV-1 seropositive patients were no more likely than HIV-1 seronegative patients to manifest clinically significant cognitive impairment. The serological screening of asymptomatic patients for HIV-1 in attempts to protect public safety was therefore deemed unnecessary. Hallucinations and delusions being not infrequent in AIDS and ARC patients, they may be indicative of cognitive impairment or later accompanied by symptoms pointing to diagnosis of delirium or dementia. Acute psychotic disorders outside of evidence of cognitive impairment may result as anomalies described within the text. Depressive syndrome may result outside of severe depressive episode or major depression due to recent diagnosis as HIV-1 positive and/or as the first stage of HIV-1 dementia. DIstinguishing between ARC and the above-mentioned states as the cause of this syndrome may be difficult. Consultation participants cited stress associated with HIV-1 infection or disease to be conditioned by several factors. Finally, neuropsychiatric disorders due to HIV-1 opportunistic processes were discussed. Country-level recommendations included preparing health workers for a wide range of neuropsychiatric conditions in the HIV-1 positive patient, and notifying then that otherwise healthy HIV-1 positive patients may not show clinically significant signs of cognitive impairment. Recommendations followed in urging health services to prepare for a large burden of neuropsychiatric illness in AIDS and ARC patients; governments should support services and train health workers accordingly. Pre- and post-serological testing counseling was stressed, with facility for and understanding of the special needs of HIV-1 positive patients' families and involved health staff. Research on the neurological and mental health needs of patients should be given high priority with attention given to the immediate policy and care implications. Final qualification of the difficulty involved in generalizing research findings to apply across sociocultural and geographical contexts was provided with mention in the text of a WHO multicenter study addressing this concern in its pilot phase at the time of publication. Neurological tests were designed for use in this study to be culturally nonspecific.