Philip Darney | University of California, San Francisco (original) (raw)
Papers by Philip Darney
Obstetrics & Gynecology, Feb 1, 2002
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Obstetrical & Gynecological Survey, Sep 1, 2011
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Obstetrics & Gynecology, May 1, 1999
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American Journal of Obstetrics and Gynecology, Mar 1, 1987
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Contraception, Jul 1, 2009
A formulation of depot medroxyprogesterone acetate (DMPA) has been developed that allows subcutan... more A formulation of depot medroxyprogesterone acetate (DMPA) has been developed that allows subcutaneous injection (104 mg/0.65 mL; DMPA-SC) and achieves highly effective contraception with a similar tolerability profile to intramuscular DMPA (150 mg/mL; DMPA-IM). This randomized, evaluator-blinded study was designed to compare efficacy, safety, and user satisfaction in women receiving DMPA-SC (n=266) or DMPA-IM (n=268) for 2 years with an option to continue for a third year. The primary objectives were to evaluate bone mineral density (BMD) changes and contraceptive efficacy after 2 years. A total of 225 women completed the first 2 years of this study (DMPA-SC, n=116; DMPA-IM, n=109). After 2 years of DMPA use, BMD loss was marginally smaller in the DMPA-SC group than in the DMPA-IM group at both the total hip (-3.3% and -3.6%, respectively) and lumbar spine (-4.3% and -5.0%, respectively). In those women who received DMPA during the third year, there were no statistically significant differences in BMD loss between DMPA-SC and DMPA-IM groups at the end of Year 3. Recovery of BMD was observed in the small subpopulation of women who had discontinued DMPA-SC or DMPA-IM after the second year. The 2-year treatment-failure cumulative pregnancy rate was 0% in the DMPA-SC group and 0.8% (95% confidence interval, 0.00-2.37%) in the DMPA-IM group (life-table method). Adverse events were similar in the two groups except that injection site reactions were more common in the DMPA-SC group. DMPA-SC is an effective and well-tolerated contraceptive option, providing comparable efficacy and BMD safety to DMPA-IM.
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Wiley-Blackwell eBooks, Feb 18, 2011
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Cambridge University Press eBooks, Aug 19, 2021
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International journal of gynaecology and obstetrics, Mar 1, 1994
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The New England Journal of Medicine, Aug 20, 2009
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Obstetrics & Gynecology, Mar 1, 2003
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American Journal of Obstetrics and Gynecology, Nov 1, 1980
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Public health reports, 1970
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Obstetrics & Gynecology, Aug 1, 2007
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American Journal of Obstetrics and Gynecology, May 1, 1994
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Clinics in obstetrics and gynaecology, Mar 1, 1986
The use of laminaria has made possible safe uterine evacuation in the second-trimester and has be... more The use of laminaria has made possible safe uterine evacuation in the second-trimester and has been identified as a protective factor in the prevention of uterine perforation in first-trimester abortion. Two additional approaches to cervical dilation are now available - synthetic hydrophilic dilators and prostaglandin analogues. Neither has been in use long enough to undergo thorough evaluation, but it seems possible that they may confer similar advantages while avoiding the discomfort and inconvenience associated with laminaria. New approaches to the use of laminaria have increased their value as cervical dilators. They may be left in the cervix for 6-48 hours. Multiple sets may be employed to achieve adequate cervical dilation for late second-trimester uterine evacuation. When fetal membranes are intact, prolonged use or multiple insertions of laminaria do not appear to increase rates of post-abortion infection. Lamicel and Dilapan are new synthetic dilators which affect the cervix much more rapidly than laminaria. The former does not apply radial force to the walls of the cervical canal, but the latter does. Significant dilation may be achieved in a few hours. Prostaglandins can also alter the cervix in only a few hours. Meteneprost appears to do so with minimal gastrointestinal side-effects and with a low risk of bleeding or abortion.
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American Journal of Obstetrics and Gynecology, Aug 1, 2000
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Seminars in Reproductive Medicine, 2001
The experience of 6 million Norplant users has led to several more advanced implants. Implanon is... more The experience of 6 million Norplant users has led to several more advanced implants. Implanon is a single-rod implant system containing a low androgenic progestin and requires 1 to 2 minutes for insertion and removal. Like other implants, Implanon prevents pregnancy by changing the character of the cervical mucus and interfering with luteal function. Unlike Norplant, though, Implanon is designed to prevent ovulation for the full duration of use. Implant contraception has several advantages over other types of contraception including high efficacy, minimal required maintenance, absence of estrogen, and rapid return of fertility after discontinuation. Implants can be a good choice for adolescents; women with hypertension, diabetes, anemia, endometriosis, or other medical problems; and women who are breast-feeding. Irregular bleeding is the most common adverse effect of implants and can be treated with several medication regimens. Preinsertion counseling, however, is the most important factor in ensuring satisfaction with implants. Unfortunately, no implant system is currently available in the United States since August 2000, but Implanon is expected to reach the U.S. market within the next 2 years.
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Family Planning Perspectives, Jul 1, 1987
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American Journal of Obstetrics and Gynecology, Apr 1, 2004
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Contraception, Feb 1, 2011
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Obstetrics & Gynecology, Feb 1, 2002
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Obstetrical & Gynecological Survey, Sep 1, 2011
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Obstetrics & Gynecology, May 1, 1999
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American Journal of Obstetrics and Gynecology, Mar 1, 1987
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Contraception, Jul 1, 2009
A formulation of depot medroxyprogesterone acetate (DMPA) has been developed that allows subcutan... more A formulation of depot medroxyprogesterone acetate (DMPA) has been developed that allows subcutaneous injection (104 mg/0.65 mL; DMPA-SC) and achieves highly effective contraception with a similar tolerability profile to intramuscular DMPA (150 mg/mL; DMPA-IM). This randomized, evaluator-blinded study was designed to compare efficacy, safety, and user satisfaction in women receiving DMPA-SC (n=266) or DMPA-IM (n=268) for 2 years with an option to continue for a third year. The primary objectives were to evaluate bone mineral density (BMD) changes and contraceptive efficacy after 2 years. A total of 225 women completed the first 2 years of this study (DMPA-SC, n=116; DMPA-IM, n=109). After 2 years of DMPA use, BMD loss was marginally smaller in the DMPA-SC group than in the DMPA-IM group at both the total hip (-3.3% and -3.6%, respectively) and lumbar spine (-4.3% and -5.0%, respectively). In those women who received DMPA during the third year, there were no statistically significant differences in BMD loss between DMPA-SC and DMPA-IM groups at the end of Year 3. Recovery of BMD was observed in the small subpopulation of women who had discontinued DMPA-SC or DMPA-IM after the second year. The 2-year treatment-failure cumulative pregnancy rate was 0% in the DMPA-SC group and 0.8% (95% confidence interval, 0.00-2.37%) in the DMPA-IM group (life-table method). Adverse events were similar in the two groups except that injection site reactions were more common in the DMPA-SC group. DMPA-SC is an effective and well-tolerated contraceptive option, providing comparable efficacy and BMD safety to DMPA-IM.
Bookmarks Related papers MentionsView impact
Wiley-Blackwell eBooks, Feb 18, 2011
Bookmarks Related papers MentionsView impact
Cambridge University Press eBooks, Aug 19, 2021
Bookmarks Related papers MentionsView impact
International journal of gynaecology and obstetrics, Mar 1, 1994
Bookmarks Related papers MentionsView impact
The New England Journal of Medicine, Aug 20, 2009
Bookmarks Related papers MentionsView impact
Obstetrics & Gynecology, Mar 1, 2003
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American Journal of Obstetrics and Gynecology, Nov 1, 1980
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Public health reports, 1970
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Obstetrics & Gynecology, Aug 1, 2007
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American Journal of Obstetrics and Gynecology, May 1, 1994
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Clinics in obstetrics and gynaecology, Mar 1, 1986
The use of laminaria has made possible safe uterine evacuation in the second-trimester and has be... more The use of laminaria has made possible safe uterine evacuation in the second-trimester and has been identified as a protective factor in the prevention of uterine perforation in first-trimester abortion. Two additional approaches to cervical dilation are now available - synthetic hydrophilic dilators and prostaglandin analogues. Neither has been in use long enough to undergo thorough evaluation, but it seems possible that they may confer similar advantages while avoiding the discomfort and inconvenience associated with laminaria. New approaches to the use of laminaria have increased their value as cervical dilators. They may be left in the cervix for 6-48 hours. Multiple sets may be employed to achieve adequate cervical dilation for late second-trimester uterine evacuation. When fetal membranes are intact, prolonged use or multiple insertions of laminaria do not appear to increase rates of post-abortion infection. Lamicel and Dilapan are new synthetic dilators which affect the cervix much more rapidly than laminaria. The former does not apply radial force to the walls of the cervical canal, but the latter does. Significant dilation may be achieved in a few hours. Prostaglandins can also alter the cervix in only a few hours. Meteneprost appears to do so with minimal gastrointestinal side-effects and with a low risk of bleeding or abortion.
Bookmarks Related papers MentionsView impact
American Journal of Obstetrics and Gynecology, Aug 1, 2000
Bookmarks Related papers MentionsView impact
Seminars in Reproductive Medicine, 2001
The experience of 6 million Norplant users has led to several more advanced implants. Implanon is... more The experience of 6 million Norplant users has led to several more advanced implants. Implanon is a single-rod implant system containing a low androgenic progestin and requires 1 to 2 minutes for insertion and removal. Like other implants, Implanon prevents pregnancy by changing the character of the cervical mucus and interfering with luteal function. Unlike Norplant, though, Implanon is designed to prevent ovulation for the full duration of use. Implant contraception has several advantages over other types of contraception including high efficacy, minimal required maintenance, absence of estrogen, and rapid return of fertility after discontinuation. Implants can be a good choice for adolescents; women with hypertension, diabetes, anemia, endometriosis, or other medical problems; and women who are breast-feeding. Irregular bleeding is the most common adverse effect of implants and can be treated with several medication regimens. Preinsertion counseling, however, is the most important factor in ensuring satisfaction with implants. Unfortunately, no implant system is currently available in the United States since August 2000, but Implanon is expected to reach the U.S. market within the next 2 years.
Bookmarks Related papers MentionsView impact
Family Planning Perspectives, Jul 1, 1987
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American Journal of Obstetrics and Gynecology, Apr 1, 2004
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Contraception, Feb 1, 2011
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