Nearly all trials used modern IUC. Most effectiveness evidence was of moderate quality, having come from single trials. Lidocaine 2% gel, misoprostol, and most NSAIDs did not help reduce pain. Some lidocaine formulations, tramadol, and naproxen had some effect on reducing IUC insertion-related pain in specific groups. The ineffective interventions do not need further research.
Since most trials addressed preventing STI/HIV and pregnancy, they emphasized condom use. However, several studies covered a range of contraceptive methods. The overall quality of evidence was low. Main reasons for downgrading the evidence were having limited information on intervention fidelity, analyzing a subsample rather than all those randomized, and having high losses.
et al. The effect of age, parity and body mass index on the efficacy, safety, placement and user satisfaction associated with two low-dose levonorgestrel intrauterine contraceptive Systems: subgroup analyses of data from a Phase III trial.
The extent to which plasma potassium determines potassium removal in hemodialysis was examined in 8 end-stage renal disease patients during 51 treaments. Dialyzers, treatment time, blood and dialysate flow were held constant. Dialysate composition was also uniform except that 24 treatments utilized glucose-free dialysate and the remaining 27 a 200 mg/dl glucose bath. At either level of dialysate glucose, approximately 40% of the potassium removal during dialysis could not be accounted for by plasma-dialysate potassium gradient, body weight or serum carbon dioxide content, although glucose-free dialysate tended to increase potassium removal by a mean of 28%. The large, unexplained variability in potassium removal suggests that therapeutic manipulation of potassium flux across cell membranes may improve the management of potassium balance in hemodialyzed patients.
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