Patients taking oral contraceptive steroids (OCS) are known to suffer contraceptive failure while taking anticonvulsants such as phenobarbitone, phenytoin and carbamazepine. We have studied the single dose kinetics of ethinyloestradiol (EE2); 50 ,ug, and levonorgestrel (Ng); 250 p,g in groups of women before and 8-12 weeks after starting therapy with phenytoin (n = 6) and carbamazepine (n = 4). The area under the plasma concentration-time curve (AUC) was measured over a 24 h period for each steroid and significant reductions were seen with both anticonvulsants. Phenytoin reduced the AUC for EE2 from 806 ± 50 (mean ± s.d.) to 411 ± 132 pg ml-' h (P < 0.05) and for Ng from 33.6 ± 7.8 to 19.5 ± 3.8 ng ml-' h (P < 0.05). Carbamazepine reduced the AUC for EE2 from 1163 ± 466 to 672 ± 211 pg ml-' h (P < 0.05) and for Ng from 22.9 ± 9.4 to 13.8 ± 5.8 ng ml-' h (P < 0.05). These changes are compatible with the known enzyme inducing effects of phenytoin and carbamazepine. Patients taking these anticonvulsants will need to be given increased doses of OCS (equivalent to 50-100 ,ug EE2 daily) to achieve adequate contraceptive effects.

The Structural Health Monitoring (SHM) in civil engineering faces several challenges. The main issue lies in defining a reliable and precise methodology of damage detection and localization in order to allow preventive maintenance or to enable the definition of repair actions. In this paper, a new methodology of SHM is proposed. Using Vibration-Based Damage Detection Methods (VBDDM), a damage detection and localization algorithm is elaborated and tested on a Finite Element Model (FEM) of an existing building. In a first case, the damage is introduced artificially by a local reduction of stiffness, while in the second case, the damage is calculated according to a real seismic signal from the italian L'Aquila earthquake. The advantages and disadvantages of each dynamic monitoring technique are discussed and the usefulness of the algorithm is highlighted.

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