Use of a Modified Minicoil for Continuous Dialysis

Abstract

Oral Contraception-Tyler MBRcITo 847 Discussion It has been quite definitely established that progestogenoestrogen oral contraception is very effective with certain recognized but not serious side-effects. Our more recent efforts, and those of most other investigators of these compounds, have taken two major directions: (1) a search for better and lowerdosage products; (2) a detailed investigation of the possible long-term effects of these compounds on various organs and body functions, and the determination of the safety, or lack of safety, of many years of consistent use by the same individual.Since most women now using these products generally take them for family-planning purposes rather than to avoid any further pregnancies, data on long-term continuous use are not easy to obtain. In our clinic the number of women who have used any of our oral contraceptive preparations for over five years continuously is less than 300, and our studies, with those of Pincus, constitute the longest investigations of this form of contraception. Therefore the total number of continuous users for over five years anywhere is likely to be very limited. It is important that long-term data about continuous use be obtained, because, as this form of contraception is being employed more and more by younger women, we will have millions who may complete their families between the ages of 25 and 30, and they will be depending on the continuous use of these products for another 15 to 20 years.The detailed blood-chemistry studies we have referred to in this report provide one method of obtaining needed information regarding safety. One problem in obtaining this type of information is that certain abnormalities may be found, and they are not necessarily suggestive of pathology. This may hold particularly true, for example, for such changes as elevations in protein-bound iodine. One would be rash, I believe, in deducing a state of hyperthyroidism because the proteinbound iodine in a patient exceeded the usual normal limit of 8 ttg./100 ml. We therefore have to attempt to correlate any changes in chemical findings with the overall physiological alterations occurring during use of the oral contraceptives. This task of obtaining the data, finding suitable controls, and making the necessary correlation is not an easy one. We would like to extend our thyroid-function tests to those studies employing radioactive material, but this presents a problem when pregnant " controls" are used.We are currently also finding stumbling-blocks in discovering suitable tests for adrenocortical function that can be employed readily in pregnant patients, with no medical or medico-legal risk. Fortunately, the reputable pharmaceutical manufacturers involved with these preparations, as well as various research organizations, are anxious to obtain all the information possible, and there is little problem regarding support in this respect. It is likely that, despite the obvious obstacles, the next few years will bring about an elucidation of the manifold effects th...