***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: It is believed that much of the small increased risk for developing pelvic inflammatory disease ( PID )  associated with the use of an intrauterine device ( IUD )  appears to be caused by bacterial contamination of the endometrial cavity at the time of insertion . Previous research suggests that use of prophylactic antibiotics immediately prior to IUD insertion may reduce the risk of developing PID . This paper presents results from a r and omized clinical trial of 1485 women in Ibadan , Nigeria evaluating the effectiveness of 200 mg of doxycycline ( versus placebo ) given orally at the time of IUD insertion in reducing the incidence of PID during the first three months of IUD use . Rate of PID infection in the doxycycline-treated group was not significantly lower than that in the placebo-treated group . The rate of unscheduled IUD-related visits to the clinic also was not significantly lower among the doxycyclinetreated group . However , the incidence of PID was low ( 21 cases ) for both study groups . Aseptic conditions during IUD insertion , follow-up visits with short intervals to monitor health , and treatment of opportunistic infections may have reduced the potential of PID within this population .ResuméOn pense qu'un bon nombre des légers risques de contracter une affection pelvienne inflammatoire liée à l'utilisation d'un dispositif intra-utérin est sans doute dû à une contamination bactérienne de la cavité utérine au moment de l'insertion . Les recherches précédentes semblen indiquer que l'administration d'antibiotiques à titre prophylactique immédiatement avant l'insertion d'un DIU peut réduire le risque de telles inflammations . Ce document présente les résultats d'un essai clinique r and omisé sur 1485 femmes effectué à Ibadan ( Nigéria ) en vue d'évaluer l'efficacité de 200 mg de la doxycycline ( comparée à un placebo ) , administrés par voie buccale au moment de l'insertion du DIU , pour réduire l'incidence des affections pelviennes inflammatoires pendant les trois premiers mois d'utilisation d'un DIU . Le pourcentage d'infection dans le groupe des femmes traitées à la doxycycline n'étaiet pas significativement moins élevé que celui du groupe traité au placebo . Le pourcentage de consultations imprévues à la clinique pour des raisons liées au DIU n'étaient pas non plus significativement moins élevé pour le groupe traité à la doxycycline . Toutefois , l'incidence d'affections pelviennes inflammatoires étaiet faible ( 21 cas ) pour les deux groupes étudiés . Il est possible que les conditions d'aseptie pendant l'insertion du DIU , les visites de suivi à intervalles rapprochés pour contrôler l'état de santé , ainsi que le traitement d'infections intercurrentes aient réduit l'eventualité de telles affections inflammatoires dans cette population .ResumenSe piensa que una gran parte de los pequeños riesgos de contraer una afección pélvica inflamatoria relacionada con la utilización de un dispositivo intrauterino parece haber sido causada por una contaminación bacteriana de la cavidad uterina en el momento de la colocación . Las investigaciones anteriores parecen indicar que la administración de antibióticos a título profiláctico inmediatamente antes de la colocación de un DIU reducir el riesgo de tales inflamaciones . En este documento se presentan los result ados de un ensayo clínico al azar realizado con 1,485 mujeres de Ibadán , Nigeria , a los efectos de evaluar la eficacia de 200 mg de doxiciclina ( en comparación con un placebo ) administrada por vía oral en el momento de colocar el DIU , para reducir la incidencia de afecciones pélvicas inflamatorias durante los primeros tres meses de utilización de un DIU . El porcentaje de infección en el grupo de mujeres tratadas con doxiciclina no era significativamente menos elevado que en el grupo tratado con un placebo ) . El porcentaje de consultas imprevistas en la clínica por motivos relacionados con el tampoco era significativamente menos elevado en el caso del grupo tratado con doxiciclina . Sin embargo , la incidencia de afecciones pélvicas inflamatorias era baja ( 21 casos ) en los dos grupos estudiados . Es posible que las condiciones de asepsia durante la colocación del DIU , las visitas de seguimiento a intervalos cortos para controlar el estado de salud , así como el tratamiento de infecciones intercurrentes , hayan reducido la posibilidad de tales afecciones inflamatorias en esta población A levonorgestrel-releasing IUD and the Copper T 380Ag IUD were in r and omized comparison for seven years in five clinics . In two other clinics the r and omized study was truncated at five years , but use of the Copper T continued . No pregnancies occurred to users of either device in years 6 and 7 . Cumulative pregnancy rates were 1.1 per 100 at seven years for the steroid-releasing and 1.4 per 100 for the copper-releasing IUDs .  Cumulative rates of PID did not differ between devices . Infection rates appeared to be lowest during the sixth and seventh years of the study . Termination attributable to amenorrhea was the principal contributor to differences in cumulative continuation rates between devices . At the five clinics that carried the comparative study to seven years , cumulative continuation rates were 24.9 per 100 for LNg20 IUD users and 29.4 per 100 for TCu 380Ag users . Women who used either method for periods of five to seven years experienced , on average , marked to mild increases in hemoglobin as compared with levels at admission . The Copper T380 family and the LNg20 IUDs represent the most effective reversible contraceptive methods yet studied in long-term r and omized trials IUDs releasing 20 mcg/day of levonorgestrel ( LNg20 ) were in r and omized trial together with the Copper T , model TCu 380Ag , in seven centers involving 2244 women . Two-year ( 25 months ) gross cumulative pregnancy rates were 0.2 + /- 0.2 and 0.9 + /- 0.3 for the levonorgestrel and copper releasing devices , respectively ( P greater than 0.05 ) . There were no ectopic pregnancies in more than 1600 woman-years of use of each device . Removal rates for bleeding and /or pain or for medical reasons other than menstrual problems did not differ significantly between devices . Oligomenorrhea or amenorrhea prompted 10.7 per hundred ( gross rate , 8.4 net rate ) women using the LNg 20 IUD to request removal in the two-year period , significantly above the 0.2 per hundred rate among women with the Copper IUD ( P less than 0.001 ) . At the end of two years an estimated 59.4 per 100 women were continuing use of the LNg 20 IUD , and 67.5 per 100 ( P less than 0.001 ) with the TCu 380Ag . This difference is almost wholly ascribable to a marked reduction in bleeding episodes and days among women using the LNg 20 device with concomitant removal of device . Hemoglobin rose an average of 0.5 g/dl ( P less than 0.001 ) for this group whereas women using the TCu 380Ag experienced a decline of 0.2 g/dl compared with baseline values ( P less than 0.001 ) To compare the clinical performance of the TCu380A , the most widely used copper IUD in the world today , and a new frameless device , the Cu-Fix , we report results from a r and omized international two-year clinical trial involving 874 parous women followed for an average of fourteen months .  Event rates at the end of two years ( per 100 women ) for pregnancy were 0.0 for the TCu380A and 1.5 for the Cu-Fix .  Termination due to expulsion was significantly less for TCu380A as compared with Cu-Fix users ( 2.0 and 11.4 per hundred women , respectively ) ; other medical reasons for termination ( bleeding/pain , pelvic inflammatory disease ( PID ) , and other ) did not differ significantly . PID incidence rates at two years were 1.0 per hundred women for the TCu380A and 1.6 for the Cu-Fix ( equivalent to 6.0 and 8.3 per 1,000 woman-years , respectively ) . The net cumulative continuation rates at two years per hundred women were 78.8 for TCu380A , and 71.9 for the Cu-Fix . Both IUDs provide highly effective protection against pregnancy , but the TCu380A has a lower expulsion rate . The low rate of PID indicates that it is an in-frequent occurrence in appropriately selected c and i date OBJECTIVES We conducted a feasibility study to enroll and follow family planning acceptors who were r and omly assigned to use an intrauterine device ( IUD ) or injectable depot-medroxyprogesterone acetate ( DMPA ) .  METHODS Centers in Brazil , Guatemala , Egypt and Vietnam aim ed to enroll 100 participants per site . Enrolled women were r and omly assigned to have inserted a TCu 380A IUD , or to receive injections of 150 mg of DMPA every 3 months , and scheduled for up to 12 months of follow-up . We tested for cervical infection at first and final visits , and examined for signs of pelvic inflammatory disease ( PID ) at each visit . RESULTS The sites screened 555 women and enrolled 368 . Two women ( 0.5 % ) had three discomfort signs of PID during follow-up . The prevalence of gonorrhea at each woman 's final follow-up visit was 0.5 % , and the prevalence of chlamydia at final visit was 5.4 % . Sixty-eight percent of women either completed 12 months of observation with their assigned method or were still using their method at the end of the study . CONCLUSION A larger , definitive clinical trial appears feasible . The majority of women we approached agreed to participate ; nearly 400 women were enrolled ; two thirds continued to use their assigned method until study closeout ; and the STI risk was moderate OBJECTIVE To evaluate in normotensive women the influence of low-dose oral contraceptives ( OC , monophasic formulations containing 30 microg of estrogen ) on 24-h blood pressure . METHODS We evaluated prospect ively in 15 normotensive healthy women ( three smokers ) the influence of OC on 24-h ambulatory blood pressure monitoring ( ABPM ) . ABPM was performed ( SpaceLabs 90207 ) before and after 6 - 9 months of use of OC . We also evaluated ABPM in eight women ( two smokers ) before and after 6 - 8 months on an  intrauterine device ( IUD ) as contraceptive method --these were used as control subjects . RESULTS OC produced a significant increase in 24-h ABPM values ( from 120+/-3/75+/-2 to 128+/-4/81+/-2 mmHg , P < 0.04 ) which was particularly evident for night-time values ( from 108+/-2/64+/-2 to 120+/-4/73+/-2 mmHg , P < 0.02 ) . After OC , two normotensive women developed ' hypertensive values ' . In OC users there was a slight but significant increase in body weight which did not correlate with the increase of blood pressure . In contrast , in the control group ( IUD ) neither ABPM values nor weight were modified by the contraceptive maneuver . CONCLUSIONS In normotensive women , low-dose OC may increase blood pressure to an extent that , at least in some women , may affect blood pressure control towards ' hypertensive values ' . This stresses the importance of monitoring blood pressure values during OC treatment Changes in body weight and the incidence of estrogen-related side effects with low-dose oral contraceptives ( OCs ) containing 20 microg ethinyl estradiol ( EE ) have not been demonstrated in placebo-controlled trials . Two placebo-controlled , r and omized trials demonstrated the efficacy of a low-dose OC for the treatment of acne in healthy females ( n = 704 ; > or=14 years old ) with regular menstrual cycles and moderate facial acne . Patients were r and omized to receive 20 microg EE/100 microg levonorgestrel ( LNG ) or placebo for six cycles . Body weight was measured at baseline and during Cycles 1 , 3 , and 6 . The occurrence of adverse events was recorded at each visit . Mean changes in weight from baseline were similar with 20 microg EE/100 microg LNG [ 0.72 kg + /- 2.64 ( SD ; n = 349 ) ] and placebo [ 0.56 kg + /- 2.64 ( SD ; n = 355 ; p > 0.05 ) ] for the last measured weight of each patient . Rates of headache , nausea , weight gain , and breast pain , side effects commonly attributed to OCs , were also similar between groups ( p > 0.05 ) . No serious , unexpected , drug-related adverse events occurred during the study . The low-dose OC containing 20 
    Output:
    
Evidence on select adverse events associated with initiation of contraceptive use is limited but does not suggest increased risk of hypertension among COC users or increased risk of PID among IUD users .
DMPA users who gain > 5 % of baseline body weight may be at increased risk of future weight gain