RESUMO
We would like to emphasize the differentiations of diagnosis and treatment between general uterine leiomyomas and diffuse uterine leiomyomatosis (DUL), which is a kind of extremely rare disease. Levonorgestrel-releasing intrauterine system (LNG-IUS) is an attainable option provided to treat DUL with cerebral thrombosis, as a feasible novel method. Case report: A 21-year-old female patient with DUL was due to cerebral venous thrombosis caused by oral contraceptives. The patient was persistently vaginal bleeding after decreasing intracranial pressure and anticoagulant therapy for 3 days. Subsequently, a hysteroscopic submucosal myomectomy was performed to restore the normal shape of the uterine cavity, and the placement of Mirena was given after surgery, which aimly played a good role in hemostasis, prevention of severe menorrhagia and reconstruction of endometrial function. Conclusion: This case report shows that, levonorgestrel-releasing intrauterine system (LNG-IUS) is efficient and secure to treat DUL after hysteroscopic surgery, and simultaneously does not increase the risk of venous thromboembolism (VTE). (AU)
Assuntos
Humanos , Feminino , Adulto Jovem , Leiomiomatose/tratamento farmacológico , Leiomiomatose/complicações , Trombose Intracraniana , Anticoncepcionais Orais/uso terapêutico , Anticoncepcionais Orais/efeitos adversos , Distúrbios MenstruaisRESUMO
Introducción: Los embarazos no deseados en adolescentes tienen graves consecuencias tanto para las propias adolescentes y sus bebés como para el uso de los recursos del sistema sanitario. Una de las razones es el escaso uso de píldoras anticonceptivas orales (ACO) entre esta población, debido principalmente a la falta de información o a la no adherencia a los medicamentos. El objetivo de este estudio fue describir la información que reciben las adolescentes sobre los ACO y su uso, así como su percepción del papel del farmacéutico comunitario en este campo. Método: Se realizó un estudio observacional transversal mediante encuesta, aplicada a mujeres entre 12-19 años residentes en España, independientemente de si habían utilizado o no ACO, durante abril de 2021. Para la difusión de esta encuesta se utilizaron diferentes redes sociales. Asimismo, se contactó con diferentes asociaciones españolas dedicadas a la orientación de la planificación familiar y la salud sexual en adolescentes. Resultados: El 81,7% (n=76) de los encuestados no había tomado ACO, aunque el 35,5% (n=33) sí había mantenido relaciones sexuales. El 6% (n=1) que tomaba o había tomado ACO informó que eran adherentes. El 88% (n=82) pensaba que el farmacéutico tiene conocimientos sobre medicamentos; sin embargo, sólo el 19,4% (n=18) les consultaría para resolver dudas sobre ACO. Conclusiones: Para resolver los problemas de falta de información sobre ACO y de adherencia en mujeres adolescentes, el farmacéutico comunitario es un profesional accesible que puede contribuir a ello adoptando una actitud activa y utilizando diferentes formas de material educativo. (AU)
Introduction: Unintended pregnancies in adolescents have serious consequences both for the adolescents themselves and their babies and for the use of health system resources. One of the reasons is the low use of oral contraceptive pills (OCPs) among this population, mainly due to lack of information or non-adherence to the medication. The aim of this study was to describe the information adolescents receive about OCPs and their use, as well as their perception of the role of the community pharmacist in this field. Method: A cross-sectional observational study was carried out by means of a survey applied to women aged 12-19 years living in Spain, regardless of whether or not they had used OCPs, during April 2021. Different social networks were used to disseminate the survey. Different Spanish associations dedicated to family planning and adolescent sexual health counselling were also contacted. Results: 81.7% (n=76) of respondents had not taken OCPs, although 35.5% (n=33) had had sex. The 6% (n=1) who were taking or had taken OCPs reported adherence. 88% (n=82) thought that the pharmacist is knowledgeable about medicines; however, only 19.4% (n=18) would consult them for OCP questions. Conclusions: To solve the problems of lack of information about OCPs and adherence in adolescent women, the community pharmacist is an accessible professional who can contribute to this by taking an active role and using different forms of educational materials. (AU)
Assuntos
Humanos , Feminino , Adolescente , Anticoncepcionais Orais/uso terapêutico , Farmacêuticos , Percepção , Serviços Comunitários de Farmácia , Espanha , Inquéritos e Questionários , Estudos Transversais , Cooperação e Adesão ao TratamentoRESUMO
El objetivo de este artículo ha sido el de analizar las evidencias disponibles sobre la eficacia y la seguridad de un nuevo anticonceptivo oral que contiene estetrol (E4) y drospirenona (DRSP). Para ellos se ha efectuado una revisión de la literatura que ha incluido los estudios publicados sobre esta nueva formulación anticonceptiva. Los ensayos clínicos en fase 2 y fase 3 realizados han puesto de manifiesto que la combinación E4 15mg/DRSP 3mg es eficaz para evitar el embarazo, es bien aceptada por las mujeres y no produce cambios de significado clínico en los parámetros de la coagulación. Para confirmar los resultados obtenidos en los ensayos en fase 2 y 3, es necesario un estudio en fase 4 que ponga de manifiesto el comportamiento de este nuevo anticonceptivo en la vida real.(AU)
The objective of this article was to analyse the available evidence on the efficacy and safety of a new oral contraceptive containing estetrol (E4) and drospirenone (DRSP). We conducted a literature review that included published studies on this new contraceptive formulation. Phase 2 and phase 3 clinical trials have shown that the E4 15mg/DRSP 3mg combination is effective in preventing pregnancy, is well accepted by women, and does not produce clinically significant changes in coagulation parameters. To confirm the results obtained in phase 2 and 3 trials, a phase 4 study is necessary to reveal the behaviour of this new contraceptive in real life.(AU)
Assuntos
Estrogênios , Anticoncepção , Etinilestradiol , Estetrol , Estradiol , Anticoncepcionais Orais , Eficácia , Ginecologia , Obstetrícia , Ensaios Clínicos Fase I como AssuntoRESUMO
La osteonecrosis múltiple se define como la presencia de osteonecrosis en 3 o más territorios óseos. Es una complicación infrecuente, que suele encontrarse solo en un 3% de los pacientes con osteonecrosis. Se ha relacionado con enfermedades sistémicas siendo los pacientes con LES, tratamiento prolongado con glucocorticoides a dosis altas, trasplantados o con alteraciones hematológicas los que presentan mayor riesgo de desarrollarla. La cabeza femoral es la zona que en más ocasiones se ve alterada. La patogenia no está bien establecida, aunque se conocen varios factores de riesgo. Presentamos el caso de una mujer joven, con antecedentes de tratamiento con glucocorticoides y anticonceptivos orales, y factores alterados de la hemostasia, que desarrolló una osteonecrosis bilateral de caderas y posteriormente de hombro. En el presente artículo se ha realizado una exhaustiva búsqueda bibliográfica sobre la etiología y tratamiento de la osteonecrosis avascular múltiple
Multifocal osteonecrosis is defined as the presence of osteonecrosis in three or more osseous sites. It is an infrequent entity representing less than 3% of cases among osteonecrosis patients. Multifocal osteonecrosis has been associated with systemic diseases, with patients at highest risk being those with lupus erythematosus, transplant recipients and those with haematological disorders or prolonged high-dose glucocorticoid treatment. The area most prone to disturbances is the femoral head. The pathogenesis of this particular disorder has not been fully defined, although several risk factors have been identified. We report the case of a young woman with abnormal hemostatic factors and a history of glucocorticoid and oral contraceptive therapy who developed bilateral hip osteonecrosis, followed by shoulder ON. The present article also provides an extensive literature review of the aetiology and treatment of multifocal ON
Assuntos
Humanos , Feminino , Adulto , Osteonecrose/terapia , Glucocorticoides/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Osteonecrose/etiologia , Fatores de Risco , Necrose da Cabeça do Fêmur/terapiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Indução da Ovulação/métodos , Fertilização In Vitro/métodos , Espermatozoides , Gonadotropinas/uso terapêutico , Hormônio Foliculoestimulante/uso terapêutico , Anticoncepcionais Orais/uso terapêutico , Inositol/uso terapêutico , Metformina/uso terapêutico , Técnicas de Maturação in Vitro de OócitosRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Anticoncepcionais Orais/efeitos adversos , Anticoncepcionais Orais/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Cobre/efeitos adversos , Testes de Química Clínica/métodos , Síndrome do Ovário Policístico/diagnóstico , Sobrepeso/tratamento farmacológicoRESUMO
Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. Objective: The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Methods: Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Results: Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists gender and detection of possible interaction (p value= 0.048). Conclusion: The quality of the pharmacists consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement (AU)
No disponible
Assuntos
Humanos , Feminino , Adulto , Agentes Comunitários de Saúde/organização & administração , Anticoncepcionais Orais/normas , Anticoncepcionais Orais/uso terapêutico , Farmacêuticos/organização & administração , Assistência Farmacêutica/organização & administração , Prática Profissional/organização & administração , Simulação de Paciente , Anticoncepcionais Pós-Coito/uso terapêutico , Serviços de Saúde Comunitária/métodos , Serviços de Saúde Comunitária , Irã (Geográfico)RESUMO
Introducción: Los anticonceptivos son drogas para evitar el embarazo y mantener controlado el ciclo hormonal femenino. Los de segunda generación incluyen el levonorgestrel y los de tercera generación están compuestos por desogestrel o gestodeno. El objetivo de esta revisión sistemática y metaanálisis es conocer el aumento de riesgo de infarto de miocardio por uso de la segunda generación o de la tercera generación de anticonceptivos orales. Material y métodos: Revisión sistemática en Medline y Cochrane, desde uno de enero de 1996 a uno de junio de 2015, de estudios observacionales. El metaanálisis se realizó utilizando un modelo de efectos aleatorios. Los outcomes son el riesgo de infarto de miocardio debido al uso de anticonceptivos orales de segunda o tercera generación. Resultados: Cumplieron criterios de inclusión y control de calidad 4 estudios observacionales. Los resultados del metaanálisis para segunda generación por modelo de efectos aleatorios fue 1,0995, y para tercera generación, 0,8298, pero fueron no significativos; los de tercera generación frente a segunda generación fueron también no significativos con un valor de 0,7361. Conclusiones: No podemos sacar conclusiones del metaanálisis debido a que los resultados son no significativos, por lo que no podemos indicar que el riesgo de infarto de miocardio aumente por el uso de segunda o tercera generación de anticonceptivos orales
Introduction: Contraceptives are drugs taken to prevent pregnancy and maintain control of the female hormonal cycle. Second-generation contraceptives include levonorgestrel, while third-generation contraceptives are made with desogestrel or gestodene. The objective of this systematic review and meta-analysis is to determine the risk of myocardial infarction when using second- or third-generation oral contraceptives. Materials and methods: A systematic review of observational studies in Medline and Cochrane from 1 January 1996 to 1 June 2015. The meta-analysis was performed using a random effects model. The outcomes are the risk of myocardial infarction due to the use of second- or third-generation oral contraceptives. Results: The four observational studies met certain inclusion and quality control criteria. The results of the meta-analysis using the random effects model were 1.0995 for second-generation and 0.8298 for third-generation contraceptives, but these results were not significant. The result of the comparison between third- and second-generation products was also not significant, with a value of 0.7361. Conclusions: We were unable to draw conclusions from the meta-analysis because the results were not significant. We are therefore unable to indicate the whether the risk of myocardial infarction increases with the use of second- or third-generation oral contraceptives
Assuntos
Humanos , Feminino , Anticoncepcionais Orais/efeitos adversos , Infarto do Miocárdio/induzido quimicamente , Fatores de Risco , Desogestrel/efeitos adversos , Levanogestrel/efeitos adversosRESUMO
Background: Emergency hormonal contraceptives (EHC) are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI) or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG) in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA). EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG), Federal Institute for Drugs and Medical Devices (BfArM), Federal Chamber of Physicians (BÄK), Drug Commission of German Physicians (AkdÄ), professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists (AU)
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Assuntos
Humanos , Masculino , Feminino , Medicamentos sem Prescrição/farmacologia , Medicamentos sem Prescrição/uso terapêutico , Anticoncepcionais Orais/farmacologia , Anticoncepcionais Orais/uso terapêutico , Formulários como Assunto/normas , Anticoncepcionais Pós-Coito/classificação , Anticoncepcionais Pós-Coito/farmacologia , Anticoncepcionais Pós-Coito/uso terapêutico , Alemanha/epidemiologia , Boas Práticas de Dispensação , Postos de Medicamentos , Medicamentos de Venda Assistida/normasRESUMO
A 41-year-old woman was admitted to the emergency room with symptoms compatible with deep vein thrombosis affecting the left lower extremity and pulmonary thromboembolism. A CT scan was consistent with pulmonary emboli and thrombosis of the iliac veins extending to the inferior vena cava, which persisted even after correct systemic fibrinolytic therapy. For this reason, a venography was performed and local thrombolysis was administered. Venography revealed a compression of the left common iliac vein caused by the right common iliac artery, so that the patient was diagnosed with May-Thurner syndrome. The clinical features of this anatomical condition and sometimes lethal clinical syndrome are discussed
No disponible
Assuntos
Humanos , Feminino , Adulto , Síndrome de May-Thurner/complicações , Embolia Pulmonar/etiologia , Trombose Venosa/fisiopatologia , Anticoncepcionais Orais/efeitos adversos , Insuficiência Venosa/complicações , Fatores de RiscoRESUMO
OBJETIVO: Identificar los factores relacionados con la adherencia y el cumplimiento de las mujeres con los anticonceptivos hormonales orales (ACO). METODOLOGÍA: Revisión bibliográfica. Se realizó una búsqueda en las bases de datos PubMed, CINAHL, Cochrane Library, MEDES y ENFISPO en los últimos 10 años. RESULTADOS: Se seleccionaron un total de 35 artículos originales y una revisión bibliográfica. Los factores que mejoran el cumplimiento de los ACO son los conocimientos que tiene la mujer sobre la píldora, iniciar el método de forma inmediata y el apoyo de la pareja. Los factores que influyen en la adherencia son el coste de los ACO, la falta de conocimientos ante los olvidos y la práctica de descansos de la píldora. CONCLUSIONES: El consejo contraceptivo debe ser individualizado, teniendo en cuenta los factores que afectan a la adherencia y el cumplimiento
AIM: To identify the factors related with the adherence and compliance of women that use the oral contraceptives (OC). METHODOLOGY: Literature review. A search in PubMed, CINAHL, Cochrane Library, MEDES, and ENFISPO databases has been performed in the last 10 years. RESULTS: A total number of 35 original articles and a review were selected. The factors which improve the compliance of OC are the knowledge of women about the pill, "the quick start" contraceptive method and the partner support. The highlighted factors which concern the adherence are the OC cost, the shortage of knowledge facing oversights and the resting periods of pill. CONCLUSIONS: The contraceptive counselling must be personalized considering the factors which concern the compliance and adherence
Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Comportamento Contraceptivo/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Adesão à Medicação , IndividualidadeRESUMO
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Assuntos
Criança , Feminino , Humanos , Masculino , Hiperplasia/metabolismo , Hiperplasia/patologia , Nodularia/citologia , Nodularia/genética , Hepatopatias/genética , Anticoncepcionais Orais/administração & dosagem , Fibrose/metabolismo , Biópsia/métodos , Hiperplasia/complicações , Hiperplasia/genética , Nodularia/classificação , Nodularia/metabolismo , Hepatopatias/metabolismo , Anticoncepcionais Orais , Fibrose/patologia , Biópsia/instrumentaçãoRESUMO
Background: Previous studies show that provision of oral contraceptive pill (OCs) without a prescription is safe, feasible and effective and that users are interested in obtaining contraception in this way, especially if a pharmacist screening is involved. A recent national survey conducted in the Republic of Ireland has highlighted that unintended pregnancy resulting from the failure of OCs could be linked to poor compliance due to costs and difficulty of access. Objective: To evaluate views and attitudes of OC users towards the availability of OCs without a prescription in the Republic of Ireland. Methods: A cross sectional survey was conducted using an opportunistic sample of OC users aged 18 to 50 years. Sixty community pharmacists were recruited nationwide. Data were collected using self-completed questionnaires. The questionnaires comprised information on: demographic data, need of the service, views on the availability of OCs without prescription, advantages and concerns around the service, role of pharmacists and cost implications for private and public patients. Results: A total of 488 eligible OC users completed the survey. The majority of the respondents (71.7%;n = 350/488) reported to have missed a pill for reasons connected to the OCs prescription status and 55.5% (n = 268/488) of the respondents reported to have felt distressed on at least one occasion because they could not renew their OC prescription. A total of 87.9% (n = 429/488) of the respondents said they were in favour of OCs being available without prescription and 92% (n = 448/488) said they were likely to obtain OCs without rescription if available. Convenience and ease of access were indicated as the main advantages of availing of OCs without prescription, while safety was the biggest concern reported. Over 88% (n = 430/488) of the respondents indicated that pharmacists would be able to safely supply OCs without prescription. Private patients expected to save an average of 27.3% on their OC if obtained without prescription. Conclusions. OC users in the Republic of Ireland are in favour of OCs being available without prescription and are willing to obtain it this way, providing that pharmacists supply them according to protocols that facilitate the safety and the efficacy of the supply. An easier and more convenient access to OCs could also reduce the likelihood of missed pills and bring considerable savings to users (AU)
Antecedentes: Estudios previos mostraron que la provisión de contraceptivos orales (OC) sin receta es segura, factible y efectiva y que las usuarias están interesadas en obtener contracepción de este modo, especialmente si está involucrado el consejo farmacéutico. Una reciente encuesta conducida en la República de Irlanda ha subrayado que los embarazos indeseados resultado de un fallo de los OC podrían estas ligados a cumplimento bajo debido a costes y dificultad de acceso. Objetivo: Evaluar la visión y actitudes de las usuarias de OC sobre la disponibilidad de OC sin receta en la Republica de Irlanda. Métodos: Se realizó un estudio transversal con una muestra oportunista de usuarias de OC de 18 a 50 años. Se reclutaron 60 farmacias comunitarias en toda la nación. Se recogieron los datos en un cuestionario autocumplimentado. Los cuestionarios comprendían información sobre: datos demográficos, necesidad de servicio, visiones sobre la disponibilidad de los OC sin receta, ventajas y preocupaciones sobre el servicio, papel del farmacéutico e implicaciones para los pacientes públicos o privados. Resultados: Un total de 488 usuarios de OC elegibles completaron la encuesta. La mayoría de los respondentes (71,7%; n=350/488) reportaron haber omitido una píldora por razones relacionadas con el estado de prescripción de los OC y el 55,5% (n=268/468) de los respondentes reporto haber sentido desasosiego al menos en una ocasión por no poder renovar su prescripción de OC. Un total de 87,9% dijo que estaba a favor de que los OC estuviesen disponibles sin receta y el 92% (n=448/488) dijo que probablemente comprarían OC sin receta si estuviesen disponibles. La comodidad y la facilidad de acceso aparecieron indicadas como las ventajas principales de disponibilizar OC sin receta, mientras que la seguridad era la mayor preocupación. Más del 88% (n=460/488) indicó que los farmacéuticos serían capaces de distribuir de modo seguro los OC sin receta. Los pacientes privados esperaban ahorrar una media del 27,3% en sus OC si los obtenían sin receta. Conclusiones: Las usuarias de OC en la República de Irlanda están a favor de que los OC estén disponibles sin receta y están dispuestas a obtenerlos de este modo, aceptado que los farmacéuticos los proporcionen de acuerdo a protocolos que faciliten la seguridad y eficacia del suministro. Un modo más fácil y más cómodo de acceso a los OC podría también reducir la probabilidad de píldoras omitidas y traería considerables ahorros a las usuarias (AU)
Assuntos
Feminino , Humanos , Masculino , Anticoncepcionais Orais/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Gravidez não Desejada , Prescrições/normas , Irlanda , Inquéritos e Questionários/normas , Inquéritos e Questionários , Anticoncepcionais Orais/provisão & distribuição , Estudos Transversais/métodosRESUMO
Presentamos el caso de una adolescente de 16 años de edad que, estando previamente asintomática y sin historia clínica de haber padecido ninguna migraña, presenta de manera progresiva, en el plazo de una semana, una cefalea holocraneal de características pulsátiles, que no mejoraba con analgésicos a dosis altas. Ante la persistencia del cuadro y los criterios de alarma que presentaba fue fundamental el uso de la Resonancia Magnética Nuclear (RMN) para su diagnóstico (AU)
We report the case of a 16-year-old female teenager, previously asymptomatic and without a medical record of migraine-like headaches, who progressively developed a pulsating holocraneal headache, which did not improve with high doses of painkillers. Given the persistence of the clinical picture and the alarm criteria, the use of Nuclear Magnetic Resonance (RMN) was fundamental for achieving an accurate diagnosis (AU)
Assuntos
Adolescente , Feminino , Humanos , Cefaleia/complicações , Cefaleia/etiologia , Cefaleia , Transtornos da Cefaleia/etiologia , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Trombose Venosa/complicações , Etinilestradiol/efeitos adversos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Fatores de Risco , Fotofobia/complicações , Anticoncepcionais Orais/efeitos adversos , Diagnóstico DiferencialRESUMO
Presentamos el caso de una paciente de 18 años que consultó por oligomenorrea, flujo menstrual maloliente y dolor pélvico tipo cólico. Ante la sospecha de alteración menstrual por defecto en el tracto de salida se realizó ecografía ginecológica y resonancia magnética con el resultado de útero doble, hemivagina obstruida o ciega derecha acompañado de agenesia renal derecha, síndrome Herlyn-Werner-Wunderlich. Tras el diagnóstico se realizó escisión del septo y drenaje de las colecciones que suprimen la sintomatología de la paciente mejorando la capacidad reproductiva (AU)
We report the case of an 18-year-old woman who consulted for oligomenorrhea, chronic pelvic pain and malodorous vaginal discharge. Ultrasonography and magnetic resonance imaging demonstrated uterus didelphys with right-sided hematometrocolpos and absent right kidney (Herlyn-Werner- Wunderlich syndrome). The patient underwent resection of the septum and drainage of collections, with complete symptom resolution (AU)
Assuntos
Humanos , Feminino , Adulto Jovem , Síndrome de Werner/complicações , Útero/anormalidades , Útero , Oligomenorreia/complicações , Oligomenorreia , Dor Pélvica/complicações , Dor Pélvica/etiologia , Anticoncepcionais Orais/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Diagnóstico Precoce , Ultrassonografia Pré-Natal/métodos , Rim/anormalidades , Útero/fisiopatologia , Rim , Anamnese/métodos , Hirsutismo/complicações , Obesidade/complicações , Abdome/patologia , Abdome , HisterossalpingografiaRESUMO
La enfermedad tromboembólica venosa (ETEV) en edad pediátrica es infrecuente y su clínica variable; se relaciona con al menos un factor de riesgo (vía venosa central, trastornos de la coagulación, traumatismos, cirugía, enfermedades malignas o tratamiento con anticonceptivos orales). Los objetivos del tratamiento son prevenir la embolización y minimizar las complicaciones. Dada la gravedad de las complicaciones de la ETEV, es preciso tener presente esta posibilidad diagnóstica ante un paciente con factores de riesgo (AU)
Venous thromboembolism (VTE) in childhood is uncommon and clinically variable. It is related to at least one risk factor (central venous catheter, bleeding disorders, trauma, surgery, malignancy or treatment with oral contraceptives). The symptoms of pulmonary embolism are variable and nonspecific. The goals of treatment are to prevent embolization and minimize complications. Due to the severity of VTE complications, we must be aware of this possible diagnosis in a patient with risk factors (AU)
Assuntos
Humanos , Feminino , Adolescente , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Fatores de Risco , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar , Transtornos da Coagulação Sanguínea/complicações , Anticoncepcionais Orais/efeitos adversos , Embolização Terapêutica/métodos , Embolização Terapêutica/tendências , Dor Abdominal/etiologiaRESUMO
Introducción: Los anticonceptivos orales (ACO) forman parte del grupo de los anticonceptivos hormonales, estando su uso altamente extendido. Aunque tienen una elevada tasa de eficacia poseen efectos adversos a nivel sistémico y local. Objetivo: Determinar si las mujeres en tratamiento con anticonceptivos orales tienen mayor incidencia de complicaciones postoperatorias. Pacientes y método: Se llevó a cabo un estudio retrospectivo de casos y controles de todas las pacientes de uno de los centros del servicio del Máster de Cirugía Bucal e Implantología Hospital Virgen de la Paloma, entre los años 2006 y 2013. Se recopilaron historias clínicas de mujeres mayores de 18 años. Las variables recogidas fueron la toma o no de anticonceptivos orales y las complicaciones que se pudieran producir tras la cirugía. Se realizó un estudio estadís-tico descriptivo inferencial para hallar laodds ratio, utilizando el programa Epidat 3.1. Resultados: En el estudio se evaluaron 219 historias clínicas, descartándose 17 porestar incompletas. En el grupo de casos (n=10), cuatro pacientes padecieron complicaciones y del grupo control (n=192), 41. Se obtuvo una Odds Ratio de 2,45.Discusión:En la realización del presente estudio, cabe destacar la falta de artículos que relacionen el tratamiento con anticonceptivos orales y las complicacionesinmediatas postoperatorias. Además, sedeben mencionar dos posibles sesgos. Asaber, el pequeño tamaño muestral estudiado; y que al tratarse de medicamentos tan extendidos el profesional no pregunta por su toma al hacerla historia clínica. Conclusión:Las mujeres en tratamiento con anticonceptivosorales tienen un odds ratio de 2,45, lo que sugiere una mayor probabilidad de padecer complicaciones postoperatorias en el tratamiento implantológico; aunque el resultado es estadísticamente no significativo, por lo que debería ampliarse la muestra para poder verificar este resultado (AU)
Introduction: Oral contraceptives are part of the group of hormonal contraceptives, whose use is highly extended. Although they have a high rate of effectiveness, they have adverse systemic and local effects. Objective: To determinate whether women taking oral contraceptives have a higher incidence of postoperative complications. Patients and Methods: It was carried out a retrospective case-control study of all patients in one of the service centers of the Master of Oral Surgery and Implantology Virgen de la Paloma Hospital, between the years 2006-2013. Medical histories of women older than 18 were collected. The variables were whether taking oral contraceptives or not, and complications that may occur after surgery. Descriptive inferential statistical analysis to find the odds ratio was performed using the program Epid at 3.1.Results:The study evaluated 219 medical histories, 17 were rejected as incomplete. In the case group (n=10) 4 patients had complications and in the control group (n=192) 41. An odds ratio = 2,45 was obtained. Discussion: In the realization of the present study there is a lack of articles that relate taking oral contraceptives and immediate postoperative complications. In addition, we should mention two possible biases. Namely, the small sample size studied, and that since it is a so widespread drug, professional does not ask about it to make the medical history. Conclusion: Women taking oral contraceptives have an odds ratio of 2,45, suggesting a greater likelihood of developing post operative complications in implant treatment; although the result is not statistically significant, so the sample should be expanded to verify it (AU)
Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Implantação Dentária , Complicações Pós-Operatórias , Estudos de Casos e Controles , CicatrizaçãoRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Peliose Hepática/complicações , Fígado/lesões , Ruptura Espontânea , Anticoncepcionais Orais/efeitos adversos , Fatores de RiscoRESUMO
Objetivo: El objetivo de este trabajo fue analizar la oferta, demanda y costos de los anticonceptivos orales disponibles en Argentina, así como también caracterizar la población usuaria y la forma de uso de los anticonceptivos parte de los mismos. Material y Método: Se realizó un estudio descriptivo y observacional donde se trabajó con un procedimiento normalizado analizando dispensaciones en un total de 42 farmacias comunitarias de Córdoba (Argentina). Resultados: 90 son los anticonceptivos hormonales orales disponibles, 81 % de los cuales son combinados. Más del 80% de las ventas se concentren solo en 3 laboratorios productores siendo paradójicamente la combinación más costosa (Drospirenona-Etinil Estradiol) la más dispensada. En más del 60% de los casos el anticonceptivo fue adquirido sin receta médica y sin cobertura de la seguridad social, lo cual fue, generalmente, compensado con descuentos adicionales que provenían en su mayoría de la farmacia. A pesar de contar la población en estudio, en su mayoría, con un nivel educativo medio-alto y experiencia en el uso de anticonceptivos, se detectó desconocimiento en los parámetros de uso y actitudes a tomar ante olvidos. Conclusiones: A pesar de la amplia oferta de anticonceptivos orales, la demanda de los mismos en farmacias comunitarias de la ciudad de Córdoba está fuertemente concentrada en los anticonceptivos orales combinados de mayor precio de venta en el mercado, existiendo deficiencias en el conocimiento por parte de los paciente respecto al modo adecuado de uso, con una fuerte tendencia a la repetición de una prescripción o automedicación a utilizar combinaciones de 3ra o 4ta generación sin que las mismas sean las más recomendadas
Aim: The aim of this study was to describe the supply and demand of oral contraceptives available in Argentina, characterize the user population and how the patients use contraceptives. Materials and Methods: We worked with a normalized procedure, analyzing 713 dispensations in 42 community pharmacies in Córdoba (Argentina). Results: The 90 oral contraceptives available in the Argentine pharmaceutical market, 81% of which correspond to combined oral contraceptive. More than 80% of the sales are concentrated in only 3 laboratories. Among combined oral contraceptive, the combinations of Drosperinone-Ethinylestradiol, those with the highest average price, were also the ones most chosen by the users. In over 60% of the cases they were purchased without a prescription and without social security coverage. This was offset by additional discounts coming mostly from the pharmacy outlets. Although most of the study population had an acceptable level of education and experience in the use of contaceptives, a certain lack of knowledge in the parameters of use and in the attitude to adopt when missing the daily dose was detected. Conclusions: Despite the broad range of oral contraceptives, the demand in community pharmacies is heavily concentrated in the combined oral contraceptive with higher price in the market, existing deficiencies in the knowledge from the patient regarding the proper way to use and there is a strong trend self-medication and use combinations of 3rd or 4th generation without the appropriate indications
Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Serviços Comunitários de Farmácia/estatística & dados numéricos , Planejamento Familiar , Comportamento Contraceptivo/estatística & dados numéricos , Revisão de Uso de Medicamentos/estatística & dados numéricos , Automedicação/estatística & dados numéricosRESUMO
No disponible