RESUMO
A single case of ultrasonographic-guided local injection of methotrexate for managing scar pregnancy is reported. The outcome was successful and had no side effects. The case was reported to increase the evidence supporting this type of management.
Assuntos
Abortivos não Esteroides , Gravidez Ectópica , Cesárea , Cicatriz/tratamento farmacológico , Feminino , Humanos , Metotrexato/uso terapêutico , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/tratamento farmacológico , Resultado do TratamentoRESUMO
The 19 of February 2018 the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco) temporary stopped the new administration of Ulipristal Acetate (UPA) for treating uterine leiomyomas symptoms, because liver injury and hepatic failure had been reported in relationship with UPA use. After the European Medicines Agency review of risks of UPA, the 3 of August 2018 the AIFA produced another note, disclosing that a cause-effect relationship between the UPA use and liver injury is not proved and that some patients can be discontinuously treated if surgery is not recommended. However, a close monitoring of hepatic function must be done in Ulipristal users. As Ulipristal has not been prescribed since February 2018 in our center, the rate of surgical operations for uterine leiomyomas significantly doubled. Therefore it will be useful know exactly which restricted indications allow to use UPA for more than 3 months. In this way it could be minimized the risks of liver injury and it could be prevented the rise of surgeries for uterine leiomyomas.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Leiomioma/tratamento farmacológico , Norpregnadienos/administração & dosagem , Neoplasias Uterinas/tratamento farmacológico , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Femininos/efeitos adversos , Feminino , Humanos , Itália , Leiomioma/cirurgia , Testes de Função Hepática , Norpregnadienos/efeitos adversos , Fatores de Tempo , Neoplasias Uterinas/cirurgiaRESUMO
Wernicke's encephalopathy has been sporadically reported in patients with severe hyperemesis gravidarum. We report a new case of Wernicke's encephalopathy in a patient who had hyperemesis gravidarum associated with signs and symptoms of dry and wet beriberi. The case was managed with very large doses of thiamine. The conclusion was that, in long-lasting hyperemesis gravidarum, recognizing signs of beriberi may help prevent the onset of Wernicke's encephalopathy, thanks to timely therapy with thiamine supplements. A thiamine therapy similar to the one reported in this article could prove useful in long-lasting hyperemesis gravidarum complicated by Wernicke's encephalopathy.