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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of intravaginal administration of prostaglandin F2 alpha (PGF2alpha) in induction of abortion was determined in a clinical trial of 16 gravidas aged 21-38, parity 0-4, between the 6th-11th weeks of pregnancy. PGF2alpha tablet (50 mg) was inserted into the posterior fornix of the vagina and repeated at 1-2 hour intervals; dose range varied from 50-250 mg. Slight to severe labor-like pain was felt by all patients in the lower abdominal region 20 minutes-4 hours after PGF2alpha administration. Vaginal bleeding occurred within 30 minutes-8 hours. In all but 1 case, the fetus and the villi were expelled broken into small pieces. All 16 patients aborted, 7 completely and 9 incompletely. This form of administration is deemed efficacious as 3 patients aborted completely within 5 hours and 4 aborted completely between 15-18 hours. Bleeding in most cases occurred following the onset of abdominal pain, 30 minutes-8 hours after treatment. In another clinical trial, the efficacy of intravaginal administration of PGF2alpha in inducing menstruation was tested in 10 volunteers aged 31-40. Either 50 or 25 mg PGF2alpha tablets were used. The patients recorded their basal body temperature (BBT) every morning. Menstruation was successfully induced in 6 of 10 patients. 6 patients treated 2-3 days before the expected date of menstruation had menstrual-like bleeding 1-9 hours after PGF2alpha administration. 3 patients treated 5, 7, and 13 days (a day before BBT shift) before the expected date of menstruation did not have vaginal bleeding. 1 patient, with monophasic BBT who was treated 3 days before the expected menstruation, did not have menstrual bleeding. Amount of induced flow was more or less the same in most patients; duration of flow was normal in all cases. The mechanism of action of PG in menstruation induction is not known. The authors speculate that PGF2alpha mechanically stimulates separation of the superficial endometrium from the remainder of the uterine wall when the endometrium is in the premenstrual state. Side effects noted were nausea, diarrhea, pyrexia, slight flushing of the face, and headache.
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PMID:The induction of abortion and menstruation by the intravaginal administration of prostaglandin F 2a . 470 6

The safety, efficacy, and acceptability of menstrual regulation with prostaglandin (PG) El vaginal suppositories was investagated in 534 women whose menses was delayed up to 8 weeks from the last menstrual period. 5 suppositories, each containing 1 mg of 16,16 dimethyl-trans-delta 2 PG El methyl ester, were inserted high in the vagina at 3 hour intervals. The success of treatment was assessed by 2 alternate criteria: 1) induction of bleeding, or 2) induction of bleeding and no surgical intervention. The success rate was 98.9% according to the 1st criterion and 86% according to the 2nd criterion. The mean duration of bleeding after treatment was 6.7 days. 47.9% of women experienced moderate bleeding and 43.8% reported heavy bleeding following treatment. Surgical intervention (curettage or vacuum aspiration) was required in 74 of the 528 bleeding cases and in 1 of the 6 nonbleeding cases with positive signs of pregnancy. The surgical intervention was performed because bleeding was considered to be either excessive or prolonged. Side effects tended to manifest themselves between the 1st and 2nd administration of suppositories. Abdominal cramps occurred in 66% of subjects; other side effects were minimal, including vomiting (2.8%), headache (5.8%), nausea (7.8%), and diarrhea (8.8%). These findings suggest that menstrual regulation with PGE1 suppositories is a safe method with the advantages of ease of administration, reversibility, a high success rate, acceptable bleeding duration, only mild side effects, and induction of menses without the need for surgical intervention. The simplicity of vaginal administration offers potential for self-treatment. Use of this method of menstrual regulation could be especially advantageious in countries with restrictive abortion laws. Single administration of a suppository, or parenteral administration, could improve the acceptability of this method.
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PMID:Menstrual regulation with prostaglandin (Pg ONO 802) in Indonesia. 615 28

The basis for this report is home interviews of users of the contraceptive vaginal ring and the pill from urban and rural clinics in 2 provinces in the Dominican Republic and clinics from 2 towns and a large city in Brazil. Dominican ring users were significantly more likely to be older than pill users, to have more schooling, and have partners with more education. 6% were illiterate and 75% had only elementary education. 1/10 of the ring users reported having had problems with insertion of the ring and 1/5 had problems removing it. It may be worthwhile to try a narrower, more flexible model that may be easier to insert and remove. 1 out of every 6 users reported vaginal odor, 1 out of 8 reported having felt the ring move in their vagina, and 1/3 were aware of the ring at some time. About 1/2 the women in each country said the ring had changed color during use, and about 1/2 of those who reported the change did not like it. It became light gray and looked dirty. Correction may improve acceptance. 10% reported having expelled the ring. Twice as many ring users reported having menstrual problems. Ring and pill users both reported headaches, vaginal discharge, menstrual pain, and increased libido. A large proportion of ring and pill users experienced decreased duration and amount of menstrual bleeding, which was seen more as a beneficial than a negative effect. The same can be said for weight gain, which was "linked" by 89% of the women in the Dominican Republic. 64% of ring users and 67% of pill users described thier respective method as good or very good. Detailed instructions should accompany the final model. They should say that it is alright for the ring to be any place within tha vagina for it to be effective.
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PMID:User's perception of the contraceptive vaginal ring: a field study in Brazil and the Dominican Republic. 641 42

Clotrimazole, a tritylimidazole and a new antimicrobial agent, produced itching and irritation of the vulva and vaginal area in less than 1% of the population (N = 131) studied. No abdominal cramps, headache or lightheadedness, nausea, vomiting, and diarrhea were observed when 200 mg of clotrimazole was inserted deep in the vagina for several days.
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PMID:Clinical toxicology of clotrimazole when administered vaginally. 700 34

The toxic shock syndrome has only recently been described. Eleven female patients aged 13 to 43 years (median 17) with toxic shock syndrome have been seen at the Mayo Clinic since August 1975. One patient died. Seven patients had one or more recurrences. As previously described, the syndrome was often life-threatening, afflicted mostly menstruating females, and was characterized by a very brief prodromal illness consisting of high fever, vomiting, diarrhea, conjunctivitis, headache, irritability, sore throat, myalgias, abdominal tenderness, and erythematous rash. The disorder can progress to hypotension or prolonged refractory shock, adult respiratory distress syndrome, diffuse intravascular coagulation with severe thrombocytopenia, and renal failure. Pancreatitis was observed in two cases. During convalescence, pronounced desquamation and peeling of the skin occurred. Numerous laboratory abnormalities are observed. In 5 of the 11 patients, Staphylococcus aureus was isolated from conjunctiva, oral cavity or nares, vagina, or stool. A recently described pyrogenic exotoxin was identified in the isolates of three patients; its etiologic role remains speculative. Therapy is mainly supportive. Antistaphylococcal therapy for the acute illness and for prevention of recurrences has not yet proved to be of any benefit. The role of vaginal tampons, if any, in the pathogenesis of this disorder remains unclear.
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PMID:Toxic shock syndrome, a newly recognized disease entity. Report of 11 cases. 744 20

This placebo-controlled, double-blind study was aimed to evaluate the clinical efficacy, safety and tolerability of human leukocyte interferon-alpha (2 x 10(6) IU/g) incorporated in a hydrophilic gel (hydroxyethylcellulose, 1%) to cure intravaginal warts in women. Preselected, subjects (n=60) who ranged between 18 and 50 years of age (mean 23.7), harbouring 275 vaginal warts (mean 4.6) with clinical, histopathological and polymerase chain reaction (PCR) confirmed diagnosis of human papillomavirus (HPV) infections were randomly divided into 2 parallel groups. A precoded tube (45 g), active or placebo, with disposable applicators and instructions was given to each patient for one week's usage. Patients were demonstrated how to inject 4 g of the trial medication deep into the vagina 2 times daily for 5 consecutive days per week. During the 4-week treatment period, patients were examined on a weekly basis. Cure was defined as absence of clinical signs of infection, as well as PCR and Southern blot hybridization confirmed negative HPV DNA on molecular assay. By the cessation of the therapy 41.7% patients and 44.4% intravaginal warts were cured. Code disclosure revealed that interferon-alpha (2 x 10(6) IU/g) in gel had cured 73.3% patients, and 79.3% intravaginal warts, while placebo healed 10% patients and 8.1% lesions (active gel versus placebo; P<0.0001). Fifty-one patients (85%) complained of no drug-related adverse reactions. Nine patients (15%) mostly in the interferon-alpha gel experienced non-objective, mild headache, tenderness, with transient increase in their body temperature (>38 degrees C). In conclusion, the findings showed that along with non-objective mild side effects, human leukocyte interferon-alpha (2 x 10(6) IU/g) in a hydrophilic gel is significantly more effective than placebo to cure intravaginal warts in women.
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PMID:Human leukocyte derived interferon-alpha in a hydrophilic gel for the treatment of intravaginal warts in women: a placebo-controlled, double-blind study. 987 27

Results of a large multicentered clinical trial of a new contraceptive vaginal ring show that the new ring may be about as effective as oral contraceptives but with fewer side effects. The ring, which is a little smaller than a 75 mm diaphragm and has a Silastic inner core and outer tubing, is avilable in 2 sizes (50 mm or 58 mm) and contains a middle layer with a steroid mixture of estrogen and progestin. Both types of ring contain about 100 mg levonorgestrel and 50 mg estradiol. Ovulation is suppressed by the steroids in the ring. The ring is placed in the vagina for about 3 weeks and then removed for 1 week. Withdrawal bleeding occurs when the ring is removed. Comparative studies of the effectiveness of the ring and a pill (Nordette, which contains 150 mcg levonorgestrel and 30 mcg estradiol) show that after a year's use, both type of contraceptives had a pregnancy rate of about 3 pregnancies per 100 users. Ring users had higher continuation rates than pill users (50/100 women for the ring vs. 30/100 for the pill). Reasons for discontinuation for the ring include occurrence of vaginal discharge, vaginitis, and menstrual problems. Ring users had lesser incidence of nausea and headache compared to pill users; they also did not experience an increase in angiotensinogen levels or blood pressure. Another advantage of the ring is its once-a-month administration. Investigators are still testing the best method for using the ring. However, as testing is not yet complete, application for approval by the Food and Drug Administration may take quite some time.
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PMID:Trials point to effectiveness of new vaginal ring. 1227 58

Some scientists added the progestin levonorgestrel to the vaginal ring which must be removed every 3 weeks to address the problem of irregular bleeding, but it adversely altered lipoprotein levels and caused too many hemorrhaging problems. On the other hand, scientists in the laboratory at Organon have conducted various studies of a vaginal ring with ethinyl estradiol and 3-keto-desogestrel at different doses which have yielded favorable results. A multicenter European study was conducted with 400 women aged 18-40 years wearing a vaginal ring with 0.120 mg keto-desogestrel and 0.015 mg ethinyl estradiol every day for 9 months. 10% had slight bleeding 15 days after insertion of the vaginal ring. In 10 women tested, the plasmal levels of progesterone and estrogen decreased by 4 nmol/l and 0.010 nmol/l, respectively. The first French study was conducted at the Gynecology College of Bordeaux and the South-West in 1988 and included 40 women followed for 9 cycles. The vaginal ring consisted of 2 compartments: the biggest compartment contained only 3-keto-desogestrel and the other also contained ethinyl estradiol. It remained in the vagina for 21 days, then was removed to be rinsed, dried, and placed in a box. It was reinserted on the 5th or 7th day of the cycle. This ring reduces the volume of blood during menses and eliminates abdominal cramps, nausea, and headaches. Women tolerate the vaginal ring better than they do oral contraceptives (OCs); for example, it does not cause them to gain weight, they tolerate glucose well, it brings about favorable changes in lipoproteins, it does not bring about conditions favorable to thrombophlebitis, and it can improve the skin for acne-sufferers. Young women accept vaginal rings enthusiastically. The efficacy of vaginal rings with 2 steroids is the same as that of OCs.
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PMID:[Vaginal contraception with steroids]. 1228

The vaginal contraceptive ring under development by the Population Council's International Committee on Contraceptive Research (ICCR) is 58 mm in diameter and consists of a core of Salastic covered by a thin layer of levonorgestrel and estradiol with an overcoat of silicone rubber. The ring is inserted on the 5th day of the menstrual cycle and withdrawn 3 weeks later for 1 week. The steroids are released from the Silastic and readily absorbed through the vagina. The blood levels of contraceptive hormones are sufficient to prevent ovulation but do not display the great daily variation commonly observed in women on oral contraceptive (OCs). The ring contains sufficient hormones for 6 months of contraception. Preliminary research in developed countries indicates that the ring is as effective as and safer than the pill. In order to determine whether a method requiring twice monthly handling of the genitals and carrying a foreign body in the vagina for 3 weeks at a time would prove acceptable to poorer periurban and rural women in developing countries, the International Development Research Centre supported a study of the ring's acceptability in actual practice in Santo Domingo, Dominican Republic, and Campinas, Brazil. The ring was offered, with other methods, in several clinics in each country where prescription, instructions, and follow-up were provided by paramedical personnel. 150-200 ring acceptors in each country were to be compared with pill users, who were chosen for comparative purposes because both methods are hormonal, require the same sequence of use and rest, and tend to induce regular menses. Ring users were slightly older than pill users and tended to be better educated. 10% of ring users complained of difficulty with insertion, 20% of difficulty with removal, 43% worried about correct placement despite being told that the ring would work however inserted, 33% reported vaginal pain, and 10% reported having expelled it at some time. About half the women said the ring had changed color and about 1/3 of them did not like the change. Twice as many ring as pill users reported menstrual problems but 26% of pill users compared to 17% of ring users reported other problems such as headaches. 42% of ring users and 62% of pill users reported gaining weight. 17% of ring users and 7% of pill users considered their experiences "very good" but the general level of satisfaction with both methods was similar. An earlier study indicated that women liked having control over use of the method, inserting and removing the ring at will for intercourse or washing. The decreased amount and duration of menstrual bleeding was welcomed by most users, as was weight gain by some users.
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PMID:The hormonal ring. A new contraceptive gains acceptance. 1231 42

The Population Council's International Committee on Contraceptive Research has been working on an alternative hormonal contraceptive in the form of a vaginal contraceptive ring. The ring is 58 mm in diameter and consists of a core of Silastic covered by a thin layer of levonorgestrel and estradiol and an overcoat of silicone rubber. The ring is inserted into the vagina on the 5th day of the menstrual cycle and withdrawn 3 weeks later for 1 week. The contraceptive steroids are released from the Silastic at a regular rate and readily absorbed through the vagina. Thus, the blood levels of contraceptive hormones reached during the use of the ring are sufficient to prevent ovulation but do not exhibit the great daily variations commonly observed in women on oral contraceptives (OCs). There are sufficient hormones in the ring to provide 6 months of contraception. Preliminary research on Swedish and other developed country women indicates that the ring is as effective as, and safer than, OCs. The International Development REsearch Center supported a study to determine the ring's acceptability in practice. It was carried out by the National Council on Population and the Family, Santo Domingo, Dominican Republic, and the Centre for Research on Maternal and Child Health, Campinas, Brazil. The ring was offered, along with other methods, in a number of clinics in each country where prescriptions, instruction, and follow-up were the responsibility of paramedical personnel. The study involved an observation period during which 150-200 ring acceptors in each country were to be enrolled and matched with OC users. Findings indicated that ring users were slightly older than OC acceptors and that they and their partners tended to have more education. 10% of ring users complained of difficulty associated with insertion, 20% of difficulty with removal. 43% worried about correct placement. Twice as many ring users reported menstrual problems, but a larger percentage of OC users (26%) than ring users (17%) reported having other problems, such as headaches. Regarding satisfaction with the method, a larger percentage of the ring users (17%) considered their experience "very good," but the general level of satisfaction with both methods was similar. The information obtained from the study provides important data for the final design of the new method and the instructions that will accompany it.
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PMID:The hormonal ring: a new contraceptive gains acceptance. 1231 3


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