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

Ketoprofen and indomethacin were compared as specific therapies for primary dysmenorrhea in this study involving 23 primary dysmenorrheic women; the study was double-blind and cross-over. Each patient was given a code-numbered package of capsules of ketoprofen (50 mg) or indomethacin (25 mg); medication (1 capsule 3 times daily) was started 1 day before menstruation and was continued until cessation of dysmenorrheic symptoms (no longer than 4 days). Patient estimation of the effect of ketoprofen was ranked as good in 70% of cases, moderate in 18%, and nil in 12%. For indomethacin, the figures were 58, 31, and 10%, respectively. Initial dysmenorrhea score of 9.6 was reduced to 3.6 during ketoprofen therapy and to 4 with indomethacin (P.001). Ketoprofen alleviated pelvic pain in 84% of cases; indomethacin in 78%. Mean duration of pelvic pain was reduced to 5.1 hours from an initial period of 10.6 hours with ketoprofen and 5 hours with indomethacin (P.01); this statistic excluded cycles of total relief. Other symptoms relieved were similar with both drugs, including: lower back pain, vomiting, diarrhea, and dizziness (alleviated in 82-97%) and headache, fatigue, and nervousness (alleviated in 40-67%). Blood loss was subjectively estimated to decrease in 42% and increase in 4% of ketoprofen-treated patients, whereas for indomethacin these figures were 36% and 7%, respectively. All side effects were mild. The rate of lost working days was significantly decreased under both treatments.
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PMID:The refief of primary dysmenorrhea by ketoprofen and indomethacin. 53 Dec 31

Prior to an abdominal operation, 125 patients were asked if they regularly had headache during the menstrual period together with or without pain in the lower pelvic region. Pelvic pain patients with endometriosis externa reported headache significantly more often than those without endometriosis. Headache proved to be almost as common a symptom as lower pelvic pain in patients with endometriosis.
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PMID:Headache as a symptom of endometriosis externa. 119 Jun 95

During the past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

From August 1988-June 1989, 983 physicians participated in a phase IV trial by following 7759 women using the monophasic oral contraceptive (OC), Demulen 1/35 (1 mg ethynodiol diacetate and 35 ug ethinyl estradiol) to evaluate its efficacy and safety. The total number of cycles for the study stood at 21,440. In addition, the total woman-years stood at 1787. Only 6382 patients could be evaluated for safety. 4.4% of the patients had adverse reactions to the OC, but only 1.7% of all patients stopped taking it. The leading side effects included nausea (67 cases), headache (45), amenorrhea (42), emotional changes (30), breast pain (19), dysmenorrhea (12), and 11 cases of weight gain, abdominal/pelvic pain, and bloating. Of the 280 reported adverse reactions, only 87 (31%) were considered severe. The leading serious adverse reactions were depression (10) and hypertension (6). Only 5412 patients could be used to determine efficacy. The physicians initially reported 121 (2.2%) pregnancies during the study. The researchers learned that 33 of the 84 returned 2nd questionnaires (response rate, 70%) reported that the women conceived after enrollment but before taking the OC. 36 conceived while taking it, but 8 did not take it daily. Noncompliance may have contributed to pregnancy for the remaining 28 cases. Therefore the 36 confirmed pregnancies made for a failure rate of .7%. 85.7% of the pregnancies happened in the 1st 3 months of taking the OC. Either patient noncompliance or true medication failure accounted for treatment failure. Therefore it is important for physicians to instruct patients on how to take OCs correctly.
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PMID:Efficacy and safety of ethynodiol diacetate, 1 mg, with ethinyl estradiol, 35 micrograms, with an emphasis on contraceptive efficacy. A phase IV trial. 204 81

The efficacy and safety of buserelin acetate in the treatment of endometriosis was studied in 4 open non-comparative trials and 2 open randomized comparative trials with danazol. 444 women were enrolled in the buserelin group and 89 in the danazol group. Treatment was for 6-10 months using 900-1200/micrograms intranasal buserelin/day and 400-800/micrograms oral danazol/day; patients were followed up for 6-8 months. Endometriotic lesions improved or disappeared in most women; pain (dysmenorrhoea, dyspareunia and pelvic pain) subsided rapidly. Most women had no, or alleviated, symptoms throughout follow-up, although ovarian function resumed promptly. Nearly a quarter of infertile women with a desire for children became pregnant. No significant differences between treatments emerged. Buserelin treatment was characterized by menopausal-like symptoms in most women, as well as by headache and nausea. Danazol treatment, which also gave rise to these effects, was accompanied by weight gain, myalgia and acne in a considerable proportion of women, as well as other anabolic and androgenic side effects. Buserelin would thus appear to be a safe and effective alternative to the standard therapy, danazol, in the treatment of endometriosis.
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PMID:Efficacy and safety of intranasal buserelin acetate in the treatment of endometriosis: a review of six clinical trials and comparison with danazol. 210 46

The efficacy of indomethacin suppositories (100 mg 1-3 times a day) in the treatment of primary dysmenorrhoea was investigated in a double-blind, crossover study involving 40 patients, in comparison to placebo. The patients were treated for four menstrual periods-two periods with placebo and two periods with indomethacin suppositories. A dysmenorrhoeic score based on subjective estimations of nine symptoms was used, the symptoms including pelvic pain, backache, headache, dizziness, nausea, vomiting, diarrhoea, nervousness and incapacitation. As compared to placebo, indomethacin suppositories led to a insignificant decrease in the frequency and severity of the associated symptoms, as evaluated by subjective rating (P less than 0.05). Indomethacin suppositories were well tolerated and there was no drop-out. No side effects were reported except for a mild burning sensation in the rectal region experienced by 3 patients on indomethacin suppositories.
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PMID:Efficacy of indomethacin suppository in primary dysmenorrhoea. 222 77

Prolonged intrauterine retention of fetal bone parts is a rare complication of induced abortion, spontaneous intrauterine fetal death, and missed abortion. Here, a case of long-term retention of fetal bone fragments in a 47-year-old Italian women who underwent elective abortion 8 years earlier is reported. The patient was admitted for acute pelvic pain with purulent vaginal discharge. She reported recurrent episodes of abdominal and pelvic pain, meteorism, dysuria, nausea and vomiting, headaches, and irregular cycles with dysmenorrhea and inter menstrual bleeding since the 1979 abortion. Initially, pelvic inflammatory disease was diagnosed and antiphlogistic drugs were prescribed. When symptoms persisted after 10 days of drug treatment, the patient underwent a laparotomy that revealed pyosalpinx with extensive pelvic adhesions. Total hysterectomy with bilateral adnexectomy was performed. The uterine cavity was found to be closely packed with fragments that were determined at stereomicroscopic examination to be pieces of fetal bone. Of particular concern is the potential of this complication to lead to secondary infertility. The retained bone fragments can function similarly to an IUD by producing an increase in the local insertion of prostaglandins and preventing blastocyst implantation. Moreover, the retained fragments are an ideal substrate for bacterial colonization, which can spread to the tubes and destroy the functional integrity of the reproductive apparatus. Retention of fetal bones should thus be considered as a possible etiologic factor in cases of infertility of women with a history of abortion.
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PMID:Prolonged retention of fetal bones: intrauterine device and extrauterine disease. 236 50

Chronic pelvic pain remains a difficult management problem that is often refractory to traditional medical or surgical therapy. The pain management center approach used successfully for the treatment of cancer pain and headache can be adapted to the treatment of chronic pelvic pain. The results of this pilot study suggest that the multidisciplinary techniques of pain management promise to be an effective modality for the treatment of chronic pelvic pain.
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PMID:The pain management approach to chronic pelvic pain. 243 89

139 women at risk pregnancy (due to unprotected sexual intercourse) participated in a multicenter assessment of the efficacy and tolerability of RU 486 prescribed as a late luteal contragestive agent. 24 women received 400 mg of RU 486 and the remaining 115 women received 600 mg on the day before the expected menses. 48 women (35%) were found to be pregnant (positive plasma beta-human chorionic gonadotropin) at the time of RU 486 intake. An ongoing pregnancy after RU 486 treatment was found in 9 cases (failure rate, 19%). Bleeding occurred in all but 6 women, 1 of whom was pregnant. The duration of bleeding was 4.6 + or - 2.9 days in pregnant women and 3.8 + or - 1.2 days in nonpregnant women. A posttreatment menstrual period occurred 31.8 + or - 6.2 days after the onset of RU 486-induced bleeding in pregnant women and 30.0 + or - 5.3 days afterwards in nonpregnant women. Few side effects were reported (asthenia, pelvic pain, headache, mailase, and dizziness), and none required specific measures. These results indicate that, when it is too late for postcoital contragestive methods and too early for vacuum aspiration abortion, RU 486 constitutes a technique with at least as much effectiveness as high-dose estrogen therapy and fewer side effects and disturbances in the menstrual cycle. However, since the success rate is only 80%, it is essential to schedule a posttreatment visit to identify women with ongoing pregnancies or incomplete uterine evacuation.
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PMID:Contragestion with late luteal administration of RU 486 (Mifepristone). 304 66

An integrated health and family planning program, operated by the University of Ife Teaching Hospital, was assessed to determine the impact of the integrated approach on family planning service utilization among the predominantly Yoruba residents of the city. In Nigeria, family planning services are generally delivered in clinics which have little or no connection with medical facilities, and service utilization is low. In 1979 the hospital decided to include family planning as part of the routine medical services provided at its 8 clinics located within a 25 kilometer radius of the hospital. Staff members at the clinics were trained in family planning. Trained female fieldworkers conducted motivational activities to encourage the women in the community to use the family planning services of the clinic. The program provided women with an opportunity to obtain contraceptives in a familiar setting and as part of their routine medical care. Neither parental nor spousal consent was required. Yoruba men tend to oppose family planning. Data for the study was obtained from the records of the program's 1495 new acceptors served by the program during its first 2 years of operation. 50.6% of the acceptors were 25-34 years of age, and another 31.7% were between 35-44 years of age. Very few teenagers utilized the services. 96% of the wome were married and they had an average of 4.4 living children. 56% were Catholic, 25% were Protestant, and 16% were Muslim. 37% were illiterate, and another 42.5% could barely read or write. Most were wives of government workers or service men. 88% had never used a modern contraceptive, and 94.5% were not using a method at the time of their first clinic visit. 68.4% of the acceptors were referred to the clinic by the fieldworkers or other health personnel. Only 11.2% sought the services on their own. 85% of the acceptors choose oral contraceptives (OCs), 13% had IUDs inserted, 0.3% were sterilized, and the remaining 2% chose other methods. The low sterilization rate probably reflected the fact that spousal consent was required for sterilization. Side effects reported by the OC users included asthma (9.6%), headaches (5.2%), phlebitis (3.5%), jaundice (1.7%), chest pain (1.5%), depression (1.5%), scanty menses (0.8%), and high blood pressure (0.4%). Among IUD users, 10.8% had intermenstrual bleeding, 18.4% reported pelvic pain, and another 6.8% reported a variety of other problems. 42.1% of the acceptors wanted no more children, and the remainder wanted to avoid the hardships associated with traditional methods of spacing. Correlation analysis revealed that the total number of living children was negatively related to maternal education and that women with sons wanted significantly fewer additional children than women with fewer or no sons. 51% of the acceptors were continuing contraceptive use at the time of the study. The study confirmed the feasibility of an integrated approach. The findings should be of use to government officials who want to improve service utilization in the national family planning program.
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PMID:Integrated family planning services: a Nigerian experience. 651 Mar 20


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