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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 a new contraceptive delayed-action preparation, Deposiston is reviewed. Deposiston is the estrogen-progestin preparation with predominant estrogen activity. The estrogen and progestin eomponents of the preparation are ehtinyl estradiol and norethindrone acetate, respectively. Contraceptive effect is associated with gonadotropic stimulation by estrogen component, while progestin component provides the thermogenic effect. Mutagenicity, carcinogenicity, and toxicity tests show safety of Deposiston. Clinical trials of Deposiston in 815 women over the period of 16,207 cycles (18.1 cycles/woman) confirm contraceptive efficacy of the preparation: pregnancy occurred in only 12 women. Side effects of Deposiston include nausea (16.06%), vomiting (3.7%), headache (5.08%), and vaginal discharge (11.86%). Each Deposiston package contains 3 white estrogen tablets and 2 red progestin tablets. A woman starts to take Deposiston on day 4 of the cycle: white tablets are taken on days 4, 11, and 18 and 2 red tablets are taken on day 25. On day 2-7 after the red progestin tablets, the woman experiences hemorrhage. Average duration of and the amount of blood loss during the hemorrhage do not differ from those during the normal menstruation. Deposiston is indicated for women with recurrent uterine hemorrhages, gastrointestinal disorders, and decreased libido. The preparation is contraindicated for adolescents younger than 16 years of age, for women with hormonal active tumors, thromboembolism, chronic liver diseases, and idiopathic jaundice.
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PMID:[Hormonal contraception using the oral depot preparation, Deposiston]. 35 70

The use of the depot preparations medroxyprogesterone acetate (MPA) (Depo-provera) and norethindrone (Norigest) is discussed. MPA is administered in dosages of 150 mg every 3 months. It inhibits ovulation, probably by affecting cyclical gonadotropin secretion. It also causes atrophy of the endometrium, affects cervical secretions and ciliogenesis. MPA has a Pearl index of .348. Norethindrone works to inhibit ovulation, but its effectiveness is also dependant on changes in cervical secretions. Dosage is 200 mg every 84 days, and it is not as effective as MPA. MPA use usually causes oligoamenorrhea or amenorrhea. Gain in weight, headaches, and nervousness are side effects of MPA use, and it can also affect carbohydrate metabolism. The restoration of fertility after discontinuing MPA use generally takes a few months. MPA is counterindicated for women with unexplained vaginal bleeding, liver function disturbances, and diabetes mellitis. It can be used during the lactation period or in cases of endometriosis. MPA can often be used when the side effects of other contraceptive agents or methods are unacceptable.
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PMID:[Pharmacological and clinical application of progestational hormone depot preparations]. 56 21

In the last decade, world literature abounds in reports of harmful side effects which develop with the use of oral contraceptives including visual problems such as partial and total clotting in the retinal veins, infections, blood in the retina, and dilated veins signalling imminent stroke. 2 particular cases treated at the Opthalmological Clinic of the Academy of Medicine in Lodz deserve consideration. M.W., a 19 year old student who had had measles and scarlet fever in childhood, reported increasing visual problems. Due to irregular menstrual periods, she had been taking the contraceptive Angravid, consisting of 1 mg ethynodiol acetate, a synthetic progestogen and .05 mg mestranol, a synthetic estrogen. After a complete examination retrobulbar neuritis with the presence of papilloedema in the eye fundus of local origin was diagnosed. She was treated for general and local infection and for the prevention of clotting. After a month all symptoms regressed. H.U., a 30 year old stomatologist, reported to the clinic, complaining of sudden and periodic visual disturbances occurring in both eyes, accompanied by severe headache pains. In childhood she had had measles and whooping cough, later frequent bouts of flu and angina. She had given birth 3 times, each a natural delivery with healthy children. Recently she had been taking the oral contraceptive femigen, consisting of 2 mg chloromadinon acetate and .05 mg mestranol. After a complete series of skull and brain tests, papilloedema with the pseudotumor syndrome cerebri was diagnosed. Intensive treatment for edema produced visible improvement and the patient was discharged.
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PMID:[Ophthalmological complications after oral contraceptives (author's transl)]. 67 30

In addition to oral contraceptives (OCs), the morning-after pill, the minipill, and depot preparations also belong to hormonal contraceptives. The latter two contraceptives have not become established among young women because of inadequate cycle control. For postcoital contraception in Austria, Neogynon and Stediril-D, consisting of 0.05 mg of ethinyl estradiol (EE) + 0.25 mg of levonorgestrel, are used within 48 hours of unprotected intercourse. Lower dose OCs have considerably reduced the risks of side effects. Micropills are the optimal OCs with EE under 50 mcg combined with the new generation of gestagens. The beneficial effects include menstrual regularity and the prevention of anemia, ovarian cysts, and fibrocystic mastopathy. Nausea, headache, spotting, and weight gain do occur in individual cases, even among young people. The potential risk of thromboembolism is the most important, although arterial cardiovascular risk is minimal in young age. The probability of postpill amenorrhea is less than 1%. Micropills can be used by young diabetics provided the disease is not beyond 10 years' duration and there is no angiopathy. Acne, seborrhea, and hirsutism are beneficially influenced by a combination of 0.035 mg of EE with 2 mg of cyproterone acetate. The relative risk of endometrial and ovarian cancer are only about half as high among OC users as among nonusers. The risk of breast cancer in young OC users has not been conclusively explained. Regular colposcopy and cytology is recommended for young OC users to preclude the risk of malignancies of the genital tract. Sex education and the use of OCs that are the most suitable and effective for young people can reduce the number of unwanted pregnancies and abortion. The comparison of two 5-year periods in the 1970s and 1980s at the University Obstetrical-Gynecological Clinic in Graz showed that the incidence of births among women under 18 years of age decreased from 3.6% (778) to 1.6% (353).
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PMID:[Benefits and risks of hormonal contraception]. 146 64

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

A total of 110 nonmenopausal women (mean age 42.1 years) presenting with symptomatic uterine leiomyomata and/or fibromatous uteri have been enrolled in this trial to evaluate the efficacy of the depot formulation of leuprorelin acetate in decreasing uterine volume and minimizing menorrhagia, dysmenorrhoea and pressure over the bladder. All patients were treated with an intramuscular injection of leuprorelin acetate depot 3.75 mg every 4 weeks for 16 weeks. Clinical examinations and hormonal and ultrasound determinations were performed before, during and at the end of treatment. Appropriate follow-up is still ongoing for most patients. At the end of the treatment period, of 88 women with enlarged fibromatous uteri, 33 (37.5%) showed a decrease in uterine volume of greater than or equal to 50% of the original size, while nine (10.2%) remained with unchanged uterine volume. Of 80 fibromas measurable separately, 47 (52.8%) decreased by greater than 50% of the initial volume and 16 (18%) remained unchanged or even increased. During treatment, clinically advantageous effects were observed in the associated symptomatology, mainly in the production of amenorrhoea and restoration of normal haemoglobin levels. Most of the patients were affected by irregular menstrual blood loss with consequent anaemia that in 29 patients was expressed by low levels of haemoglobin (mean 9.2 g/dl; SD 1.5; range 4.5-11.8 g/dl). By the end of the treatment, only one patient still had moderate vaginal blood loss. Haemoglobin levels rose to a mean value of 11.8 g/dl (SD 1.3; range 8.5-14.1 g/dl). Three patients (2.7%) failed to complete the 16-week treatment protocol, because of headache (one patient) and increased blood pressure (two patients). As a result of the treatment, of the 107 patients who were candidates for surgery and who were included in this study, only nine (8.4%) required surgery during leuprorelin acetate treatment. Of these, four operations were vaginal excision of the submucous myomata protruding into the cervix during treatment, and in five hysterectomy performed because of persistence of symptoms. In most patients the achievement of amenorrhoea minimized the fear of surgical emergency, facilitating an increased awareness of their clinical condition. With the exception of the three patients who dropped out, side effects were mild in all patients, consisting mainly of hot flushes, which were easily tolerated. In the following 8-12 months, the regrowth of uterine volume to original size has been usual in most of the 82 patients now in follow-up.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Efficacy of leuprorelin acetate depot in symptomatic fibromatous uteri: the Italian Multicentre Trial. 160 94

In 1983, a previously healthy 21-year old mother came to University Hospital in Dijon, France feeling weak and had a severe frontal headache with vomiting. Clinical and biochemical tests were normal. She smoked 20 cigarettes/day and used a high dosed combined oral contraceptive (OC) (ethinyl estradiol and cyproterone acetate). 15 days later, the headache returned and she could not understand spoken words and the bilateral section of the brain had slowed. Yet her mental status was normal as were cerebrospinal fluid and cerebral computerized tomography tests. The antiherpes virus drug, vidabarine, did not alleviate symptoms. At least 1 month later, a severe left pulmonary embolism caused acute right heart failure. She also had a prethrombotic left iliac vein, so physicians began heparin therapy, adding nifedipine and buflomedil to control the spasms in the right internal iliac artery and both external iliac arteries. Acute ischemia of the lower limbs eased within a week but sensory disorders remained for 2 months. Satisfactory collaterality transpired due to a blocked left external iliac artery and left iliac vein. The following signs and symptoms indicated her condition to be homocystinuria: blond hair with deep blue eyes, macrocytic anemia, factor VII deficit (51%), strong positive Brandt's reaction, cystine homocystine in the plasma, and presence of homocystine, cystathionine, and methionine in the urine. Physicians took her off the OC and discharged her on vitamin B6/day, folic acid/day, betaine citrate/day, and the anticoagulant Coumadin. A subsequent check of her 19-year old sister found she had it too. They assessed the patient's condition yearly. In 1988, her left leg developed edema and she limped when not using elastic stockings. Effects of iliac vein phlebitis were evident. She no longer suffered from headaches. Since plasma methionine was within the normal range and homocystine no longer was present in plasma and urine, the physicians halted the anticoagulant therapy. In conclusion, the OC precipitated this partial form of homocystinuria.
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PMID:Vascular manifestations in homocystinuria. 161 Jun 63

To assess the contribution of gonadal steroids to sexual behavior in aging women, we conducted a 10-week, double-blind, hormone replacement study of 40 naturally menopausal women (mean age, 58.3 yr). Prospective measurements of basal and stimulated vaginal vasocongestion and daily self-reports of mood, physical symptoms, sexual behavior, and perceived sexual pleasure were collected. Daily treatments were either conjugated equine estrogen, i.e. Premarin (P; 0.625 mg), Premarin and medroxyprogesterone acetate, i.e. Provera (PP; 0.625 and 5 mg, respectively), Premarin and methyltestosterone (PT; 0.625 and 5 mg, respectively), or placebo (PL). Compared to placebo, hormone treatment had significantly reduced hot flashes in the P and PP groups by week 4 and in the PT group by week 5. Headaches were reduced in the P vs. PL group, only. Hormone treatment did not significantly alter mood ratings, sexual behaviors, or psychophysiologically measured sexual arousal. PT treatment significantly increased reports of pleasure from masturbation compared to the other three groups, underscoring the apparent contribution of androgens to self-stimulatory behavior. However, the data suggest that in these physically and sexually healthy women, gonadal steroids do not influence major components of sexual functioning, including arousal and a wide variety of sexual activity and experience.
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PMID:Effects of estrogen, androgen, and progestin on sexual psychophysiology and behavior in postmenopausal women. 169 Jul 46

After at least 6 months on conventional hemodialysis (cellulosic dialyzers, acetate dialysate, and a 3- to 4-hour treatment time), 56 patients were changed to short-time hemodialysis (less than 180 minutes) using polysulfone dialyzers and bicarbonate-containing dialysate. Treatment time decreased (191 +/- 5 v 147 +/- 5 min; P = 0.001), while Kt/V (1.22 +/- 0.04 v 1.29 +/- 0.06; P = NS) and normalized protein catabolic rate (pcr) (1.10 +/- 0.05 v 1.10 +/- 0.07 g/kg/d; P = NS) remained constant. When compared with the conventional period, 30 months of short-time hemodialysis resulted in no changes in predialysis blood pressure (BP) (151 +/- 2/84 +/- 1 v 151 +/- 2/86 +/- 1 mm Hg), postdialysis BP (144 +/- 2/81 +/- 1 v 143 +/- 3/84 +/- 1 mm Hg), interdialytic weight gain (2.4 +/- 0.1 v 2.7 +/- 0.2 kg), or blood urea nitrogen (BUN) (26.1 +/- 0.71 v 25.3 +/- 1.07 mmol/L [73 +/- 2 v 71 +/- 3 mg/dL]). Shorter treatment times were not associated with an increase in intradialytic complications. Actually, the frequency (%) of dialysis treatments associated with nausea (5.94 +/- 1.33 v 2.21 +/- 0.52), vomiting (3.12 +/- 0.87 v 0.54 +/- 0.14; P less than 0.05), headaches (5.60 +/- 1.13 v 2.03 +/- 0.52; P less than 0.05), and back pain (0.91 +/- 0.25 v 0.05 +/- 0.05; P less than 0.05) was decreased.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical experience with short-time hemodialysis. 173 82

We did a double blind, crossover, prospective study comparing bicarbonate and acetate containing solutions in haemodialysis. Thirty stable patients with end stage renal disease on maintenance haemodialysis while awaiting a renal transplant were each studied on three dialysis with acetate and three with bicarbonate. Nine patients developed symptoms like headache, nausea, vomiting, giddiness, and malaise and developed hypotension during acetate dialysis and three patients during bicarbonate dialysis. There were symptoms during 16.66% of acetate dialysis sessions and 5.55% of bicarbonate dialysis sessions. (P less than 0.05). There was a statistically significant decrease in PaO2 and PaCO2 on acetate dialysis at 30 minutes after initiation of dialysis. There was no significant difference in weight loss on dialysis, or in blood pressure and correction of acidosis. We conclude that bicarbonate dialysis is better tolerated, but acetate intolerance is not a major problem since we use small surface area dialysers (0.8 M2).
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PMID:Short term study on relative merits of acetate and bicarbonate dialysis. 181 18


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