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

The use of depot-type injections of the contraceptive medroxyprogesterone acetate (DMPA) was studied in 1132 women for up to 5 1/2 years. Continuation rates, reasons for discontinuation, method failure rates, and bleeding patterns were considered. The women received a dose of 400 mg DMPA in aqueous suspension (injected into the deltoid muscle) every six months. In addition, each patient received an oral dose of .04 mg ethynl estradiol for 10 days each lunar month. Of the original acceptors, 36.4 percent used the method for the full 5 1/2 years. The major reasons for discontinuation of DMPA injections were bleeding problems (including amenorrhea) and such other medical reasons as palpitation, abdominal pain, headache, weakness, and dizziness. A total of 26 women became accidently pregnant while using DMPA during the 5 1/2 years. Advantages of DMPA injections were the simplicity, safety, and effectiveness of the method, and the psychological appeal of an injectable contraceptive.
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PMID:Use-effectiveness of six-month injections of DMPA as a contraceptive. 482 85

A study involving an injectable contraceptive regimen utilizing 2 commercially available hormonal preparations, medroxyprogesterone acetate (Depo-Provera, The Upjohn Company) and estradiol-17 beta-cyclopentylpropionate (Depo-Estradiol Cypionate, The Upjohn Company), is described. 90 multigravidas received intramuscular injections of 50 mg of medroxyprogesterone acetate and 10 mg of estradiol-17 beta-cyclopentylpropionate as a contraceptive every 5 weeks, for a total of 1155 periods. The injections were found to be safe and completely effective. In 15% of the therapeutic cycles, bleeding did not appear for a period of 30 or more days. In 14%, bleeding and/or spotting lasted for longer than 9 days during a 30 day period. The incidence of aminorrhea increased somewhat after the first 10 months of treatment. Endometrial biopsies showed a "suppressed" endometrium. Adrenal pituitary responsiveness to metyrapone was found to be normal in 17 of 21 patients tested. Although almost half of the patients presented some complaints during the study, these were mostly transient and minor in nature. Headache was the complaint most frequently observed (14%), but it was generally limited to 1 cycle. The monthly injectable contraceptive regimen may be useful in a particular population of patients who, for various reasons, cannot tolerate or cannot be relied upon to take oral contraceptives. The authors believe that because of the high incidence of alterations in the bleeding pattern while on the therapeutic regimen, as well as the frequent occurrence of aminorrhea following discontinuation of therapy, the use of such a contraceptive regimen in the general population might not be desirable.
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PMID:Evaluation of an injectable progestin-estrogen as a contraceptive. 491 52

2 experimental contraceptive injection programs are reported. 1 method provides for administration of a combined long-acting estrogen-progestogen product once a month, the other uses a long acting progestogen alone once every 90 days. In the once-a-month injection program in Los Angeles 615 patients representing 871 admissions were studied; treatment data are for both 1st and all admissions. Age distribution was 21-25 years. Patients received 150 mg of progestogen/10 mg estrogen injection. 88.1% reported cycles of 22-30 days/on admission. Some results are: For 1st and all admissions average duration of flow was 6.6 days; for 1st admission group complaints consisted of breast tenderness, 46% dysmenorrhea, 61.8%, weakness or dizziness, 42.8%, local reaction to injection, 37.4%. For all admissions, complaints were: breast tenderness, 43.3%, dysmenorrhea, 59.6%, weakness, 40.2%, local reaction, 33%. Reasons for dropout for both groups included rigidity of protocol, about 52%, moved away, 4.5%, extraneous illness, 1.5%; 64.4% of all admissions discontinued treatment due to unrelated reasons. No pregnancies were reported. The once every 90 day injection of medroxyprogesterone acetate given in doses of 150 mg were given to 243 women, of whom 57% were aged 20-29. Some results are: 1) number of days of bleeding ranged from 6-20 days, 2) 4.6% reported nervousness, 3.4% nausea, 2.1% headaches, 3) main reasons for dropouts were moving away, 11.8%, bleeding, 4.6%, and 4) 1/3 resumed ovulation within 1/2 year. Both methods are found to be extremely effective.
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PMID:Present status of injectable contraceptives: results of seven-years study. 550 12

100 patients of a private gynecologic practice took Planovine (4 mg megestrol acetate 50 mcg ethinyl estradiol) for 1-26 cycles, starting in 1968. The group was composed of 17 nulliparas, 57 who had 1-3 abortions, 69 taking Planovine for various gynecologic indications, and 40 using contraception for the 1st time. The menstrual flow was usually the same, but diminished in 19 women, became more regular in 10 women, but intermenstrual bleeding occurred in 18 women during 1 to 7 cycles. 38 gynecologic disorders were improved. Side effects included nausea or stomach pain (15 cases), weight gain (27), weight loss (40), headache (5), and nervous complaints (11). Although 15 women initially had mild venous disorders such as swollen veins, heavy limbs, and varicosities, no further circulatory complications appeared. 19 representative endometrial biopsies are described.
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PMID:[Clinical study of Planovine in gynecologic practice]. 556 16

The antiarrhythmic efficacy and safety of oral flecainide acetate and quinidine sulfate were compared in a double-blind, 16-center parallel trial involving 280 patients with chronic premature ventricular complexes (PVCs). Eighty-five percent of the flecainide patients had at least 80% suppression of PVCs, vs 57% of the quinidine patients (p less than 0.0001). Sixty-eight percent of the flecainide patients met the above criterion and also had complete suppression of couplets and beats of ventricular tachycardia, vs 33% of the quinidine patients (p less than 0.0001). PR and QRS intervals were prolonged by flecainide without clinical consequence, but they were not substantially affected by quinidine (p less than 0.0001). Quinidine prolonged JT (QT minus QRS) intervals significantly more than flecainide (p less than 0.05). Nineteen of 141 flecainide patients and 21 of 139 quinidine patients discontinued therapy because of side effects (p greater than 0.50). Flecainide side effects included dizziness, blurred vision, headache and nausea. Quinidine side effects included diarrhea, nausea, headache and dizziness. Flecainide was more effective than quinidine in suppressing chronic ventricular arrhythmias (especially complex forms), and thus is an important new antiarrhythmic agent.
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PMID:Flecainide versus quinidine for treatment of chronic ventricular arrhythmias. A multicenter clinical trial. 633 10

Benefits of using bicarbonate (B) containing dialysates instead of acetate (A) dialysates is still controversial. A single blind study was therefore performed using patients as their own control. Thirteen males and 10 females (mean age 44 years), with a poor dialysis tolerance were included in the study. 14 patients were dialyzed one week with dialysate A (A 38 mmol/l, CO3H 0, Na 140, K 1.5, Ca 1.75, Mg 0.75, Cl 108.5) and then one week with dialysate B (A 9, CO3H 29, Na 140, K 1.5, Ca 1.75, Mg 0.75, Cl 108.5); 9 patients were dialyzed one week with B and then one week with A. Measured osmolarity was 302 mOsm/l for dialysate A and 291 for dialysate B. A Unimat dialysate generator from Bellco was used in both cases. Student paired t tests were used for comparisons. Predialysis mean values of body weight, systolic and diastolic blood pressures, serum Na, K, Ca, P, BUN, and creatinin did not differed significantly with A and B dialysates. Hypotensive episodes (19.6% vs 36.2% p less than 0.05), headaches (5.8% vs 14.5%, p less than 0.05), and vomiting (8.0% vs 18.5%, p less than 0.10) were less frequent with B than with A. Postdialysis blood CO3H, K and P were higher with B than with A (all p less than 0.05). Results confirm, in acute conditions, the better tolerance of bicarbonate dialysis comparatively to acetate dialysis.
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PMID:[Improvement of tolerance of dialysis sessions using bicarbonate baths. Results of a controlled study]. 636 55

When deciding on the choice of a contraceptive, it is necessary to determine whether the method is to be permanent or reversible. If permanent, then the menstrual irregularities, the weight gain, headaches and subjective side effects of depot medroxyprogesterone acetate (DMPA) would suggest that it is not the most appropriate contraceptive for use up to the onset of menopause. Indeed there would be difficulty, given the frequent incidence of amenorrhea, in determining when this had occurred. If the contraception required is to be reversible, then it would be essential to inform the women that, provided she is of proven fertility, her chance of becoming pregnant after the use of DMPA is severely limited for 12 months after her last injection, and that she will have a conception rate of 75% by 15 months and 95% by 24 months. Very few women planning further pregnancies would tolerate that sort of delay in return of fertility, which makes the reliable spacing of their pregnancies impossible. DMPA seems not be the most appropriate agent for permanent contraception, for nulliparous women, for lactating women, or for women planning to space their pregnancies as accurately as possible. Sensitive discussion and accurate information on the advantages, disadvantages and relative reliability of all the available methods of contraception (hormonal, chemical, mechanical, barrier, and natural methods) should enable the woman, in consultation with her sexual partner and her medical practitioner, to choose the method most appropriate to her current and future needs. On the basis of the most recent information about DMPA, it is doubtful that DMPA will ever be the most appropriate choice.
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PMID:Injectable contraception. 645 20

The immediate postpartum period and the week of hospitalization is a privileged time for imparting information about the physiology of reproduction and contraception. Contraceptive counseling at this time may be done in groups or in individual sessions. Apart from the usual requirements of efficacy, innocuity, acceptability, and reversibility, postpartum contraception must respect lactation and the return of menstruation. 3/4 of women ovulate before the 1st postpartum mentstrual period, but never before the 25th postpartum day. In the absence of lactation, about 80% ovulate within 9 weeks. If lactation occurs ovulation is delayed and usually 1 or more anovulatory cycles occur, but the rate of conception is difficult to estimate. Methods that are unsuitable for postpartum use include the temperature method because of the absence of the hyperthermic plateau, cervical caps and diaphragms because correct measurements cannot be made until 5-6 months after delivery, and IUDs becuase of the large size of the uterine cavity, the fragility of the walls, the presence of lochia, the large size of the cervix, and the absence of cervical mucus which protects against infection. Local contraception with tablets, spermicidal gels, or condoms is a good choice, especially for breastfeeding women, because of improved success rates, good tolerance, and acceptability. In prescribing oral contraceptives, pathologies of pregnancy such as hypertension and phlebitis must be considered along with the classical contraindicatins. The formulation must not affect the quality or quantity of milk. Standard dosed combined pills and monophasic and biphasic minidose pills increase the thromboembolic risk if they are taken soon after delivery, used by women who smoke, if the estrogen component is large, or if the women's cholesterol level is elevated. Minipills and progestagen-only micropills are interesting choices for postpartum women because of the reduced steroid doses. Micropills should be chosen if lactation is expected to continue for more than 2 months. Injectable medroxyprogesterone acetate can be used for long acting progestagen contraception, but the patient should be warned of possible side efforts including menstrual problems, amenorrhea, delayed reversibility, weight gain, and headaches. Postpartum voluntary sterilization is often requested and may be indicated for a number of medical or socioeconomic conditions. It is preferable to wait a few months before carrying out the procedure because of the risk of psychological problems following loss of fertility.
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PMID:[Contraceptive advice for the postpartum period]. 656 69

To verify if bicarbonate dialysis actually improves the dialytic tolerance of acetate intolerant patients, we have measured the incidence of dialysis with side effects such as headache, nausea, vomiting, hypotension, post-dialytic fatigue at 180 days interval in 2 groups of patients. The first with a good tolerance to acetate, the other with a bad tolerance acetate but put meanwhile for 90 days on a bicarbonate dialysis. While the incidence of side effects did not change in the first group, it decreased by 75% in the second, in spite of a greater weight loss. Thus bicarbonate improves the dialytic tolerance in patients intolerant to acetate as well as ultrafiltration.
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PMID:[A hemodialysis bath with bicarbonate improves comfort and ultrafiltration]. 666 27

Hemodialysis tolerance was studied in 3 children during periods of respectively 6, 7 and 9 months comparing bicarbonate (B) versus acetate (A) with equivalent number of sessions. Parameters used for tolerance in these three cases were: hypotensive bouts, solutes perfused during sessions, mean alimentary intake, vomiting, headache, abdominal pain and benzodiazepine prescriptions, taking account of ultrafiltration and dry weight variations during this periods. Results with bicarbonate are following: Obs. n degrees 1 (11 year old female, cystinosis, A: 38 sessions, B: 44 sessions): significant improvement of hypotension episodes and reduction of solutes perfused (p less than 0,05), of vomiting (p less than 0,001), and increase of mean alimentary intake (p less than 0,001). Obs. n degrees 2 (11 year old male, glomerular nephropathy, A: 25 sessions, B: 27 sessions): non significant improvement of hypotension episodes, but improvement for mean alimentary intake (p less than 0,01). Obs. n degrees 3 (4 year old male, uropathy with renal hypoplasia): no significant improvement, but for this child A hemodialysis tolerance was better than for both others. B hemodialysis seems a good alternative for children with A intolerance.
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PMID:[Clinical tolerance of hemodialysis sessions in children. Comparison of bicarbonate and acetate baths]. 666 28


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