ABSTRACT
INTRODUCCIÓN: La anticoncepción hormonal, a través de implantes subdérmicos, es uno de los métodos anticonceptivos reversibles de larga duración más eficaces en la actualidad que está disponible en nuestro país en forma gratuita en el sistema público. OBJETIVO: Reconocer los efectos adversos y los motivos de retiro del Implante Jadelle® en usuarias del Hospital de Clínicas, así como evaluar la información recibida por las usuarias al momento de la colocación. MATERIAL Y MÉTODOS: Un total de 160 pacientes participaron en el estudio a través de una encuesta previo consentimiento informado. Se utilizó la estadística descriptiva en números absolutos y porcentuales. Resultados: Previo al uso, recibieron información sobre los probables efectos adversos del método el 83% de ellas, y acerca de la efectividad del método el 89 %. En cuanto a efectos adversos los presentaron el 80,6% de las usuarias, siendo la irregularidad de la menstruación la causa más frecuente constituyendo un 61%. CONCLUSIONES: Es alta la frecuencia de pacientes que presentan efectos adversos y que solicitan retiro del implante antes del tiempo a causa de ello, 35% de las usuarias, siendo el principal motivo la irregularidad menstrual en un 43% de los casos. Es recomendable realizar un correcto asesoramiento previo a la colocación e incentivar a las pacientes a concurrir a los controles médicos, luego de la colocación, para brindar asesoramiento y tratamiento si se presentara algún efecto adverso, con el fin de obtener una mejor continuidad de uso del método.
INTRODUCTION: Hormonal contraception, through subdermal implants, is one of the most effective long active reversal contraceptive methods currently available in our country for free in the public system. OBJETIVE: Recognize the adverse effects and the reasons for its withdrawal in users of the Hospital de Clínicas as well as to evaluate the information received by the users at the time of placement. METHODOLOGY: A total of 160 patients participated in the work with prior informed consent through a survey. Descriptive statistics were used in absolute and percentage numbers. They received information on the probable adverse effects of the 83% pre-use method, about the effectiveness of the 89% method. RESULTS: Regarding adverse effects, they were present in 80.6% of the users; the being irregularity of menstruation is the most frequent, constituting 61%. Concluding that the frequency of patients presenting with adverse effects and requesting removal of the implant before the time is high because of it, 35% of the users who requested removal menstrual irregularities were the main reason for 43% of patients. CONCLUSIONS: It is advisable to make a correct advice prior to placement and encourage patients to attend medical controls, after placement, to provide advice and treatment if any adverse effect occurs, in order to give better use in terms of method time.
Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Contraceptive Agents, Female/adverse effects , Device Removal , Drug Implants/adverse effects , Progesterone/administration & dosage , Progesterone/adverse effects , Cross-Sectional Studies , Surveys and Questionnaires , Levonorgestrel/administration & dosage , Levonorgestrel/adverse effects , Contraception/methods , Contraceptive Agents, Female/administration & dosage , MotivationABSTRACT
Resumo Os procedimentos terapêuticos invasivos têm aumentado frequentemente com a evolução da medicina, consequentemente aumentando o número de complicações decorrentes deles. O dispositivo contraceptivo subdérmico (DCS) tem um benefício para a contracepção feminina, mas o implante e a retirada apresentam uma taxa de complicações em torno de 3%. Neste artigo, relatamos e discutimos um caso de pseudoaneurisma traumático da artéria braquial após tentativa de retirada do implante, complicada com a compressão do nervo mediano.
Abstract The frequency of invasive therapeutic procedures has increased as medicine evolves, and the number of complications related to them has increased as a consequence. Subdermal contraceptive implants (SCI) offer benefits for female contraception, but implant and removal are associated with a complication rate of around 3%. In this article, we report and discuss a case of traumatic brachial artery pseudoaneurysm after an attempt to remove an SCI, complicated by compression of the median nerve.
Subject(s)
Humans , Female , Adolescent , Aneurysm, False , Contraceptive Agents, Female , Drug Implants/adverse effects , Brachial Artery , Median Nerve , Nerve Compression SyndromesABSTRACT
A gravidez indesejada continua a ser um grave problema de saúde pública em todo o mundo. Uma das explicações para a manutenção de altas taxas de gestações não planejadas relaciona-se com os efeitos adversos provocados por grande parte dos métodos contraceptivos disponíveis que levam as usuárias a descontinuar seu uso. Nos últimos anos, tem se visto um aumento nas opções de contracepção para garantir métodos mais eficazes, com maiores taxas de continuação e níveis elevados de satisfação da paciente. Entre os métodos contraceptivos de longa ação e com rápida reversibilidade, o implante é considerado um dos mais eficazes e mais seguros. Dentre os efeitos adversos relacionados com esse tipo de contracepção, estão incluídos: alterações no padrão do sangramento, cefaleia, aumento do peso, acne, mastalgia, labilidade emocional e dor abdominal. Portanto, no presente estudo, fez-se uma atualização sobre os possíveis efeitos colaterais desse contraceptivo, visando a um melhor aconselhamento pelos profissionais de saúde antes da inserção desse método, a fim de garantir melhor adesão a ele. Estudos demonstram que um aconselhamento claro antes de iniciar um método de longa duração como o implante subdérmico é imprescindível para melhorar a satisfação e a adesão ao método contraceptivo.
Unwanted pregnancy remains a serious public health problem worldwide. An explanation for keeping high rates of unplanned pregnancies is related to the adverse effects caused by most of the available contraceptive methods that lead users to discontinue its use. In recent years, it has been seen an increase in contraceptive options to ensure the most effective methods with higher continuation rates and high levels of patient satisfaction. Among the long-acting contraceptive methods with rapid reversibility, the implant is considered one of the most effective and safest ways. Among the adverse effects associated with the drug are included: changes in the pattern of bleeding, headache, weight gain, acne, breast pain, emotional lability and abdominal pain. Therefore, in our study it was made an update review on possible side effects of contraception, seeking a better counseling by health professionals before insertion in order to ensure better adherence to the method. Studies show that clear advice before starting long duration method as subdermal implant is essential to improve the satisfaction and adherence to contraception.
Subject(s)
Humans , Female , Contraception/adverse effects , Drug Implants/adverse effects , Progesterone/adverse effects , Contraception , Contraception/methods , Education, Continuing , Pregnancy, Unwanted , Progesterone/pharmacology , Societies, ScientificABSTRACT
A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.
Subject(s)
Humans , Male , Middle Aged , Device Removal/methods , Dexamethasone/administration & dosage , Diagnosis, Differential , Drug Implants/adverse effects , Endophthalmitis/diagnosis , Eye Infections, Bacterial/diagnosis , Glucocorticoids/administration & dosage , Intravitreal Injections/adverse effects , Retinal Vein Occlusion/diagnosis , VitrectomyABSTRACT
OBJECTIVE: To study the menstrual patterns and side effects of Jadelle use in Thai women aged between 20 and 45 years. STUDY DESIGN: Prospective descriptive study. SETTING: Family Planning Clinic, Department of Obstetrics and Gynecology, King Chulalongkorn Memorial hospital. MATERIAL AND METHOD: A prospective clinical trial study was conducted at the Family Planning Unit, King Chulalongkorn Memorial Hospital in June 2005. The study duration was 6 months. The data was obtained from each patient S medical record. The descriptive statistics was frequency, percentage, mean, SD and 95% Confidence Interval (CI). The statistical analyses were performed by using the paired t test for comparison of means before and after 6 months of Jadelle used. RESULTS: A total of 59 women were recruited in a 6-month clinical study. Their mean age was 29.07years. Most acceptors had completed secondary school. No accidental pregnancy occurred throughout the 6 months of use in the present study. The most common menstrual pattern was amenorrhea followed by irregular bleeding. The major side effect was irregular bleeding. There was no significant change in body weight, body mass index, and systolic-diastolic blood pressure during the 6 months follow up period. The common non menstrual adverse effects were headache, acne, alopecia. DISCUSSION: The most common menstrual patterns found in the present study were amenorrhea and irregular bleeding followed by a regular cycle. The common nonmenstrual adverse effects were headache, acne, and alopecia. There were no pregnancies in the 6-month follow-up period. Jadelle was an effective implant contraceptive method with an acceptable bleeding pattern. Over all acceptability was good. This should become another choice of contraception for Thai women.
Subject(s)
Adult , Contraceptive Agents, Female/administration & dosage , Drug Implants/adverse effects , Female , Humans , Levonorgestrel/administration & dosage , Menstrual Cycle/drug effects , Middle Aged , ThailandABSTRACT
Os implantes de silastic contendo o progestogênio levonorgestrel foram testados como anticoncepcionais de longa duraçao em 325 mulheres. Durante os primeiros dois anos de exposiçao, nenhuma gravidez ocorreu. Após três anos completos de exposiçao, a taxa acumulada de gravidez foi O,83 por cento. As taxas acumuladas de continuaçao foram 8O,01 por cento aos 12 meses, 47,95 por cento aos 24 meses e 31,75 por cento aos 36 meses. O efeito colateral mais importante foi sangramento aumentado, e foi a razao principal para pedidos de remoçao. Outros efeitos colaterais importantes levando à remoçao foram hipomenorréia/amenorréia e aumento de peso. Conclui-se que os implantes de levonorgestrel sao muito eficazes para evitar uma gravidez durante os três primeiro anos de uso; a alta taxa de continuaçao demonstra a sua aceitabilidade. Os poucos efeitos colaterais justificam a possibilidade de oferecer este novo método anticoncepcional para as mulheres brasileiras.
Subject(s)
Humans , Female , Adolescent , Adult , Contraceptive Agents, Female , Dimethylpolysiloxanes , Drug Implants , Progestins , Age Factors , Arterial Pressure , Body Weight , Contraceptive Agents, Female/adverse effects , Dimethylpolysiloxanes/adverse effects , Drug Implants/adverse effects , Follow-Up Studies , Parity , Progestins/adverse effects , Time FactorsABSTRACT
A un grupo de 1061 mujeres en edad fértil que solicitaron esterilización quirúrgica con pellets de quinacrina insertos en la cavidad uterina por 2 ó 3 veces con un intervalo de 30 a 40 días y en las cuales se había efectuado uno o varios exámenes de Papanicolaou, antes o después de la esterilización, obtuvimos algún grado de positividad en 75 mujeres 7,1 por ciento. En 36 de ellas esta positividad fue anterior a la inserción, tasa de prevalencia= 34,05 por ciento. En 39 mujeres aparecieron lesiones después de la inserción, tasa de incidencia= 2,62 por ciento en un total de 3285 años/mujer entre el primero y el último PAP efectuado. Los resúmenes de los análisis estadísticos se adjuntan en varias tablas. La conclusión de este estudio indica que la utilización de quinacrina intrauterina no aumenta las tasas de incidencia de cáncer cérvico uterino en la población esterilizada con respecto a las cifras que espontáneamente se presentan en la población de Santiago