ABSTRACT
Combined oral contraceptives (COC) are the most popular contraceptive method in developed countries. Since their introduction there have been numerous changes and modifications in its composition with the aim to improve safety and tolerability while maintaining contraceptive efficacy. Most of the changes have been conducted on the progestin component, since most of the combinations include ethinyl estradiol as oestrogen. One of the adverse effects of COC is the increased risk of venous thromboembolism (VTE) in two clinical forms of presentation: deep vein thrombosis or pulmonary embolism. This review details the changes in haemostasis induced by progestin-only contraceptives and the risk of VTE in women who utilize this type of contraception; the relationship with other risk factors such as thrombophilia; the interactions of these contraceptives with anticoagulant treatment and finally the eligibility criteria for the use of hormonal contraception in women with previous VTE or thrombophilia carriers.
Subject(s)
Contraceptives, Oral, Combined/adverse effects , Contraceptives, Oral, Combined/pharmacology , Progestins/adverse effects , Progestins/pharmacology , Venous Thromboembolism/chemically induced , Contraceptives, Oral, Combined/chemistry , Female , Hemostasis/drug effects , Humans , Progestins/chemistry , Risk Factors , Thrombophilia/blood , Thrombophilia/chemically induced , Venous Thromboembolism/bloodABSTRACT
A new case of hepatic inflammatory pseudotumor (HIP) is reported. A 66-year-old woman presented with fever and toxic syndrome. Analysis demonstrated an elevation in erythrocyte sedimentation, CRP, leukocytosis and normocytic anemia. A lesion was observed on ultrasonography in the right hypoechoic hepatic lobe with echos within (mosaic pattern). The lesion was hypodense on CT scan and was hypervascularized on angiography. NMR was hypointense on T1 and hyperintense on T2. The patient underwent surgery with intraoperative biopsy being performed. Hepatectomy was not carried out given negativity of malignancy. Following surgery the patient remained asymptomatic and the analytical alterations normalized. After a asymptomatic 5-year period the clinical-analytical alterations reappeared following erysipelas. Fever showed partial response to non steroid antiinflammatory drugs and a satisfactory response to corticoids. Studies are required to evaluate the role of corticoid treatment in this disease.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Granuloma, Plasma Cell/drug therapy , Liver Diseases/drug therapy , Prednisone/therapeutic use , Aged , Biopsy , Combined Modality Therapy , Female , Granuloma, Plasma Cell/diagnosis , Humans , Liver/diagnostic imaging , Liver/pathology , Liver Diseases/diagnosis , Magnetic Resonance Imaging , Recurrence , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The authors study the serum lactate dehydrogenase (LDH) activity in multiple myeloma patients in relation to survival, plasma cells bone marrow infiltration, and creatinine and paraprotein serum values. Twenty five patients seen between 1979 and 1983 were studied considering two groups, one with LDH values higher than 100 IU/1 and the other with LDH values lower than 100 IU/1. Patients having more than 100 IU/1 showed a more marked bone marrow infiltration. Paraprotein concentration was higher in patients having less than 100 IU/1. No correlation was observed for the other factors considered.
