Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthritis, Rheumatoid/drug therapy , Cyclooxygenase Inhibitors/therapeutic use , Peptic Ulcer/chemically induced , Sulfonamides/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Celecoxib , Cyclooxygenase Inhibitors/adverse effects , Double-Blind Method , Female , Humans , Male , Middle Aged , Multicenter Studies as Topic , Naproxen/adverse effects , Naproxen/therapeutic use , Pyrazoles , Randomized Controlled Trials as Topic , Reproducibility of Results , Sulfonamides/adverse effects , Treatment OutcomeABSTRACT
Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity. Tuberosity avulsion fractures cause pain and tenderness at the base of the fifth metatarsal and follow forced inversion during plantar flexion of the foot and ankle. Local bruising, swelling and other injuries may be present. Nondisplaced tuberosity fractures are usually treated conservatively, but orthopedic referral is indicated for fractures that are comminuted or displaced, fractures that involve more than 30 percent of the cubo-metatarsal articulation surface and fractures with delayed union. Management and prognosis of both acute (Jones fracture) and stress fracture of the fifth metatarsal within 1.5 cm of the tuberosity depend on the type of fracture, based on Torg's classification. Type I fractures are generally treated conservatively with a nonweight-bearing short leg cast for six to eight weeks. Type II fractures may also be treated conservatively or may be managed surgically, depending on patient preference and other factors. All displaced fractures and type III fractures should be managed surgically. Although most fractures of the proximal portion of the fifth metatarsal respond well to appropriate management, delayed union, muscle atrophy and chronic pain may be long-term complications.
Subject(s)
Fractures, Bone , Metatarsal Bones/injuries , Acute Disease , Fractures, Bone/classification , Fractures, Bone/diagnostic imaging , Fractures, Bone/therapy , Humans , Metatarsal Bones/diagnostic imaging , Prognosis , RadiographySubject(s)
Contraception/methods , Contraceptives, Oral, Synthetic , Levonorgestrel/administration & dosage , Progesterone Congeners , Coitus , Contraceptives, Oral, Synthetic/administration & dosage , Emergencies , Female , Humans , Progesterone Congeners/administration & dosage , Tablets , United StatesABSTRACT
PIP: A study supported by the World Health Organization's Task Force on Postovulatory Methods of Fertility Control compared the efficacy of the Yuzpe and levonorgestrel-only methods of emergency contraception (EC). Enrolled in this double-blind, randomized trial were 1998 women from 21 centers around the world who requested EC within 72 hours of unprotected intercourse. The pregnancy rate was 1.1% for levonorgestrel alone and 3.2% for the combined ethinyl estradiol-levonorgestrel regimen. The crude relative risk of pregnancy was 0.36 (95% confidence interval, 0.18-0.70) for levonorgestrel compared with the Yuzpe regimen. The former method prevented 85% of expected pregnancies, while the latter prevented only 57%. Finally, side effects such as nausea, vomiting, dizziness, and fatigue were significantly less common in the levonorgestrel group. Although these findings document the superiority of the levonorgestrel regimen for EC, the 0.75 mg tablets are not currently manufactured in the US.^ieng
