RESUMO
Damage to progestin containing contraceptive implants has been reported for Implanon® rods but there appear to be few reports of damage to Nexplanon® rods. This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear. Evidence based guidelines to inform management of suspected damage to contraceptive implants would be helpful. In the meantime, a shared decision-making process offering removal and replacement of damaged implants would seem reasonable.
Assuntos
Anticoncepcionais Femininos/efeitos adversos , Desogestrel/efeitos adversos , Falha de Equipamento , Adolescente , Adulto , Anticoncepcionais Femininos/administração & dosagem , Desogestrel/administração & dosagem , Remoção de Dispositivo/métodos , Feminino , Humanos , Menorragia/etiologiaAssuntos
Infarto do Miocárdio/diagnóstico , Pancreatite/complicações , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/etiologia , Idoso , Cateterismo Cardíaco , Diagnóstico Diferencial , Feminino , Humanos , Pancreatite/diagnóstico , Edema Pulmonar/etiologia , Troponina/sangueRESUMO
Squamous cell carcinoma arising in a dentigerous cyst is a rare lesion with distinct histopathology and stringent criteria for diagnosis.(1,2) During the past century, <60 cases have been reported.(3) Of the previously documented cases, all have occurred in adults. We present the case of a squamous cell carcinoma arising in a dentigerous cyst in a 16-month-old girl. This case poses interesting questions regarding the pathophysiology of these tumors and highlights the importance of maintaining a high index of suspicion regardless of age when evaluating cystic lesions of the mandible and maxilla.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/etiologia , Cisto Dentígero/complicações , Cisto Dentígero/diagnóstico por imagem , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/etiologia , Carcinoma de Células Escamosas/patologia , Cisto Dentígero/patologia , Feminino , Humanos , Lactente , Neoplasias Mandibulares/patologia , RadiografiaRESUMO
An elderly patient with a history of chronic migraine was hospitalized with systolic hypertension and significant mental status changes, including increasing confusion, combative behavior, and remarkably detailed auditory hallucinations of several weeks' duration. Daily increased consumption of a product containing ergotamine 1 mg and caffeine 100 mg coincided with both onset and increasing severity of symptoms. To our knowledge, this is the first case reported in the contemporary literature of severe mental status changes and hallucination possibly due to ergotamine-caffeine.