ABSTRACT CASE STUDIES SIDE EFFECTS DMPA INJECTABLE CONTRACEPTIVES VILLAGE HEALTH POST SETIA PANGLEGUR IN THE DISTRICT

TLANAKAN PAMEKASAN DMPA injectable contraceptive methods (Depo Progesterone Medroxi acetate) given every 12 weeks is the most widely used contraceptive in Indonesia in the District Tlanakan Pamekasan in 2011 there were 5442 or 59% were using injectable contraceptives. As an initial study in January to March 2012 there were 20 people who experience side effects from the use of KB injection for the researchers aim to learn and know the description of what the side effects experienced by injectable DMPA acceptors. This research uses descriptive method with a total sampling number of the existing population of the 17 respondents who visited in June to July 2012 in the village health post Setia Panglegur Village District Tlanakan Pamekasan. Measuring instrument used is a checklist or survey, the variables studied are the side effects of the injectable contraceptive DMPA 12 weeks with the amount of the 1cc or 3cc. From the results of the study 17 respondents, most side effects are experienced menstrual disorders (amenorhea) of 64.71% (11 acceptors), weight changes, which gained 0.6 kg - 1 kg total of 35.29% (6 acceptor) , whereas headache, vaginal discharge and other complaints, most do not have to only 29.41% are experiencing. It is recommended on the official provider of family planning services should provide an explanation and information about possible side effects experienced by the acceptors of injectable DMPA administration KB 12 weeks, so if the incidence of these side effects occur can be addressed, hopefully the results of this study may be a reference for future studies .

Key words: Effects, side, injections, KB, DMPA The number of references: 18. The number of page 49

Elevated white blood cell count and outcome in cancer patients with venous thromboembolism. Findings from the RIETE Registry.
Trujillo-Santos J, Di Micco P, Iannuzzo M, Lecumberri R, Guijarro R, Madridano O, Monreal M; RIETE Investigators.

Collaborators (70) Source

Department of Internal Medicine, Hospital Universitario Santa Maria de Rosell, Cartagena, Murcia, Spain.

Abstract
A significant association between elevated white blood cell (WBC) count and mortality in patients with cancer has been reported, but the predictive value of elevated WBC on mortality in cancer patients with acute venous thromboembolism (VTE) has not been explored. RIETE is an ongoing registry of consecutive patients with acute VTE. We compared the three-month outcome of cancer patients with acute VTE according to their WBC count at baseline. As of May 2007, 3805 patients with active cancer and acute VTE had been enrolled in RIETE. Of them, 215 (5.7%) had low- (<4,000 cells/microl), 2,403 (63%) normal- (4,000-11,000 cells/microl), 1,187 (31%) elevated (>11,000 cells/microl) WBC count. During the study period 190 patients (5.0%) had recurrent VTE, 156 (4.1%) major bleeding, 889 (23%) died (399 of disseminated cancer, 113 of PE, 46 of bleeding. Patients with elevated WBC count at baseline had an increased incidence of recurrent VTE (odds ratio [OR]: 1.6; 95% confidence interval [CI]: 1.2-2.2), major bleeding (OR: 1.5; 95% CI: 1.1-2.1) or death (OR: 2.7; 95% CI: 2.3-3.2). Most of the reported causes of death were significantly more frequent in patients with elevated WBC count. Multivariate analysis confirmed that elevated WBC count was independently associated with an increased incidence of all three complications. In conclusion, cancer patients with acute VTE and elevated WBC count had an increased incidence of VTE recurrences, major bleeding or death. This worse outcome was consistent among all subgroups and persisted after multivariate adjustment. PMID: 18989537 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

Publication Types

Multicenter Study

Research Support, Non-U.S. Gov't

MeSH Terms

Acute Disease Aged Anticoagulants/adverse effects Argentina Europe Female Hemorrhage/chemically induced Hemorrhage/mortality Humans Israel Leukocyte Count* Male Middle Aged Neoplasms/blood* Neoplasms/complications Neoplasms/mortality Odds Ratio Prospective Studies Pulmonary Embolism/blood Pulmonary Embolism/etiology Recurrence Registries Risk Assessment Risk Factors Time Factors Treatment Outcome Venous Thromboembolism/blood*

Venous Thromboembolism/drug therapy Venous Thromboembolism/etiology Venous Thromboembolism/mortality

Substances

Anticoagulants

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Br J Neurosurg. 2013 Feb;27(1):56-62. doi: 10.3109/02688697.2012.714817. Epub 2012 Aug 31.

Medically treated prolactin-secreting pituitary adenomas: when should we operate?

Vale FL, Deukmedjian AR, Hann S, Shah V, Morrison AD.

Source
Department of Neurological Surgery & Brain Repair, University of South Florida, Tampa, FL 33606, USA. fvale@health.usf.edu

Abstract
BACKGROUND: The incidence of medical failure for prolactin (PRL)-secreting pituitary tumours is not well known. Object. The purpose of this study is to report clinical, radiographic and laboratory findings of PRL-secreting tumours that predict failed medical management. METHODS:

An analysis of 92 consecutive patients was performed that met the inclusion criteria. Decision for surgery was made based on failure of dopamine agonists to either control clinical symptoms and normalise hormonal level or diminish mass effect on follow-up evaluation. RESULTS: Of the 92 patients treated, 14 patients (15%) required trans-nasal, trans-sphenoidal pituitary surgery (TSS). One patient underwent surgery for repair of a skull defect and 13 patients (14%) required surgery after failed medical management. Higher initial PRL was statistically significant regarding the need for surgical intervention, but a persistently abnormal level after initiation of treatment was a more significant predictor (Fisher exact test, p = 0.005 vs. p < 0.001). Size was also a statistically significant factor (p = 0.014); macroadenomas had a relative risk of 9.27 (95% CI: 1.15-74.86) for needing surgery compared to microadenomas. In addition, macroadenomas with cavernous sinus (CS) extension and pre-operative visual field deficit demonstrated a strong tendency for surgical intervention. CONCLUSION: Medical management remains the most effective treatment option for prolactinomas. A partial hormonal response to medical management seems to be the most significant predictive factor but adenomas > 20 mm, visual field deficit and invasion of the CS may help predict the need for surgery. We suggest a minimum trial period (at least 8 weeks) of medical treatment prior to the consideration of surgery