Database : MEDLINE
Search on : Menorrhagia [Words]
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[PMID]: 29524595
[Au] Autor:Alaqzam TS; Stanley AC; Simpson PM; Flood VH; Menon S
[Ad] Address:Department of Pediatrics, Division of Adolescent Medicine, Medical College of Wisconsin. Electronic address: talaqzam@mcw.edu.
[Ti] Title:Treatment Modalities in Adolescents Who present With Heavy Menstrual Bleeding.
[So] Source:J Pediatr Adolesc Gynecol;, 2018 Mar 07.
[Is] ISSN:1873-4332
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY OBJECTIVE: This study sought to determine the relationship of bleeding disorders to iron deficiency anemia. Additionally, this study was undertaken to examine all current treatment modalities used in a menorrhagia clinic with respect to heavy menstrual bleeding management to identify the most effective options for menstrual management in the setting of an underlying bleeding disorder. DESIGN, SETTING, PARTICIPANT, INTERVENTION, AND MAIN OUTCOME MEASURES: Retrospective chart review of adolescent <21 years with heavy menstrual bleeding attending a multidisciplinary hematology-adolescent gynecology clinic. Information included demographics, bleeding diathesis, hematologic parameters, treatment, and the diagnosis was extracted from each chart. Subjects were grouped into two categories based on the diagnosis of a bleeding disorder. Hemoglobin level, iron deficiency anemia, and need for transfusion were compared between a bleeding disorder and no bleeding disorder group. Subjects were grouped into categories depending on hormonal modality and treatment success of the groups were compared. RESULTS: 73 subjects tested for a bleeding disorder. Of the subjects completing testing, 34 (46%) were diagnosed with a bleeding disorders. 39 (54%) subjects had heavy menstrual bleeding due to other causes. There was no significant difference in hemoglobin between those with and without a bleeding disorder. Iron deficiency anemia was significantly higher in subjects without bleeding disorder. When comparing hormone therapy success, the levonorgestrel IUD (LNG-IUD) (89%) had the highest rate of menstrual suppression followed by norethindrone acetate 5-10mg/day (83%), and the transdermal patch (80%). All subjects using both tranexamic acid and hormonal therapy had 100% achievement of menstrual suppression. CONCLUSION: A high frequency of bleeding disorder was found in those tested. Subjects with a bleeding disorder were less likely to present with severe anemia requiring blood transfusion and less likely to have iron deficiency anemia. While combined oral contraceptives were commonly used clinically for menstrual suppression, they were not found to be the most effective option.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 4505 MEDLINE  
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[PMID]: 29511672
[Au] Autor:Ierardi AM; Savasi V; Angileri SA; Petrillo M; Sbaraini S; Pinto A; Hanozet F; Marconi AM; Carrafiello G
[Ad] Address:Department of Diagnostic and Interventional Radiology, San Paolo Hospital Medical School, University of Milan, Via A. Di Rudinì 8, 20142 Milan, Italy.
[Ti] Title:Percutaneous High Frequency Microwave Ablation of Uterine Fibroids: Systematic Review.
[So] Source:Biomed Res Int;2018:2360107, 2018.
[Is] ISSN:2314-6141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA). The purpose of the present review is to describe feasibility results and safety of PMWA according to largest studies available in current literature. Moreover technical aspects of the procedure were analyzed providing important data on large scale about potential efficacy of PMWA in clinical setting. However larger studies with international registries and randomized, prospective trials are still needed to better demonstrate the expanding benefits of PMWA in the management of uterine fibroids.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1155/2018/2360107

  3 / 4505 MEDLINE  
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[PMID]: 29517444
[Au] Autor:Kruse TN; Bowman MR; Ramer JC; Fayette MA; Greer LL; Stadler CK; Garner MM; Proudfoot JS
[Ti] Title:SURGICAL MANAGEMENT OF UTERINE LESIONS IN TWO CAPTIVE ORANGUTANS ( PONGO SPP.).
[So] Source:J Zoo Wildl Med;49(1):210-213, 2018 Mar.
[Is] ISSN:1042-7260
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uterine lesions in two orangutans were effectively managed with surgical intervention. A 26-year-old hybrid orangutan ( Pongo spp.) was diagnosed with uterine adenomyosis based on advanced imaging. Histologic evaluation identified multifocal myometrial endometriosis, a variant of adenomyosis. A 27-year-old Bornean orangutan ( Pongo pygmaeus) was diagnosed with a focal uterine fibroid based on histologic examination. The animals were housed at separate institutions and initially presented with dysmenorrhea and menorrhagia. Both animals were treated intermittently for episodes of dysmenorrhea, with recurrence of clinical signs after each treatment. Due to the lack of consistent response to medical management, an ovariohysterectomy in the hybrid orangutan and a myomectomy in the Bornean orangutan were performed and resulted in complete resolution of clinical signs. Surgical management of adenomyosis and neoplasia has previously been reported in nonhuman primates. These cases are the first known documentation of surgical management of multifocal myometrial endometriosis and a fibroid in orangutans.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1638/2017-0109R.1

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[PMID]: 29517145
[Au] Autor:Chotaliya AB; Saifi SGA; Achuthan G
[Ad] Address:Department of Radiology, Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India.
[Ti] Title:Sonographic appearance of endometrial osseous metaplasia.
[So] Source:J Clin Ultrasound;, 2018 Mar 08.
[Is] ISSN:1097-0096
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Osseous metaplasia of the endometrium is a rare condition characterized by the presence of mature or immature bone in the endometrium. Most cases present with secondary infertility following an abortion or chronic endometritis. Some patients are asymptomatic, while others have menstrual abnormalities such as menorrhagia or oligomenorrhea. Removal of the bony fragments helps in spontaneous conception. We hereby present two cases of osseous metaplasia of the endometrium with radiological and pathological correlation.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/jcu.22587

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[PMID]: 29500924
[Au] Autor:Abdollahi NG; Mirghafourvand M; Mollazadeh S
[Ad] Address:Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran.
[Ti] Title:The effects of fennel on menstrual bleeding: A systematic review and meta-analysis.
[So] Source:J Complement Integr Med;, 2018 Mar 02.
[Is] ISSN:1553-3840
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Introduction Fennel has many medicinal properties and is used in the treatment of dysmenorrhea. Given the widespread use of herbal medicine among women for menstrual problems and considering the fact that there has been no study to date about the effect of fennel on menstrual bleeding and duration of menstrual bleeding through systematic review, the present study was conducted to determine the effect of fennel on the amount (primary outcome) and duration of menstrual bleeding and its side-effects (secondary outcomes). Materials All articles, including Persian and English, with no time limit were searched for in the following databases: Medline (through PubMed), Scopus, EMBASE (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, ProQuest, Clininaltrial.gov, SID, Magiran, Irandoc, and Iranmedex, using MeSH terms, including menstrual bleeding, menstruation, severity of bleeding, hypermenorrhea, menorrhagia, fennel, fennelin, Foeniculum vulgare, dysmenorrhea, and painful menstruation, which were searched separately or in combination. Two authors separately reviewed articles to determine the inclusion criteria, and any disagreement was resolved by reaching consensus with a third person. Results A total of 7993 articles were identified through searching the databases, of which 7327 were excluded as duplicates and 666 were screened for inclusion. Six hundread and forty six were excluded by title and abstract based on not being relevant to the review and being conducted on animals. Eventually, six articles were included in the study and four articles entered into the meta-analysis. The results from meta-analysis showed that using fennel caused a significant increase in mean menstrual bleeding in the first cycle after treatment in the intervention group compared to the control (Std. mean difference: 0.46; 95 % CI: 0.18-0.73; p = 0.001; I2 = 9 %). However, it had no significant effect on menstrual bleeding in the second cycle after treatment (Mean difference: 1.44; 95 % CI:-5.09 to 7.96; p = 0.67; I2 = 0 %). Conclusions The results of meta-analysis of four articles showed that in the first cycle after treatment, use of fennel increased menstrual bleeding in the intervention group compared to the control, but meta-analysis of two articles showed no significant difference between intervention and control groups in the amount of menstrual bleeding in the second cycle after treatment. Given the poor quality of articles, conducting clinical trials to determine the effect of fennel on menstrual bleeding appears necessary.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  6 / 4505 MEDLINE  
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[PMID]: 29420229
[Au] Autor:Kiran A; Geary RS; Gurol-Urganci I; Cromwell DA; Bansi-Matharu L; Shakespeare J; Mahmood T; van der Meulen J
[Ad] Address:Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
[Ti] Title:Sociodemographic differences in symptom severity and duration among women referred to secondary care for menorrhagia in England and Wales: a cohort study from the National Heavy Menstrual Bleeding Audit.
[So] Source:BMJ Open;8(2):e018444, 2018 02 02.
[Is] ISSN:2044-6055
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To examine symptom severity and duration at time of referral to secondary care for heavy menstrual bleeding (HMB) by socioeconomic deprivation, age and ethnicity DESIGN: Cohort analysis of data from the National HMB Audit linked to Hospital Episode Statistics data. SETTING: English and Welsh National Health Services (secondary care): February 2011 to January 2012. PARTICIPANTS: 15 325 women aged 18-60 years in England and Wales who had a new referral for HMB to a gynaecology outpatient department METHODS: Multivariable linear regression to calculate adjusted differences in mean symptom severity and quality of life scores at first outpatient visit. Multivariable logistic regression to calculate adjusted ORs. Adjustment for body mass index, parity and comorbidities. PRIMARY OUTCOME MEASURES: Mean symptom severity score (0=best, 100=worst), mean condition-specific quality of life score (0=worst, 100=best) and symptom duration (≥1 year). RESULTS: Women were on average 42 years old and 12% reported minority ethnic backgrounds. Mean symptom severity and condition-specific quality of life scores were 61.8 and 34.7. Almost three-quarters of women (74%) reported having had symptoms for ≥1 year. Women from more deprived areas had more severe symptoms at their first outpatient visit (difference -6.1; 95% CI-7.2 to -4.9, between least and most deprived quintiles) and worse condition-specific quality of life (difference 6.3; 95% CI 5.1 to 7.5). Symptom severity declined with age while quality of life improved. CONCLUSIONS: Women living in more deprived areas reported more severe HMB symptoms and poorer quality of life at the start of treatment in secondary care. Providers should examine referral practices to explore if these differences reflect women's health-seeking behaviour or how providers decide whether or not to refer.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1802
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:In-Process
[do] DOI:10.1136/bmjopen-2017-018444

  7 / 4505 MEDLINE  
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[PMID]: 29424980
[Au] Autor:Alcalá-Alcalde MM; Pantoja-Garrido M; Frías-Sánchez Z
[Ti] Title:Mioma parasitario intestinal primario como hallazgo durante la cirugía laparoscópica ginecológica. [Primary intestinal parasitic fibroid, an incidental finding during gynecological laparoscopic surgery].
[So] Source:Ginecol Obstet Mex;84(9):593-600, 2016 Sep.
[Is] ISSN:0300-9041
[Cp] Country of publication:Mexico
[La] Language:spa
[Ab] Abstract:Background: Uterine fibroids are the most frequent solid pelvic benign tumors in women. Their most common location is the uterine corpus, cervix and broad ligament but they can also be found in other areas, less commonly as extragenital locations and/or in a parasitic way. Clinical case: A 40 years old patient, who consulted for menorrhagia and dysmenorrhea on long evolution. On physical examination, the enlarged uterus, inflamated, hard consistency and normal mobility was identified. The sonographic features and location suggested a fibroid nodule type II (Wamsteker classification), which deformed the endometrial cavity. It was decided to perform the surgery and during the procedure the enlarged uterus, deformed at the expense of a localized fundal formation, like a intramural fibroid. By mobilizing the intestinal loops and change the position of the patient (Trendelenburg) a solid tumor, cranially separated from the internal genitals it was observed. In reviewing the insertion site, it was visualized that remained attached to antimesial of the jejunum. Total hysterectomy was performed with monopolar and bipolar energy, and vascular sealant. The postoperative was favorable, without complication. The pathological study reported a primary leiomyoma of the small intestine, while in the uterus of multiple myomas was confirmed. Conclusión: The parasitic fibroids are those located separately from the uterus that receive vascular irrigation from another organ or abdominopelvic structure. They are a very rare pathology. The diagnosis has made as an accidental event, during an abdominal surgery or during the differential diagnosis of a abdominopelvic tumor. The therapeutical choice depends on the clinical presentation, the location of the fibroid and the reproductive desires of the patient, most commonly recomending their surgycal removal.
[Mh] MeSH terms primary: Intestinal Diseases, Parasitic/diagnosis
Laparoscopy/methods
Leiomyoma/diagnosis
Uterine Neoplasms/diagnosis
[Mh] MeSH terms secundary: Adult
Female
Gynecologic Surgical Procedures/methods
Humans
Incidental Findings
Intestinal Diseases, Parasitic/parasitology
Leiomyoma/parasitology
Uterine Neoplasms/parasitology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180210
[St] Status:MEDLINE

  8 / 4505 MEDLINE  
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[PMID]: 29410143
[Au] Autor:Liu J; Lin Q; Blazek K; Liang B; Guan X
[Ad] Address:Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
[Ti] Title:Transvaginal Natural Orifice Transluminal Endoscopic Surgery Myomectomy: A Novel Route for Uterine Myoma Removal.
[So] Source:J Minim Invasive Gynecol;, 2018 Feb 02.
[Is] ISSN:1553-4669
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY OBJECTIVE: Transvaginal surgery is the most minimally invasive surgery for a gynecologic procedure, but it has the limitation of lack of exposure and limited surgical space when using traditional vaginal surgical instrumentation, such as in a hysterectomy for a uterus without descent or for a myomectomy. Transvaginal natural orifice transluminal endoscopic surgery (NOTES) offers similar benefits of traditional vaginal surgery but also expands the horizon of transvaginal surgery by allowing the surgeon to perform procedures that are typically limited to an abdominal approach. The advantages of NOTES may include no incisional pain as well as a better cosmetic outcome. These benefits help outweigh the obstacle of learning this novel approach. Our objective is to demonstrate the transvaginal NOTES technique as a combination of traditional vaginal surgical skill with single-site surgical skill. DESIGN: Stepwise demonstration of the transvaginal NOTES technique for myomectomy with narrated video footage (Canadian Task Force classification III). SETTING: Academic tertiary care hospital. PATIENT: A 42-year-old woman. INTERVENTIONS: Transvaginal NOTES myomectomy with combined transvaginal surgical and single-site surgical skills. MEASUREMENTS AND MAIN RESULTS: A 42-year-old woman (gravida 2 para 2) with a preoperative transvaginal ultrasound diagnosis of a 6-cm left anterior myoma requested myoma removal with uterine preservation. She presented with a 2-year history of left pelvic pain and menorrhagia. The myoma was removed with minimal blood loss, and pathology revealed a necrotic myoma. The patient had resolution of her left-sided pelvic pain. CONCLUSIONS: Combined with traditional transvaginal anterior colpotomy, single-site surgical skills allow the surgeon to access the entire abdomen and perform myomectomy through a transvaginal single port. Transvaginal NOTES myomectomy is not only possible but allows myomectomy to be performed with no abdominal incision.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher

  9 / 4505 MEDLINE  
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[PMID]: 29462709
[Au] Autor:Sinning KM; Jude DC; Yoost JL
[Ad] Address:Marshall University Department of Obstetrics and Gynecology, 1600 Medical Center Drive Suite 4500, Huntington, West Virginia, USA 25701.
[Ti] Title:Post-insertional pain following intrauterine device placement among nulliparous adolescents.
[So] Source:J Pediatr Adolesc Gynecol;, 2018 Feb 17.
[Is] ISSN:1873-4332
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY OBJECTIVE: To quantify the "normal" adolescent experience after IUD insertion, in order to provide appropriate counseling for future adolescents. DESIGN: Prospective cohort study. SETTING: Marshall University Department of Obstetrics and Gynecology generalist and adolescent gynecology clinics. PARTICIPANTS: Nulliparous adolescents age 13-18 and parous adults ≥18 years receiving a levonorgestrel intrauterine system (LNG-IUS). INTERVENTIONS: Visual analog scale pain score (VAS) and medication log was used for data collection for two weeks after LNG-IUS. A separate chart review was completed for demographic factors and indications for procedure. MAIN OUTCOME MEASURES: VAS pain scores and medication use was compared between groups. RESULTS: 93 subjects returned the VAS record and medication log (46 adolescents and 47 adults). There was no difference in the incidence of endometriosis or dysmenorrhea, but there was a higher prevalence of menorrhagia among adolescents (65.2% vs 21.3%, p= <.001). 45 (95.7%) adults vs 25 (54.3%) adolescents had contraception as an indication for IUD use (p= <.001). Pain scores were statistically higher among the adolescent group each day (p=<.05) in the two week study period. The greatest mean differences occurred in the first four days. 32.6% of adolescents vs 12.8% of adults had a pain score >5 during the first three days, p=0.022. A statistical difference in amount of ibuprofen recorded was only noted on day 1 (p=.023) and day 4 (p=.046). CONCLUSION: Nulliparous adolescents undergoing LNG-IUS placement experience more post-insertional discomfort compared to parous adults; however, this method should still be considered first-line in this age group.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher

  10 / 4505 MEDLINE  
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[PMID]: 29460388
[Au] Autor:Kulkarni R; James AH; Norton M; Shapiro A
[Ad] Address:Michigan State University, East Lansing, MI, USA.
[Ti] Title:Efficacy, safety and pharmacokinetics of a new high-purity factor X concentrate in women and girls with hereditary factor X deficiency.
[So] Source:J Thromb Haemost;, 2018 Feb 20.
[Is] ISSN:1538-7836
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: A high-purity, plasma-derived factor X concentrate (pdFX) is approved to treat hereditary factor X deficiency, an autosomal recessive disorder. OBJECTIVE: Post hoc assessment of pdFX pharmacokinetics, safety, and efficacy in women and girls with hereditary factor X deficiency. PATIENTS/METHODS: Subjects aged ≥12 years with moderate/severe factor X deficiency (plasma factor X activity <5 IU/dL) received on-demand or preventive pdFX (25 IU/kg) for ≤2 years. RESULTS: Of 16 enrolled subjects, 10 women and girls (aged 14-58 years [median, 25.5 years]) received 267 pdFX infusions. Mean monthly infusions per subject were higher among women and girls (2.48) than men and boys (1.62). In women and girls, 132 assessable bleeding episodes (61 heavy menstrual bleeding, 47 joint, 15 muscle, 9 other) were treated with pdFX, with a 98% treatment success rate versus 100% in men and boys. Mean pdFX incremental recovery was similar in the 2 groups (2.05 vs 1.91 IU/dL per IU/kg), as was mean half-life (29.3 vs 29.5 hours). Of 142 adverse events in women and girls, headache was the most common (12 events in 6 subjects). Six events (2 infusion-site erythema, 2 fatigue, 1 back pain, 1 infusion-site pain) in 2 subjects were considered possibly pdFX related. Following the trial, pdFX was used to successfully maintain hemostasis in 2 subjects undergoing obstetric delivery. CONCLUSIONS: pdFX was well tolerated and effective in women and girls with factor X deficiency. Although women and girls had different bleeding symptoms and sites than men and boys, their pdFX pharmacokinetic profile was comparable. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher
[do] DOI:10.1111/jth.13983


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