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[PMID]: 29172411 [Au] Autor: Brown EJ; Deshmukh P; Antell K [Ad] Endereço: Christiana Care Health System Value Institute Ammon Center 2E55, 4755 Ogletown-Stanton Rd, Newark, DE 19718. [Ti] Título: Contraception Update: Oral Contraception. [So] Source: FP Essent;462:11-19, 2017 Nov. [Is] ISSN: 2159-3000 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The oral contraceptive pill (OCP) is the most commonly used form of reversible contraception. The two types of OCPs are combination oral contraceptives (COCs), which contain estrogen and progesterone, and progestin-only pills (POPs). Both have failure rates of approximately 7.2% to 9% with typical use, and are safe for most patients. Because estrogen-containing contraceptives can increase the risk of venous thromboembolism, patients with conditions associated with a risk of cardiovascular events should not use COCs. Blood pressure level should be assessed before initiation of oral contraceptives. Noncontraceptive benefits of oral contraceptives include reduced risk of ovarian and endometrial cancers, more favorable bleeding patterns, and improvement in menstruation-related symptoms such as acne, migraine headaches, and premenstrual dysphoric disorder. OCPs can be initiated any time the physician can be reasonably certain that the patient is not pregnant. Extended cycle regimens may be preferred by some patients. After assessing need, physicians should present all methods that can be used safely using a tiered effectiveness approach. High-quality contraceptive counseling includes working collaboratively with patients to find the most effective and acceptable method for them and helping to identify factors that may assist in or hinder their ability to use the method correctly over time. [Mh] Termos MeSH primário: Anticoncepcionais Orais Serviços de Planejamento Familiar Medicina de Família e Comunidade [Mh] Termos MeSH secundário: Anticoncepcionais Orais/efeitos adversos Anticoncepcionais Orais/uso terapêutico Interações Medicamentosas Feminino Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Contraceptives, Oral) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE

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[PMID]: 27773713 [Au] Autor: Karpilow QC; Thomas AT [Ad] Endereço: Child Trends, Bethesda, MD. [Ti] Título: Reassessing the importance of long-acting contraception. [So] Source: Am J Obstet Gynecol;216(2):148.e1-148.e14, 2017 Feb. [Is] ISSN: 1097-6868 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Several recent studies have highlighted the need for greater use of long-acting contraception. The most influential of these studies is the Contraceptive CHOICE Project, which was credited with substantially reducing participants' pregnancy risk by increasing their use of long-acting methods such as intrauterine devices and subdermal implants. However, because participants' rates of nonuse and condom use fell to zero at the outset of the intervention, it is possible that sizable pregnancy reductions could still have been achieved if enrollees had chosen shorter-acting, female-controlled methods such as oral contraception. OBJECTIVE: The objective of the study was to estimate the proportion of the CHOICE Project's fertility impacts that could have been achieved without any increase in long-acting method use. STUDY DESIGN: The FamilyScape 3.0 microsimulation model was used to estimate CHOICE's impact on pregnancy risk and to simulate the counterfactual effect of moving all nonusers and condom users onto shorter-acting, female-controlled methods. FamilyScape models the sexual and contraceptive behaviors of women in the United States between 2006 and 2010, which is the period when CHOICE was implemented. RESULTS: Nearly three quarters of the CHOICE intervention's effects on pregnancy risk could have been achieved if participants had chosen shorter-acting, female-controlled methods over long-acting methods. CONCLUSION: Prioritizing the adoption of long-acting contraception may not be the most advisable strategy for reducing unintended pregnancy. The most impactful interventions will likely be those that increase the use of female-controlled methods, long-acting or otherwise. [Mh] Termos MeSH primário: Comportamento Contraceptivo/estatística & dados numéricos Anticoncepção/métodos Anticoncepcionais Femininos/uso terapêutico Dispositivos Intrauterinos/utilização [Mh] Termos MeSH secundário: Simulação por Computador Anticoncepcionais Orais/uso terapêutico Preparações de Ação Retardada Implantes de Medicamento Feminino Seres Humanos Modelos Teóricos Gravidez Gravidez não Planejada [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Contraceptive Agents, Female); 0 (Contraceptives, Oral); 0 (Delayed-Action Preparations); 0 (Drug Implants) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 180112 [Lr] Data última revisão: 180112 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161107 [St] Status: MEDLINE

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[PMID]: 29205027 [Au] Autor: Suvitie P [Ti] Título: Dysmenorrhea in teenagers. [So] Source: Duodecim;133(3):285-91, 2017. [Is] ISSN: 0012-7183 [Cp] País de publicação: Finland [La] Idioma: eng [Ab] Resumo: Dysmenorrhea affects quality of life, but is often inadequately treated in teenagers. The mainstay of treatment is NSAID, which must be started pre-emptively and in adequate dose. If NSAID provides insufficient pain relief, or when contraception is required, combined oral contraceptives can be prescribed concomitantly. Hormonal IUD can also be used in teenagers. If dysmenorrhea persists despite appropriate treatment, the patient must be referred to a gynecologist. Endometriosis, the most common cause of severe dysmenorrhea, can manifest already during adolescence. [Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico Anticoncepcionais Orais/uso terapêutico Dismenorreia/complicações Dismenorreia/tratamento farmacológico Endometriose/complicações Manejo da Dor/métodos [Mh] Termos MeSH secundário: Adolescente Feminino Seres Humanos Qualidade de Vida [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Contraceptives, Oral) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180108 [Lr] Data última revisão: 180108 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171206 [St] Status: MEDLINE

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[PMID]: 29211666 [Au] Autor: Hunter DJ [Ad] Endereço: From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. [Ti] Título: Oral Contraceptives and the Small Increased Risk of Breast Cancer. [So] Source: N Engl J Med;377(23):2276-2277, 2017 12 07. [Is] ISSN: 1533-4406 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Neoplasias da Mama Anticoncepcionais Orais [Mh] Termos MeSH secundário: Feminino Seres Humanos Risco Fatores de Risco [Pt] Tipo de publicação: EDITORIAL; COMMENT [Nm] Nome de substância: 0 (Contraceptives, Oral) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171208 [Lr] Data última revisão: 171208 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171207 [St] Status: MEDLINE [do] DOI: 10.1056/NEJMe1709636

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[PMID]: 29046001 [Au] Autor: Hohmann C; Pfister R; Michels G [Ti] Título: [Different Symptoms and Course of Coronary Heart Disease in Men and Women]. [Ti] Título: Koronare Herzerkrankung ­ Unterschiede in Symptomatik und Verlauf bei Männern und Frauen.. [So] Source: Dtsch Med Wochenschr;142(21):1578-1584, 2017 Oct. [Is] ISSN: 1439-4413 [Cp] País de publicação: Germany [La] Idioma: ger [Ab] Resumo: According to the federal statistical office, cardiovascular disorders are still the leading cause of death in Germany. Chronic ischemic heart disease and acute myocardial infarction are the most important subgroups. In addition to evidence-based and personalized medicine, in recent years gender medicine has been established as an independent research area. Gender differences are evident in the majority of prevalent diseases, including cardiovascular disorders. The following article provides an insight into the diagnostically and therapeutically specific aspects of coronary heart disease in men and women. [Mh] Termos MeSH primário: Doença das Coronárias/fisiopatologia [Mh] Termos MeSH secundário: Adulto Anticorpos Antifosfolipídeos/metabolismo Anticoncepcionais Orais/administração & dosagem Anticoncepcionais Orais/efeitos adversos Doença das Coronárias/complicações Doença das Coronárias/etiologia Doença das Coronárias/terapia Diabetes Mellitus Tipo 2/complicações Dislipidemias/complicações Terapia de Reposição de Estrogênios Feminino Seres Humanos Hipertensão/complicações Lúpus Eritematoso Sistêmico/complicações Masculino Menopausa Precoce Meia-Idade Sobrepeso/complicações Pré-Eclâmpsia Gravidez Psicologia Fatores de Risco Fatores Sexuais Fumar/efeitos adversos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antibodies, Antiphospholipid); 0 (Contraceptives, Oral) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171027 [Lr] Data última revisão: 171027 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171019 [St] Status: MEDLINE [do] DOI: 10.1055/s-0043-104467

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[PMID]: 28991943 [Au] Autor: Kraus C; Hooper-Lane C [Ad] Endereço: University of Wisconsin-Madison School of Pharmacy and Department of Family Medicine and Community Health, Madison, WI, USA. [Ti] Título: Are oral emergency contraceptives a safe and effective form of long-term birth control? [So] Source: J Fam Pract;66(10):632-634, 2017 Oct. [Is] ISSN: 1533-7294 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Yes, but not as effective as some other methods. Annual pregnancy rates in women using pericoital levonorgestrel 150 mcg to 1 mg range from 4.9% to 8.9%; menstrual irregularity is the most common adverse effect (strength of recommendation [SOR]: B, Cochrane review of lower-quality trials). In women younger than 35 years who have sexual intercourse 6 or fewer times per month, correct and consistent use of pericoital levonorgestrel 1.5 mg results in an annual pregnancy rate of 11% (SOR: B, one large prospective, open-label trial). Pericoital contraception is less effective than long-acting reversible contraceptives (annual pregnancy rates of 0.05%-0.8%) or perfect use of combined oral contraceptives (0.3% annual pregnancy rate), but similar to, or better than, typical use of combined oral contraception (9%) and condoms (18%). [Mh] Termos MeSH primário: Anticoncepcionais Orais Anticoncepcionais Pós-Coito [Mh] Termos MeSH secundário: Anticoncepcionais Orais/administração & dosagem Anticoncepcionais Orais/efeitos adversos Anticoncepcionais Pós-Coito/administração & dosagem Anticoncepcionais Pós-Coito/efeitos adversos Feminino Seres Humanos Gravidez Gravidez não Desejada [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Contraceptives, Oral); 0 (Contraceptives, Postcoital) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171018 [Lr] Data última revisão: 171018 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171010 [St] Status: MEDLINE

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[PMID]: 28929625 [Au] Autor: Roberts AL; Malspeis S; Kubzansky LD; Feldman CH; Chang SC; Koenen KC; Costenbader KH [Ad] Endereço: Harvard T. H. Chan School of Public Health, Boston, Massachusetts. [Ti] Título: Association of Trauma and Posttraumatic Stress Disorder With Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women. [So] Source: Arthritis Rheumatol;69(11):2162-2169, 2017 Nov. [Is] ISSN: 2326-5205 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To conduct the first longitudinal study examining whether trauma exposure and posttraumatic stress disorder (PTSD) are associated with increased risk of incident systemic lupus erythematosus (SLE) in a civilian cohort. METHODS: We examined the association of trauma exposure and PTSD symptoms with SLE incidence over 24 years of follow-up in a US longitudinal cohort of women (n = 54,763). Incident SLE in women meeting ≥4 American College of Rheumatology criteria was ascertained by self-report and confirmed by medical record review. PTSD and trauma exposure were assessed with the Short Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PTSD and the Brief Trauma Questionnaire, respectively. Women were categorized as having no trauma, trauma and no PTSD symptoms, subclinical PTSD (1-3 symptoms), or probable PTSD (4-7 symptoms). We examined whether longitudinally assessed health risk factors (e.g., smoking, body mass index [BMI], oral contraceptive use) accounted for increased SLE risk among women with trauma exposure and PTSD versus those without. RESULTS: During follow-up, 73 cases of SLE occurred. Compared to women with no trauma, probable PTSD was associated with increased SLE risk (for 4-7 symptoms, hazard ratio [HR] 2.94 [95% confidence interval {95% CI} 1.19-7.26], P < 0.05). Subclinical PTSD was associated with increased SLE risk, although this did not reach statistical significance (for 1-3 symptoms, HR 1.83 [95% CI 0.74-4.56], P = 0.19). Smoking, BMI, and oral contraceptive use slightly attenuated the associations (e.g., for 4-7 symptoms, adjusted HR 2.62 [95% CI 1.09-6.48], P < 0.05). Trauma exposure, regardless of PTSD symptoms, was strongly associated with incident SLE (HR 2.83 [95% CI 1.29-6.21], P < 0.01). CONCLUSION: This study contributes to growing evidence that psychosocial trauma and associated stress responses may lead to autoimmune disease. [Mh] Termos MeSH primário: Lúpus Eritematoso Sistêmico/epidemiologia Trauma Psicológico/epidemiologia Transtornos de Estresse Pós-Traumáticos/epidemiologia [Mh] Termos MeSH secundário: Adulto Consumo de Bebidas Alcoólicas/epidemiologia Índice de Massa Corporal Estudos de Coortes Anticoncepcionais Orais/uso terapêutico Exercício Feminino Seres Humanos Incidência Estudos Longitudinais Meia-Idade Obesidade/epidemiologia Modelos de Riscos Proporcionais Fatores de Risco Fumar/epidemiologia Estados Unidos/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Contraceptives, Oral) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171106 [Lr] Data última revisão: 171106 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170921 [St] Status: MEDLINE [do] DOI: 10.1002/art.40222

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[PMID]: 28857134 [Au] Autor: Klompenhouwer AJ; Bröker MEE; Thomeer MGJ; Gaspersz MP; de Man RA; IJzermans JNM [Ad] Endereço: Department of Surgery, Erasmus MC, Rotterdam, The Netherlands. [Ti] Título: Retrospective study on timing of resection of hepatocellular adenoma. [So] Source: Br J Surg;104(12):1695-1703, 2017 Nov. [Is] ISSN: 1365-2168 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Hepatocellular adenoma (HCA) is a benign liver tumour that may be complicated by bleeding or malignant transformation. Present guidelines advise cessation of oral contraceptives and surgical resection if the lesion is still larger than 5 cm at 6 months after diagnosis. The aim of this study was to evaluate whether this 6-month interval is sufficient to expect regression of a large HCA to 5 cm or smaller. METHODS: This retrospective cohort study included all patients with an HCA larger than 5 cm diagnosed between 1999 and 2015 with follow-up of at least 6 months. Medical records were reviewed for patient characteristics, clinical presentation, lesion characteristics, management and complications. Differences in characteristics were assessed between patients kept under surveillance and those who underwent treatment for an HCA larger than 5 cm. RESULTS: Some 194 patients were included, of whom 192 were women. Eighty-six patients were kept under surveillance and 108 underwent HCA treatment. Patients in the surveillance group had a significantly higher BMI (P = 0·029), smaller baseline HCA diameter (P < 0·001), more centrally located lesions (P < 0·001) and were more likely to have multiple lesions (P = 0·001) than those in the treatment group. There were no significant differences in sex, age at diagnosis, symptoms, complication rates and HCA subtype distribution. Time-to-event analysis in patients managed conservatively and those still undergoing treatment more than 6 months after diagnosis showed that 69 of 118 HCAs (58·5 per cent) regressed to 5 cm or smaller after a median of 104 (95 per cent c.i. 80-128) weeks. Larger HCAs took longer to regress (P < 0·001). No complications were documented during follow-up. CONCLUSION: This study suggests that a 6-month cut-off point for assessment of regression of HCA larger than 5 cm to no more than 5 cm is too early. As no complications were documented during follow-up, the cut-off point in women with typical, non-ß-catenin-activated HCA could be prolonged to 12 months, irrespective of baseline diameter. [Mh] Termos MeSH primário: Adenoma de Células Hepáticas/cirurgia Neoplasias Hepáticas/cirurgia [Mh] Termos MeSH secundário: Adenoma de Células Hepáticas/patologia Adulto Índice de Massa Corporal Anticoncepcionais Orais Feminino Seguimentos Seres Humanos Neoplasias Hepáticas/patologia Masculino Meia-Idade Guias de Prática Clínica como Assunto Estudos Retrospectivos Fatores de Tempo Suspensão de Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Contraceptives, Oral) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171025 [Lr] Data última revisão: 171025 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170901 [St] Status: MEDLINE [do] DOI: 10.1002/bjs.10594

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[PMID]: 28818831 [Au] Autor: Orellana C; Saevarsdottir S; Klareskog L; Karlson EW; Alfredsson L; Bengtsson C [Ad] Endereço: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. [Ti] Título: Oral contraceptives, breastfeeding and the risk of developing rheumatoid arthritis: results from the Swedish EIRA study. [So] Source: Ann Rheum Dis;76(11):1845-1852, 2017 Nov. [Is] ISSN: 1468-2060 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVES: To study whether oral contraceptive (OC) use or breastfeeding (BF) influence the risk of rheumatoid arthritis (RA), stratifying the cases by presence/absence of anticitrullinated protein antibodies (ACPA), and whether these factors interact with known risk factors in the development of ACPA-positive RA. METHODS: Women aged ≥18 years, participants in the population-based case-control Swedish Epidemiological Investigation of RA study (2641 cases/4251 controls), completed an extensive questionnaire regarding OC, BF and potential confounders. We calculated ORs, with 95% CIs, adjusted for age, residential area, smoking and alcohol consumption. Attributable proportion due to interaction (AP) was estimated to evaluate presence of interaction. RESULTS: Compared with never users, ever and past OC users had a decreased risk of ACPA-positive RA (OR=0.84 (95% CI 0.74 to 0.96); OR=0.83 (95% CI 0.73 to 0.95), respectively). No significant associations were found for ACPA-negative RA. Long duration of OC use (>7 years vs never use) decreased the risk of both ACPA-positive (p=0.0037) and ACPA-negative RA (p=0.0356).A history of long BF decreased the risk only of ACPA-positive RA in a dose-dependent manner (p=0.0086), but this trend did not remain after adjustments. A significant interaction was observed between the lack of OC use and smoking (AP=0.28 (95% CI 0.14-0.42)) on the risk of ACPA-positive RA. No interactions were found for BF. CONCLUSIONS: OC decreased the risk of RA, especially ACPA-positive RA, where an interaction with smoking was observed. A long duration of OC use decreased the risk of both disease subsets. We could not confirm an association between BF and a decreased risk of either ACPA-positive or ACPA-negative RA. [Mh] Termos MeSH primário: Artrite Reumatoide/etiologia Autoanticorpos/sangue Aleitamento Materno/efeitos adversos Anticoncepcionais Orais/efeitos adversos Peptídeos Cíclicos/imunologia [Mh] Termos MeSH secundário: Adulto Artrite Reumatoide/imunologia Autoanticorpos/imunologia Estudos de Casos e Controles Feminino Seres Humanos Meia-Idade Razão de Chances Fatores de Risco Fumar/efeitos adversos Suécia Fatores de Tempo Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Autoantibodies); 0 (Contraceptives, Oral); 0 (Peptides, Cyclic); 0 (cyclic citrullinated peptide) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171023 [Lr] Data última revisão: 171023 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170819 [St] Status: MEDLINE [do] DOI: 10.1136/annrheumdis-2017-211620

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[PMID]: 28759386 [Au] Autor: Cuzick J [Ad] Endereço: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK. Electronic address: j.cuzick@qmul.ac.uk. [Ti] Título: Preventive therapy for cancer. [So] Source: Lancet Oncol;18(8):e472-e482, 2017 Aug. [Is] ISSN: 1474-5488 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Therapeutic cancer prevention is a developing area that can gain a lot from the successes in the prevention of cardiovascular diseases. Although weight control and physical activity are important in the prevention of both diseases, several other preventive measures exist. Low-dose aspirin for cancer prevention is often cited as the most important approach in terms of population benefit, and should be offered to those older than 50 years of age without hypertension or risk factors for gastrointestinal bleeding. Universal vaccination against the human papillomavirus, ideally with the nine-valent vaccine, also offers substantial benefits for the whole population if given before infection occurs (ie, typically at age 12-14 years). Other therapies, such as anti-oestrogen drugs for breast cancer prevention, should be targeted to high-risk groups to maintain a favourable benefit-risk ratio. Better algorithms for identification and improved platforms to reach these groups, such as during a screening visit, remain a key priority to allow existing knowledge to inform public health. Many other promising compounds have been identified, often as components of food, but results suggesting increased disease incidence with ß carotene and vitamin E administration indicate that such treatments need rigorous evaluation before acceptance. [Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico Anticarcinógenos/uso terapêutico Aspirina/uso terapêutico Quimioprevenção Neoplasias/prevenção & controle [Mh] Termos MeSH secundário: Inibidores da Aromatase/uso terapêutico Colectomia Anticoncepcionais Orais/uso terapêutico Dieta Antagonistas de Estrogênios/uso terapêutico Vacinas contra Hepatite B/uso terapêutico Seres Humanos Neoplasias/genética Ovariectomia Vacinas contra Papillomavirus/uso terapêutico Mastectomia Profilática Tamoxifeno/uso terapêutico [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Anticarcinogenic Agents); 0 (Aromatase Inhibitors); 0 (Contraceptives, Oral); 0 (Estrogen Antagonists); 0 (Hepatitis B Vaccines); 0 (Papillomavirus Vaccines); 094ZI81Y45 (Tamoxifen); R16CO5Y76E (Aspirin) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170919 [Lr] Data última revisão: 170919 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170801 [St] Status: MEDLINE

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