Influence of age on tolerability, safety and effectiveness of subdermal contraceptive implants.

The use of long-acting contraceptive methods is on the rise. The aim of this study was to describe the main variables (effectiveness, tolerability, menstrual bleeding) associated with the use of subdermal contraceptive implants and to investigate the influence of age on these variables. This was a descriptive, retrospective, observational study of 221 cases of contraceptive implants inserted at a Spanish hospital between 2006 and 2015.

Endometrial study in patients with postmenopausal metrorrhagia.

Introduction: The aim of the study was to devise a strategy to diagnose malign endometrial pathologies (adenocarcinoma or atypical hyperplasia) that minimizes the number of invasive tests done (hysteroscopy, aspiration biopsy or curettage) with no loss of its detection efficiency.

Material And Methods: We retrospectively studied the clinical histories of 779 postmenopausal women at the University Hospital Complex of Albacete, for whom an endometrial study had been done (hysteroscopy, aspiration biopsy or curettage) with a 1-year follow-up between 1 March 2006 and 31 March 2008.

Results: There were 77 cases of a malignant pathology (66 adenocarcinomas and 11 hyperplasias with atypia); 96.

[Spontaneous hemoperitoneum and clear cell tumor of ovary].

Unlabelled: Hemoperitoneum is a rare cause of acute abdomen, which is usually due to liver, spleen, hematologic and vascular causes. We should consider gynecological origin in women in reproductive age, being a rare etiology in postmenopausal.

Clinical Case: We report the case of a spontaneous hemoperitoneum in a postmenopausal woman as the first manifestation of an ovarian tumor, with exceptional pathological lineage: clear cell carcinoma.

[Non-surgical management of rectovaginal fistula: a case report].

Background: The rectovaginal fistula is a rare disease whose treatment is extremely difficult.

Objective: To present the expectant management of rectovaginal fistula as an alternative to surgery for those cases in which the surgical risk is not an acceptable option.

Clinical Case: We report the case of a rectovaginal fistula in an 85-year-old woman with significant comorbidity that avoided the performance of any surgical technique.

[Diagnosis and treatment of hemophilia A acquired during postpartum ].

Acquired hemophilia A is a truly exceptional hemorrhagic diathesis, that consists of the emergence of polyclonal autoantibodies (inhibitor) IgG-type (subclasses 1 and 4, in most cases) against the coagulant function of the circulating factor VIII, which acts in the domains C2, A2 and A3 of the molecule, thus interfering their interaction with the factor IXa, the phospholipids and the Von Willebrand factor. Its morbidity and mortality are high, but nevertheless its low incidence (1-1.5 cases per million population per year) is the most frequent autoimmune disorder.

Can pulse transit time be useful for detecting hypertension in patients in a sleep unit?

Introduction: Pulse transit time (PTT) is the time that a pulse wave takes to travel between two different arterial points, and may be useful in estimating blood pressure. This noninvasive technique, which does not add any cost to the procedure, offers the advantage of avoiding 'arousals' during sleep measurement as occurs with ambulatory blood pressure monitoring (ABPM). We aim to confirm the usefulness of PTT for the detection of hypertension, and to study the correlation between both measurements.

Medical therapy (methotrexate and mifepristone) alone or in combination with another type of therapy for the management of cervical or interstitial ectopic pregnancy.

Objective: To describe cases of cervical or interstitial ectopic pregnancy managed conservatively with combined medical treatment (methotrexate and mifepristone) alone or in association with other minimally invasive strategies.

Study Design: We describe four cervical and two interstitial ectopic pregnancies at our hospital between 2006 and 2010. All received combined treatment with methotrexate and mifepristone.