Browsing by Author "Costa, M. M."
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- Reason, myths and fantasies : preliminary data and reflections about the Portuguese experience with LNG-IUS-induced hypomenorrheaPublication . Oliveira da Silva, Miguel; Costa, M. M.Objective: To evaluate the efficacy and tolerance of the levonorgestrel-releasing intrauterine system (LNG-IUS) among Portuguese women, with particular emphasis on the implications of changes in bleeding pattern. Study design Forty healthy premenopausal women (average age 42.7 ± 4.5 years) were recruited in each one of the three Portuguese centers (a total of 120) where the LNG-IUS was used as a contraceptive method during a maximum period of 5 years. All women had previously given their informed consent and were informed about the eventual changes in bleeding pattern. Serum ferritin levels and hemogram measurements were performed before and 1 year after the introduction of the IUS. The results were analyzed by the Student t test (raw data and paired test). Results: Preliminary data showed a continuation rate of 70% with an excellent efficacy rate (no pregnancies) 1 year after the introduction of the IUS. The hypomenorrhea rate was 35% while 12.5% of the women had amenorrhea. The average increase in serum ferritin level was 13 ng/ml and of hemoglobin 0.4 g/dl. The comparisons of hemoglobin results were statistically significant (p = 0.05, t raw data and p = 0.028, t paired test). Most complaints were related to cultural difficulties in accepting the changes in menstrual bleeding pattern. Conclusion In order to minimize and control the most common menstrual bleeding side-effects that occur when using this IUS, as well as to improve the continuation rate, clinicians must make a judicious choice of potential users, owing to the psychological and cultural implications that menstrual bleeding changes can have, mainly among women of low socioeconomic levels. Moreover, non-contraceptive therapeutic benefits should be emphasized.
- Splenic lymphoma with villous lymphocytes in two sistersPublication . Ribeiro, I.; Costa, M. M.; Fernandes, B. A.; Sousa, I.; Melo, A.; Parreira, A.; Uva, L. S.Splenic lymphoma with villous lymphocytes is a new entity characterised by the presence of atypical lymphocytes in the peripheral blood and bone marrow, and splenic infiltration in the white and red pulp. Cell membrane markers are those of a B mature cell, and no particular chromosomal abnormalities have been associated with this disease. A case of this rare lymphoma occurred in two sisters. Histological examination of splenic tissue was identical in both cases, with the same immunological surface markers, although the clinical and laboratory features were different. Karyotype analysis showed an abnormal pattern in one case; no environmental causative factor could be detected. Familial cases of other lymphoproliferative disorders have been reported, but no consistent common link has been found. It is suggested that further reports of this lymphoma, including cytogenetic and molecular studies, may provide a better understanding of the aetiology.