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Quaas and Ginsburg (2007) provided a systematic review on prevention and treatment of uterine bleeding in the setting of hematologic malignancy.  These researchers performed MEDLINE, PubMed, EMBASE and Cochrane searches with the terms uterine bleeding, uterine hemorrhage, hematologic malignancy.  All identified literature sources were included in the review.  The identified literature is largely comprised of case series and pilot studies.  No evidence-based protocols for gynecologists and hematologists are available.  The majority of the identified literature centers on menstrual suppression with GnRH agonists in hematologic malignancy, although no randomized trials could be identified.  Review of the identified literature suggests that medical prevention with GnRH agonist therapy is highly effective for prevention of uterine bleeding in hematologic malignancy.  With respect to treatment of acute uterine bleeding in the setting of hematologic malignancy, medical therapy can be used and is successful in the majority of patients, according to the identified studies.  Surgical treatment should be used expeditiously if medical treatment options fail to control acute bleeding.  Empiric prevention and treatment algorithms for the discussed clinical settings are proposed.  The authors stated that more research is necessary on the topic, with the goal to develop evidence-based guidelines for gynecology and hematology-oncology care providers.  Close cooperation between the specialties may improve morbidity and mortality associated with uterine bleeding in hematological malignancy in the future.

LUPRON DEPOT ® (leuprolide acetate for depot suspension) mg for 1-month and mg for 3-month administration with iron therapy are used before fibroid surgery to improve anemia due to vaginal bleeding from fibroids. Your doctor may consider a one-month trial of iron alone as some patients’ anemia will improve with iron alone. It is recommended that LUPRON DEPOT not be used for more than 3 months in patients with fibroids. Experience with LUPRON DEPOT in females has been limited to women 18 years of age and older.

Q. My arm became limp after flu shot & have had pain in arm. Vaccine itself or improper injection? Any advice? I could not move my arm about 3 hours after the injection. It took about 3 days before I could raise my arm at all. It became painful to use and has bothered me for a couple of months. The doctor gave me a cortisone shot which helped some but not completely. He had never seen this reaction before. Is it a reaction to the vaccine or could it be the way it was injected? Is their anyone who has had or knows of a similar case? A. I had a flu shot last October, and it was given to me directly on the backside (and up high) of my shoulder. I went to the gym after I received the shot, and now have two tears in my (torn) rotator cuff, with a perforation in my rotator cuff tendon. I think it may have been improperly given. Now I need to have surgery to repair it. Look up your symptoms on webmd, and surf the net. Talk to your doctor too. The only way to find out what is really going on with it is to have an MRI. A simple xray will not reveal a tear in the muscle or tendon in the rotator cuff. If you can't lift your arm, and have trouble sleeping at night, and pain on your deltoid and bicep (rotator cuff injury pain radiates to these areas) because of the pain, then chances are you have an injured rotator cuff. These people giving these immunizations need more training. They are causing serious injury to people that go in to get a shot to stay healthy, and then end up with a serious injury, and possible surgery !!! Goo

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