RESUMEN
The Authors relate about the current state of knowledge on Cyclosporin A metabolism, mechanism of action, toxic potential, necessity of therapeutic monitoring. The methods for measurement of Cyclosporin A and its metabolites and the study of their immunosuppressive activity are described. Their use for measurement of Cyclosporin G is discussed.
Asunto(s)
Ciclosporina/farmacología , Inmunosupresores/farmacología , Animales , Ciclosporina/farmacocinética , Ciclosporina/uso terapéutico , Humanos , Inmunosupresores/farmacocinética , Inmunosupresores/uso terapéuticoRESUMEN
Two patients with clinical complications of endometriosis mimicking stage IV epithelial ovarian cancer are described. One had bilateral pleural effusions, ascites, and a serum CA 125 level of 440 U/ml. The other had a right-sided pleural effusion and a large abdominal mass.
Asunto(s)
Ascitis , Antígeno Ca-125/sangre , Endometriosis/diagnóstico , Neoplasias Ováricas , Derrame Pleural , Anciano , Diagnóstico Diferencial , Endometriosis/patología , Endometriosis/cirugía , Femenino , Humanos , Histerectomía , Persona de Mediana EdadRESUMEN
The endocrine equilibrium which regulates reproductive function in women can be affected by physical and psychological factors. Blood levels of hormones depend on a balance between production, metabolism and clearance rates. Intensive physical exercise may affect this balance via different mechanisms, such as stress associated with competition, dieting, reduction of body fat and body weight, production of heat or hypoxia. Women who engage in regular high intensity exercise may be at risk, as a consequence of these hormonal changes, of developing menstrual disturbances such as oligomenorrhoea, delayed menarche and amenorrhoea. Impaired production of gonadotrophins, which leads to luteal phase deficiency and anovulation, is a common hormonal finding with exercise-induced menstrual disturbances, but several other hormones may show significant alterations. In this article we have reviewed the recent literature on the effects of intensive physical exercise on the menstrual cycle, on some important physical parameters such as bone mineral density and bodyweight, and on those hormones (gonadotrophins, prolactin, melatonin, opioid peptides and steroids) which regulate, directly or indirectly, the reproductive function in women.
Asunto(s)
Ejercicio Físico/fisiología , Hormonas Esteroides Gonadales/fisiología , Menstruación/fisiología , Densidad Ósea , Estradiol/sangre , Femenino , Gonadotropinas/fisiología , Humanos , Trastornos de la Menstruación/fisiopatología , Resistencia Física/fisiología , Progesterona/sangreRESUMEN
A group of 60 consecutive women admitted to the gynaecology department of Eastbourne District General Hospital for pelvic pain were entered into this study. Evidence of C. trachomatis infection of the genital tract was investigated by detection of chlamydial lipopolysaccharide antigen in the peritoneal fluid collected from the pouch of Douglas during laparoscopy and in the endocervical swab. The test used was an Enzyme-Linked Immunosorbent Assay (ELISA). Peritoneal fluid was positive in 11 subjects (18%, P < 0.05), endocervical swab was positive in 3 (5%, P < 0.05). The difference was statistically significant (P = 0.01, two tailed test at 1% level). Ten women with a positive ELISA on the peritoneal fluid had a negative cervical swab, 2 women with a positive cervical swab had negative peritoneal fluid and in only one woman were both cervical swab and peritoneal fluid positive.
Asunto(s)
Infecciones por Chlamydia/patología , Chlamydia trachomatis , Laparoscopía , Enfermedad Inflamatoria Pélvica/patología , Frotis Vaginal , Adulto , Antígenos Bacterianos/análisis , Líquido Ascítico/inmunología , Técnicas Bacteriológicas , Cuello del Útero/patología , Chlamydia trachomatis/inmunología , Chlamydia trachomatis/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática , Femenino , HumanosRESUMEN
Ten eumenorrheic nonathletic women, aged 21-25, were studied on the 8th day following the LH peak in three consecutive cycles. Plasma level and metabolic clearance rate (MCR) of estradiol (E2) and progesterone (P) were measured before and during a 2-h continuous treadmill test at a speed corresponding to 70% of their running speed at anaerobic threshold on three separate occasions. A significant decrease of plasma level of the hormones (-30% and -40%, respectively, P less than 0.01; mean) from resting values was found, while their metabolic clearance rate increased significantly [E2-MCR from 1017 l.d-1 to 1312 l.d-1 (+29%), P less than 0.001; mean; P-MCR from of 2061 l.d-1 to 2988 l.d-1 (+45%), P less than 0.003; mean]. The increase in MCR of the two hormones was significantly correlated with the increase in heart rate and systolic blood pressure accompanying the beginning of the exercise test.
Asunto(s)
Estradiol/sangre , Ejercicio Físico , Progesterona/sangre , Adulto , Umbral Anaerobio , Presión Sanguínea , Estradiol/farmacocinética , Femenino , Frecuencia Cardíaca , Humanos , Tasa de Depuración Metabólica , Consumo de Oxígeno , Progesterona/farmacocinéticaRESUMEN
A total of 416 gloves were tested for punctures after 200 episiotomy repairs. Evidence of perforation was found in 34 (8%) of the gloves used and in only half the cases did the surgeon actually realise that a perforation had occurred. The left index finger and thumb were more often perforated than other parts of the gloves. The implications of the findings, especially as regards spread of infections to surgeons, are discussed.
Asunto(s)
Episiotomía , Guantes Quirúrgicos , Femenino , HumanosRESUMEN
We describe the management by CO 2 laser of a case of recurrent extramammary Paget's disease of vulva and perineum, previously managed on three occasions with conventional surgical excision. Ablation of the whole lesion took less than 30 minutes, and the patient was able to go home on the third postoperative day. There were no significant complications. At follow-up after 12 months, multiple biopsies from the lasered area have shown no recurrence, and the symptomatic improvement has been satisfactory.
Asunto(s)
Terapia por Láser , Recurrencia Local de Neoplasia/cirugía , Enfermedad de Paget Extramamaria/cirugía , Perineo/cirugía , Neoplasias de la Vulva/cirugía , Anciano , Femenino , Humanos , Terapia por Láser/métodosRESUMEN
A survey of glove perforation in 200 consecutive Caesarean sections (100 elective and 100 emergency) was undertaken. A total of 1276 gloves were tested for punctures after the end of the operation. Evidence of perforation of one or more gloves was found following 39 elective (234 gloves, 37.2%) and 43 emergency sections (290 gloves, 44.8%) (total 82, 41%). Only in 17 of these cases (20.7%) was it realised that a perforation had actually occurred. The surgeons were found to be significantly more at risk of perforation than the other members of the operating team.