RESUMEN
The avian herpesvirus, Marek's disease virus (MDV) and several retroviruses, reticuloendotheliosis virus (REV), avian leukosis virus (ALV) (chickens) and lymphoproliferative disease virus (turkeys) are oncogenic and immunosuppressive agents. These viruses were detected either alone, or in various combinations in blood and tumor DNAs of commercial birds using PCR. We present a 5-year retrospective study that included 207 chicken and 52 turkey flocks. Of these, 32 chicken and 18 turkey flocks were negative. Of the positive chicken and turkey flocks 76% and 75%, respectively, had a single, while the rest, 24% and 25%, had a multiple virus infection. In the chickens of the multiple virus-infected flocks, 14% and 17% of the blood and tumor DNAs carry dual MDV and REV and/or ALV sequences, that is about 30% of the PCR-positive, and about 5% of the total DNAs analysed. Multiple virus sequences were detected only in the turkey blood DNAs-11% of 84 samples. Following that quantitation we aimed to analyse the molecular status of the retrovirus sequences in order to determine whether retrovirus sequences were integrated into the herpesvirus genome. We focused on the MDV BamH1-H 132 bp tandem repeat fragment proximity using a combined PCR (cPCR) to identify chimeric PCR products. That included amplification with heterologous combinations of the MDV and retroviral LTR primers. In 13 of 35 DNAs that had both MDV and retrovirus sequences new products were produced. Of 4 MDV + REV chimeric products that were sequenced, one was homologous to the Chicken Repeat element 1 non-LTR type retrotransposon. No evidence for a retrovirus LTR integration was found in the 132 bp repeat proximity, but in two of these products we detected nucleotide stretches of 20 bp and 21 bp with a 70% and 71% homology to the REV-LTR. Also, the amplification of the chimeric products using a retrovirus primer denoted that at least short nucleotide stretches homologous to retroviral LTR primer were present in these DNAs, and that they might resemble ancient retroviral insertions, as previously demonstrated (Isfort et al., 1992).
Asunto(s)
Pollos/virología , Enfermedades de las Aves de Corral/virología , Infecciones por Retroviridae/veterinaria , Infecciones Tumorales por Virus/veterinaria , Pavos/virología , Animales , Secuencia de Bases , ADN de Neoplasias/análisis , ADN Viral/análisis , Diagnóstico Diferencial , Ensayo de Inmunoadsorción Enzimática , Herpesvirus Gallináceo 2/genética , Herpesvirus Gallináceo 2/aislamiento & purificación , Enfermedad de Marek/complicaciones , Enfermedad de Marek/epidemiología , Enfermedad de Marek/patología , Enfermedad de Marek/virología , Datos de Secuencia Molecular , Virus Oncogénicos/genética , Virus Oncogénicos/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/patología , Prevalencia , Retroviridae/genética , Retroviridae/aislamiento & purificación , Infecciones por Retroviridae/complicaciones , Infecciones por Retroviridae/epidemiología , Infecciones por Retroviridae/virología , Secuencias Repetidas Terminales , Infecciones Tumorales por Virus/complicaciones , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/virologíaRESUMEN
OBJECTIVE: To evaluate the efficacy of i.v. administration of human albumin solution for the prevention of severe ovarian hyperstimulation syndrome (OHSS). DESIGN: A prospective, randomized, placebo-controlled study comparing the effects of i.v. administration of human albumin solution versus sodium chloride 0.9% solution at the time of oocyte retrieval with patients undergoing IVF-ET who are at high risk for the development of severe OHSS. SETTING: Specialized assisted reproduction unit. PATIENTS: Thirty-one patients undergoing IVF-ET who had serum E2 levels of 1,906 pg/mL (> 7,000 pmol/L) and multiple follicular development on the day of hCG administration. INTERVENTIONS: After hCG administration, patients were randomized to receive i.v., either 50 g of human albumin diluted in 500 mL of sodium chloride 0.9% or 500 mL of sodium chloride 0.9% at the time of oocyte retrieval. MAIN OUTCOME MEASURES: Ovarian size as measured by pelvic ultrasonography, development of ascites, serum E2 concentrations during the luteal phase, and results of the IVF-ET cycles. RESULTS: Although no patient who had received human albumin solution developed severe OHSS, there were four such cases in the control group. All four were hospitalized with marked ascites and ovarian enlargement. There were no significant differences between the two groups comparing serum E2 levels on the day of hCG administration and during the luteal phase, the number of oocytes retrieved, fertilization, and pregnancy rates. CONCLUSIONS: Our preliminary results suggest that the administration of human albumin solution may help to prevent the development of severe OHSS in high-risk patients. Further research is needed to assess the potential of this novel approach.
Asunto(s)
Fertilización In Vitro , Síndrome de Hiperestimulación Ovárica/prevención & control , Albúmina Sérica/uso terapéutico , Adulto , Gonadotropina Coriónica/uso terapéutico , Femenino , Humanos , Inyecciones Intravenosas , Placebos , Estudios ProspectivosRESUMEN
A case of uterine rupture caused by extraovular PGE2 in a sequence with intravenous oxytocin during midtrimester termination of pregnancy is presented. It teaches us that when oxytocin is used after prostaglandins in patients having a scarred uterus, the lowest effective dose should be applied.
Asunto(s)
Aborto Terapéutico , Dinoprostona/efectos adversos , Oxitocina/efectos adversos , Rotura Uterina/inducido químicamente , Adulto , Dinoprostona/administración & dosificación , Femenino , Muerte Fetal , Humanos , Oxitocina/administración & dosificación , Embarazo , Segundo Trimestre del EmbarazoRESUMEN
The safety of vaginal birth for breech-vertex twins has not been addressed directly before. We retrospectively compared the perinatal outcome of two groups of breech-vertex twins: 24 delivered vaginally and 35 delivered abdominally. Vaginal delivery was allowed under the same protocol developed for singletons in breech presentation. Both groups had similar maternal and neonatal characteristics except for a significantly higher rate (P = .003) of pregnancies after infertility in the abdominal delivery group. Intergroup differences in perinatal outcome, as measured by Apgar scores and morbidity and mortality cases, were not significant. Our data suggest that if measures for safe vaginal delivery are taken, this route appears to incur no morbidity and mortality for breech-vertex twins.
Asunto(s)
Presentación de Nalgas , Parto Obstétrico/métodos , Embarazo Múltiple , Adulto , Peso al Nacer , Cesárea , Femenino , Humanos , Recién Nacido , Embarazo , GemelosRESUMEN
A previously healthy 27 years-old woman developed psychotic depression and parkinsonism shortly after delivery of her first child. Her neuropsychiatric symptoms progressed to dementia and she died 5 years after onset. Diffuse Lewy body disease was found at autopsy. This case is unusual because of the early age of onset and the abrupt development of symptoms following pregnancy.
Asunto(s)
Enfermedad de Parkinson/patología , Trastornos Puerperales/patología , Adulto , Encéfalo/patología , Química Encefálica , Femenino , Humanos , Técnicas para Inmunoenzimas , Enfermedad de Parkinson/fisiopatología , Trastornos Puerperales/fisiopatologíaRESUMEN
During 1985 to 1989, 177 vaginal hysterectomies were performed in the Department of Gynecology, Kaplan Hospital, Rehovot, Israel, using the Porges technique with some modifications. Ninety patients had some degree of loss of the pelvic support--anterior or posterior wall relaxation, enterocele or uterine prolapse in various degrees. The patients were allocated to two groups, in which two different techniques were compared: group 1, with repair of the pubocervical and pararectal fascia and group 2 without the repair. The repair of the pubocervical and pararectal fascia after vaginal hysterectomy prevented vaginal vault prolapse (zero versus 15 percent, p < 0.01) and reduced the incidence of recurrent rectocele (23 versus 55 percent, p < 0.05) and recurrent cystocele (14 versus 45 percent, p < 0.005). Recurrent genuine stress incontinence was found in 9 percent of patients in group 1 and 18 percent of patients in group 2 (not statistically significant; p = 0.163). Optimal management of relaxation of the vaginal wall during vaginal hysterectomy requires clinical suspicion and precise preoperative diagnosis and therapeutic plan. In the present study, the need for careful repair of the pubocervical and pararectal fascia during vaginal hysterectomy to prevent vaginal vault prolapse is emphasized. This procedure does not prolong the operation significantly (92 +/- 15 versus 84 +/- 17 minutes) and has no deleterious postoperative complications.
Asunto(s)
Fasciotomía , Histerectomía Vaginal/métodos , Anciano , Femenino , Hospitales de Enseñanza , Humanos , Histerectomía Vaginal/normas , Incidencia , Israel/epidemiología , Tiempo de Internación/estadística & datos numéricos , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Prolapso Rectal/epidemiología , Prolapso Rectal/etiología , Prolapso Rectal/prevención & control , Recurrencia , Factores de Tiempo , Enfermedades de la Vejiga Urinaria/epidemiología , Enfermedades de la Vejiga Urinaria/etiología , Enfermedades de la Vejiga Urinaria/prevención & control , Incontinencia Urinaria de Esfuerzo/epidemiología , Incontinencia Urinaria de Esfuerzo/etiología , Incontinencia Urinaria de Esfuerzo/prevención & control , Prolapso Uterino/epidemiología , Prolapso Uterino/etiología , Prolapso Uterino/prevención & controlRESUMEN
This report details the emergence of a progressive parkinsonian syndrome, dementia and behavioural disturbance in a 33 year-old woman which can be dated to the delivery of her first child. The findings of this case indicate that cortical Lewy body disease should be considered in any patient with temporoparietal dementia and idiopathic Parkinson's disease irrespective of the age of onset.
Asunto(s)
Demencia/diagnóstico , Enfermedad de Parkinson/diagnóstico , Trastornos Puerperales/diagnóstico , Adulto , Encéfalo/patología , Demencia/patología , Demencia/psicología , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/patología , Trastorno Depresivo/psicología , Femenino , Humanos , Trastornos Neurocognitivos/diagnóstico , Trastornos Neurocognitivos/patología , Trastornos Neurocognitivos/psicología , Examen Neurológico , Neuronas/patología , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/psicología , Trastornos Puerperales/patología , Trastornos Puerperales/psicologíaRESUMEN
This case report describes the treatment of tubal pregnancy by aspiration of the gestational sac content and injection of methotrexate by transvaginal sonographic guidance. The confirmation of the embryo aspiration as indicated by disappearance of the embryo with its heart beat and the resulting 46,XY karyotype, raises the question whether methotrexate injection is necessary.
Asunto(s)
Aborto Terapéutico/métodos , Embarazo Ectópico/cirugía , Adulto , Gonadotropina Coriónica/sangre , Transferencia de Embrión , Femenino , Fertilización In Vitro , Humanos , Metotrexato/uso terapéutico , Embarazo , Embarazo Ectópico/diagnóstico por imagen , Embarazo Ectópico/tratamiento farmacológico , Embarazo Ectópico/etiología , Succión , UltrasonografíaRESUMEN
Twenty-five mild and 19 severe preeclampsia cases in twin pregnancies (12.5%) were compared to 44 matched for gestational age controls. All three groups were similar with respect to maternal age, intertwin birthweight differences, and rates of abdominal deliveries and low (less than 7) 5-minute Apgar scores. The frequency of primiparas in the severe preeclampsia group was significantly higher compared with controls (p less than 0.03). Severe preeclampsia patients delivered at a significantly earlier gestational age (p less than 0.005) and had a significantly lower mean twin birthweight (p less than 0.003) compared with the mild preeclamptic group. The mean twin birthweight of the severe preeclamptic cases was also significantly lower compared with that of controls. All three neonatal deaths occurred in severely discordant second twins born to severe preeclamptic patients. It is concluded that adverse perinatal outcome is associated with severe but not with mild preeclampsia in twin gestations.
Asunto(s)
Preeclampsia/complicaciones , Resultado del Embarazo , Embarazo Múltiple , Adulto , Peso al Nacer , Femenino , Humanos , Mortalidad Infantil , Recién Nacido , Embarazo , GemelosRESUMEN
Endometrial biopsy was performed in 27 infertile women participating in the IVF program. Their mean age was 31.8 years, 33% of the women being over 35 years old. The average duration of infertility was 6.9 years. The superovulation protocol consisted of hMG/hCG in 5 cases, of combined GnRH analog/gonadotropin therapy in 20 women, and 2 patients received combined contraceptive pill/gonadotropin treatment. Judging by hormonal profiles, follicular growth rate and number of oocytes retrieved, the response to stimulation was normal. The mean estradiol (E2) levels increased from 132.7 pg/ml on day -5 (SEM = 9.67) to 1272 pg/ml (SEM = 103.7) on the day of hCG administration and to 1813 pg/ml (SEM = 209.6) 1 day later. One day before the hCG application, the mean progesterone and LH levels were 1.34 ng/ml and 8.38 IU/ml, respectively. Only one patient had clinical hyperstimulation syndrome. Ova were harvested in all women, the mean number of oocytes being 7.7 (SEM = 0.83) per patient. In all 27 cases lack of fertilization or faulty ovum cleavage were observed. Thus, an endometrial biopsy (EB) was performed 72 h after oocytes retrieval. The mean estrogen and progesterone levels on the EB day were 610.9 pg/ml (SEM = 78.44) and 45.4 ng/ml (SEM = 7.53), respectively. Histologic examination of the endometrium showed normal secretory endometrium consistent with day 16-17 of spontaneous ovulatory cycle. Two women who received combined contraceptive pills/gonadotropin therapy showed inactive endometrium with subnuclear vacuoles and decidual reaction in the stroma similar to that observed in women on estrogen-progestin birth control medication.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Transferencia de Embrión , Endometrio/citología , Endometrio/fisiología , Estradiol/sangre , Fertilización In Vitro , Progesterona/sangre , Adulto , Biopsia , Implantación del Embrión/efectos de los fármacos , Endometrio/efectos de los fármacos , Femenino , Fármacos para la Fertilidad Femenina/farmacología , Humanos , EmbarazoRESUMEN
A case of invasive papillary serous adenocarcinoma of the endocervix in pregnancy is described. The pure papillary pattern appears rarely, and to the best of our knowledge has never been described previously in pregnancy.
Asunto(s)
Cistadenocarcinoma/diagnóstico , Complicaciones Neoplásicas del Embarazo , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Femenino , Humanos , Embarazo , Tomografía Computarizada por Rayos XRESUMEN
Recurrent massive haemoperitoneum of ovarian origin during anticoagulant therapy in a patient with mitral valve prosthesis is described. The patient was treated conservatively on both occasions. The authors suggest that a trial of conservative approach may be considered in such patients.
Asunto(s)
Transfusión de Eritrocitos , Hemoperitoneo/terapia , Cardiopatía Reumática/tratamiento farmacológico , Warfarina/efectos adversos , Adulto , Transfusión Sanguínea , Cuerpo Lúteo/efectos de los fármacos , Femenino , Prótesis Valvulares Cardíacas , Hemoperitoneo/inducido químicamente , Humanos , Válvula MitralRESUMEN
A case of parasitic leiomyoma is presented. The clinical significance of such a rare condition is discussed.
Asunto(s)
Leiomioma/diagnóstico , Neoplasias Uterinas/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Leiomioma/cirugía , Neoplasias Uterinas/cirugíaAsunto(s)
Cesárea/estadística & datos numéricos , Cesárea/tendencias , Femenino , Humanos , EmbarazoRESUMEN
Two cases of severe hemolytic disease of the newborn due to c-isoimmunization are presented. Both women were multiparous, had previous blood transfusion and high maternal titers of anti-c (1:1024 and 1:4036, respectively).
Asunto(s)
Eritroblastosis Fetal/inmunología , Isoanticuerpos/inmunología , Isoinmunización Rh/inmunología , Adulto , Transfusión Sanguínea , Femenino , Humanos , Recién Nacido , Paridad , EmbarazoRESUMEN
The hormonal profiles following clomiphene citrate (CC) administration during a single cycle were compared in infertile women who conceived and in those who did not. Of 41 treated patients, ovulation was assumed to have occurred in 28 and was confirmed by clinical pregnancy in five. In the 28 women who presumably ovulated, two distinct patterns of hormonal secretion were observed. A normal response was exhibited by 17 patients (including the five who became pregnant). The other 11 patients exhibited an abnormal response, characterized by significantly higher luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios than in the normal response group from day 9 until the occurrence of the LH peak (days 9 and 10, P less than 0.05; days 11 and 12, P less than 0.001), and significantly higher oestradiol (E2) levels throughout the cycle (P less than 0.01). In addition, in comparison with the normal response group their LH levels during the follicular phase were significantly higher (P less than 0.05) but their LH peaks at ovulation were significantly lower (P less than 0.02). Moreover, their progesterone levels, in contrast to those in the normal response group, began to increase prior to the LH peak and remained high during the early and mid-luteal phases. None of the women who exhibited this abnormal gonadotrophin response to CC therapy achieved a clinical pregnancy. Exposure to high LH levels in the follicular phase following CC therapy seems to reduce the rate of fertilization and/or to contribute to early embryonic loss.