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BACKGROUND: Achilles' tendon chronic rupture is a common entity that is usually misdiagnosed or mistreated. Hence, she was presented to us later or with complications affecting her gait. Surgical resection is needed to either bridge the gap or reinforce the strength of the tendon repair. OBJECTIVES: Our study's goal was to assess the clinical results of repairing chronic Achilles' tendon lesions employing the middle segment of the proximal portion of the tendon (gastro-soleus), as a turn-down flap. METHODS: Our prospective interventional single arm study included 18 patients with chronic Achilles' tendon rupture attending at Al-Azhar university hospitals in Cairo, Egypt from May 2020 to April 2023. Diagnosis of the patients was confirmed by radiographic and clinical investigations. They were all treated with the same open reconstruction procedure using a modified GSF. The average follow-up was 12 months. The results of this study were assessed by the Achilles tendon rupture score (ATRS), American Orthopedic Foot and Ankle Society (AOFAS) score, and capacity to perform repeated heel raises on the affected side. RESULTS: The mean operative time was 72.77 min. The median (IQR) time of reconstruction was 10 (8-12) after the injury. The median (IQR) length of flab was 4.5 (4.3-5) 9 (Table 2). No intraoperative complications occurred. The typical follow-up period was 12 months (6-18 months). In terms of the ATRS, we found a significant reduction from 82.8 ± 3 preoperatively to 20.8 ± 6.7 at 12 months postoperatively (P value = 0.001). As regards the AOFAS score, it was increased from 49.5 ± 10 preoperatively to 83.8 ± 8.5 12 months postoperatively (P = 0.001). In terms of the post operative complications, there was no re-rupture. Two patients experienced superficial wound infection which improved with daily dressing and antibiotics. Additionally, two patients had slight ankle stiffness four months after the operation, which improved after programmed rehabilitation at the sixth month. CONCLUSION: The modified GSTF is a simple, safe, well-tolerated and effective method of treatment with excellent functional results and greater patient content.
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Tendón Calcáneo , Traumatismos del Tobillo , Procedimientos de Cirugía Plástica , Traumatismos de los Tendones , Humanos , Femenino , Tendón Calcáneo/cirugía , Estudios Prospectivos , Traumatismos de los Tendones/diagnóstico por imagen , Traumatismos de los Tendones/cirugía , Colgajos QuirúrgicosRESUMEN
Objective: The current study aims to assess the prevalence of menopausal symptoms among postmenopausal Egyptian women and their effect on the quality of these women's lives.Study design: A cross-sectional study was carried out in a tertiary university hospital between January and December 2017. We enrolled 350 postmenopausal women aged 45-70 years. All women were interviewed using the Menopause-Specific Quality of Life (MENQOL) questionnaire after translation into the Arabic language by a certified translation expert. The Mann-Whitney test and the Kruskal-Wallis test were used to compare MENQOL item scores.Results: Low backache was the most common complaint among the study participants (86%). The sexual domain imposed the greatest impact on quality of life (mean = 3.12 ± 1.66), followed by physical (mean = 3.18 ± 0.92), psychological (mean = 3.08 ± 0.98), and vasomotor (mean = 3.01 ± 1.78) domains. Moreover, we found a significant positive moderate correlation between body mass index (BMI) and the total score (r = 0.689, p < 0.001). Multivariable linear regression analysis found that the best-fitting predictors for the MENQOL score were age (p < 0.001), BMI (p < 0.001), and exercise (p < 0.001).Conclusions: Physical symptoms were the most prevalent symptoms in this study. In general, older women, housewives, hand workers, less physically active women, and those of low socioeconomic status had poor quality of life.
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Menopausia/fisiología , Calidad de Vida , Factores de Edad , Anciano , Índice de Masa Corporal , Estudios Transversales , Egipto , Ejercicio Físico , Femenino , Humanos , Menopausia/psicología , Persona de Mediana Edad , Investigación Cualitativa , Encuestas y Cuestionarios , Salud de la MujerRESUMEN
BACKGROUND: Liver donors are subjected to specific postresection hemodynamic changes. The aim was to monitor these changes and to evaluate the effect of magnesium sulfate infusion (MgSO4) on these changes together with total anesthetic agents consumption. PATIENTS AND METHODS: A total of 50 donors scheduled for right hepatotomy were divided into two equal groups. Controls (C) received saline and magnesium group (Mg) received MgSO4 10% (30 mg/kg over 20 min) administered immediately after induction of anesthesia, followed by infusion (10 mg/kg/h) till the end of surgery. Hemodynamics, transesophageal Doppler (TED) data and anesthetic depth guided by Entropy were recorded. RESULTS: Postresection both groups demonstrated an increase in heart rate (HR) and cardiac output (COP) in association with lowering of systemic vascular resistance (SVR). The increase in HR with Mg was lower when compared with C, P = 0.00. Increase in COP was lower with Mg compared to (C) (6.1 ± 1.3 vs. 7.5 ± 1.6 L/min, P = 0.00) and with less reduction in SVR compared to C (1145 ± 251 vs. 849.2 ± 215 dynes.s/cm(5), P < 0.01), respectively. Sevoflurane consumption was lower with Mg compared to C (157.1 ± 35.1 vs. 187.6 ± 25.6 ml, respectively, P = 0.001). Reduced fentanyl and rocuronium consumption in Mg group are compared to C (P = 0.00). Extubation time, postoperative patient-controlled fentanyl were lower in Mg than C (P = 0.001). CONCLUSION: TED was able to detect significant hemodynamic changes associated with major hepatotomy. Prophylactic magnesium helped to reduce these changes with lower anesthetic and analgesics consumption and an improvement in postoperative pain relief.
RESUMEN
OBJECTIVES: The current study was carried out to examine the influence of aspirin (400 mg/kg of body weight) and gum acacia (one g/day) and their combination on pancreatic, intestinal mucosal enzymes, intestinal tissue iron and zinc after 21 days of treatment on experimental rats. MATERIALS AND METHODS: The treated rats were sacrificed and the pancreatic and intestinal lipase and amylase were measured photometrically. Moreover, zinc and iron level were determined using atomic absorption spectrometry. Intestinal sections were stained with hematoxylin and eosin. RESULTS: The results showed that treatment with aspirin caused a marked decrease in pancreatic lipase and amylase compared with that of the control group. This decrease in aspirin treated group was accompanied by significant increase in the intestinal amylase, lipase, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) compared with the control group. On the other hand, gum combined with aspirin caused a significant increase in pancreatic and intestinal lipase, amylase accompanied with significant increase in intestinal ALP and LDH compared with that of the control group. Concentration of Zn in wet weight of intestine showed a significant decrease in aspirin and aspirin combined with gum groups but it was increased significantly in gum acacia treated group. Histological analysis revealed intestinal epithelial damage in aspirin treated rats, this damage was not noticed with gum acacia treatment. Co-administration of gum in combination with aspirin indicated some changes of denuded intestinal mucosal cells compared with that of the control. CONCLUSIONS: Gum acacia exhibited a protective property that can ameliorate the alterations induced hazardous effect of aspirin treatment.
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Aspirina/toxicidad , Goma Arábiga/farmacología , Yeyuno/efectos de los fármacos , Páncreas/efectos de los fármacos , Sustancias Protectoras/farmacología , Fosfatasa Alcalina/metabolismo , Amilasas/metabolismo , Animales , Biomarcadores/metabolismo , Citoprotección , Hierro/metabolismo , Yeyuno/enzimología , Yeyuno/patología , L-Lactato Deshidrogenasa/metabolismo , Lipasa/metabolismo , Masculino , Páncreas/enzimología , Páncreas/patología , Ratas , Ratas Sprague-Dawley , Espectrofotometría Atómica , Factores de Tiempo , Zinc/metabolismoRESUMEN
OBJECTIVE: Colorectal cancer (CRC) is more common in developed countries and is the third most common cancer among both men and women. CRC provides an attractive model of tumour biology with normal mucosa to adenoma to carcinoma sequence. The TF-antigen (Thomsen-Friedenreich) can be identified by galactose oxidase-Schiff's (GOS) reaction either on tissues or on rectal mucus samples from patients with CRC. TF antigen is expressed in the neoplastic mucosa and not expressed in colonic mucosa of normal subjects. Apomucins play important role in cell signalling and their specific pattern of expression during the different steps of tumor progression toward adenocarcinoma suggests that they play significant roles in tumorigenesis. The family of secreted mucins including MUC2 is contributing in mucus formation to protect underlying epithelia against diverse injuries. The current study was investigated the expression of MUC2 and TF antigens in patients with adenoma and CRC. MATERIALS AND METHODS: MUC2 and TF antigen expressions were detected immunohistochemically in CRC biopsies using specific monoclonal antibodies. Moreover, the TF antigen was invesigated using GOS reaction. RESULTS: The results showed that in normal colonic specimens, MUC2 expression was detected in 20%, while TF antigen was completely negative in 100% of samples as detected by GOS and immunohistochemistry using anti-TF monoclone. Expressions of MUC2, and TF antigen as detected by GOS and anti-TF monoclone were positive in 96%, 80%, and 60% respectively in cases with adenoma. On the other hand, in cases with adenocarcinoma, the expression of MUC2 was seen in 92% of cases, while TF antigen was observed in 84% and 60% of cases as detected by GOS and immunohistochemically respectively. CONCLUSIONS: Thus, it is concluded that the expression of MUC2 and TF antigens are altered during CRC carcinogenesis. Furthermore, MUC2 and TF antigens may have a diagnostic and or prognostic potential in CRC.
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Antígenos de Carbohidratos Asociados a Tumores/análisis , Neoplasias Colorrectales/inmunología , Mucina 2/análisis , Neoplasias Colorrectales/diagnóstico , Egipto , Galactosa Oxidasa/química , Humanos , Inmunohistoquímica , Mucina 2/genéticaRESUMEN
Mycobacterium tuberculosis can cause life-threatening complications in which the immune response plays an important role. This study was designed to evaluate the serum levels of interleukin-18 (IL-18), interferon-gamma (IFN-gamma) and soluble Fas (sFas) in cases with pulmonary tuberculosis due to confirmed M. tuberculosis infection. The study comprised 50 patients with M. tuberculosis classified to 13 complicated cases and 37 uncomplicated patients. A significant (P<0.05) increase was found in the serum levels of IL-18, IFN-gamma and sFas in patients compared to controls and also in complicated cases compared to uncomplicated ones. Moreover, a positive significant correlation was found between serum levels of sFas with IL-18 (r=0.532, P<0.001), and with IFN-gamma (r=0.37, P=0.008) and lastly between serum levels of IL-18 with IFN-gamma (r=-0.612, P<0.001). It is concluded from these results with the recent observations that IFN-gamma levels are elevated after successful MTB treatment, suggest the possibility of enhanced Fas expression and then stimulating the infected macrophages to show an increased FasL-induced apoptosis. Modulation of FasL system by M. tuberculosis might represent an escape mechanism to evade the effect of apoptosis. Moreover, the elevated serum levels of IL-18, IFN-gamma and sFas can be considered as pathognomonic markers suggesting pulmonary tuberculosis especially in complicated cases.
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Interferón gamma/sangre , Interleucina-18/sangre , Tuberculosis Pulmonar/inmunología , Receptor fas/sangre , Adulto , Anciano , Biomarcadores , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/microbiologíaRESUMEN
Hepatitis C has emerged as a major worldwide public health problem. The host immune response to HCV infection is composed of both a non-specific immune response, including interferon (IFN) production and natural killer (NK) cell activity, and a virus-specific immune response, including humoral and cellular components. Susceptibility to infection has been related to immunological disturbances. Several studies have provided experimental evidence of disorders of both cellular and humoral immunity. The present study was carried out to evaluate the serum immunoglobulins level (IgG, IgM, IgA) and IgG-subclasses (IgG1-4) in chronic hepatitis C patients in comparison with healthy control patients. This study included 50 patients with biochemical, serologic, virologic, and histologic evidence of chronic hepatitis C. Total IgG, IgA, and IgM were assayed by nephelometry. IgG subclasses were assayed using human IgG subclasses enzyme immunoassay. The results showed a significant increase of total serum IgG and IgM levels found in patients with chronic HCV compared with the healthy control patients (P < 0.001 for each). There was a statistically significant difference in the IgG subclasses (IgG1 to IgG4) between the patients and controls (P < 0.001 for each). On the other hand, no significant difference was found between patients and healthy controls in IgA level (P = 0.4). The normal total serum immunoglobulins pattern is apparently shifted in chronic hepatitis C infection in the Egyptian patients. This pattern may include an ethnic or biologic background and could be used in the differentiation of the patients with minimal liver disease.
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Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/inmunología , Inmunoglobulinas/sangre , Adulto , Estudios de Casos y Controles , Egipto/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Hepatitis C Crónica/sangre , Hepatitis C Crónica/epidemiología , Humanos , Masculino , Nefelometría y Turbidimetría , ARN Viral/análisis , Pruebas SerológicasAsunto(s)
Antiinfecciosos/uso terapéutico , Pie Diabético/tratamiento farmacológico , Miel , Própolis/uso terapéutico , Terpenos/uso terapéutico , Infección de Heridas/tratamiento farmacológico , Anciano , Animales , Terapia Combinada , Pie Diabético/complicaciones , Traumatismos de los Pies/complicaciones , Traumatismos de los Pies/tratamiento farmacológico , Humanos , Masculino , Cicatrización de Heridas , Infección de Heridas/complicacionesRESUMEN
Infection with Schistosoma mansoni causes hepatic granuloma formation and fibrosis in response to parasite eggs. The present work localized the leucine aminopeptidase (LAP) in S. mansoni eggs and in liver tissue sections from infected mice. Fresh eggs and livers obtained from infected hamsters were processed and stained with the L-leucine-7-amino-trifluoromethyl-coumarin specific substrate. The L-argnine-7-amino-trifluoro-methylcoumarin and Bestatin (leucine aminopeptidase inhibitor) were used to test the LAP substrate specificity and reactivity. The staining pattern for that enzyme in the egg and liver tissue reflects that the leucine aminopeptidase is a major egg constituent distributed in nearly all the egg except the spine. The control substrates confirmed the substrate broad specificity of LAP. In conclusion, the LAP enzyme is a major egg antigen and the target antigen for the antipathology vaccine development studies.
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Leucil Aminopeptidasa/análisis , Hígado/enzimología , Óvulo/enzimología , Schistosoma mansoni/enzimología , Esquistosomiasis mansoni/enzimología , Animales , Cricetinae , Leucil Aminopeptidasa/inmunología , Hígado/parasitología , Ratones , Schistosoma mansoni/inmunología , Esquistosomiasis mansoni/prevención & control , Especificidad por Sustrato , VacunasRESUMEN
Schistosoma mansoni infection is characterized by a strong T-helper type 2 (Th2) cell-associated immune response, but in the case of viral infection, it is associated with interferon-gamma (IFN-gamma) increase and induction of Th1 immune response. Few data are available about the immune response of cases infected with combined hepatitis C virus (HCV) and schistosomiasis. Thus, the investigation of the cytokine pattern in patients coinfected with both HCV and Schistosoma mansoni was our rationale. This study included four patient groups: Group 1 included 20 patients infected with chronic HCV, Group 2 included 15 patients infected with schistosomiasis alone, Group 3 included 20 patients with chronic HCV and schistosomiasis and Group 4 included 15 healthy control individuals with matched age and sex. Serum levels of IFN-gamma, interleukin (IL)-4, IL-10 and IL-18 were measured in all groups by enzyme-linked immunosorbent assay. The results showed that the patients infected with HCV had significantly higher serum levels of IFN-gamma and IL-18 compared with the controls and with the patients with schistosomiasis and coinfection (P < 0.001). On the other hand, serum levels of IL-4 and IL-10 were significantly higher in patients with schistosomiasis and coinfection compared with the control group (P < 0.001 and 0.0001, respectively) and with the HCV patients (P < 0.05 and P < 0.001, respectively). A significant increase in serum levels of IL-4 and IL-10 was also found in HCV patients compared with the control (P < 0.05). Schistosomiasis appears to induce a Th2 cytokine profile, with increase in serum levels of IL-4 and IL-10, even in the presence of HCV coinfection. In conclusion, schistosomiasis may downregulate the stimulatory effect of HCV on Th1 cytokines and this may lead to the chronicity of HCV infection in coinfected patients.
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Citocinas/sangre , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/inmunología , Esquistosomiasis mansoni/complicaciones , Esquistosomiasis mansoni/inmunología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Interferón gamma/sangre , Interleucina-10/sangre , Interleucina-18/sangre , Interleucina-4/sangre , Masculino , Persona de Mediana Edad , Células TH1/inmunología , Células Th2/inmunologíaRESUMEN
Quality of life (QOL) assessments that are easily administered and which do not impose a great burden on the respondent are needed for use in large epidemiological surveys, clinical settings and clinical trials. Using data from the WHOQOL-BREF field trials, the objectives of this work are to examine the performance of the WHOQOL-BREF as an integrated instrument, and to test its main psychometric properties. The WHOQOL-BREF is a 26-item version of the WHOQOL-100 assessment. Its psychometric properties were analysed using cross-sectional data obtained from a survey of adults carried out in 23 countries (n = 11,830). Sick and well respondents were sampled from the general population, as well as from hospital, rehabilitation and primary care settings, serving patients with physical and mental disorders and with respect to quotas of important socio-demographic variables. The WHOQOL-BREF self-assessment was completed, together with socio-demographic and health status questions. Analyses of internal consistency, item-total correlations, discriminant validity and construct validity through confirmatory factor analysis, indicate that the WHOQOL-BREF has good to excellent psychometric properties of reliability and performs well in preliminary tests of validity. These results indicate that overall, the WHOQOL-BREF is a sound, cross-culturally valid assessment of QOL, as reflected by its four domains: physical, psychological, social and environment.
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Psicometría/instrumentación , Calidad de Vida , Perfil de Impacto de Enfermedad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Organización Mundial de la SaludRESUMEN
The biological activity of blood coagulation factors II, V, VII, VIII, IX, X, XI and XII, fibrinogen and prekallikrein was assessed in 15 healthy subjects and 60 patients with endemic Egyptian hepatosplenomegaly. The degree of liver disease was graded according to the Child-Pugh classification, the intensity of S. mansoni infection was monitored by determination of circulating schistosome immune complexes (CSIC) level using a monoclonal antibody and hemostasis activation was detected by measurement of hemostatic markers D-dimer and prothrombin fragment 1 + 2 (F1+2). Functional activity of antithrombin III, alpha2-antiplasmin and protein C as well as quantitative determination of plasma concentrations of alpha1-antitrypsin, C1 activator inhibitor and alpha2-macroglobulin were also carried out. The progressive deterioration of liver function which matched the severity of the disease and the intensity of schistosomal infection led to a reduction in anticoagulant proteins (decreases in antithrombin III and protein C) resulting in hypercoagulability and thrombin generation (increased F1+2) subsequently followed by consumption (prolongation of coagulation screening tests, thrombocytopenia, hypofibrinogenemia and decreased factor VIII resulting in hypocoagulability and secondary fibrinolysis (increased D-dimer and decreased alpha2-antiplasmin). A significant decline in fibrinogen and factors VII, XII and prekallikrein was detected in bleeders compared with ascitic patients. The decline in factor XII was closely related to CSIC high titers in all disease groups, but was not correlated to D-dimer or F1+2 concentrations. This suggests that circulating schistosome immune complexes may exert an inhibitory effect on contact factor XII which should be taken into account when considering the reasons for schistosomal coagulopathy and bleeding in hepatosplenic schistosomiasis.
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Factores de Coagulación Sanguínea/metabolismo , Parasitosis Hepáticas/sangre , Fallo Hepático/parasitología , Esquistosomiasis mansoni/sangre , Enfermedades del Bazo/sangre , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Várices Esofágicas y Gástricas/complicaciones , Hemorragia Gastrointestinal/etiología , Humanos , Persona de Mediana Edad , Enfermedades del Bazo/parasitologíaRESUMEN
The present study included nine patients suffering from various types of malignant salivary gland neoplasms. The patients were monitored both pre and post operatively utilizing the circulating immune complex assay. The (CIC) levels decreased significantly after the surgical eradication of the neoplasms. This diagnostic parameter proved to be of great value in monitoring therapy in patients with various types of malignancies.
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Complejo Antígeno-Anticuerpo/sangre , Biomarcadores de Tumor/sangre , Neoplasias de las Glándulas Salivales/diagnóstico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
The analgesic efficacy and tolerability of diclofenac-potassium 50 mg were compared with those of glafenine 200 mg in 109 outpatients suffering from moderate to severe dental pain. Throughout the four-day trial period, patients (Diclofenac-potassium: n = 58, mean age = 32.84 +/- 12.0 yrs. Glafenine n = 51, mean age = 34.12 +/- 14.0 yrs.) were randomised, in a double-blind fashion, to receive one tablet of either medications three times daily, together with an antibiotic, ampicillin, 500 mg, 8 hourly. Half an hour following the administration of the first analgesic dose, both treatment groups showed highly statistically significant (P < 0.001) reductions in the mean pain level when compared with their baseline values. The mean decrease of pain level in diclofenac-potassium group after 1/2 hour was significantly (P < 0.01) greater than that in the glafenine group. Moreover, the percent of pain free patients after 1/2 hour in the diclofenac-potassium group was significantly higher (P = 0.05) compared with those in the glafenine group. The mean decreases in pain and tenderness on the second and fourth days, in relation to their initial values, were greater in the diclofenac-potassium treated patients than the glafenine treated ones. The overall evaluation of therapeutic effect was considered excellent in 72% of the diclofenac- potassium patients compared with 57% of the glafenine patients. Furthermore, 95% of the diclofenac-potassium patients, compared with 90% of the glafenine ones, expressed their willingness to use the trial medication again in similar conditions. None of the patients in both treatment groups discontinued the trial due to unwanted effects. Both therapies were well tolerated. Only one patient (1.72%) in the diclofenac-potassium treatment group experienced slight diarrhoea. It can be concluded from this study that both medications are effective and well tolerated in the management of dental pain. However, diclofenac-potassium with its fast onset of effect is particularly suitable in the management of acute painful conditions.
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Analgésicos no Narcóticos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Diclofenaco/uso terapéutico , Glafenina/uso terapéutico , Odontalgia/tratamiento farmacológico , Adolescente , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del DolorRESUMEN
The percentages of pan T (CD3+), T helper (CD4+), T cytotoxic/suppressor (CD8+), B (CD22+) and natural killer (CD57+) cells in peripheral blood lymphocytes of 15 urinary bladder carcinoma patients and in parallel, 10 healthy donors were estimated, using monoclonal antibodies in indirect membrane immunofluorescence. A significant decrease in the percentage of CD3+ lymphocytes and a highly significant decrease in the proportion of CD8+ cells was revealed in urinary bladder cancer patients. This change was accompanied by a significant increase in the CD4/CD8 ratio and in the frequency of CD57+ (HNK-1+) cells. Our data document, for the first time, the complete lymphocyte profile of patients with advanced (T3) urinary bladder carcinoma. The reason and significance of the decline in CD8+ lymphocyte percentage and the increase of CD57+ cells are discussed.
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Subgrupos Linfocitarios/inmunología , Neoplasias de la Vejiga Urinaria/sangre , Adulto , Antígenos CD , Antígenos de Diferenciación de Linfocitos T , Complejo CD3 , Antígenos CD57 , Antígenos CD8 , Carcinoma de Células Escamosas/sangre , Carcinoma de Células Escamosas/inmunología , Carcinoma de Células Transicionales/sangre , Carcinoma de Células Transicionales/inmunología , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/inmunologíaRESUMEN
PIP: This supplement presents an extensive review of patterns of IUD use in the US, unanswered controversies related to the role of the IUD in pelvic inflammatory disease (PID) and sexually transmitted diseases, and the ethical and mediciolegal aspects of IUD marketing. Also included is a section on an Adolescent Festival scheduled to be held in Turkey in June 1986 which will focus on beginning a dialog between adolescents and parents, educators, and physicians. The text is amply illustrated with figures and includes 10 tables. There has been a constant decline in the number of IUD users in the US, from 2.2 million in 1981 to 1.4 million in 1985. Many women asked to have their IUDs removed after successive withdrawals of 1st-generation IUDs from the US market. It has been well established that users of copper IUDs are at higher risk for pelvic infection, especially nulligravidas under 25 years of age. The PID seen in IUD users is caused by microbiological contaminants such as Chlamydia trachomatis, ureaplasma urealyticum, and Neisseria gonorrhoeae. The constant presence of the IUD tail in the cervical canal and vagina is associated with transuterine migration of virus, bacteria, and fungus to the upper urogenital tract. In addition, the microbiologic contaminants in semen colonize on selected IUD parts. The lack of sophisticated evaluation of types of IUDs has been in part a reflection of insufficient testing on the part of IUD manufacturers who have a financial interest in study results. The ethical aspects of IUD use should be considered in relation to religion, ethnic groups, cultural patterns, government regulations, the role of gynecologists, family planning centers, marketing promotion, package inserts, and prevention of adolescent pregnancy. A series of IUD Documentation workshops are planned to assess the current status of this contraceptive method.^ieng
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Anexos Uterinos , Adolescente , Chlamydia , Anticoncepción , Enfermedad , Ética , Servicios de Planificación Familiar , Genitales Femeninos , Infecciones , Infertilidad , Dispositivos Intrauterinos , Enfermedad Inflamatoria Pélvica , Política , Enfermedades de Transmisión Sexual , Sistema Urogenital , Factores de Edad , Américas , Biología , Demografía , Países Desarrollados , Países en Desarrollo , Genitales , América del Norte , Fisiología , Población , Características de la Población , Reproducción , Estadística como Asunto , Estados UnidosRESUMEN
A study was conducted to evaluate serum prolactin during lactation among 60 mothers with prolonged breastfeeding for 2 years. Patients were classified into 3 groups with 20 in each: lactating for less than 6 months, lactating for 6-12 months, and lactating for 12-24 months. There was hyperprolactinemia during lactation and serum prolactin levels decreased as lactation progressed. After long lactation (over a year), 10 of 20 women were amenorrheic and 10 were menstruating; 6 of the menstruating women were ovulating and 4 nonovulating. Prolonged lactation was found to be relatively successful for family spacing.