RESUMEN
OBJECTIVE: To evaluate the effectiveness and safety of interferon beta in women with recurrent cervical human papillomavirus (HPV) lesions. METHODS: Women with recurrent HPV of the cervix were assigned randomly to received either 3 million IU of interferon beta daily for 5 days, followed by 2 days of rest for 3 weeks, or placebo on the same schedule (N = 61 in each group). They were evaluated at 6 and 12 months after cytology, colposcopy, and directed punch biopsy. Comparison between groups was carried out by chi(2), Fisher exact test, and Student t test, depending on the variable. Multivariable logistic regression was used to evaluate influence of variables to treatment and categorical and continuous variables were compared by Mantel-Haenszel and Wilcoxon tests. RESULTS: When treatment success rates for all patients at 6 and 12 months were compared, a highly significant statistical difference was found in the treated group compared with the placebo group [48 of 61 (79%) versus 33 of 61 (54%), P =.001, and 43 of 61 (70%) versus 26 of 61 (43%), P =.002, respectively]. Multivariable analysis showed treatment success rates with interferon beta were higher between the group with initial histopathology of cervical intraepithelial neoplasia (CIN) (odds ratio 4.86; 95% confidence interval 1.75, 13.49), and the group receiving placebo (P =.002). Side effects treatments were minimal in 70% of women; the most severe events were headaches and flulike symptoms that did not interfere with the treatment. No clinically significant changes were found in laboratory measurements of glucose or transaminases during treatment or follow-up. CONCLUSIONS: Intramuscular injections of interferon beta were effective for treating recurrent HPV lesions, particularly when associated with CIN. The only side effects were mild and controllable.
Asunto(s)
Antineoplásicos/uso terapéutico , Interferón beta/uso terapéutico , Papillomaviridae , Infecciones por Papillomavirus/prevención & control , Infecciones Tumorales por Virus/prevención & control , Displasia del Cuello del Útero/prevención & control , Neoplasias del Cuello Uterino/prevención & control , Adulto , Antineoplásicos/administración & dosificación , Femenino , Humanos , Inyecciones Intramusculares , Interferón beta/administración & dosificación , Modelos Logísticos , Prevención Secundaria , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare the effectiveness in the control of climacteric symptoms, the tolerability and the uterine bleeding pattern between two types of hormone replacement therapy. MATERIAL AND METHODS: 81 postmenopausal women between 40 and 60 years age with vasomotor symptoms were studied. Randomly it was administered: I. Conjugated equine estrogens (CEE)-Medroxyprogesterone acetate (MPA): 21 tablets with 0.625 mg of CEE and 10 tablets with 5 mg of MPA which were taken with the last ten tablets of CEE in each cycle (n = 3 7). II. E2V-CPA: 11 tablets with 2 mg of E2V and 10 tablets with 2 mg of E2V and 1 mg of CPA (n = 44). Each cycle comprised 28 days. The treatments were compared with squared Chi and Mann-Whitney U test. RESULTS: The hot flushes presence was significantly greater in the group with CEE-MPA (p < 0.03). Severe throbs at the end of the study had a trend to be more frequent in the group with EC-MPA (p < 0.06). At the end of the study there was a greater frequency of breast tenderness in the group with CEE-MPA (P = 0.009). CONCLUSIONS: Both treatments have good effectiveness, tolerability and same bleeding pattern. Only the frequency of hot flushes, the presence of severe throbs and breast tenderness were lower in the group with E2V-CPA, that makes this preparation an option that can have a better acceptance by the women.
Asunto(s)
Climaterio , Acetato de Ciproterona/uso terapéutico , Estradiol/análogos & derivados , Estradiol/uso terapéutico , Estrógenos Conjugados (USP)/uso terapéutico , Terapia de Reemplazo de Hormonas , Acetato de Medroxiprogesterona/uso terapéutico , Congéneres de la Progesterona/uso terapéutico , Adulto , Femenino , Humanos , Persona de Mediana EdadRESUMEN
OBJECTIVE: To describe 19 cases with Rokitansky syndrome, as well as their endocrine features, and other associated malformations. METHODS: Nineteen cases of utero-vaginal atresia are reported. Serum levels of luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, and progesterone were measured. Genetic study was done by karyotype and X chromatin. Pelvic ultrasound was performed, and searches for associated urinary and bone malformations were done by intravenous pyelogram and spinal column X-rays, respectively. RESULTS: In all patients, mammary growth began between 9 and 12 years, and pubic hair growth between 11 and 14 years. Nine of them sought advice for primary amenorrhea, and 10 for difficulty in sexual intercourse. Thirteen patients had begun sexual activity, between 18 and 30 years of age; six of them had dyspareunia, and in four it was impossible to have sexual intercourse, but three reported satisfactory sexual relations. External genitalia were normal in all, vaginal length was between 0.5 and 7 cm, and in all ended in a blind pouch. On pelvic ultrasound, normal ovaries and absent uterus were delineated; only one had polycystic ovaries. All had a 46XX karyotype and positive X chromatin. Hormone levels were normal in 16, 3 had hyerprolactinemia. In 7 out of 11 in whom progesterone was measured, it was ovulatory. In 8 out of 11, the pyelogram was abnormal, and in the same number, skeletal anomalies were found. CONCLUSIONS: In three patients, MURCS association was documented. It is proposed as an easy and minimally invasive study protocol for diagnosis.
Asunto(s)
Anomalías Múltiples/diagnóstico , Amenorrea/fisiopatología , Dispareunia/fisiopatología , Útero/anomalías , Vagina/anomalías , Anomalías Múltiples/fisiopatología , Adolescente , Adulto , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Genotipo , Humanos , Riñón/anomalías , Hormona Luteinizante/sangre , Pelvis/diagnóstico por imagen , Fenotipo , Progesterona/sangre , Prolactina/sangre , Radioinmunoensayo , Síndrome , Ultrasonografía , UrografíaRESUMEN
Obesity has been mentioned as a major risk factor to develop gestational diabetes mellitus (GDM). In this work the main purpose was to compare the distribution of body fat tissue and insulin serum levels in obese women suffering GDM. Twenty obese pregnant patients, ten with GDM and ten non-diabetic control subjects were selected. To define the body fat distribution the following anthropometric indexes were performed: subscapular/triceps skinfold index (STI) during pregnancy (24-28 weeks) and STI plus waist/hip ratio (WHR) in postpartum (6 weeks). The two obese groups were evaluated through an oral glucose tolerance test, taking blood at 0, 60, 120 and 180 minutes; after centrifugation glucose serum levels were measured immediately by the glucose oxidase technique and the rest of the sample was kept frozen at -20 degrees C until insulin determinations by radioimmunoassay. The ten patients with GDM presented upper body fat, segment distribution, while among those without GDM, only six had this last feature and four were found with lower body fat segment distribution (p < 0.047). Insulin serum levels in GDM group were higher than in women without GDM (p < 0.01). The STI during and after pregnancy correlated positively (r = 0.77, p < 0.00003) and also with WHR (r = 0.61, p < 0.0001). There was correlation between STI and WHR both measured in postpartum (r = 0.52, p < 0.0007).
Asunto(s)
Diabetes Mellitus/sangre , Insulina/sangre , Obesidad , Tejido Adiposo , Adulto , Glucemia/análisis , Femenino , Humanos , Periodo Posparto , Embarazo , Distribución TisularAsunto(s)
Bromocriptina/administración & dosificación , Agonistas de Dopamina/administración & dosificación , Hiperprolactinemia/tratamiento farmacológico , Administración Intravaginal , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Prolactina/sangre , Resultado del TratamientoRESUMEN
A study of semen quality was conducted in 197 smoking and 161 non-smoking men undergoing initial infertility investigation. The men were allocated into groups according the number of cigarettes smoked per day < 10 (n = 57), 11-20 (n = 115), and > 20 cigarettes (n = 25). Smokers had significantly poorer sperm density (P < .005), a lower percentage of viability (P < .007), a lower percentage of normal sperm morphology (P < .005), and the percentage of motile sperm was lower (P < .005). These parameters were worse in the heavy smoking groups. Thus the present study corroborates reports of detrimental effects of cigarette smoking on sperm characteristics. Further studies are needed to explain the mechanism by which smoking affects spermatogenesis.
Asunto(s)
Semen , Fumar/efectos adversos , Humanos , Masculino , México , Plantas Tóxicas , NicotianaRESUMEN
The purpose of this study was to determine the sensitivity, specificity, positive and negative predictive value of analyzed variables in the ultrasonographic endometrial study in patients with postmenopausal uterine bleeding. Nineteen women with postmenopausal uterine bleeding were studied, in all of them and in the same day a transvaginal ultrasound and endometrial biopsy were performed. It was observed that endometrial thickness median was 4 mm; most of the endometria were proliferative (n = 12), and a greater trend to obesity and upper segment fat distribution was found. Endometrial thickness, refringence and liquid on uterine cavity had a sensitivity and a negative predictive value NPV) of 100%, specificity and positive predictive value were lower. When endometrial thickness and refringence were associated also a sensitivity and NPV of a 100% was found. It can be concluded that transvaginal ultrasound is useful to define in which patient with postmenopausal uterine bleeding the endometrial biopsy is indicated.
Asunto(s)
Endometrio/diagnóstico por imagen , Posmenopausia , Hemorragia Uterina/diagnóstico por imagen , Adulto , Anciano , Biopsia , Endometrio/patología , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Ultrasonografía IntervencionalRESUMEN
The purpose of this work was to correlate the histologic findings and ultrasonographic variables of the endometrium in relation to corporal weight and body fat distribution, in two groups of women: one with posmenopausal uterine bleeding and other under hormonal replacement therapy (HRT). Thirty one posmenopausal women were studied and divided into two groups: I. women with posmenopausal uterine bleeding (n = 19) and II women with HRT (conjugated estrogens and chlormadinone) (n = 12). In both groups transvaginal ultrasound was accomplished the same day previous to the endometrial biopsy (EB). The EB was taken in the group I the day they attended the hospital referring transvaginal bleeding and in group I a statistical significant correlation was found among the corporal weight and histologic findings and among the endometrial refringence and the histologic findings. In group II there was a statistical significant correlation among the body fat distribution and endometrial refringence and among the endometrial thickness and histologic findings. It can be concluded that in women with posmenopausal bleeding the corporal weight influences the histologic findings and the refringence is related with histologic findings, while those under HRT is more important the body fat distribution over endometrial refringence and the endometrial thickness is related with histologic findings.
Asunto(s)
Tejido Adiposo , Peso Corporal , Endometrio/diagnóstico por imagen , Endometrio/patología , Posmenopausia , Adulto , Anciano , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Persona de Mediana Edad , Ultrasonografía , Hemorragia UterinaRESUMEN
Fourteen asthenoteratozoospermic (ATZS) patients were treated with 75-IU follicle-stimulating hormone (FSH) injections 3 times a week for 3 months. In the group as a whole, sperm motility, viability, and morphology were improved, but not significantly. Only 3 patients impregnated their wives following treatment. Semen characteristics of the 3 patients whose wives were pregnant showed significant improvement in sperm morphology (p = .001). Only FSH levels were statistically higher (p = .022) than controls. The administration of FSH in weekly doses can improve the fertilization potential of sperm.
Asunto(s)
Hormona Folículo Estimulante/farmacología , Espermatozoides/efectos de los fármacos , Adulto , Supervivencia Celular , Femenino , Humanos , Infertilidad Masculina , Masculino , Persona de Mediana Edad , Embarazo , Motilidad Espermática , Espermatozoides/fisiologíaRESUMEN
The objective was to measure gastrin (G) levels in maternal and neonatal sera as well as in amniotic fluid in patients with fetal distress and a control group. Twenty-five patients with term pregnancies were assigned to the following two groups: fifteen with acute fetal distress and ten with previous cesarean section. Maternal and neonatal blood and amniotic fluid samples were taken at the time of delivery. Differences between groups were calculated with non-parametric Mann Whitneys' U test. A significant difference (p < 0.001) between G levels in amniotic fluid of fetal distress and those of the control group was found. In conclusion, serum G levels can be used as another predictor of fetal distress, although further studies must be performed before it can be used as a clinical tool.