RESUMEN
Tubo-ovarian actinomycosis was observed after chemotherapy for breast cancer in a patient with an intrauterine device. Does chemotherapy increase the risk? How can it be prevented?
Asunto(s)
Actinomicosis/inducido químicamente , Antineoplásicos/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Enfermedades de las Trompas Uterinas/inducido químicamente , Dispositivos Intrauterinos , Enfermedades del Ovario/inducido químicamente , Neoplasias de la Mama/complicaciones , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Absolute and percent numbers of peripheral blood lymphocyte (PBL) subpopulations were evaluated using monoclonal antibodies in 20 subjects splenectomised for trauma. A significant increase was observed in the absolute counts of total PBL, B, null and Leu 7+ cells and in the percent counts of null and Leu 7+ lymphocytes. The percent numbers of OKT11+, OKT4+ and OKT8+ lymphocytes were significantly reduced, but the OKT4+/OKT8+ ratio was not statistically different from normal controls. The increase in B and killer/natural killer cells may provide a compensatory mechanism responsible for surveillance against infections and tumors in splenectomised patients, despite the numerous humoral and cellular abnormalities they commonly display.
Asunto(s)
Linfocitos/clasificación , Esplenectomía , Adolescente , Adulto , Anciano , Anticuerpos Monoclonales , Linfocitos B/inmunología , Niño , Técnica del Anticuerpo Fluorescente , Humanos , Células Asesinas Naturales/inmunología , Recuento de Leucocitos , Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Bazo/lesiones , Esplenectomía/efectos adversos , Linfocitos T/inmunologíaRESUMEN
Serum immunoglobulin and complement concentrations were evaluated in 20 patients who had undergone splenectomy after trauma. The concentrations of IgE and IgA in the patients were significantly increased compared with those in controls. The IgE values were not correlated with the time after splenectomy or IgA, IgG, IgM, IgD, C3, and C4 values.
Asunto(s)
Inmunoglobulina E/metabolismo , Bazo/lesiones , Esplenectomía , Adolescente , Adulto , Anciano , Niño , Complemento C3/metabolismo , Complemento C4/metabolismo , Femenino , Humanos , Inmunoglobulina A/metabolismo , Inmunoglobulinas/metabolismo , Masculino , Persona de Mediana EdadRESUMEN
PIP: This article examines various aspects of clip sterilization in an effort to assess its potential contribution to the technology of female sterilization. The essential advantage of clips is their possibility of use in laparoscopic sterilization. Of the 3 types of clips widely used at present, the Hulka-Clemens, Bleier, and Filshie, the Filshie is preferred by the authors for its ease of use. Clips achieve their contraceptive effect by compression and subsequent tubal epithelial necrosis, which together provide a barrier to the ascension of sperm. Laparoscopic clip sterilization usually requires general anesthesia. The clip is placed on the isthmus 3 cm from the uterine cornu in an operation requiring about 15 minutes for completion. During laparoscopy the entire internal genital tract is visible, so that latent infection can be ruled out. Clips can also be used in conjunction with any gynecologic laparotomy. Perioperative complications are rare because the application is done without changing the position of the tube. Among possible operative errors are application to some other structure than the tube, faulty placement in which case a 2nd clip can be applied adjacent to the 1st, and intraabdominal loss of the clip, which can be retrieved or left in place. The duration of hospitalization varies from 24 hours to 3 days. Tubal damage is minimized with clip sterilization, enhancing the chances for successful reversal. Extrauterine pregnancy is less common following reversal than with other methods of sterilization. Between .1% and 10% of sterilization patients are estimated to request reversals, but reversal attempts are feasible in only 30-70% of cases. Even microsurgical anastomosis is not always successful. A couple should be provided with full information on alternative contraceptive methods before a decision to sterilize is made. Haste, poor psychological preparation, and an inadequate indication are probably factors in poor response to sterilization. Women under age 35, whose youngest child is under 5 years old, in families with 3 or fewer children, in unstable unions, and in some ethnic or religious groups are more likely to experience regret after sterilization. Women with these risk factors for regret or reversal requests should be urged to reconsider or postpone sterilization. Regardless of the initial reasons for sterilization requests, the technique used should be that with the greatest potential for reversal. Clip sterilization has provided some of the highest rates of successful reversal. 3 brief interviews concerning triphasic oral contraceptives, vasectomy, and progesterone IUDs follow the discussion of clip sterilization.^ieng