RESUMEN
OBJECTIVE: To determine whether oral glucose tolerance tests (OGTT) play a role as predictors of preeclampsia (PET) in pregnant women. METHODS: A retrospective case-control study was conducted in 2,002 singleton pregnancies that had a uterine artery (UtA) Doppler at 22-25 weeks and an OGTT. The UtA Doppler and OGTT were adjusted based on maternal characteristics, and the results were expressed as multiples of the expected normal median and compared between groups. Logistic regression analysis was used to determine whether maternal characteristics, OGTT, and UtA Doppler significantly contribute to the prediction of early- (<34 weeks), intermediate- (34-37 weeks), or late-onset (>37 weeks) PET. The performance of the screening was determined by ROC curves. RESULTS: Women who developed PET were characterized by an older maternal age, an increased body mass index, and an altered UtA Doppler. The group with intermediate-onset PET was the only one associated with higher 2-hour OGTT levels compared to controls. Combined models were developed via logistic regression analysis using maternal characteristics, UtA Doppler, and OGTT to predict PET. These combined models were able to detect around 74, 42, and 21% of women who later developed early-, intermediate-, or late-onset PET, respectively, with only a 5% false-positive rate. CONCLUSIONS: This study shows that the combination of maternal characteristics, second-trimester UtA Doppler, and OGTT is a predictor of the development of PET in healthy pregnant women.
Asunto(s)
Prueba de Tolerancia a la Glucosa , Preeclampsia/diagnóstico , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Diabetes Gestacional/epidemiología , Femenino , Edad Gestacional , Humanos , Modelos Logísticos , Edad Materna , Preeclampsia/epidemiología , Embarazo , Nacimiento Prematuro/epidemiología , Curva ROC , Estudios Retrospectivos , Ultrasonografía , Arteria Uterina/diagnóstico por imagenRESUMEN
La microlitiasis testicular (MT) es una entidad poco común, caracterizada por el depósito de calcio en el lumen de los túbulos seminíferos. Su verdadera incidencia y etiopatogenia no han sido definidos. La MT tiene una apariencia ultrasonográfica característica, que consiste en la presencia de focos hiperecogénicos menores de 2 mm, distribuidos en forma difusa en el parénquima testicular, generalmente en forma bilateral.
Asunto(s)
Humanos , Masculino , Niño , Enfermedades Testiculares/diagnóstico , Enfermedades Testiculares/patología , Enfermedades Testiculares , Túbulos SeminíferosRESUMEN
Levels of thyrotropin-releasing hormone (TRH), TRH mRNA and pyroglutamyl peptidase II were analyzed in the hypothalamus-adenohypophyseal axis during lactation and estrous cycle. Mediobasal hypothalamic levels of TRH dropped 41% (p less than 0.01) from pregnancy levels (taken as 100%) on the first day of lactation, recovering until day 15 to the values observed at pregnancy. A sharp decrease was also observed during weaning (36%, p less than 0.01 compared to last day of lactation). TRH levels in the neurohypophysis increased during lactation and dropped at weaning. Highest TRH mRNA levels in the paraventricular nucleus were found at the end of pregnancy and beginning of lactation; they decreased 37% (p less than 0.05) at day 5 of lactation and stayed constant thereafter. Pyroglutamyl peptidase II adenohypophyseal activity was not modified during lactation but changed during estrous cycle. Relative to estrous values, activity diminished 58% (p less than 0.05) at 10.00 h (57% at 14.00 h) during diestrus 2 and 27% at 10.00 h (37% at 14.00 h) during proestrus. Hypothalamic TRH mRNA levels fluctuated in an opposite manner to adenohypophyseal pyroglutamyl peptidase II during the estrous cycle with a peak at diestrus 2: 183% of the estrous value (p less than 0.05). These data point to a regulation of TRH metabolism in conditions where prolactin (PRL) secretion fluctuates. They also suggest a sharp release of TRH between the end of pregnancy and the first day of lactation and that translational efficiency or post-translational processing of TRH precursor in the paraventricular neurons (projecting to the median eminence) increases during lactation and drops at weaning, concomitantly with PRL secretion.
Asunto(s)
Aminopeptidasas , Estro/fisiología , Lactancia/fisiología , Preñez/metabolismo , Hormona Liberadora de Tirotropina/metabolismo , Animales , Femenino , Hipotálamo/metabolismo , Adenohipófisis/metabolismo , Embarazo , Piroglutamil-Peptidasa I/metabolismo , Ácido Pirrolidona Carboxílico/análogos & derivados , ARN Mensajero/metabolismo , Ratas , Ratas Endogámicas , Serina Endopeptidasas/sangre , Hormona Liberadora de Tirotropina/genética , DesteteRESUMEN
Among the enzymes capable of degrading thyrotropin-releasing hormone (TRH) in vitro, two pyroglutamate aminopeptidases (PGA) are specific for TRH: thyroliberinase, a seric enzyme and PGAII, a membrane-bound peptidase. The effect of thyroid hormone status on the activity of these enzymes was evaluated in serum and various tissues. Only in adenohypophysis, triiodothyronine treatment increased PGAII to 376% of control; hypothyroidism produced the reverse effect (decrease to 23% of control). As previously reported, similar changes were observed for thyroliberinase. TRH degradation at the adenohypophysis level may participate in the negative feedback control of thyroid hormones.