RESUMEN
A 53-year-old women underwent D & C and diagnostic hysteroscopy for suspected endometrial hyperplasia, when the posterior uterine wall was perforated. An endometrial polyp prolapsed into the abdominal cavity after uterine rupture which was diagnosed upon subsequent abdominal hysterectomy.
Asunto(s)
Dilatación y Legrado Uterino/efectos adversos , Endometriosis/patología , Perforación Uterina/etiología , Endometriosis/cirugía , Femenino , Humanos , Histerectomía , Persona de Mediana Edad , Resultado del Tratamiento , Prolapso Uterino/patología , Prolapso Uterino/cirugíaRESUMEN
It was previously postulated on the basis of clinical data that the cardiovascular sequelae of extracorporeal whole-body hyperthermia (e-WBH), i.e., hypotension (which requires catecholamine support) results in unique nephrotoxicity in combination with select chemotherapeutic agents. In an attempt to explain this phenomenon, we mimicked e-WBH physiological conditions in a rat model. Animals were treated with and without ifosfamide (IFO) and/or carboplatin (CBDCA) at 37 degrees C or 41.5-41.8 degrees C, with blood pressure monitoring and catecholamine support comparable to the clinical setting. Ex vivo post-treatment data (24 h) from artificially perfused kidneys (i.e., histology, urine volume, perfusion rate, glomerular filtration rate, and the reabsorption of sodium, glucose, and water) demonstrated unique toxicity including proximal tubular necrosis for the combination of WBH and IFO, for WBH and CBDCA and for WBH and IFO plus CBDCA, but not for IFO and CBDCA without WBH. These data, considered together with results derived from a subsequent clinical trial and the laboratory work of others were consistent with the hypothesis.