RESUMO
The GH receptor antagonist pegvisomant is an efficient agent to achieve biochemical control of acromegaly in those cases refractory to surgery and medical therapy with somatostatin analogs. We conducted an observational multicenter study consisting of data collection in accordance with the standard management of patients with acromegaly in everyday practice. We reviewed the medical records of 28 patients, 23 females, who were treated with pegvisomant due to the lack of biochemical response or intolerance to the somatostatin analogs. The objective was to monitor long-term safety and efficacy of the antagonist. 82% of the patients had previous pituitary surgery, 53.6% radiotherapy and 96.4% received medical therapy for acromegaly. Only 19.2% of the patients had pituitary residual tumor size larger than 1 cm, the remainder harbored a microadenoma or no visible tumor in the pituitary images. In terms of biochemical efficacy, IGF-I levels decreased to normal ranges in 45% and 58.8% of patients after 3 and 6 months of treatment, respectively, the daily mean dose of pegvisomant being 9.6+/-1.1 mg. Adverse events, potentially related to pegvisomant were reported in 6 patients (21.4%), local injection site reaction and elevated liver enzymes being the most frequent. Tumor size did not show enlargement in the evaluated population (15 patients) during the period of the study. This paper presents preliminary data from a small observational study in Argentina which represents the first database in our country.
Assuntos
Acromegalia/tratamento farmacológico , Hormônio do Crescimento Humano/análogos & derivados , Receptores da Somatotropina/antagonistas & inibidores , Acromegalia/sangue , Adulto , Idoso , Feminino , Hormônio do Crescimento Humano/efeitos adversos , Hormônio do Crescimento Humano/uso terapêutico , Humanos , Fator de Crescimento Insulin-Like I/análise , Masculino , Pessoa de Meia-IdadeRESUMO
It is well accepted that routine semen analysis is a useful tool for valuation of male potential fertility. In our environment, HOST has been recently applied as an additional approach which early detects structural and/or functional alterations of the sperm membranes. We investigated the possible relationship between some semen parameters and HOST in males from A) fertile couples (23-32 years old; n = 11) and B) sterile couples (25-35 years old; n = 171. Sperm concentration, motility, morphology and HOST (semen incubation in hypoosmotic saline solution-sodium citrate and fructose, 150 m0sm/1--, 37 degrees C during 60 min) were evaluated. In HOST determinations, results higher than 60% of swollen cells are considered within the normal range. In our study, sperm from males of B group showed a significantly lower percentage of hyperhydrated cells than those from A group (55.7 + 2.2% and 70.4 + 2.3% respectively; p < .001). In addition, a significant statistical correlation between HOST vs motility or normal morphology was found. On the contrary, we detected no correlation between HOST vs sperm concentration or volume. We suggest that development and application of HOST as a routine, can play an important role in the evaluation and prognosis of an infertile couple.
Assuntos
Fertilidade , Infertilidade Masculina/diagnóstico , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Espermatozoides/citologia , Adulto , Humanos , Masculino , Pressão OsmóticaRESUMO
It is well accepted that routine semen analysis is a useful tool for valuation of male potential fertility. In our environment, HOST has been recently applied as an additional approach which early detects structural and/or functional alterations of the sperm membranes. We investigated the possible relationship between some semen parameters and HOST in males from A) fertile couples (23-32 years old; n = 11) and B) sterile couples (25-35 years old; n = 171. Sperm concentration, motility, morphology and HOST (semen incubation in hypoosmotic saline solution-sodium citrate and fructose, 150 m0sm/1--, 37 degrees C during 60 min) were evaluated. In HOST determinations, results higher than 60
of swollen cells are considered within the normal range. In our study, sperm from males of B group showed a significantly lower percentage of hyperhydrated cells than those from A group (55.7 + 2.2
and 70.4 + 2.3
respectively; p < .001). In addition, a significant statistical correlation between HOST vs motility or normal morphology was found. On the contrary, we detected no correlation between HOST vs sperm concentration or volume. We suggest that development and application of HOST as a routine, can play an important role in the evaluation and prognosis of an infertile couple.
RESUMO
It is well accepted that routine semen analysis is a useful tool for valuation of male potential fertility. In our environment, HOST has been recently applied as an additional approach which early detects structural and/or functional alterations of the sperm membranes. We investigated the possible relationship between some semen parameters and HOST in males from A) fertile couples (23-32 years old; n = 11) and B) sterile couples (25-35 years old; n = 171. Sperm concentration, motility, morphology and HOST (semen incubation in hypoosmotic saline solution-sodium citrate and fructose, 150 m0sm/1--, 37 degrees C during 60 min) were evaluated. In HOST determinations, results higher than 60
of swollen cells are considered within the normal range. In our study, sperm from males of B group showed a significantly lower percentage of hyperhydrated cells than those from A group (55.7 + 2.2
and 70.4 + 2.3
respectively; p < .001). In addition, a significant statistical correlation between HOST vs motility or normal morphology was found. On the contrary, we detected no correlation between HOST vs sperm concentration or volume. We suggest that development and application of HOST as a routine, can play an important role in the evaluation and prognosis of an infertile couple.