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1.
Ultrasound Obstet Gynecol ; 61(2): 231-242, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36178788

RESUMEN

OBJECTIVE: Previous work has suggested that the ultrasound-based benign simple descriptors (BDs) can reliably exclude malignancy in a large proportion of women presenting with an adnexal mass. This study aimed to validate a modified version of the BDs and to validate a two-step strategy to estimate the risk of malignancy, in which the modified BDs are followed by the Assessment of Different NEoplasias in the adneXa (ADNEX) model if modified BDs do not apply. METHODS: This was a retrospective analysis using data from the 2-year interim analysis of the International Ovarian Tumor Analysis (IOTA) Phase-5 study, in which consecutive patients with at least one adnexal mass were recruited irrespective of subsequent management (conservative or surgery). The main outcome was classification of tumors as benign or malignant, based on histology or on clinical and ultrasound information during 1 year of follow-up. Multiple imputation was used when outcome based on follow-up was uncertain according to predefined criteria. RESULTS: A total of 8519 patients were recruited at 36 centers between 2012 and 2015. We excluded patients who were already in follow-up at recruitment and all patients from 19 centers that did not fulfil our criteria for good-quality surgical and follow-up data, leaving 4905 patients across 17 centers for statistical analysis. Overall, 3441 (70%) tumors were benign, 978 (20%) malignant and 486 (10%) uncertain. The modified BDs were applicable in 1798/4905 (37%) tumors, of which 1786 (99.3%) were benign. The two-step strategy based on ADNEX without CA125 had an area under the receiver-operating-characteristics curve (AUC) of 0.94 (95% CI, 0.92-0.96). The risk of malignancy was slightly underestimated, but calibration varied between centers. A sensitivity analysis in which we expanded the definition of uncertain outcome resulted in 1419 (29%) tumors with uncertain outcome and an AUC of the two-step strategy without CA125 of 0.93 (95% CI, 0.91-0.95). CONCLUSION: A large proportion of adnexal masses can be classified as benign by the modified BDs. For the remaining masses, the ADNEX model can be used to estimate the risk of malignancy. This two-step strategy is convenient for clinical use. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.


Asunto(s)
Enfermedades de los Anexos , Neoplasias Ováricas , Femenino , Humanos , Estudios Retrospectivos , Neoplasias Ováricas/patología , Enfermedades de los Anexos/patología , Ultrasonografía/métodos , Antígeno Ca-125 , Sensibilidad y Especificidad , Diagnóstico Diferencial
2.
Ultrasound Obstet Gynecol ; 57(1): 164-172, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32484286

RESUMEN

OBJECTIVE: To describe the ultrasound features of different endometrial and other intracavitary pathologies inpre- and postmenopausal women presenting with abnormal uterine bleeding, using the International Endometrial Tumor Analysis (IETA) terminology. METHODS: This was a prospective observational multicenter study of consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler and fluid-instillation sonography were performed. Endometrial sampling was performed according to each center's local protocol. The histological endpoints were cancer, atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (EIN), endometrial atrophy, proliferative or secretory endometrium, endometrial hyperplasia without atypia, endometrial polyp, intracavitary leiomyoma and other. For fluid-instillation sonography, the histological endpoints were endometrial polyp, intracavitary leiomyoma and cancer. For each histological endpoint, we report typical ultrasound features using the IETA terminology. RESULTS: The database consisted of 2856 consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler was performed in all cases and fluid-instillation sonography in 1857. In 2216 women, endometrial histology was available, and these comprised the study population. Median age was 49 years (range, 19-92 years), median parity was 2 (range, 0-10) and median body mass index was 24.9 kg/m2 (range, 16.0-72.1 kg/m2 ). Of the study population, 843 (38.0%) women were postmenopausal. Endometrial polyps were diagnosed in 751 (33.9%) women, intracavitary leiomyomas in 223 (10.1%) and endometrial cancer in 137 (6.2%). None (0% (95% CI, 0.0-5.5%)) of the 66 women with endometrial thickness < 3 mm had endometrial cancer or atypical hyperplasia/EIN. Endometrial cancer or atypical hyperplasia/EIN was found in three of 283 (1.1% (95% CI, 0.4-3.1%)) endometria with a three-layer pattern, in three of 459 (0.7% (95% CI, 0.2-1.9%)) endometria with a linear endometrial midline and in five of 337 (1.5% (95% CI, 0.6-3.4%)) cases with a single vessel without branching on unenhanced ultrasound. CONCLUSIONS: The typical ultrasound features of endometrial cancer, polyps, hyperplasia and atrophy and intracavitary leiomyomas, are described using the IETA terminology. The detection of some easy-to-assess IETA features (i.e. endometrial thickness < 3 mm, three-layer pattern, linear midline and single vessel without branching) makes endometrial cancer unlikely. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Asunto(s)
Endometrio/patología , Enfermedades Uterinas/diagnóstico , Adulto , Endometrio/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Ultrasonografía , Hemorragia Uterina/epidemiología , Hemorragia Uterina/etiología
3.
Transplant Proc ; 48(6): 2072-5, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27569946

RESUMEN

BACKGROUND: The aim of our study was to evaluate the rate of surgical complications, patient outcomes, and impact on graft function in renal transplant recipients in whom cholecystectomy for acute cholecystitis was performed. METHODS: We reviewed data on transplant patients from January 1, 2006, to December 31, 2013. The subgroup of patients who required subsequent cholecystectomy for acute cholecystitis was assessed, and their data were further analyzed. RESULTS: Thirty-one patients who underwent cholecystectomy for acute cholecystitis after renal transplantation were included in the study. Clinical signs such as pain in the right upper quadrant, temperature >38°C, and elevation in bilirubin levels occurred in 20 (64.5%), 8 (25.8%), and 3 (9.7%) patients, respectively. Ultrasound signs of acute cholecystitis were present in 27 patients (87.1%). In terms of laboratory values, white blood cell counts >10 × 10(9)/L occurred in 17 patients (54.8%), and C-reactive protein levels >40 mg/L were reported in 21 patients (67.7%). The conversion rate to open surgery was 32.3% (10 patients). In 13 cases, acalculous cholecystitis was present (41.9%). The average serum creatinine level 1 year after cholecystectomy had no statistically significant differences. One patient required temporary dialysis during the postoperative period (with subsequent graft recovery), and 1 graft was lost. CONCLUSIONS: Acute cholecystitis in kidney transplant recipients is a serious complication, with frequent difficulties related to evaluation and diagnosis. Because clinical signs could be very mild compared with severity of gallbladder affliction, there is little room if any for conservative treatment in these patients. We have not noticed adverse impact of acute cholecystitis on 1-year graft function.


Asunto(s)
Colecistectomía Laparoscópica/métodos , Colecistitis Aguda/cirugía , Trasplante de Riñón , Adulto , Anciano , Proteína C-Reactiva/metabolismo , Colecistitis Aguda/diagnóstico por imagen , Conversión a Cirugía Abierta , Femenino , Supervivencia de Injerto , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Diálisis Renal , Estudios Retrospectivos , Ultrasonografía , Adulto Joven
4.
Bratisl Lek Listy ; 115(2): 101-2, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24601705

RESUMEN

We report five cases of early venous complications, all successfully rescued by graft removal, re-perfusion and re-transplantation, these kidneys would have been lost otherwise. All kidneys were from deceased donors, mean donor age was 39 years (range 29-55), with serum creatitine levels on harvesting being 81 µmol/l (65-108), glomerular filtration of 1.46 ml/s (0.82-1.83). Reasons for venous complications were following: Two cases of renal vein stenosis, another two with renal vein laceration, one renal vein thrombosis for unknown reason. All the five kidney grafts have been rescued successfully. One year's results in this group comes as mean serum creatinine level of 127 µmol/l. The described approach gives a chance to the patients with early vein thrombosis and offers the kidney graft salvage (Ref. 4).


Asunto(s)
Oclusión de Injerto Vascular/etiología , Oclusión de Injerto Vascular/cirugía , Trasplante de Riñón/efectos adversos , Venas Renales/cirugía , Terapia Recuperativa/métodos , Trombosis de la Vena/etiología , Trombosis de la Vena/cirugía , Adulto , Estudios de Cohortes , Diagnóstico Precoz , Femenino , Estudios de Seguimiento , Oclusión de Injerto Vascular/diagnóstico , Supervivencia de Injerto , Humanos , Trasplante de Riñón/métodos , Masculino , Persona de Mediana Edad , Reoperación , Donantes de Tejidos , Resultado del Tratamiento , Trombosis de la Vena/diagnóstico
5.
Transplant Proc ; 45(2): 770-7, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23498819

RESUMEN

OBJECTIVE: The diagnosis of sepsis is difficult in immunocompromised patients owing to their modified response to infection. Our experiment in minipigs was designed to compare responses to sepsis between experimental groups of septic minipigs with and without immunosuppression. METHODS: Minipigs with identical baseline parameters were randomized into 3 groups: Sepsis (n = 10); immunosuppression (n = 11), including cyclosporine, methylprednisolone, and mycophenolate mofetil treatment before surgery, and a sham group (n = 6). Sepsis was induced by cecal ligation and puncture (CLP). We recorded selected clinical and laboratory parameters up to 24 hours postoperatively. RESULTS: All CLP animals developed septic shock with a febrile response, tachycardia, and hypotension requiring noradrenaline administration. The hemodynamic responses to sepsis in septic groups with and without immunosuppression were similar. Noradrenaline infusion was started on average later in the immunosuppression than in the group without immunosuppression; however, the difference was not significant. The kinetics of the plasma levels of most selected cytokines and C-reactive protein were similar in both septic groups. At 10 hours after surgery, the immunosuppression group showed significantly lower interleukin (IL)-6 levels compared with the sepsis group. At 19, 22, and 25 hours after surgery immunosuppressed animals displayed significantly greater increases in IL-10 levels compared with the cohort without immunosuppression. CONCLUSIONS: CLP is a simple, reproducible model of sepsis in minipigs. All CLP animals developed sepsis within 24 hours on average. Significant differences in IL-6 and IL-10 plasma levels were recorded between septic animals with versus without immunosuppression.


Asunto(s)
Ciego/cirugía , Huésped Inmunocomprometido , Inmunosupresores/farmacología , Sepsis/inmunología , Animales , Biomarcadores/sangre , Cardiotónicos/farmacología , Ciego/microbiología , Ciclosporina/farmacología , Modelos Animales de Enfermedad , Hemodinámica , Mediadores de Inflamación/sangre , Ligadura , Metilprednisolona/farmacología , Ácido Micofenólico/análogos & derivados , Norepinefrina/farmacología , Punciones , Sepsis/sangre , Sepsis/tratamiento farmacológico , Sepsis/microbiología , Sepsis/fisiopatología , Porcinos , Porcinos Enanos , Factores de Tiempo
6.
Ultrasound Obstet Gynecol ; 40(4): 470-5, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22605534

RESUMEN

OBJECTIVE: To compare spatiotemporal image correlation-high definition flow (STIC-HDF) indices from spherical samples of ovary between women with polycystic ovary syndrome (PCOS) and normal women. METHODS: This was a prospective case-control study of premenopausal women with a diagnosis of PCOS according to the Rotterdam criteria and of healthy, regularly menstruating, premenopausal women (controls) matched for age (< 35 years) and body mass index. Women were assessed in the follicular phase of the menstrual cycle by 4D STIC-HDF transvaginal ultrasound. Based on 1-cm(3) spherical sampling, we calculated for each woman the vascularization index (VI) for the most vascularized part of the ovarian stroma in all three-dimensional volumes of the 4D STIC-HDF sequence. The maximum (VI(sys)) and minimum (VI(diast)) values were assumed to represent systole and diastole, respectively, and the mean VI for all frames from one cardiac cycle was calculated. Based on these three VI values, we calculated the following indices: volumetric systolic/diastolic ratio (vS/D), volumetric resistance index (vRI) and volumetric pulsatility index (vPI), and compared them between study and control groups. RESULTS: The study included 32 PCOS women (mean age, 29.6 years) and 32 controls (mean age, 30.4 years). Mean VI(sys) (26.246% vs 8.136%, P < 0.0001) and mean VI(diast) (22.242% vs 5.997%, P < 0.0001) were significantly higher in PCOS women compared with controls. Median vS/D (1.15 vs 1.33, P < 0.001), mean vRI (0.17 vs 0.30, P < 0.001) and median vPI (0.14 vs 0.28, P < 0.001) were significantly lower in PCOS women compared with controls. CONCLUSION: 4D STIC-HDF indices from 1-cm(3) spherical samples of the ovaries were different between PCOS women and controls, suggesting lower impedance to flow in ovarian stromal vessels in PCOS women.


Asunto(s)
Ovario/irrigación sanguínea , Síndrome del Ovario Poliquístico/patología , Células del Estroma/patología , Útero/irrigación sanguínea , Adulto , Velocidad del Flujo Sanguíneo , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Fase Folicular , Humanos , Imagenología Tridimensional , Variaciones Dependientes del Observador , Ovario/diagnóstico por imagen , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Estudios Prospectivos , Reproducibilidad de los Resultados , Células del Estroma/diagnóstico por imagen , Ultrasonografía , Útero/diagnóstico por imagen
7.
Ultrasound Obstet Gynecol ; 35(5): 602-8, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20183808

RESUMEN

OBJECTIVE: To assess whether, when using spherical sampling with Virtual Organ Computer-Aided Analysis (VOCAL) for calculating three-dimensional (3D) power Doppler angiography (PDA) indices, the sphere volume affects performance in the prediction of malignancy in vascularized cystic-solid or solid adnexal masses. METHODS: One hundred and thirty-eight women (mean +/- SD age, 51.8 +/- 14.1 years) diagnosed as having vascularized cystic-solid or solid adnexal masses on B-mode and two-dimensional (2D) power Doppler ultrasound were evaluated by 3D-PDA prior to surgery. Five women had bilateral masses, giving a total number of 143 masses analyzed. Vascularization was assessed using VOCAL software. 3D-PDA vascular indices (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) from the most vascularized area within papillary projections and solid areas were calculated automatically using spherical sampling. Five different volumes of sphere were used (1 cm(3), 2 cm(3), 3 cm(3), 4 cm(3) and 5 cm(3)) in each case. A definitive histological diagnosis was obtained in each case after surgical tumor removal. RESULTS: One hundred and seventeen (82%) masses were malignant and 26 (18%) were benign. Morphological evaluation revealed 34 (24%) unilocular solid masses, 49 (34%) multilocular solid masses and 60 (42%) mostly solid masses. The 1-cm(3) sphere could be used in 100% of the cases, the 2-cm(3) sphere could be used in 98.2% of the cases and the 3-5-cm(3) spheres could be used in 97.2% of the cases. The median VI, FI and VFI for all sphere volumes were significantly higher in malignant compared with non-malignant tumors. Receiver-operating characteristics curve analysis showed that VI and VFI, independently of sphere volume, were better predictors of malignancy than was FI. The best cut-off values for the 3D-PDA indices differed depending on sphere volume. VI was significantly more specific than were VFI and FI. CONCLUSIONS: Sphere volume does not affect the performance of 3D-PDA. We recommend the use of different cut-off values for 3D-PDA indices for discriminating between benign and malignant adnexal masses, depending on the sphere volume used. Use of VI is preferable due to its higher specificity.


Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias Ováricas/diagnóstico por imagen , Ultrasonografía Doppler en Color/métodos , Enfermedades de los Anexos/diagnóstico por imagen , Enfermedades de los Anexos/patología , Femenino , Humanos , Imagenología Tridimensional , Persona de Mediana Edad , Neovascularización Patológica , Neoplasias Ováricas/patología , Reproducibilidad de los Resultados
8.
Bratisl Lek Listy ; 110(2): 65-8, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19408835

RESUMEN

OBJECTIVES: The technical aspects of a procedure are most important for the outcome of the experiment. This study was designed to compare two techniques suitable for graft revascularization. METHODS: The first technique, where the animal is both donor and the recipient, consists of connecting the grafts' vascular anastomoses to the mesenteric vessel bed. In the second technique, one animal is the graft donor and the other is the recipient, with revascularization to the central vessel bed (subrenal inferior vena cava and aorta). Techniques of restoring digestive tract continuity and creation of diagnostic "chimney ileostomy" were identical in both groups. All experimental animals were monitored clinically regularly basis as per protocol (weight, temperature, stoma appearance, output and nature of stools). Blood and biopsy samples were obtained on days 0, 3, 5, 7, 10, 20, and 30. RESULTS: Overall, 43 transplant procedures were performed. The first group included 18 transplants and 66.7% animals had vascular complications. While in the second group (25 transplant procedures), vascular complication rate was only 12% (3 out of 25) perhaps due to technique modifications. CONCLUSION: Our experiment showed that both types of vascular anastomosis could be used in small bowel transplantation. Connecting the graft vessels to the aorta and inferior vena cava is technically simpler and safer because of fewer subsequent complications (Tab. 1, Fig. 4, Ref. 6). Full Text (Free, PDF) www.bmj.sk.


Asunto(s)
Intestino Delgado/irrigación sanguínea , Intestino Delgado/trasplante , Procedimientos Quirúrgicos Vasculares/métodos , Anastomosis Quirúrgica , Animales , Arteria Mesentérica Superior/cirugía , Venas Mesentéricas/cirugía , Trasplante de Órganos , Sus scrofa , Recolección de Tejidos y Órganos/métodos
9.
Rozhl Chir ; 88(11): 662-8, 2009 Nov.
Artículo en Checo | MEDLINE | ID: mdl-20662448

RESUMEN

AIM: Transplantation of the small intestine is a standard treatment method in patients with small intestinal failures. The aim of this study was to master the surgical technique, optimalize immunosuppression regimes, diagnose acute cellular graft rejection based on cellular and humoral indicators. METHODS: The authors performed a total of 43 transplantation procedures in pigs. The first, surgical part of the experiment was aimed at mastering two principal methods of vascular anastomosis- firstly, connecting the graft with mesenteric vessels (Group n1 = 18) and secondly, connecting the graft with the aorta and the inferior vena cava (Group n2 = 25). The second part of the experiment included assessment of rejection changes in various immunosuppression regimes. Only animals who did not die because of a technical failure of the procedure or due to internal reasons (n = 24) were assessed. The study animals were assigned to four groups (A (n = 3)--autotransplantation, without immunosuppresion; B (n = 7) and C (n = 8)--allotransplantation with immunosuppression using tacrolimus, resp. in a combination with sirolimus; D (n = 6)--allotransplantation without immunosuppression. Rejection was diagnosed based on histological examination of the grafts@ biopsy samples. Plasmatic citruline was used as a non-invasive humoral indicator of the graft impairment. RESULTS: Procedural complications were observed in 12 (67%) study animals from the first group, and in 3 (12%) animals from the second group. In the assessment of rejection changes, the longest survival was observed with autotransplantations, the shortest survival period was shown with allotransplantations without immunosuppression. No significant survival differences were demonstrated between the both treated groups. (p < 0.05). Group C showed lower rates of cellular rejections, compared to Group B and D. CONCLUSION: During the experiment, the authors managed to master the graft collection, as well as the transplantation technique. Lower rates of surgical complications were observed when the graft was supplied by the central vascular system. No significant differencies were observed between the tacrolimus monoterapy regimen and the combination therapy with sirolimus. Histological examination is the golden standard for the cellular rejection diagnostics. Plasmatic citruline has no signifiance in the rejection assessment.


Asunto(s)
Intestino Delgado/trasplante , Animales , Animales Endogámicos , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/patología , Inmunosupresores/administración & dosificación , Porcinos , Recolección de Tejidos y Órganos
10.
Rozhl Chir ; 85(6): 290-2, 2006 Jun.
Artículo en Checo | MEDLINE | ID: mdl-16977867

RESUMEN

The authors present a case-review of a polymorbid patient, who underwent repetitive endoscopic transgastric drainage of the pancreatic pseudocyst in chronic pancreatitis. 3 months after the stents were released, the terminal ileus perforated. Ileocaecal resection was then completed. Further postoperative course was uncomplicated and the patient's current clinical condition is good.


Asunto(s)
Drenaje/instrumentación , Endoscopía del Sistema Digestivo , Migración de Cuerpo Extraño/complicaciones , Migración de Cuerpo Extraño/terapia , Íleon/lesiones , Perforación Intestinal/etiología , Seudoquiste Pancreático/cirugía , Stents/efectos adversos , Anciano , Humanos , Perforación Intestinal/cirugía , Masculino , Seudoquiste Pancreático/complicaciones , Pancreatitis Crónica/complicaciones
11.
Gynecol Endocrinol ; 15(4): 304-11, 2001 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-11560105

RESUMEN

The aim of the study was to see if there are any correlations between changes in the endocrine system and clinical condition of asthmatic patients, in particular their lung function, caused by hormone replacement therapy (HRT). Fifty-five asthmatic and 20 healthy postmenopausal women (aged 48-60) were studied before HRT and after 6 months of cyclical transdermal 17 beta-estradiol and medroxyprogesterone acetate treatment. Serum estradiol, cortisol and dehydroepiandrosterone sulfate (DHEAS) concentrations were assessed with the use of RIA, and spirometry parameters were measured. Statistically significant diminution of asthma exacerbations, reduced consumption of inhaled glucocorticosteroids and improvement in all investigated spirometry parameters was shown in patients treated with glucocorticosteroids during HRT. A reduction in mean 24-hour serum estradiol levels in asthmatic women was noted, whereas cortisol and DHEAS serum concentrations were decreased in asthmatic patients treated with glucocorticosteroids compared with the control group, before HRT. HRT produced increases in the concentrations of estradiol, cortisol and DHEAS in serum. Significant positive correlations were noted between estradiol concentrations and small and medium bronchi tests. In conclusion, HRT in postmenopausal asthmatic women has a favorable influence on the course of asthma, reduces daily use of glucocorticosteroids and frequency of asthma exacerbations and normalizes serum concentrations of estradiol, cortisol and DHEAS, which were decreased before HRT.


Asunto(s)
Asma/sangre , Sulfato de Deshidroepiandrosterona/sangre , Terapia de Reemplazo de Hormonas , Espirometría , Administración Cutánea , Estudios Transversales , Estradiol/administración & dosificación , Estradiol/sangre , Femenino , Humanos , Hidrocortisona/sangre , Medroxiprogesterona/administración & dosificación , Menopausia , Persona de Mediana Edad
12.
Endocr Regul ; 35(4): 217-22, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11858769

RESUMEN

OBJECTIVE: To assess mean 24-h serum concentrations of dehydroepianrosterone (DHEAS) in postmenopausal women with asthma before and after hormone replacement therapy (HRT). METHODS: Studies were performed in 55 asthmatic and 20 healthy postmenopausal women aged 48-60 before HRT and after 6 months of transdermal 17b-estradiol (E2) and medroxyprogesterone acetate treatment (cyclical method). Serum DHEAS concentrations were assessed with the use of RIA method. RESULTS: In the group of postmenopausal asthmatic women treated with glucocorticoids the mean 24 h DHEAS serum levels were lower than in a similar group not treated with glucocorticoids and a control group of healthy postmenopausal women. However, in both groups of asthmatic women (e.g. glucocorticoid treated and untreated) a significant increase of mean daily DHEAS levels after 6 months of HRT was observed. The hormone concentrations did not change in control group. CONCLUSIONS: Postmenopausal asthmatic women show diminished circadian dehydroepiandrosterone sulphate serum concentrations irrespective whether they were treated with glucocorticoids or not. However, after 6 months of hormonal replacement therapy in these groups increased levels of DHEA were found.


Asunto(s)
Asma/sangre , Ritmo Circadiano , Sulfato de Deshidroepiandrosterona/sangre , Terapia de Reemplazo de Estrógeno , Posmenopausia , Administración Cutánea , Asma/tratamiento farmacológico , Estradiol/administración & dosificación , Femenino , Glucocorticoides/uso terapéutico , Humanos , Acetato de Medroxiprogesterona/administración & dosificación , Persona de Mediana Edad
13.
J Clin Pharm Ther ; 25(6): 461-6, 2000 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11123500

RESUMEN

OBJECTIVES: Assessment of mean 24 h oestradiol (E2) and oestrone (E1) concentration and basic FSH secretion in postmenopausal asthmatic women, before and after HRT use, and to identify any connections between changes in hormone concentrations and patients' clinical state. SUBJECTS: Postmenopausal women (55 asthmatic and 20 healthy, aged 48-60 years). METHOD: Serum hormone concentration was assessed by radioimmunoassay before HRT and after 6 months of transdermal 17beta-E2 and medroxyprogesterone acetate treatment (cyclical method). Intensification of menopausal symptoms was assessed by Kupperman's index. RESULTS: Secretion of oestrogens was lower in postmenopausal women asthmatic women than in postmenopausal healthy women. HRT caused an increase in oestrogen concentration. The 24-h fluctuations of E1 and E2 in all studied groups before and after HRT did not differ significantly. A statistically significant decrease in the number of menopausal symptoms was found during the course of HRT. During the period of HRT, there was a reduction in the number of patients in whom it was necessary to use oral glucocorticoid therapy during exacerbation of asthma. CONCLUSION: A greater reduction in oestrogen secretion was found in postmenopausal asthmatic women than in postmenopausal healthy women. HRT resulted in normalization of serum oestrogen concentration in asthmatic women and diminishing psychosomatic symptoms of the menopause and symptoms of asthma.


Asunto(s)
Asma/sangre , Estradiol/sangre , Terapia de Reemplazo de Estrógeno , Estrona/sangre , Anciano , Sistema Endocrino/efectos de los fármacos , Sistema Endocrino/metabolismo , Estradiol/uso terapéutico , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Medroxiprogesterona/uso terapéutico , Persona de Mediana Edad , Radioinmunoensayo
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