RESUMEN
OBJECTIVE: To describe the outcomes after uterine artery embolization treatment of leiomyoma. DESIGN: Case report. SETTING: Department of Gynecology - Federal University of São Paulo. PATIENT: a 34-year-old woman with a diagnosis of leiomyoma for two years. INTERVENTION: embolization of uterine arteries with 500 to 700-microm diameter polyvinyl alcohol particles. MAIN OUTCOME MEASURE: pregnancy and delivery. RESULTS: After embolization, the follow-up revealed a good clinical response with significant reduction in uterus and leiomyoma volume. Also, the patient became spontaneously pregnant, but the delivery was cesarean section due to placenta accreta.. CONCLUSION: Regardless of arterial embolization results for controlling uterine bleeding, this procedure might have some consequences on pregnancy outcome.
Asunto(s)
Leiomioma/terapia , Complicaciones Neoplásicas del Embarazo/terapia , Embolización de la Arteria Uterina/métodos , Neoplasias Uterinas/terapia , Útero/patología , Adulto , Femenino , Humanos , Leiomioma/irrigación sanguínea , Embarazo , Resultado del Tratamiento , Neoplasias Uterinas/irrigación sanguínea , Útero/irrigación sanguíneaRESUMEN
BACKGROUND: This study was performed to evaluate antithrombin III levels in postmenopausal women receiving hormonal replacement treatment. METHODS: It is a prospective randomized study concerning 19 postmenopausal patients, aged 40 to 65 years, who received either continuous daily oral equine conjugated estrogen 0.625 mg (group A, N=10) or daily transdermal 17beta-estradiol 50 microg (group B, N=9). Medroxyprogesterone acetate (5 mg/day, 14 days monthly) was given to all patients. Blood samples were obtained before and after 3, 6, 9 and 12 months of treatment. Coagulation tests included Antithrombin III (functional method), prothrombin time, partial activated prothrombin time, thrombin time, factor V, fibrinogen, platelet count and euglobulin lysis time. Friedman analysis of variance and Mann-Whitney test were used for statistical analysis. RESULTS: Antithrombin III level was reduced (p<0.05) in group A but not in group B, although it remained within normal range. No changes were detected in the other coagulation tests. CONCLUSIONS: These data suggest that oral conjugated estrogen replacement reduces functional ATIII, whereas transdermal estradiol replacement therapy does not modify it.
Asunto(s)
Antitrombina III/análisis , Estradiol/farmacología , Terapia de Reemplazo de Estrógeno/métodos , Estrógenos Conjugados (USP)/farmacología , Posmenopausia/sangre , Administración Cutánea , Administración Oral , Adulto , Antitrombina III/efectos de los fármacos , Estudios de Cohortes , Estradiol/administración & dosificación , Estrógenos Conjugados (USP)/administración & dosificación , Femenino , Humanos , Medroxiprogesterona/administración & dosificación , Medroxiprogesterona/farmacología , Persona de Mediana Edad , Posmenopausia/efectos de los fármacos , Congéneres de la Progesterona/administración & dosificación , Congéneres de la Progesterona/farmacología , Estudios ProspectivosRESUMEN
The ACTH test has been used to confirm the diagnosis of adrenal insufficiency and the classic and the non-classic adrenal hyperplasia due to the 3-HSD, 21 OH e 110H deficiencies. This article reviews the historical aspects of the use of ACTH in the diagnosis of hirsutism and points out its mains indications. In spite of new biological molecular advances in the diagnosis of adrenal enzymatic deficiencies, the use of the ACTH test can help the physician to predict both genothipus and fenothipus in populations with hyperandrogenic manifestations due to non-classical or late-onset congenital adrenal hyperplasia.