Emerging contaminants and antibiotic resistance in the different environmental matrices of Latin America.

This review aims to gather and summarize information about the occurrence of emerging contaminants and antibiotic resistance genes in environmental matrices in Latin America. We aim to contribute to future research by compiling a list of priority pollutants adjusted to the needs and characteristics of Latin America, according to the data presented in this study. In order to perform a comprehensive research and secure a representative and unbiased amount of quality data concerning emerging contaminants in Latin America, the research was performed within the Scopus® database in a time frame from 2000 to July 2019. The countries with higher numbers of published articles were Brazil and México, while most studies were performed in the surroundings of Mexico City and in Southern and Southeastern Brazil. The main investigated environmental matrices were drinking water and surface water. The presence of antibiotic resistance was frequently reported, mainly in Brazil. Monitoring efforts should be performed in other countries in Latin America, as well as in other regions of Brazil and México. The suggested priority list for monitoring of emerging contaminants in Latin America covers: di(2-ethylhexyl) phthalate (DEHP), bisphenol-A (BP-A), 4-nonylphenol (4-NP), triclosan (TCS), estrone (E1), estradiol (E2), ethinylestradiol (EE2), tetracycline (TC), amoxicillin (AMOX), norfloxacin (NOR), ampicillin (AMP) and imipenem (IMP). We hope this list serves as a basis for the orientation of the future research and monitoring projects to better understand the distribution and concentration of the listed emerging substances.

TiO2 and ZnO mediated photocatalytic degradation of E2 and EE2 estrogens.

In this work, the photocatalytic degradation of selected estrogens (E2 and EE2) was evaluated, using bench-scale and continuous treatment systems assisted by artificial UV-A and solar radiation. Processes based on the use of TiO2 permit an efficient degradation of E2 and EE2 estrogens, usually at reaction times lower than 15 min. Especially remarkable is the high degradation efficiency shown by sunlight-assisted processes, which are extremely favored by the high efficiency of compound parabolic collectors.

Alopécia androgenética feminina: estudo hormonal e avaliaçäo do tratamento com antiandrógenos / Female androgenetic alopecia: hormonal study and evaluation of antiandrogen treatment

O objetivo deste trabalho foi avaliar a eficácia do tratamento com antiandrógenos em mulheres com alopécia androgenética (AA). Realizamos dosagens de testosterona total (T), testosterona livre (TL), sulfato de deidroepiandrosterona (DHEA-S), androstenediona (A), proteína ligadora dos hormônios sexuais (SHBG), androstanediol glucuronídeo (3alpha-diol G), TSH, anticorpo antimicrossomal e as relaçöes T/SHBG (x100) e 3alpha-diol G/SHBG em 30 mulheres com AA, idades entre 14 e 46 anos, e comparamos com grupo controle, constituído por 11 mulheres, idades entre 16 e 27 anos. Quatro pacientes tiveram diagnóstico de doença endócrina: hipotireoidismo primário (n=2), síndrome dos ovários policísticos e hirsutismo idiopático. Nas demais 26 pacientes, a relaçäo 3alpha-diol G/SHBG foi maior (p<0,05), sem diferença na concentraçäo dos androgênios, quando comparamos com o grupo controle. Sete pacientes utilizaram acetato de ciproterona (50mg/dia) associado com etinilestradiol (AC+E) e cinco pacientes utilizaram espironolactona (100mg/dia) por 6 meses. Houve diminuiçao estatisticamente significativa nas dosagens de 3alpha-diol G, SHBG e da relaçäo T/SHBG somente nas pacientes que utilizaram AC+E. Todas as pacientes relataram melhora da queda do cabelo. Observamos, através do tricograma, um aumento estatisticamente significativo dos pêlos anágenos nas pacientes que utilizaram AC e espironolactona (p<0,05) e diminuiçao de pêlos anágenos disäo androgênica que ocorre em mulheres geneticamente predispostas. O tratamento com AC+E acarreta uma melhora no perfil hormonal e na análise do tricograma sendo necessário tratamento mais prolongado para que seja observado aumento na quantidade do pêlo.

Avaliação da tolerabilidade e do controle de ciclo de dois contraceptivos orais de baixa dose: estudo comparativo aberto / Assessment of the tolerability and cycle control of two low-dose oral contraceptives: an open-label study

Realizou-se um estudo aberto comparativo em nove centros brasileiros para avaliar a tolerabilidade e o controle de ciclo obtido com o uso de dois contraceptivos orais de baixa dose contendo 20 mg etinilestradiol/75 mg gestodeno e 20 mg etinilestradiol/150 mg desogestrel, durante seis ciclos de tratamento. Foram selecionadas 167 mulheres saudáveis com vida sexual ativa (77 no grupo do gestodeno e 90 no grupo do desogestrel), das quais 138 completaram os seis ciclos de tratamento. Em um subgrupo de novas usuárias realizou-se também perfil lipídico e hemostático. Foram avaliados 867 diclos no total. Ocorreu sangramento irregular em 4,6 por cento dos ciclos com gestodeno e em 8,1 por cento com desogestrel. A tolerabilidade a ambas preparações foi boa, mas houve significativamente mais náusea no grupo do desogestrel. O controle de ciclo foi bom com os dois contraceptivos, sendo que houve freqüência significativamente menor de sangramento irregular no grupo do gestodeno quando se leva em conta que todos os ciclos foram considerados. Não houve alterações clinicamente significativas no perfil hemostático. O perfil lipídico mostrou tendência a tornar-se mais favorável após seis ciclos de tratamento com as duas preparações. Não ocorreu alteração no peso médio das mulheres no grupo do gestodeno; no grupo do desogestrel houve aumento significativo no peso médio de aproximadamente 1 Kg após seis meses de tratamento. A adesão ao tratamento foi boa com as duas preparações. Os resultados deste estudo mostram que preparações contendo baixa dose de gestodeno ou desogestrel associados a 20 mg de etinilestradiol são contraceptivos bem tolerados que permitem bom controle de ciclo, sem efeitos colaterais significantes.

Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices.

This study evaluated the performance of progesterone vaginal rings (n = 187), progestin-only pills (n = 117), Norplant implants (n = 120), and Copper T 380-A intrauterine devices (n = 122) in lactating women. Contraceptive efficacy, bleeding pattern, and influence of the method upon breastfeeding duration and infant growth were compared with those of untreated women (n = 236) who relied on lactational infertility. Participants were healthy, 18 to 38 years, had had a normal delivery, and were intending to breastfeed for as long as possible. Contraceptives were initiated at day 57 +/- 3 postpartum. Results are reported for the first year of use. All methods were highly effective, with pregnancy rates below 1%. None affected breastfeeding performance or the rate of infant growth. Users of the progestin-only methods experienced a period of lactational amenorrhea 4 to 5 months longer than did users of Copper T or untreated women. More than half of the women in each contraceptive group reported a bleeding in the first month after treatment initiation, which was not considered in the calculation of the duration of amenorrhea. Prolonged or frequent bleedings were infrequent. The proportion of bleedings lasting more than 10 days ranged from 0 in the progestin-only pills group to 7% in the Norplant implants group. The four methods, initiated around the eighth postpartum week, provided effective contraception with no negative effects upon lactation or infant growth and without the bleeding problems associated with their use in nonlactating women.

Endometriose da coxa / Endometriosis of the thigh

É relatado um caso de endometriose que se manifestou inicialmente na coxa. O tumor comprometia a face ântero-superior da coxa direita, era doloroso e aumentava de volume na época menstrual. No entanto, cerca de seis anos após as terapêuticas cirúrgica e hormonal houve recidiva do tumor e evidenciou-se a presença de foco primário, intraperitoneal. Por fim, säo feitas consideraçöes sobre a endometriose, intra e extraperitoneal, e descritas as principais teorias histogenéticas

[Effects of lynestrenol used singly in low doses, as a contraceptive]. / Efectos del linestrenol utilizado solo a dósis baja, como anticonceptivo

PIP: The effects of lynestrenol, administered continuously in the dose of .5 mg/day, were studied in 50 women during 1146 menstrual cycles. 45 patients completed 24 cycles each. Before treatment and every 6 cycles all patients were subjected to questioning, physical examination, cytological, blood and urea nitrogen tests and urinalysis. 50% were also subjected to hepatic function tests (sulfobromophtalein excretion, glutamic oxalacetic transaminase, alkaline phosphatase, cephalin-cholesterol flocculation) and endometrial biopsies every 6 cycles. Subjective side effects were absent and weight and blood pressure remained unchanged. Laboratory tests and cytological studies showed normal results. Only 14% of the biopsies performed showed interferen ce with the normal hormonal transformation of the endometrium. The average duration of menstruation was 4-5 days; 7% of all cycles were shortened by 5-10 days and .2% by 11-14 days. 7% of the cycles were prolonged by 5-10 days and .8% by 11-20 days. Amenorrhea was present in .4% of the cycles. Irregular bleeding (either spotting or breakthrough bleeding) was present in 14% of the cycles. 6 patients (12%) stopped the treatment for this reason. It is concluded that the preparation studied is effective and very well tolerated. Patients must be advised regarding the possibility of irregularities in the menstrual cycle, the efficacy of the drug and the absence of other unwanted side effects, to decrease the dropout rate.^ieng

[Clinical studies on Ovostat--a combined oral contraceptive with a low dose of lynestrenol]. / Klinische Untersuchung mit Ovostat--einem kombinierten oralen Kontrazeptivum mit einer niedrigen Dosis Lynestrenol

PIP: Experience with the oral contraceptive Ovostat (.1 mg mestranol and 1 mg lynestrenol) in 324 women (5714 cycles) is reported. Only 1 pregnancy was observed, in a patient who had forgotten several pills. Side effects included headache (11 patients), nervousness (5 patients), amenorrhea (4 patients), and chloasma (3 patients). Breakthrough bleeding and spotting were rare. Cervical mucus (samples on Days 9-11 and 13-15 in 50 women) was uniformly inhospitable to sperm: low viscosity, negative Farn test, constant pH. Endometrial biopsy showed tissue typical of "suppressed" endometrium.^ieng

[Clinico-pathological study of the effects of contraceptive treatment with mestranol-lynestrol by a sequential type method]. / Estudio clínico-patologico de los effectos de la terapia contraceptiva con mestranol-linestrol en una modalidad del tipo secuencial.

PIP: 100 healthy fertile women, with active sexual lives and of reproductive age, were treated during 10 cycles in 1 year with mestranol-lynestrenol of the sequential type, for the purpose of determining the effectiveness of the drug as a contraceptive and study its effects on endometrial morphology, endocervical mucus, cervicovaginal cytology and urinary excretion of pregnanediol. The changes in the menstrual cycle and side effects were observed. The results obtained clearly show that the combination of mestranol-lynestrenol is an effective contraceptive (no pregnancy occurred), safe and well tolerated, with minimal side effects.^ieng

[Clinical study of a mestranol lynestrenol combination of 1 mg. (preliminary report)]. / Estudio clínico con la combinación de mestranol y linestranol de 1 mg. (reporte preliminar)

PIP: 135 women who had had at least 1 child were treated with 80 mg of mestranol and 1 mg of lynestrenol on a 22 day on, 6 day off basis for a total of 800 cycles of observation. Follow-up was done monthly. Endometrial and cervical biopsies were done and levels of pregnanediol in the urine were tested. Cycles were between 25-31 days with an average of 28. Flow averaged 3 days' duration and was slight in 53.1% of the cycles, normal in 39.3% and heavy in 2.1%. 48.3% of the cycles were characterized by no dysmenorrhea, 35.7% by slight, 11% by moderate, and 1.8% by severe. Incidence of spotting and breakthrough bleeding was slight. Side effects were also slight; nausea was present in 7.6% of the cycles, hypogastric tension in 6.6%, chloasma in 5.9%, and severe headache in 4.3%. Headaches were the only side effect reported with any regularity. No pregnancies occurred. Only 14 patients discontinued. Test results indicated that under medication the amount of pregnanediol diminished, the endometrium modified its ovulatory functions, the cervical mucus lost it ability to crystallize or stretch, and vaginal shedding was slightly modified.^ieng