Efficacy and safety of a phytoestrogen preparation derived from Glycine max (L.) Merr in climacteric symptomatology: a multicentric, open, prospective and non-randomized trial.

A multicentric, open, prospective, observational and no-randomized clinical trial was carried out in Spain with 190 postmenopausal women receiving a soy preparation rich in isoflavones (PHYTO SOYA, capsules containing 17.5 mg isoflavones). The main object of the present study was to investigate its efficacy in alleviating the symptomatology derived from the lack of estrogen, mainly hot flushes, but also other symptoms such as sleep disorder, anxiety, depression, vaginal dryness, loss of libido and bone pain. Each patient received 35 mg isoflavones per day in two doses. During the four months' treatment, a statistically significant decrease in the number of hot flushes with PHYTO SOYA was experienced by 80.82% women; only 5,48% patients did not improve with the treatment. The average reduction was 47.8%, which is equivalent to 4 hot flushes. All the other studied parameters also showed a statistically significant decrease. No severe side-effects were reported and tolerance was excellent. Treatment with PHYTO SOYA resulted in a significant improvement of the symptomatology that accompanies the lack of estrogen during menopause.

Expression of P450c17 messenger ribonucleic acid in postmenopausal human ovary tissues.

OBJECTIVE: To investigate the expression of the P450c17 gene in postmenopausal human ovaries compared with normal cycling ovaries. DESIGN: Prospective nonrandomized clinical research study. SETTING: Servei de Medicina Reproductiva and Centre d'Investigacions en Bioquimica i Biologia Molecular, Hospitals Vall d'Hebron, Barcelona, Spain. PATIENT(S): Six premenopausal women and four postmenopausal women undergoing bilateral oophorectomy for nonovarian gynecologic disease. INTERVENTION(S): Extraction of 10 mL of peripheral venous blood for hormone measurements. Extraction of RNA from surgically removed ovaries for Northern blot, ribonuclease protection, and reverse transcriptase polymerase chain reaction Southern blot assays. MAIN OUTCOME MEASURE(S): Definition of the reproductive cycle state of each patient and determination of the level of P450c17 gene expression in all samples with the use of the semiquantitative reverse transcriptase polymerase chain reaction Southern blot assay. RESULT(S): P450c17 messenger RNA levels in postmenopausal ovaries varied considerably between samples. Although the levels were similar to those detected in the early follicular phase, one of the samples had levels as high as those observed in the late follicular phase. CONCLUSION(S): Although the degree varied from one sample to another, all the postmenopausal ovaries studied expressed the P450c17 gene at the messenger RNA level. In a sample from a patient with endometrial adenocarcinoma, the level was as high as the levels observed in the late follicular phase.

Detection of c-erbB-2/neu and fibroblast growth factor-3/INT-2 but not epidermal growth factor receptor gene amplification in endometrial cancer by differential polymerase chain reaction.

BACKGROUND: It currently is well established that the activation of protooncogenes could trigger uncontrolled cell growth and cancer development. Although this correlation already has been evidenced in several human tumors, no conclusive studies have related oncogene activation with the development of endometrial neoplasia. Nevertheless, few reports suggest that c-erbB-2/neu, which is a prognostic marker in breast cancer, epidermal growth factor receptor (EGFR), which is overexpressed in a variety of neoplasms, and fibroblast growth factor-3 (FGF-3/INT-2), which has been found to be amplified in breast and ovarian cancer, could be implicated in the development of endometrial adenocarcinoma. METHODS: Amplification of c-erbB-2/neu, EGFR, and FGF-3/INT-2 was examined in 50 endometrial carcinomas, 10 adenomatous hyperplasias, and 50 normal endometrial samples, using the genomic differential polymerase chain reaction with the single copy reference gene interferon-gamma. Quantitation of the ratios between the amplified bands was assessed by image analysis. RESULTS: c-erbB-2 and FGF-3/INT-2 were amplified in a first group of 7 (14%) and a further group of 7 (14%) patients, respectively, of a total of 50 in whom endometrial cancer had been studied. In the latter seven, a strong correlation between this genetic marker and an advanced disease stage (International Federation of Gynecology and Obstetrics Stage III) was found. In two patients, both genes were amplified. No EGFR gene amplification was detected in any case. CONCLUSION: c-erbB-2/neu but not EGFR gene amplification was detected and FGF-3/INT-2 amplification and advanced disease were correlated in endometrial cancer.

Increasing incidence of ovarian pregnancy.

This paper presents the results of a review of seven ovarian pregnancies occurring during an 11 year period (1976-1986). The prevalence of the disease is higher than that expected either for the number of deliveries or for all ectopic pregnancies. The presence of etiological factors such as pelvic inflammatory disease, previous abdominal surgery, endometriosis or use of IUD, is considered. Four of these cases presented in actual users of IUD and one in an infertile woman previously diagnosed of endometriosis. The clinical pattern was similar to that recorded for tubal ectopic pregnancies. The role of IUDs and other risk factors in the apparent increase in the number of ectopic pregnancies detected is discussed. Measures to increase accuracy in the detection of early ovarian pregnancies are proposed.

PIP: To investigate further the apparent increase in the incidence of ectopic ovarian pregnancy and its possible association with IUD use, the 7 such pregnancies recorded in the authors' Barcelona hospital practice in 1976-86 were reviewed. During this period, ectopic pregnancies accounted for 1 of every 141 deliveries, which ectopic ovarian pregnancies represented 1 in every 18 ectopic pregnancies. 6 of the 7 ectopic ovarian pregnancies occurred in recent years: 1 in 1984, 2 in 1985, and 3 in 1986. The patients' mean age was 31 years (range, 28-33 years). All cases displayed both ovarian and trophoblastic tissue within the same microscopic field, while the macroscopic appearance of the homolateral tube was normal. The clinical symptoms (predominantly abdominal pain and menstrual disturbances) and physical examination results (the presence of an adnexal mass and pain at the level of the Douglas pouch) in women with ovarian pregnancies did not differ from those in women with ectopic pregnancies. Echography was highly accurate in the detection and localization of early ovarian pregnancies. 2 of the risk factors considered--pelvic inflammatory disease and previous abdominal surgery--were not present in this series of 7 cases; a 3rd-- endometriosis--was reported in 1 case, making this the most apparent risk factor.

[Obstetrical behaviour in diabetes. Perinatal mortality (author's transl)]. / Conducta obstétrica ante la diabetes. Mortalidad perinatal.

Ever today diabetes and pregnancy constitute a high risk situation of the mother as well for the fetus, since still high maternal-fetal mortality rates are observed. A series of 134 diabetic women (99 type A, 15 type B, and 20 type C) were evaluated during pregnancy and delivery, and the results obtained during two different periods of time (1972-1975 and 1976-1978) are analyzed. From the results obtained the reduction of the indexes of perinatal mortality (before and after birth) stands out. These facts could probably be related to a change in the protocol applied during the last years and consisting in the administration of a carbohydrate supplement at night in order to avoid nocturnal hypoglycemias, admission of patients after the 32nd-34th week of pregnancy, complete rest in bed, control of the maturity of the fetus, etc. Likewise, there was a lack of significant rise in the presence of macrosomias, premature births, or urinary infection in the mother. As it was to be expected, the incidence of hydramnios as well as toxemia was higher than normal. The evaluation of the newborns through the Apgar score proved that 20 percent of the neonates in the type C diabetes were still partially or seriously depressed after 5 minutes of birth. A protocol of assistance in this special situation affords an evident reduction in perinatal mortality.

A betamimetic drug and human fetal lung maturation.

In a double-blind and randomized study the administration of a betamimetic drug to the mother from week 33 to 35 produces a significant increase in amniotic fluid palmitic acid levels. We suggest that the administration of a betamimetic drug during pregnancy to the mother can be useful in producing an acceleration of the fetal lung maturation.