Errores de interpretación / Interpretation errors

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Osteoporosis / Osteoporosis

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¿Medicinas alternativas? / Alternative medicines?

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Las nuevas tecnologías de la información / New information technologies

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Virus Zika / Zika virus

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Avances en diagnóstico prenatal / Advances in prenatal diagnosis

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Tumor de Brenner / Brenner tumor

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Fertility and histology after rabbit ovarian wedge resection with CO2 laser or electrocautery using posterior reconstruction with nylon or polyglactin sutures.

In an experimental study in rabbits, the CO2 laser and electrocautery were compared in performing microsurgical ovarian wedge resection; polyglactin and nylon sutures were compared for ovarian reconstruction. Histologic reaction, adhesion formation, and functional parameters (number of corpora lutea, number of pregnancies, nidation index) were evaluated 30 and 90 days postoperatively. Thirty days after surgery, the tissue inflammatory response was very similar in the four groups; fibrosis was not detected. Significant reductions (P less than 0.01) were found for the experimental (operated right ovary) vs. the control (unoperated left ovary) groups when comparing the number of corpora lutea and the number of pregnancies. No significant differences in the nidation index were demonstrated. Adhesion formation was not different between any of the experimental procedures; adhesions were not detected in the control ovaries. At 90 days, the polyglactin suture was entirely absorbed and no inflammatory reaction persisted. Minimal giant cell infiltration was found around the nylon suture. The histologic differences between the two sutures were statistically significant (P less than 0.02). No fibrosis was observed. The functional parameters did not reveal statistically significant differences between the two sutures.

Serial measurements of a plasma prostacyclin inhibitor in a patient with recurrent abortions and lupus anticoagulant; a case report.

Defective plasmatic stimulation of prostacyclin (PGI2) production by vascular cells has been described in patients with lupus anticoagulant (LAC). A young woman with recurrent abortions, LAC and evidence for deficient PGI2 production was studied. Serial measurements of a plasma PGI2 inhibitor, LAC and anticardiolipin antibodies (ACA) have been performed before and throughout her fourth pregnancy. Antenatal care and treatment with prednisone and heparin started at 10 weeks gestation. The plasma of our patient continued to inhibit PGI2 production by vascular cells despite treatment. The presence of inhibitor(s) of PGI2 release was confirmed by mixing the patient's plasma with normal plasma. In addition, an IgM lupus anticoagulant fraction (but not the IgG fraction) interfered with the release of arachidonic acid in human endothelial cells induced by thrombin. Despite prednisone and heparin treatment we did not find a complete correction of the LAC activity and the ACA (IgM type) still remained positive before the detection of a fetal death at 26 weeks. The placenta showed abundant infarcts and areas of ischaemic necrosis. We suggest that the defect in vascular PGI2 release could compromise fetal outcome.

Conservative treatment of intrapartum fetal acidosis with a betamimetic agent.

553 cases of intrapartum fetal acidosis (pH less than 7.25) were treated with a betamimetic agent (ritodrine 250-300 micrograms/min). In 403 cases (72.8%), an improvement of fetal pH greater than 0.05 pH U was observed. Improvement was comparable in cases where the cause of fetal distress was abnormal uterine activity and in those where this was not the cause. Indeed, the recovery rate was the same, independent of the percentage of uterine activity inhibition. The neonatal condition was better in the pH recovered versus not recovered group. We suggest that conservative treatment of fetal distress with betamimetic drugs is a reasonable measure for improvement of fetal and neonatal condition.

Renal transplantation during pregnancy--a case report.

A case of renal transplantation during the 12th week of pregnancy is presented. An episode of rejection 6 days after surgery was treated satisfactorily. At the 18th week, the patient showed a mild hypertension which was treated by hidralazine. At the 30th week a fetal pyelouretheral stenosis with celiciar dilatation was diagnosed and the mother had another rejection episode. At the 33rd week a cesarean section was performed after a pathological NST. Neonatal and maternal developmental courses were good.

Long-term hospitalization and beta-mimetic therapy in the treatment of intrauterine growth retardation of unknown etiology.

A group of 98 third trimester pregnant women whose ultrasonographic studies raised the suspicion of intrauterine fetal growth retardation was studied. The patients were randomly assigned to two groups: Group A (Treatment group: 44 patients) and Group B (Control group: 54 patients). All patients were admitted to the hospital upon diagnosis for baseline evaluation. Those in Group A remained in the hospital until delivery (mean stay 15 +/- 5 days) and received treatment with 10 mg/t.i.d. of p.o. ritodrine. Group B patients were discharged after an average stay of 7 +/- 3 days. This group was not treated with ritodrine, and they were seen weekly in an outpatient setting. The prevalence of low-birth-weight infants for their gestational age was 47.73% in the treatment group and 40.74% in the control group. Of the deliveries in the treatment group, 40.9% were induced (half for fetal indications). In the control group 35.18% of the induced labors was (47.35% for fetal indications). Of the cases in the treatment group 18.18% were delivered by cesarean section, of which 62.5% were performed for fetal distress. The control group showed similar figures: 16.66% cesarean sections with 77.7% of them done for fetal distress. We observed an incidence of 20.45% of acute fetal distress in the study group against 12.96% in the control group. Such a difference is not statistically significant. The group under study demonstrated a rate of 6.82% pathological pH value in the umbilical artery, while the rate of abnormal values in the control group was 18.52%. In both groups, the greatest percentage of acidotic pH was observed in patients with IGR.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of a cyproterone-containing oral contraceptive on hormonal levels in polycystic ovarian disease.

The management of polycystic ovarian disease in women not desiring pregnancy is controversial. To avoid the progressive androgenic effects on peripheral target organs, some advocate the use of oral contraceptives. This study reports the effects of a preparation with 50 micrograms ethinyl estradiol and 2 mg cyproterone acetate on gonadotropins, prolactin, testosterone, sex hormone binding globulin (SHBG), androstenedione, and calculated free testosterone index before and after six months of treatment. Gonadotropins, testosterone, and androstenedione levels decreased, prolactin did not change, and sex hormone binding globulin increased as the result of the treatment. This led to a net decrease in the calculated free testosterone.

[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.

Neonatal respiratory distress syndrome (RDS) in cases of premature labor treated by betamimetic drugs.

In 87 premature labors, 31 were treated with betamimetic drugs. The incidence of RDS in the treated group has been lower than in the non-treated group, especially when gestational age was shorter than 35 wk and when newborn's weight was lower than 2000 g.

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.

Orciprenaline and fetal lung maturation in rabbits.

The palmitic and stearic acids and the palmitic/stearic ratio in fetal rabbit lungs were studied after orciprenaline administration to the mother from the 26th to the 31st day of gestation. The results were significantly higher in the treated groups than in the control group for the palmitic acid and palmitic/stearic ratio.

A comparative study between the values of lecithin, sphingomyelin, lysolecithin, the L/S index, and the Clements test in amniotic fluid.

The relationship between the concentration of several phospholipids in amniotic fluid and the ocurrence of neonatal RDS was established some years ago. However the methods used for the determination of those substances are sophisticated and time consuming. They require specalized equipment and take at least 2 or 3 hours. CLEMENTS described a semiquantitative method which overcomes these disadvantages. The present study compared the concentration of lecithin, shingomyelin, lysolecithin and the L/S ratio against the results obtained when processing the same samples with the CLEMENTS Test. the results are expressed in mg/100 ml. for the different phospholipids and the test was evaluated as positive, intermediate or negative. a statistically significant correlation has been found between the values of lecithin, lysolecithin and L/S ratio and the results of the CLEMENTS Test, respectively. No correlation could be found with sphingomyelin (Figs. 1-4). It is concluded that the CLEMENTS Test can be a useful tool as a screening test available to any obstetrical centre.