[Clinical comparision of alpha dihydroergocryptine against cabergoline in the treatment of the fibrocystic mastopathy]. / Comparación clínica de alfa dihidroergocriptina contra cabergolina en el tratamiento de la mastopatía fibroquística.

BACKGROUND: Fibrocystic breast disease is one of the most frequent conditions of the breast among women from 30 to 49 years, with a frequency of about 60%, hence the interest in studying and treating it with the most advanced and effective resources. OBJECTIVE: To compare the efficacy and adverse events of alpha dihydroergocryptine with cabergoline in patients with fibrocystic breast disease. MATERIAL AND METHODS: A prospective, longitudinal, open, comparative study between alpha-dihydroergocryptine and cabergoline, made in the service of Gynecology and Obstetrics at the Dr. Miguel Silva General Hospital in Morelia, Michoacán. 171 patients diagnosed with fibrocystic breast disease were randomly assigned to the alpha-dihydroergocryptine or the cabergoline group. Assessments were made at baseline and every month subsequently. The following symptoms were evaluated: breast tenderness, breast pain, lumps and nipple discharge. The concentrations of prolactin were determined and an ultrasound was performed at baseline and at 3 and 6 months, patients were questioned about adverse events. RESULTS: 171 patients were included (81treated with alpha-dihydroergocryptine and 90 with cabergoline); 156 completed the study. The age limits were 18 and 51 years. The evolution time prior to study entry was 17.71 +/- 18.3 months for the alpha-dihydroergocryptine group and 18.57 +/- 20.35 for the cabergoline group. 15 patients discontinued treatment due to adverse events (8 of the alpha-dihydroergocryptine group and 7 of the cabergoline group). The most common adverse event was headache. CONCLUSIONS: In this study alpha-dihydroergocryptine was better tolerated and had better clinical response compared with cabergoline; breast pain and breast tenderness disappeared within the first month of treatment. Adverse events were similar for both treatments.

[Evaluation of efficacy of ketoconazole 800 mg-clindamycin 100 mg tablets vaginal against ketoconazole 800 mg- clindamycin 100 mg vaginal capsules in candida vaginitis and vaginosis]. / Evaluación de la eficacia de ketoconazol 800 mg-clindamicina 100 mg tabletas vaginales, contra ketoconazol 800 mg-100 mg de clindamicina cápsulas vaginales en vaginitis candidiásica y vaginosis.

BACKGROUND: pharmaceutical forms (presentations) influence treatment compliance and therefore the effectiveness. Here we present the results in the relief of vaginitis and vaginosis with two different dosage forms. OBJECTIVE: To compare the efficacy and safety of a combination of ketoconazole 800 mg + clindamycin in soft vaginal gel capsules 100 mg (vaginal capsules) against ketoconazole 800 mg + 100 mg clindamycin vaginal tablets (TV) in the management of vaginitis by C. albicans and/or vaginosis. MATERIAL AND METHOD: In a randomized, multicenter, comparative open label study, patients between 18 and 60 years with a diagnosis of vaginitis by C. albicans and/or vaginosis were included. Patients were evaluated clinically and direct exam of genital discharge and culture were performed. Patients were randomized to one of two treatments vaginal tablets or vaginal capsules, for 3 days. RESULTS: one hundred an sitxty nine patients were included, 85 in TV Group and 84 in vaginal capsules group. We found significant statistical difference in clinical response for tablet group at day three for burning p = 0.032 and itching p = 0.043. Microbiological cure was observed in patients with vaginitis by C. albicans, 92.5% in Group TV vs. 90.47% vaginal capsules group, all patients with G. vaginalis at baseline were negative for the organism at the end of the study, cure in patients with mixed infections were 78.94% for TV group vs. 78.26% vaginal capsules; group no adverse events were reported during treatment. CONCLUSIONS: Treatment of vaginitis/vaginosis with vaginal tablets is clinically better than vaginal soft gelatin capsules both treatments were well tolerated.

Double blind study of placebo and ribavirin as prophylaxis in cases of contact with varicella in children.

The aim of this study was to determine whether or not ribavirin provides protection against varicella in those who come in contact with the virus. In a double blind placebo study, ribavirin (20 mg/kg/day, p.o.) or placebo was administered to children who had contact with varicella. Treatment was administered to 61 children (Group 1) within the first 3 days of contact, 45 of them were immunocompetent and 16 were immunodepressed. Treatment was given to 54 children on the 7th day after contact (Group 2); 48 of them were immunocompetent and 6 immunodepressed. In group 1, 11 (50%) of the immunocompetent treated with ribavirin developed chicken pox while 11 (50%) were asymptomatic. For seroconversion, there was no significant difference (p=0.586). In group 2, we did not find varicella in immunocompetent patients receiving ribavirin (0/24), for placebo there were 2 (2/24) cases of varicella. Varicella was not observed in immunodepressed patients in Group 2. A difference was not observed with the administration of ribavirin at day 3 or 7 versus placebo to prevent development of varicella. This study may have implications for the public health efforts in the prophylaxis of chicken pox.

[Ketoconazole and clindamycin efficacy vs oral clindamycin in premature membranes rupture prevention]. / Eficacia del ketoconazol y la clindamicina vaginal vs clindamicina oral en la prevención de la rotura prematura de membranas.

BACKGROUND: Vulvovaginitis is one of the main causes of premature membrane rupture. OBJECTIVE: To evaluate effectiveness of a combination of ketoconazole (400 mg) and clindamycin (100 mg) in vaginal tablets, compared with clindamicyn alone (600 mg/daily) orally, for six days, to prevent premature membrane rupture in patients with vulvovaginitis. PATIENTS AND METHOD: Longitudinal, prospective, comparative, randomized, double-blind, double-dummy study in patients older than 18 years, during them third trimester of normoevolutive pregnancy with symptomatic vulvovaginitis. Patients were monitored as out patient. Genital secretion culture and fresh studies were made. Signs and symptoms were evaluated in regular intervals: 4, 7 and 11 days. Pregnancy control was performed every three weeks, until childbirth or premature membrane rupture. RESULTS: 105 patients were included: 53 in the group of ketoconazole and clindamicyn (1), and 52 in the group of clindamycin alone (2). Symptoms were similar in both groups of treatment, without statistically significant differences. A case of group 2 has premature membrane rupture (p = 0.495). C. albicans was cultured in 35% of group 2 and in 11% of group 2. No adverse events with treatments were reported. CONCLUSIONS: The combination of ketoconazole and cindamycin was effective to prevent premature membrane rupture in patients with vulvovaginitis.

Evaluación de la actividad reepitelizante del Triticum vulgare en la cervicitis crónica erosiva / Evaluation of reepithelizing activity of Triticum vulgare in chronic cervicitis

Las fitoestimulinas o bioestimulinas de origen vegetal, obtenidas por un proceso de extracción en gramíneas (principalmente en Triticum vulgare o trigo), estimulan la síntesis de RNAm y DNA en fibroblastos y activan la reepitelización de los tejidos. La cervicitis crónica se caracteriza por colecciones difusas de células inflamatorias en el estroma subepitelial y ocurre una proliferación del tejido conectivo fibroso en el estroma cervical. Ello resulta en una hipertrofia del cuello uterino.Se realizó un estudio clínico doble ciego en 40 pacientes con cervicitis crónica erosiva. Veinte pacientes recibieron crema vaginal del extracto acuoso de Triticum vulgare, dos veces al día durante 14 días consecutivos y las restantes placebo. Una vez iniciado el tratamiento con el Triticum vulgare, la leucorrea disminuyó tanto en cantidad como en porcentaje de pacientes que la presentaban (16.7por ciento vs 42.1por ciento en los grupos Triticum vulgare y placebo respectivamente). El tamaño de la lesión se redujo significativamente y la reepitelización completa de la misma empezó a manifestarse desde el día 16 en el grupo con Triticum vulgare. Al día 48, el 77.8por ciento de las pacientes con Triticum vulgare presentaban reepitelización total, comparado con 47.4por ciento del grupo con placebo. Observamos un caso de hipersensibilidad probablemente relacionada al medicamento; asimismo, también se presentó una inflamación intensa en una paciente del grupo placebo. Podemos concluir que el extracto acuoso de Triticum vulgare es un medicamento útil en la cervicitis crónica erosiva, ya que acelera significativamente la reepitelización del cuello uterino.

Efecto reepitelizante del Triticum vulgare en el ectropión cauterizado del cérvix / Reepithelización effect of triticum vulgare after cervix cuatherization

El ectropión del cérvix es un trastorno común en la práctica ginecológica. El tratamiento más satisfactorio es la destrucción del tejido afectado mediante electrocauterización, criocirugía o vaporización con rayo láser, que obtienen la cicatrización con la posterior reparación mediante la proliferación de fibroblastos y reepitelización. La reepitelización completa puede llevar más de ocho semanas. Con el objeto de acortar el tiempo requerido para la reepitelización, se evaluó la eficacia del extracto acuoso de Triticum vulgare en un estudio doble ciego comparativo con placebo. Se estudiaron 40 pacientes con ectropión tratadas con vaporización mediante rayo láser. Posteriormente las pacientes del primer grupo fueron tratadas con óvulos de Triticum vulgare, dos veces al día durante dos semanas consecutivas; las pacientes del grupo control recibieron placebo. El extracto acuoso de Triticum vulgare fue capaz de acortar el tiempo para la reepitelización. Al día 40, el 40 por ciento de las pacientes tratadas con Triticum vulgare presentaron una reepitelización completa, comparado con 5 por ciento de las que recibieron placebo; 75 por ciento vs 35 por ciento al día 48, y 85 por ciento vs 55 por ciento al día 56, respectivamente. No se observaron eventos adversos. Se concluye que el extracto acuoso de Triticum vulgare acelera la reepitelización postratamiento del ectropión con rayo láser y tiene buena tolerabilidad vaginal.

Eficacia de la ribavirina al 7.5 por ciento por vía tópica en el tratamiento del herpes labial / Eficacy of the ribavirin at 7.5 per cent by topical route in the treatment of labial herpes

Estudio prospectivo en 40 pacientes con herpes labial, comparando Ribavirina tópica al 7.5 por ciento contra placebo. Se observó efecto antiviral demostrado por la supresión de nuevas vesículas en el mismo brote