Effects of levonorgestrel implant upon TSH and LH levels in male infants during lactation.

OBJECTIVES: The objective of the study is to evaluate the effects of levonorgestrel transferred through breast milk on thyroid stimulating hormone (TSH) and luteinizing hormone (LH) levels in full breast-fed infants. METHODS: Forty healthy postpartum women and their male newborns were recruited for the study. Women were randomly allocated to two study groups: Group 1, IUD users and group 2, Norplant users. Blood and milk samples were collected on the day of IUD or Norplant insertion and 3 and 6 months later for TSH and levonorgestrel measurements. RESULTS: The results disclosed a significant decrease in TSH levels, and a negative relationship between LNG levels and TSH concentration in breast feeding infants at 3 months after implant insertion. The lowest TSH levels were observed at 6 months in the women from group 2. CONCLUSIONS: The overall data indicate that the LNG levels transferred to fully breast-fed infants through breast milk from Norplant users significantly modified their TSH levels.

Luteinizing hormone releasing hormone agonist for postpartum contraception.

OBJECTIVE: To compare the effects of a GnRH agonist upon ovarian function, bleeding pattern, and nursing practice in two groups of Mexican women during the postpartum period. DESIGN AND PATIENTS: Two doses of a GnRH agonist (300-600 micrograms) were investigated during the postpartum period in fully breastfeeding mothers at 6 weeks postpartum. A total of 29 women who desired to breast feed for at least 6 months were allocated in three study groups; group I (control); group II, taking 300 micrograms; and group III, taking 600 micrograms. RESULTS: After treatment initiation, an increase of estrone levels was observed among treated women; thereafter, irregular fluctuations of estrone levels were observed, mainly among women from group III. All the control women and two participants from group III ovulated during the study. Moderate bleeding was registered in most of the women from group I, while amenorrhea and spotting were observed in participants from groups II and III, respectively. There was no significant effect of the treatment on nursing practice between groups. CONCLUSION: GnRH agonists have advantages over steroids for hormonal contraception during the postpartum period in breastfeeding women. Symptoms of hypoestrogenism were not reported any time in either the controls or the treated groups, as estrone levels were not suppressed to menopausal values. Once-daily administration of GnRH agonist could be a reliable, acceptable and safe contraceptive method during the postpartum period in breastfeeding women. More information is required to establish GnRH analog contraceptive efficacy.

Quimioterapia de la onconcercosis: utilidad del mebendazol a nivel comunitario / Drug therapy of onchocercosis: use of mebendazole at communitary level

Resumen El mebendazol, compuesto que en un estudio controlado a nivel hospitalario demostró tener efecto sobre los adultos hembras y las microfilarias de Onchocerco volvulus. fue ahora evaluado en un estudio abierto comunitario para el tratamiento de la oncocercosis. Un total de 26 individuos de diferentes edades y sexos de una comunidad del foco endémico sur del estado de Chiapas, con diferentes densidades de microfilarias en la piel, fueron distribuidos en tres grupos de tratamiento: Grupo 1 formado por 11 hombres mayores de 14años que recibieron I g de mebendazol dos veces al día oralmente durante 4 semanas; Grupo 2 integrado por 6 mujeres mayores de 14 años que recibieron 100mg de dietilcarbamazina dos veces al día durante 4 semanas; y Grupo 3, de 9 menores de 14 aftas de ambos sexos, que recibieron 30 mg de mebendazol por Kg de peso al día. repartidos en dos tomas durante 4 semanas. En los grupos que recibieron mebendazol se observó una baja importante y sostenida en las densidades de microfiliarias, lo cual contrasta notablemente con lo observado en el grupo que recibió dietilcarbamazina. en quienes la baja de las densidades de microfilarias fue inmediata a la administración del medicamento (una semana) y a partir de los 6 meses se observ6 recuperación gradual en el número de microfilarias en la piel, persistiendo una alza lenta a los 14 meses posteriores al inicio del tratamiento. Los efectos secundarios se presentaron con más frecuencia y severidad en el grupo que recibió dietilcarbamazina que en los que se trataron con mebendazol. En ninguno de ellos se presentaron alteraciones oculares atribuibles al tratamiento. Estos resultados sugieren que el mebendazol es seguro y efectivo en el tratamiento de la oncocercosis en la comunidad y que puede ser preferible a la dietilcarbamazina

Comparison of flubendazole and diethylcarbamazine in treatment of onchocerciasis.

Flubendazole, an injectable benzimidazole drug, was compared with diethylcarbamazine (DEC) in a prospective double-blind study of the treatment of onchocerciasis. Nineteen Mexican men were randomly assigned to receive either flubendazole 750 mg intramuscularly once a week for 5 doses, or DEC 100 mg twice daily for 14 days, and they were then followed up for 12 months. Major systemic side-effects during the first 3 weeks were common in the DEC group but not in the flubendazole group in which there was considerable inflammation at the injection site instead. Ocular complications (limbitis, punctate keratitis, and uveitis) were also common in the DEC group, whereas in the flubendazole group they consisted only of one new punctate opacity at day 4 in one subject. One DEC patient also had several new areas of chorioretinal changes on day 2 but these had disappeared by 2 months. Skin microfilaria counts fell rapidly in the DEC group, but returned to the pretreatment levels. In contrast, skin microfilaria counts in the flubendazole group fell slowly, but by 6 and 12 months were lower than in the DEC group (at 12 months 0.2 vs 7.3 mf/mg, p less than 0.001). In addition, by 6 months none of the flubendazole subjects had intracorneal microfilariae, and only one had microfilariae in the anterior chamber, whereas the numbers of intraocular microfilariae in the DEC group had returned to pretreatment levels. The results suggest that flubendazole is safer and more effective than DEC in the treatment of onchocerciasis.

Enfermedad de Chagas: persistente produccion de una glicoproteina de linfocitos T en pacientes tratados con agentes anti Trypanosoma cruzi. / Chagas disease: persistent production of a glycoprotein of T-lymphocytes in patients treated with antiTrypanosoma cruzi agents

Alto numero de linfocitos T circulantes en pacientes con enfermedad de Chagas son ricos en una sustancia PAS-positiva citoplasmatica (PASPLS), que reacciona como glicoproteina. En el presente trabajo se demuestra que esa sustancia (PASPLS) esta presente tambien en linfocitos de pacientes chagasicos que fueron tratados con drogas anti Trypanosoma cruzi varios anos antes de este estudio. Se hallo que todos mostraron un alto numero de linfocitos circulantes poseedores de PASPLS, tal como los chagasicos no tratados. La correlacion con otros datos del seguimiento de los pacientes tratados sugiere que la intensa actividad PASPLS-productora descrita como caracteristica de Chagas seria mantenida a traves de memoria inmunologica una vez iniciado el fenomeno. Ademas, se registro un avance o, en ciertos casos, la aparicion de manifestaciones clinicas de Chagas, en varios de los tratados con los agentes anti Trypanosoma cruzi, aunque sus parasitemias se negativizaron en todos y en varios casos desaparecieron ademas los anticuerpos anti Trypanosoma cruzi fijadores del complemento. Se estima que sera de interes ampliar la discusion sobre esas evidencias cuando esten disponibles mas datos sobre el fenomeno de PASPLS-produccion en Chagas

Enfermedad de Chagas: persistente produccion de una glicoproteina de linfocitos T en pacientes tratados con agentes anti Trypanosoma cruzi. / Chagas' disease: persistent production of a glycoprotein of T-lymphocytes in patients treated with antiTrypanosoma cruzi agents

Alto numero de linfocitos T circulantes en pacientes con enfermedad de Chagas son ricos en una sustancia PAS-positiva citoplasmatica (PASPLS), que reacciona como glicoproteina. En el presente trabajo se demuestra que esa sustancia (PASPLS) esta presente tambien en linfocitos de pacientes chagasicos que fueron tratados con drogas anti Trypanosoma cruzi varios anos antes de este estudio. Se hallo que todos mostraron un alto numero de linfocitos circulantes poseedores de PASPLS, tal como los chagasicos no tratados. La correlacion con otros datos del seguimiento de los pacientes tratados sugiere que la intensa actividad PASPLS-productora descrita como caracteristica de Chagas seria mantenida a traves de memoria inmunologica una vez iniciado el fenomeno. Ademas, se registro un avance o, en ciertos casos, la aparicion de manifestaciones clinicas de Chagas, en varios de los tratados con los agentes anti Trypanosoma cruzi, aunque sus parasitemias se negativizaron en todos y en varios casos desaparecieron ademas los anticuerpos anti Trypanosoma cruzi fijadores del complemento. Se estima que sera de interes ampliar la discusion sobre esas evidencias cuando esten disponibles mas datos sobre el fenomeno de PASPLS-produccion en Chagas

Chemotherapy of onchocerciasis: a controlled comparison of mebendazole, levamisole, and diethylcarbamazine.

Four drug regimens for treating onchocerciasis were compared in a double-blind study in persons from an endemic area in southern Mexico. 40 men were randomly assigned to receive either diethylcarbamazine (DEC) (200 mg/day), mebendazole (2 g/day), levamisole (150 mg per week), or mebendazole plus levamisole. DEC produced the most rapid fall in skin microfilaria counts, but by 6 months the two groups receiving mebendazole showed similar or slightly greater reductions. Despite the administration of corticosteroids to persons receiving DEC, more systemic side-effects were seen in this group. Ocular complications were also commoner and more severe in those receiving DEC. The reduction in the number of intraocular microfilariae at 6 months was similar to those receiving DEC and mebendazole, alone or in combination with levamisole. Levamisole alone had no significant effect on microfilaria counts. Examination of adult worms in nodules excised at 2 months showed changes suggestive of an interruption of embryogenesis in those persons receiving the mebendazole-containing regimens only. The findings suggest that mebendazole may be a useful alternative to DEC in the treatment of onchocerciasis.