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1.
Actual. osteol ; 18(2): 75-81, oct. 2022. graf, tab
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1437673

RESUMO

Para la evaluación longitudinal de la composición corporal por DXA se deben calcular los cambios mínimos significativos (CMS). No está claro si hay diferencias de género para los CMS de adultos. Con consentimiento informado se realizaron 2 escaneos DXA de cuerpo completo consecutivos, con reposicionamiento entre ellos, en 40 varones y 40 mujeres (rango de edad de 22 a 85 años), con un equipo GE Lunar Prodigy Advance®, siguiendo las pautas de la International Society for Clinical Densitometry (ISCD). Todos los escaneos fueron obtenidos por la misma técnica experta. Los CMS se calcularon de acuerdo con el método propuesto por la ISCD. Los resultados se analizaron con GraphPad® para Windows 6.0, con una significancia fijada en p < 0,05. No hubo diferencias de género para la edad (p = 0,846) o el índice de masa corporal (p = 0,802). La altura, la masa corporal, la masa magra y el contenido mineral óseo (CMO) fueron mayores en los varones (todos p < 0,0001), mientras que la masa grasa fue mayor en las mujeres (p = 0,0036). No hubo diferencias significativas entre géneros para los coeficientes de variación de masa grasa (p = 0,0698), masa magra (p = 0,1483) o CMO (p = 0,5254). Los CMS (para IC de 95%) para la masa grasa fueron 1,780 kg (varones), 1,671 kg (mujeres) y 1,727 kg (ambos sexos); para masa magra, 1,658 kg (varones), 1,644 kg (mujeres) y 1,651 (ambos sexos); y para CMO, 112,2 g (varones), 109,4 (mujeres) y 110,8 g (ambos sexos). Los resultados sugieren que los CMS para la composición corporal de su-jetos adultos pueden calcularse a partir de una muestra de cualquier género o una que incluya sujetos de ambos sexos. (AU)


Lack of gender-related differences in least significant changes for DXA body composition analysis in adult subjectsFor longitudinal assessment of body composition by DXA, least significant changes (LSCs) should be calculated. It is unclear if there are gender differences for adult LSCs. With informed consent, 2 consecutive total-body DXA scans, with repositioning between them, were performed on 40 males and 40 females (age range 22 to 85 years) with a GE Lunar Prodigy Advance scanner, following the guidelines of the International Society for Clinical Densitometry (ISCD). All scans were obtained by the same skilled technologist. The LSCs were calculated according to the method proposed by the ISCD. Results were analyzed with GraphPad for Windows 6.0, with significance set at p < 0.05. There were no gender differences for age (p = 0.846) or body mass index (p = 0.802). Height, body mass, lean mass, and bone mineral content (BMC) were higher in males (all p < 0.0001), whereas fat mass was higher in females (p = 0.0036). There was no significant difference between genders for the coefficients of variation of fat mass (p = 0.0698), lean mass (p = 0.1483), or BMC (p = 0.5254). The LSCs (for a 95% CI) for fat mass were 1.780 kg (men), 1.671 kg (women), and 1.727 kg (both genders); for lean mass, 1.658 kg (men), 1.644 kg (women) and 1,651 (both genders); and for BMC, 112.2 g (men), 109.4 (women), and 110.8 g (both genders). These results suggest that LSCs for body composition of adult subjects can be calculated from either a sample of each gender or one that includes subjects of both genders. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Composição Corporal , Absorciometria de Fóton , Densidade Óssea , Fatores Sexuais , Valores de Referência , Estatura , Peso Corporal , Índice de Massa Corporal , Antropometria , Interpretação Estatística de Dados , Fatores Etários , Adiposidade
2.
Actual. osteol ; 18(3): 157-168, 2022. ilus
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1452184

RESUMO

El año 2022 marca el primer centenario del descubrimiento de la vitamina D, hallazgo que recompensó la prolongada búsqueda de la causa del raquitismo, su prevención y tratamiento. Al mismo tiempo puso en marcha importantes investigaciones relaciona-das con su biotransformación y el mecanismo de su acción antirraquítica, además de estudios sobre diversos efectos biológicos sin relación directa con su papel en la salud ósea. Esta breve revisión se limitará a delinear la prehistoria de la vitamina D y los diversos estudios, básicos y clínicos, que condujeron a su descubrimiento y caracterización química. (AU)


The year 2022 marks the centenary of the discovery of vitamin D, a breakthrough that rewarded the long search for the cause of rickets, its prevention and treatment. At the same time, it launched important investigations related to its biotransformation and the mechanism of its antirachitic action, as well as studies on various biological effects without direct relation to its role in bone health. This brief review will be limited to an outline of the prehistory of vitamin D and the various basic and clinical studies that led to its discovery and chemical characterization. (AU)


Assuntos
Humanos , Raquitismo/história , Vitamina D/história , Raios Ultravioleta , Óleo de Fígado de Bacalhau
3.
World J Gastrointest Pathophysiol ; 8(2): 59-66, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28573068

RESUMO

AIM: To assess whether higher sensitivity of colonic epithelium to hypoxia at the serosal side is associated with oxygen transfer asymmetry. METHODS: Rats were fed either with normal chow or a low-sodium diet. Tissues were mounted as flat sheets in a modified, airtight Ussing chamber with oxygen meters in each hemichamber. Mucosal samples from normal diet animals were studied under control conditions, in low-chloride solution and after adding chloride secretion inhibitors and chloride secretagogues. Samples from sodium-deprived rats were studied before and after ouabain addition. In separate experiments, the correlation between short-circuit current and oxygen consumption was analyzed. Finally, hypoxia was induced in one hemichamber to assess the relationship between its oxygen content and the oxygen pressure difference between both hemichambers. RESULTS: In all studied conditions, oxygen consumption was larger in the serosal hemichamber than in the mucosal one (P = 0.0025 to P < 0.0001). Short-circuit current showed significant correlation with both total oxygen consumption (r = 0.765; P = 0.009) in normoxia and oxygen consumption in the serosal hemichamber (r = 0.754; P = 0.011) during mucosal hypoxia, but not with oxygen consumption in the mucosal hemichamber. When hypoxia was induced in the mucosal hemichamber, an oxygen pressure difference of 13 kPa with the serosal hemichamber was enough to keep its oxygen content constant. However, when hypoxia was induced in the serosal hemichamber, the oxygen pressure difference with the mucosal hemichamber necessary to keep its oxygen content constant was 40 kPa (P < 0.0001). CONCLUSION: Serosal oxygen supply is more readily available to support short-circuit current. This may be partly due to a rectifying behavior of transepithelial oxygen transfer.

4.
Saudi J Gastroenterol ; 21(5): 290-4, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26458855

RESUMO

BACKGROUND/AIM: Aerobic metabolism is necessary for ion transport in many transporting epithelia, including the human colonic epithelium. We assessed the effects of the epithelial sodium channel blocker, amiloride, on oxygen consumption and short-circuit current of the human sigmoid epithelium to determine whether these effects were influenced by the age of the subject. MATERIALS AND METHODS: Segments of the sigmoid colon were obtained from the safety margin of resections performed in patients of 62-77 years of age. Isolated mucosa preparations were obtained and mounted in airtight Ussing chambers, fit for simultaneous measurement of short-circuit current and oxygen concentration, before and after blocking epithelial sodium channels with amiloride (0.1 mmol/L). Regression analyses were performed to assess the associations between short-circuit current, oxygen consumption, and age of the subject as well as to define the relationship between the decreases in short-circuit current and oxygen consumption after blockade. RESULTS: Epithelial sodium channel blockade caused an 80% reduction in short-circuit current and a 26% reduction in oxygen consumption. Regression analysis indicated that both changes were significantly related (r = 0.884;P = 0.0007). Oxygen consumption decreased by 1 m mol/h/cm2 for each 25 m A/cm2 decrease in short-circuit current. Neither short-circuit current nor oxygen consumption had any significant relationship with the age of the subjects. CONCLUSION: The decrease in epithelial oxygen consumption caused by amiloride is proportional to the decrease in short-circuit current and independent of the age of the subject.


Assuntos
Amilorida/farmacologia , Colo Sigmoide/efeitos dos fármacos , Diuréticos/farmacologia , Epitélio/efeitos dos fármacos , Consumo de Oxigênio/efeitos dos fármacos , Sódio/metabolismo , Fatores Etários , Idoso , Cátions Monovalentes/metabolismo , Colo Sigmoide/metabolismo , Bloqueadores do Canal de Sódio Epitelial/farmacologia , Epitélio/metabolismo , Feminino , Humanos , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/metabolismo , Transporte de Íons/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade
5.
Acta Gastroenterol Latinoam ; 45(3): 203-11, 2015 09.
Artigo em Inglês | MEDLINE | ID: mdl-28590603

RESUMO

INTRODUCTION: The colonic epithelium is a classical aldosterone target, but the effect of the hormone on the oxygen consumption rate (QO2 ) of this tissue is unknown. Objectives. We aimed at assessing, in the rectal epithelium of rats fed with diets of different sodium content, the effect of epithelial sodium channel (ENaC) blockade on short-circuit current (ISC ) and QO2 , and the acute effect of aldosterone incubation on ISC and QO2 . METHODS: Adult male rats were fed with normal, low or high-sodium diets for 8 days. Plasma sodium and serum aldosterone were measured. Isolated mucosa preparations from the rectal portion of the colon were mounted in Ussing chambers modified to measure ISC and QO2. RESULTS: Baseline ISC and QO2 were highest in sodium-deprived rats. Both were proportionally reduced by amiloride (0.1 mM) in this group and in the normal sodium group, but not in sodium-loaded rats. In separate experiments, incubation with aldosterone (10 nM) for 7 h increased ISC and QO2 in all groups; increases were larger in the normal and sodium-loaded groups. Amiloride decreased both ISC and QO2 , abolishing the differences between groups. Linear regression of the decrease in QO2 and ISC after amiloride showed the steepest slope for the sodium-deprived group and the flattest one for the sodium-loaded group. CONCLUSIONS: Baseline epithelial QO2 of sodium-deprived and control rats is reduced by ENaC blockade. Aldosterone increased QO2 proportionally to ISC augmentation in all groups, but the coupling between aerobic metabolism and electrogenic transport seems more efficient in sodium-deprived animals.


Assuntos
Aldosterona/sangue , Epitélio/metabolismo , Mucosa Intestinal/metabolismo , Consumo de Oxigênio/fisiologia , Reto/metabolismo , Sódio , Aldosterona/metabolismo , Amilorida/farmacologia , Animais , Bloqueadores do Canal de Sódio Epitelial/farmacologia , Epitélio/efeitos dos fármacos , Mucosa Intestinal/efeitos dos fármacos , Masculino , Ratos , Ratos Wistar , Reto/efeitos dos fármacos , Sódio/administração & dosagem , Sódio/sangue , Sódio/deficiência , Canais de Sódio/metabolismo
6.
Dig Dis Sci ; 58(9): 2499-506, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23695875

RESUMO

BACKGROUND AND AIMS: In isolated colonic mucosa, decreases in short-circuit current (ISC) and transepithelial resistivity (RTE) occur when hypoxia is either induced at both sides or only at the serosal side of the epithelium. We assessed in human colon biopsies the sensitivity to serosal-only hypoxia and mucosal-only hypoxia and whether Na, K-ATPase blockade with ouabain interacts with hypoxia. MATERIALS AND METHODS: Biopsy material from patients undergoing colonoscopy was mounted in an Ussing chamber for small samples (1-mm2 window). In a series of experiments we assessed viability and the electrical response to the mucolytic, dithiothreitol (1 mmol/l). In a second series, we explored the effect of hypoxia without and with ouabain. In a third series, we evaluated the response to a cycle of hypoxia and reoxygenation induced at the serosal or mucosal side while keeping the oxygenation of the opposite side. RESULTS: 1st series: Dithiothreitol significantly decreased the unstirred layer and ISC but increased RTE. 2nd series: Both hypoxia and ouabain decreased ISC, but ouabain increased RTE and this effect on RTE prevailed even during hypoxia. 3rd series: Mucosal hypoxia caused lesser decreases of ISC and RTE than serosal hypoxia; in the former, but not in the latter, recovery was complete upon reoxygenation. CONCLUSIONS: In mucolytic concentration, dithiothreitol modifies ISC and RTE. Oxygen supply from the serosal side is more important to sustain ISC and RTE in biopsy samples. The different effect of hypoxia and Na, K-ATPase blockade on RTE suggests that their depressing effect on ISC involves different mechanisms.


Assuntos
Colo/fisiologia , Hipóxia/fisiopatologia , Mucosa Intestinal/fisiologia , Oxigênio/fisiologia , Membrana Serosa/patologia , Biópsia , Colo/patologia , Ditiotreitol , Eletrofisiologia , Feminino , Humanos , Hipóxia/patologia , Técnicas In Vitro , Mucosa Intestinal/patologia , Masculino , ATPase Trocadora de Sódio-Potássio/antagonistas & inibidores
8.
J Osteoporos ; 2013: 150154, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23533947

RESUMO

The Osteoporosis Self-assessment Tool (OST) is a clinical instrument designed to select patients at risk of osteoporosis, who would benefit from a bone mineral density measurement. The OST only takes into account the age and weight of the subject. It was developed for Asian women and later validated for European and North American white women. The performance of the OST in a sample of 4343 women from Greater Mendoza, a large metropolitan area of Argentina, was assessed. Dual X-ray absorptiometry (DXA) scans of lumbar spine and hip were obtained. Patients were classified as either osteoporotic (N = 1830) or nonosteoporotic (n = 2513) according to their lowest T-score at any site. Osteoporotic patients had lower OST scores (P < 0.0001). A receiver operating characteristic (ROC) curve showed an area under the curve of 71% (P < 0.0001), with a sensitivity of 83.7% and a specificity of 44% for a cut-off value of 2. Positive predictive value was 52% and negative predictive value was 79%. The odds ratio for the diagnosis of osteoporosis was 4.06 (CI95 3.51 to 4.71; P < 0.0001). It is concluded that the OST is useful for selecting postmenopausal women for DXA testing in the studied population.

9.
J Osteoporos ; 2013: 953271, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23533948

RESUMO

Weight-bearing and resistance physical activities are recommended for osteoporosis prevention, but it is unclear whether an intensity level above current recommendations has a positive effect on adult premenopausal women. Body composition and bone mineral density (BMD) by DXA were compared in three groups of women as follows: Sedentary, Maintenance exercise, and federated Sport Team (n = 16 for each group). Physical activity was estimated from the International Physical Activity Questionnaire (IPAQ). The groups did not differ in age, height, weight, or body mass index. Bone mineral content and non-fat soft tissue mass were higher and fat mass was lower in the Sport Team group than in the other groups. The same was true for BMD of total skeleton, lumbar spine, femoral neck, and total hip. A test for linear trend of body composition and BMD showed significant results when including all three groups. Simple and multiple regression analyses showed significant associations between physical activity level (or alternatively, years of participation in programmed physical activity) and bone mass measures at all sites except for the middle third of radius. It is concluded that a level of physical activity higher than that usually recommended benefits bone health in adult premenopausal women.

10.
Bone ; 50(1): 9-13, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21920487

RESUMO

Yerba Mate (Ilex paraguariensis) tea consumption is higher in Argentina and other South American countries than those of coffee or tea (Camellia sinensis). The effects of Yerba Mate on bone health have not previously been explored. From a program for osteoporosis prevention and treatment, postmenopausal women who drank at least 1 L of Yerba Mate tea daily during 4 or more years (n=146) were identified, and matched by age and time since menopause with an equal number of women who did not drink Yerba Mate tea. Their bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck. Yerba Mate drinkers had a 9.7% higher lumbar spine BMD (0.952 g/cm(2) versus 0.858 g/cm(2): p<0.0001) and a 6.2% higher femoral neck BMD (0.817 g/cm(2) versus 0.776 g/cm(2); p=0.0002). In multiple regression analysis, Yerba Mate drinking was the only factor, other than body mass index, which showed a positive correlation with BMD at both the lumbar spine (p<0.0001) and the femoral neck (p=0.0028). Results suggest a protective effect of chronic Yerba Mate consumption on bone.


Assuntos
Densidade Óssea/efeitos dos fármacos , Ilex paraguariensis/química , Osteoporose Pós-Menopausa/terapia , Fitoterapia , Preparações de Plantas/farmacologia , Preparações de Plantas/uso terapêutico , Chá/química , Absorciometria de Fóton/métodos , Índice de Massa Corporal , Estudos Transversais , Feminino , Colo do Fêmur/anatomia & histologia , Humanos , Vértebras Lombares/anatomia & histologia , Osteoporose Pós-Menopausa/prevenção & controle , Estudos Retrospectivos
11.
Int J Colorectal Dis ; 26(9): 1205-10, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21519802

RESUMO

INTRODUCTION: It is recognized that epithelial ion transport depends on oxygen supply, but this dependence has not been characterized in the human colon in vitro despite its surgical and clinical implications. PURPOSES: The aim of this study is to measure the oxygen consumption of colonic epithelium under conditions which preserve vectorial ion transport and to assess the sensitivity of the human colonic epithelium short-circuit current (I (sc)) to acute hypoxia induced in vitro. METHODS: Isolated mucosa preparations from human sigmoid colon were placed in a modified Ussing chamber which allows simultaneous measurement of short-circuit current (I (sc)) and oxygen consumption (QO(2)). In separate experiments, the sensitivity to acute hypoxia induced in a conventional Ussing chamber was assessed. RESULTS: Basal mean ± SEM values (n = 8) were I (sc) = 3.3 ± 0.5 µEq h(-1) cm(-2) and QO(2) = 8.09 ± 0.55 µmol h(-1) cm(-2). The contribution of the serosal side to the oxygen supply was higher than that of the mucosal side (p = 0.0023). Ouabain reduced I (sc) by 70% (P < 0.0001) and QO(2) by 26% (n = 8; P = 0.0009), suggesting that a large fraction of QO(2) is needed to support ouabain-sensitive electrogenic transport. Induction of hypoxia at both sides of the Ussing chamber caused a rapid decrease in I (sc) after 2 min. I (sc) was also significantly depressed when hypoxia was induced by 5 min in the serosal side (n = 6, P < 0.0001), but was unaffected by hypoxia induced in the mucosal side. CONCLUSION: The present results allow a better understanding of the clinical consequences of acute hypoxia on intestinal ion transport.


Assuntos
Colo/metabolismo , Colo/patologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Consumo de Oxigênio , Idoso , Idoso de 80 Anos ou mais , Dissecação , Eletricidade , Feminino , Humanos , Hipóxia/patologia , Técnicas In Vitro , Transporte de Íons , Masculino , Pessoa de Meia-Idade , Oxigênio
12.
J Craniofac Surg ; 22(2): 706-10, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21415640

RESUMO

A number of potential effects of mobile cellular phones on human health have been pinpointed, but the question of whether they affect bone mineralization has rarely been addressed. This study assessed differences in bone mineralization in the right and left hip of healthy male adult volunteers who were either nonusers of mobile phones (n=24) or users who carried the phone close to the right hip, for at least 1 year (n=24). Dual-energy x-ray absorptiometry (GE Lunar Prodigy) was performed in dual femur mode for each subject. Right and left hip bone mineral density (BMD) and bone mineral content (BMC) were compared. No difference in mean BMDs and BMCs between groups was found. Nonusers had higher BMC in the right femoral neck (P=0.0044), a difference absent in mobile phone users (P=0.028 for the right-left difference in nonusers vs users). Mobile phone users, but not nonusers, had lower BMD at the right trochanter (P=0.027) and lower BMC at the right trochanter (P=0.014) and right total hip (P=0.039). Linear regression showed a correlation between estimated cumulative hours carrying a cell phone on the right hip and differences between right and left trochanter BMD (r=0.434; P=0.034). The different asymmetries between right and left hip dual-energy x-ray absorptiometry values in nonusers and mobile phone users suggest that these devices may adversely affect bone mineralization.


Assuntos
Densidade Óssea , Telefone Celular , Quadril/diagnóstico por imagem , Absorciometria de Fóton , Adulto , Estudos Transversais , Humanos , Modelos Lineares , Masculino
13.
J Pediatr Endocrinol Metab ; 23(3): 245-56, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20480723

RESUMO

Central adiposity is increasing in childhood. To find a simple index of central fatness that accurately predicts insulin resistance we studied 55 obese children and 53 siblings, aged 6-16 years. We recorded the family metabolic score, calculated clinical and DXA-derived fat distribution indexes and HOMA-IR. Umbilical waist-to-height ratio (W-to-Ht) had the best combination of ROC area (0.99, IC95: 0.93 to 1.0), Youden's index (0.976), coefficient of variation (4.9) and correlation with HOMA-IR (r = 0.58, p < 0.0001); it also correlated (p < 0.001) with BMI (r = 0.95) and DXA-trunk fat mass index (r = 0.93). It was the best predictor of insulin resistance in a multiple regression model (p < 0.0001). Odds ratios for insulin resistance were 9.33 when the family score was >10 (p < 0.01) and 14.35 when umbilical W-to-Ht was >0.54 (p < 0.0001). Umbilical W-to-Ht, a simple marker of central adiposity, strongly relates to children's DXA-trunk fat mass index and insulin resistance.


Assuntos
Gordura Abdominal , Estatura , Resistência à Insulina , Síndrome Metabólica , Obesidade Abdominal/diagnóstico , Circunferência da Cintura , Absorciometria de Fóton , Adolescente , Antropometria/métodos , Argentina/epidemiologia , Biomarcadores , Composição Corporal , Índice de Massa Corporal , Criança , Diagnóstico Precoce , Saúde da Família , Feminino , Humanos , Masculino , Sensibilidade e Especificidade
14.
Dig Dis Sci ; 53(6): 1593-600, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17939049

RESUMO

The distal colon epithelium of rats submitted to chronic hypoxia shows higher short-circuit current (Isc) which, unlike non-hypoxic rat epithelium, has an amiloride-sensitive component despite low serum aldosterone levels. Isc and oxygen consumption (QO2) were simultaneously measured in mucosae from rats submitted to 0.5 atm for 10 days and from control rats in a modified Ussing chamber. Hypoxia increased Isc but not QO2. The slope of the regression line between Isc and QO2 reduction after ouabain addition was decreased in epithelia from hypoxic rats (P = 0.03). Chloride secretion blockade reduced Isc and QO2 in both groups, while sodium channel blockade did so only in the hypoxic group. Dual blockade in hypoxic rat epithelia caused correlated (P = 0.0025) additive decreases in Isc and QO2. Presented results suggest that chronic hypoxia induces an improved coupling between QO2 and electrogenic ion transport, and electrogenic sodium absorption despite low aldosterone levels.


Assuntos
Colo/metabolismo , Hipóxia/fisiopatologia , Transporte de Íons/fisiologia , Consumo de Oxigênio/fisiologia , Sódio/metabolismo , Aldosterona/sangue , Análise de Variância , Animais , Pressão Atmosférica , Doença Crônica , Eletrofisiologia , Masculino , Ratos , Ratos Wistar
15.
Medicina (B Aires) ; 67(5): 481-90, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-18051234

RESUMO

Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. Its efficacy is moderate, preventing about 80% of pregnancies. Efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. Tolerance is similar to, or better than, those of other oral emergency contraceptives. Adverse effects include nausea, vomiting, headache, breast tenderness and transient alteration of menstrual bleeding pattern. It is not known whether levonogestrel increases the risk of ectopic pregnancy when the treatment fails. Its use as an ongoing contraceptive method is discouraged. When given before the preovulatory LH peak, levonorgestrel blocks or delays ovulation. It may also affect sperm migration in the female reproductive tract and have an effect on fertilization. Although it has been often postulated, there is no evidence for an anti-implantatory effect. Acquaintance with the method is quite variable among different societies, but it remains underutilized even where it is well known. Advance provision of the drug has been proposed as a way to promote its use. In clinical trials, advance provision did not adversely modify sexual or regular contraceptive behavior, but it did not reduce pregnancy or abortion rate either. Therefore, emergency contraception with levonorgestrel should be regarded as a backup method which is not a substitute for the continued use of more effective contraceptive methods.


Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Orais Sintéticos/administração & dosagem , Levanogestrel/administração & dosagem , Ovulação/efeitos dos fármacos , Ensaios Clínicos como Assunto , Anticoncepcionais Orais Sintéticos/efeitos adversos , Tubas Uterinas/efeitos dos fármacos , Feminino , Fertilização/fisiologia , Humanos , Dispositivos Intrauterinos , Levanogestrel/efeitos adversos , Gravidez , Gravidez Ectópica/etiologia
16.
Medicina (B.Aires) ; 67(5): 481-490, sep.-oct. 2007.
Artigo em Espanhol | LILACS | ID: lil-489373

RESUMO

La contracepción de emergencia puede evitar el embarazo luego de un coito sin medidas contraceptivas o cuando éstas fallan. Se recomienda el levonorgestrel, un gestágeno sintético, en dosis única de 1.5 mg (alternativamente en dos dosis de 0.75 mg espaciadas 12 h). Su eficacia es moderada, pues impide aproximadamente 80% de los embarazos. La eficacia es mayor cuanto más precozmente se administre, pero puede darse hasta 5 días post-coito. La tolerancia es similar o superior a la de otros preparados empleados con igual propósito. Los efectos adversos comprenden náuseas, vómitos, cefalea, tensión mamaria y alteraciones transitorias en la siguiente menstruación. Se desconoce si el levonorgestrel aumenta la probabilidad de embarazo ectópico cuando el tratamiento fracasa. No se recomienda su empleo como contraceptivo habitual. Cuando se administra antes del pico preovulatorio de LH, el levonorgestrel generalmente bloquea o retrasa la ovulación. Puede asimismo afectar la migración de los espermatozoides en el tracto genital femenino e, indirectamente, la fertilización. Pese a haberse postulado reiteradamente, no existe evidencia de un efecto antiimplantatorio. El conocimiento del método es muy variable en diferentes sociedades, pero aun donde es bien conocido permanece subutilizado. Se ha propuesto proveer levonorgestrel por adelantado para promover su uso. En ensayos clínicos, tal provisión no afectó adversamente el comportamiento sexual ni el empleo de otros contraceptivos, pero tampoco redujo el número de embarazos o abortos. En consecuencia, el empleo de levonorgestrel debe considerarse un método de respaldo que no reemplaza el uso de contraceptivos más eficaces.


Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. Its efficacy is moderate, preventing about 80% of pregnancies. Efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. Tolerance is similar to, or better than, those of other oral emergency contraceptives. Adverse effects include nausea, vomiting, headache, breast tenderness and transient alteration of menstrual bleeding pattern. It is not known whether levonogestrel increases the risk of ectopic pregnancy when the treatment fails. Its use as an ongoing contraceptive method is discouraged. When given before the preovulatory LH peak, levonorgestrel blocks or delays ovulation. It may also affect sperm migration in the female reproductive tract and have an effect on fertilization. Although it has been often postulated, there is no evidence for an anti-implantatory effect. Acquaintance with the method is quite variable among different societies, but it remains underutilized even where it is well known. Advance provision of the drug has been proposed as a way to promote its use. In clinical trials, advance provision did not adversely modify sexual or regular contraceptive behavior, but it did not reduce pregnancy or abortion rate either. Therefore, emergency contraception with levonorgestrel should be regarded as a backup method which is not a substitute for the continued use of more effective contraceptive methods.


Assuntos
Humanos , Feminino , Gravidez , Anticoncepção Pós-Coito , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Orais Sintéticos/administração & dosagem , Levanogestrel/administração & dosagem , Ovulação/efeitos dos fármacos , Ensaios Clínicos como Assunto , Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Orais Sintéticos/efeitos adversos , Tubas Uterinas/efeitos dos fármacos , Fertilização/fisiologia , Dispositivos Intrauterinos , Levanogestrel/efeitos adversos , Gravidez Ectópica/etiologia
17.
Biocell ; 30(1): 43-9, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16845828

RESUMO

Electrophysiological events occur early after fertilization, along with changes in intracellular Ca2+ concentration. Passive electrical parameters were determined in golden hamster oocytes by whole cell patch-clamp method. In separate experiments the effect of 4-aminopyridine on resting oocytes was tested. The single-channel patch clamp configuration was employed to assess the electrical response to fertilization with homologous sperm. Structure of oocytes submitted to patch clamp was evaluated with scanning electron microscopy and found to be preserved. Oocyte diameter was 70.2 +/- 2.2 microm; their resting parameters were: membrane potential 23.8 +/- 0.8 mV; total membrane specific resistance 519.1 +/- 94.6 ohms.cm2, and specific capacity 0.99 +/- 0.03 microF.cm(-2). Total membrane current was decreased by 42 % by 4-aminopyridine. Control oocytes and oocytes exposed to sperm differed in their membrane currents in response to a voltage ramp clamping membrane potential from - 100 mV to + 100 mV. In both cases, currents were largest at the most negative potentials, but sperm-exposed oocytes had larger currents. Additionally, while in control oocytes the current was inward at negative potentials but outward at positive potentials, in the presence of spermatozoa oocytes was inward within the whole voltage range tested. This latter current may represent Ca2+ entry.


Assuntos
Interações Espermatozoide-Óvulo/fisiologia , 4-Aminopiridina/farmacologia , Animais , Cricetinae , Eletrofisiologia , Feminino , Técnicas In Vitro , Masculino , Potenciais da Membrana , Mesocricetus , Microscopia Eletrônica de Varredura , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , Oócitos/ultraestrutura , Técnicas de Patch-Clamp , Bloqueadores dos Canais de Potássio/farmacologia , Interações Espermatozoide-Óvulo/efeitos dos fármacos
18.
Biocell ; 30(1): 43-49, abr. 2006. ilus, tab
Artigo em Inglês | LILACS | ID: lil-448077

RESUMO

Electrophysiological events occur early after fertilization, along with changes in intracellular Ca2+ concentration. Passive electrical parameters were determined in golden hamster oocytes by whole cell patch-clamp method. In separate experiments the effect of 4-aminopyridine on resting oocytes was tested. The single-channel patch clamp configuration was employed to assess the electrical response to fertilization with homologous sperm. Structure of oocytes submitted to patch clamp was evaluated with scanning electron microscopy and found to be preserved.Oocyte diameter was 70.2 ± 2.2 µm; their resting parameters were: membrane potential 23.8 ± 0.8 mV; total membrane specific resistance 519.1 ± 94.6 Ù.cm2, and specific capacity 0.99 ± 0.03 µF.cm-2. Total membrane current was decreased by 42 % by 4-aminopyridine.Control oocytes and oocytes exposed to sperm differed in their membrane currents in response to a voltage ramp clamping membrane potential from - 100 mV to + 100 mV. In both cases, currents were largest at the most negative potentials, but sperm-exposed oocytes had larger currents. Additionally, while in controloocytes the current was inward at negative potentials but outward at positive potentials, in the presence of spermatozoa oocytes was inward within the whole voltage range tested. This latter current may represent Ca2+ en try


Assuntos
Masculino , Cobaias , Animais , Feminino , Bloqueadores dos Canais de Potássio/farmacologia , Fertilização/fisiologia , Mesocricetus , Oócitos , Oócitos/fisiologia , Oócitos/ultraestrutura , Técnicas de Patch-Clamp/veterinária
19.
Biocell ; 30(1): 43-49, abr. 2006. ilus, tab
Artigo em Inglês | BINACIS | ID: bin-121605

RESUMO

Electrophysiological events occur early after fertilization, along with changes in intracellular Ca2+ concentration. Passive electrical parameters were determined in golden hamster oocytes by whole cell patch-clamp method. In separate experiments the effect of 4-aminopyridine on resting oocytes was tested. The single-channel patch clamp configuration was employed to assess the electrical response to fertilization with homologous sperm. Structure of oocytes submitted to patch clamp was evaluated with scanning electron microscopy and found to be preserved.Oocyte diameter was 70.2 ± 2.2 Am; their resting parameters were: membrane potential 23.8 ± 0.8 mV; total membrane specific resistance 519.1 ± 94.6 Ù.cm2, and specific capacity 0.99 ± 0.03 AF.cm-2. Total membrane current was decreased by 42 % by 4-aminopyridine.Control oocytes and oocytes exposed to sperm differed in their membrane currents in response to a voltage ramp clamping membrane potential from - 100 mV to + 100 mV. In both cases, currents were largest at the most negative potentials, but sperm-exposed oocytes had larger currents. Additionally, while in controloocytes the current was inward at negative potentials but outward at positive potentials, in the presence of spermatozoa oocytes was inward within the whole voltage range tested. This latter current may represent Ca2+ en try(AU)


Assuntos
Masculino , Cobaias , Animais , Feminino , Oócitos/ultraestrutura , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , Técnicas de Patch-Clamp/veterinária , Bloqueadores dos Canais de Potássio/farmacologia , Fertilização/fisiologia , Mesocricetus
20.
Biocell ; 30(1): 43-49, abr. 2006. ilus, tab
Artigo em Inglês | BINACIS | ID: bin-119273

RESUMO

Electrophysiological events occur early after fertilization, along with changes in intracellular Ca2+ concentration. Passive electrical parameters were determined in golden hamster oocytes by whole cell patch-clamp method. In separate experiments the effect of 4-aminopyridine on resting oocytes was tested. The single-channel patch clamp configuration was employed to assess the electrical response to fertilization with homologous sperm. Structure of oocytes submitted to patch clamp was evaluated with scanning electron microscopy and found to be preserved.Oocyte diameter was 70.2 ± 2.2 Am; their resting parameters were: membrane potential 23.8 ± 0.8 mV; total membrane specific resistance 519.1 ± 94.6 Ù.cm2, and specific capacity 0.99 ± 0.03 AF.cm-2. Total membrane current was decreased by 42 % by 4-aminopyridine.Control oocytes and oocytes exposed to sperm differed in their membrane currents in response to a voltage ramp clamping membrane potential from - 100 mV to + 100 mV. In both cases, currents were largest at the most negative potentials, but sperm-exposed oocytes had larger currents. Additionally, while in controloocytes the current was inward at negative potentials but outward at positive potentials, in the presence of spermatozoa oocytes was inward within the whole voltage range tested. This latter current may represent Ca2+ en try(AU)


Assuntos
Masculino , Cobaias , Animais , Feminino , Oócitos/ultraestrutura , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , Técnicas de Patch-Clamp/veterinária , Bloqueadores dos Canais de Potássio/farmacologia , Fertilização/fisiologia , Mesocricetus
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