Clinical value of metabolic PET parameters of primary vulvar carcinoma. / Valor clínico de los parámetros metabólicos de la PET en el carcinoma vulvar primario.

PURPOSE: We aim to establish the prognostic value of metabolic parameters of the primary tumor in patients diagnosed with vulvar squamous cell carcinoma (VSCC) who underwent a pretreatment 18F FDG PET/CT scan. MATERIALS AND METHODS: This retrospective study included 47 patients with a histopathologically confirmed diagnosis of VSCC, and who underwent a 18F FDG PET/CT scan prior to treatment. The disease stage and age at diagnosis, the maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values of the primary tumor, based on a baseline PET scan, were recorded. The relationship between these factors, and progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The mean age of the 47 study patients was 69.6±1.9 years. Among the patients, 18 were in early stage of the disease and 29 were in the advanced stage. The age, and SUVmax, SUVmean, MTV and TLG values were statistically significantly associated with OS and PFS. Furthermore, it was noted that OS and PFS were significantly longer in the early stage patients than in the advanced stage patients, in patients with a tumor size <4cm than those with a tumor size ≥4cm, and in patients with a negative lymph node metastasis than those with a positive lymph node metastasis. CONCLUSION: Our findings suggest that PET parameters are prognostic factors for VSCC. To the best of our knowledge, this study is the first to investigate the prognostic value of the PET parameters of primary tumors in patients with VSCC, and as such, we believe it contributes to literature.

Role of 18F-FDG PET/CT in the detection of primary malignancy in patients with bone metastasis of unknown origin. / Papel de la PET/TC con 18F-FDG en la detección del tumor primario en pacientes con metástasis óseas de origen desconocido.

OBJECTIVE: The present study investigates the role of 18F-FDG PET/CT in the detection of primary malignancy in patients with bone metastasis of unknown primary origin (BMUO). MATERIAL AND METHODS: This retrospective study considered histopathological examination findings or clinical follow-up data as the standard reference in the diagnosis of primary tumors, and results were compared with results of PET/CT scans. RESULTS: The study included 100 patients with BMUO (74 males, 26 females, mean age 61 years). The primary origin was identified in 92 of the 100 patients. Adenocarcinoma was the most common histopathological subtype in patients in whom the primary origin of tumor was detected (65.2%). The most common primary tumor was lung carcinoma (n=52) followed by prostate (n=13), breast (n=7), colon (n=4), gastric (n=3), ovarian (n=2), renal cell (n=2), adrenal (n=1), thyroid (n=1), endometrial (n=1) and parotid (n=1) carcinoma, hepatobiliary cancers (n=2), leiomyosarcoma (n=2) and maxillary sinus tumor (n=1). The numbers of patients in whom PET/CT showed true positive, true negative, false positive (FP) and false negative (FN) results were 72, 7, 8 and 13, respectively. The sensitivity, specificity, accuracy and detection rate of PET/CT in detecting the primary tumor were 84.7%, 46%, 79% and 72%, respectively. The overall survival was significantly lower in lung cancer group when compared to non-lung cancer group, whereas it was significantly higher in prostate cancer group than in non-prostate cancer group. CONCLUSIONS: PET/CT, as a non-invasive method, can be preferred as the first choice in the detection of primary tumor in patients with BMUO.

The prognostic role of PET/CT in small-cell lung cancer. / El papel pronóstico de la PET/TC en el cáncer pulmonar de células pequeñas.

OBJECTIVE: The aim in the present study is to determine the prognostic value of metabolic parameters related to the primary tumors detected in pretreatment Fluorine-18 2-fluoro-2-Deoxy-D-glucose (18F FDG) positron emission tomography/computerized tomography (PET/CT) scans of patients diagnosed with small-cell lung cancer (SCLC). MATERIAL AND METHODS: Enrolled in this retrospective study were 63 patients with a histopathologically confirmed diagnosis of SCLC who underwent an 18F FDG PET/CT scan at baseline. Disease stage, age at diagnosis, gender, albumin level and maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values related to the primary tumor at the baseline PET scan were recorded, and the relationship of these factors with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The study included a total of 63 patients (10 female, 53 male, mean age of 64.8 and age range of 43-82 years), 22 of which had limited disease (LD) and 41 had extensive disease (ED). The OS and PFS were significantly higher in patients with LD than in patients with ED (15±2.9 vs. 10±0.9 months, p = 0.002 for OS; 10± 0.7 vs 6±0.6 months, p = 0.014 for PFS). However, no statistically significant relationship was identified between gender, albumin level, age and SUVmax, SUVmean, MTV, TLG values related to the primary tumor and PFS or OS. CONCLUSION: The present study found that pretreatment PET parameters were of not predictive value for PFS and OS in patients with SCLC.

[Clinical factors associated with the outcome of oocyte donation]. / Facteurs cliniques et résultats du don d'ovocytes.

This article aims at reviewing the literature in order to provide a summary of the actual knowledge about the clinical factors of the oocyte recipient (other than those affecting the morphology of the uterine cavity) influencing the outcome of oocyte donation cycles. Recipient age, from 45 years onwards, is clearly associated with a poorer outcome in oocyte donation cycles as well as the presence of a hydrosalpinx. The negative impact of smoking has recently been confirmed. The exact influence of a high body mass index is under examination but it is likely that it is associated with a lower ongoing pregnancy rate. Endometriosis does not have a negative impact when standard endometrial priming protocols are used in oocyte donation. During endometrial priming, serum estradiol levels and endometrial thickness, if >5 mm, does not influence negatively the outcome; however duration of estrogen treatment of more than 7 weeks is associated with a diminished pregnancy and implantation rate.

Fetal weight estimation and prediction of fetal macrosomia in non-diabetic pregnant women.

In the present study we investigated the accuracy of Shepard's formula in the sonographic diagnosis of macrosomic fetus of non-diabetic pregnant women. Three hundred and eighty-one macrosomic and 450 appropriate for gestational age (AGA) fetuses born to non-diabetic mothers between 37-42 weeks of gestation were included in the study. Ultrasonographic fetal weight estimation within two days of delivery was made using Shepard's formula in all patients. The estimated fetal weights were compared with the actual birth weights of the same subjects. We did not observe any macrosomic newborn birth in pregnant women with 3200 g or less fetal weight estimation. However, in patients with 3400-3499 g fetal weight estimation, a statistically significant increase in macrosomic newborn birth was observed. Only 3.2% of newborns having actual birth weights greater than or equal to 4000 g had sonographic birth weight estimation less than 4000 g. Accuracy of weight estimations using the Shepard's formula was found to be low in macrosomic fetus. On the other hand, increased incidence of macrosomic newborn birth was observed in subjects with ultrasonographic fetal weight estimations above 3400 g and this level may be useful as a cut-off value for prediction of macrosomic fetus in non-diabetic pregnant women.

Does leukocytospermia associate with poor semen parameters and sperm functions in male infertility? The role of different seminal leukocyte concentrations.

To investigate the effect of leukocytospermia on standard semen analysis and sperm function tests such as acrosome reaction, hypoosmotic swelling, antisperm antibody binding and cervical mucus penetration, a prospective clinical study was performed. Two hundred and nineteen male infertility patients undergoing investigation and treatment were included in the study. There was a significant association between acrosome reaction positivity and leukocytospermia according to WHO (World Health Organization) criteria. Increased hypoosmotic swelling test score, higher sperm concentration and enhanced acrosome reaction were closely related to leukocytospermia. When the patients were divided into subgroups according to seminal leukocyte concentrations, acrosome reaction and hypoosmotic swelling were observed to be higher in semen samples with higher leukocyte concentrations compared to those with low seminal leukocyte concentration. In addition, higher sperm concentrations were observed in semen samples with increased leukocyte levels compared to semen samples with low leukocyte levels. These results suggest that leukocytospermia may have a favorable effect on some sperm functions at seminal leukocyte concentrations between 1 and 3x10(6)/ml.

Vascular cell adhesion molecule-1 (VCAM-1) and leukocyte activation in pre-eclampsia and eclampsia.

OBJECTIVE: To evaluate the levels of VCAM-1 in pre-eclampsia/eclampsia as a possible marker of leukocyte activation and endothelial damage. METHODS: We performed a case-control study on 25 healthy pregnant women and 35 patients diagnosed as pre-eclampsia or eclampsia which were randomly selected. Peripheral venous blood samples were obtained and serum levels of VCAM-1 were measured by enzyme-linked immunoassay (ELISA). RESULTS: In pre-eclampsia/eclampsia, VCAM-1 levels were higher than in normal pregnancy. Serum concentrations of VCAM-1 were significantly higher in severe pre-eclampsia and eclampsia compared to mild pre-eclampsia or healthy controls. ROC analysis detected that VCAM-1 > or = 450 ng/ml had a sensitivity of 0.79 and a specificity of 0.90 in detecting severe pre-eclampsia and eclampsia. CONCLUSION: This is the first study to correlate VCAM-1 levels with severity of disease in pre-eclampsia. Our findings indicate that increasing levels of soluble VCAM-1 are present in the circulation of patients with severe pre-eclampsia/eclampsia compared to mild pre-eclampsia or healthy pregnant women. Elevated VCAM-1 levels may represent a possible mechanism by which endothelial cells attract leukocytes and cause endothelial cell damage.

Contribución de PET/CT a la diferenciación de derrame pleural benigno y maligno en pacientes con cáncer de ovario / The contribution of PET/CT to the differentiation of benign and malignant pleural effusion in patients with ovarian carcinoma

Objetivo En nuestro estudio el objetivo fue investigar la contribución de los hallazgos de la tomografía por emisión de positrones (PET)/tomografía computarizada (TC) en la diferenciación no invasiva entre el derrame pleural (DP) de origen benigno (DPB) y maligno (DPM) en pacientes diagnosticadas de un carcinoma de ovario (CO). Material y método Se incluyeron en el estudio a 32 pacientes diagnosticadas de CO con DP. Se efectuó análisis comparativo entre el DPB y el DPM para los siguientes parámetros: SUVmáx. del DP, índice objeto/fondo (TBRp: target/background ratio) del DP, dividiendo el SUVmáx. del DP por el SUVmedio del flujo sanguíneo mediastínico (MBP: medistinal blood pool), engrosamiento pleural, adenopatías supradiafragmáticas, DP unilateral o bilateral, diámetro del DP, edad de la paciente y niveles de CA125. Resultados La edad media de las 32 pacientes fue de 57±2,8 años. Se observó mayor frecuencia significativa de un TBRp>1,1, engrosamiento pleural y ganglios linfáticos supradiafragmáticos en el DPM respecto al DPB. Aunque no se detectó ningún nódulo pleural en las pacientes con DPB, estos estuvieron presentes en 7 pacientes con DPM. En la distinción DMP-DBP la sensibilidad del TBRp fue del 95,2% y la especificidad del 72,7%, la sensibilidad del engrosamiento pleural fue del 80,9%, y la especificidad del 81,8%, la sensibilidad de los ganglios linfáticos supradiafragmáticos fue del 38% y la especificidad del 90,9%, y la sensibilidad del nódulo pleural fue del 33,3% y la especificidad del 100%. No hubo diferencias significativas entre los 2 grupos respecto al resto de factores. Conclusión El engrosamiento pleural y el valor de TBRp determinados en la PET/TC pueden contribuir a la diferenciación entre DMP y DBP, especialmente en aquellas pacientes con CO en estadio avanzado y mal estado general, o que no son tributarias de ser sometidas a tratamiento quirúrgico (AU)

Objective The present study investigates the ability of non-invasive contribution of positron emission tomography (PET)/computed tomography (CT) to distinguish between benign pleural effusions (BPE) and malignant pleural effusions (MPE) in patients diagnosed with ovarian carcinoma (OC). Material and method Included in the study were 32 OC patients with a PE diagnosis. The cases with BPE and MPE were compared in terms of the PE maximum standardized uptake value (SUVmax), PE SUVmax/mean standardized uptake (SUVmean) value of the mediastinal blood pool (TBRp), the presence of pleural thickening, the presence of supradiaphragmatic lymph node, unilateral or bilateral PE, pleural effusion diameter, patient age and CA125 value. Results The mean age of the 32 patients was 57±2.8 years. TBRp>1.1, pleural thickening and supradiaphragmatic lymph node were observed significantly more frequently in the MPE than the BPE cases. While no pleural nodules were detected in patients with BPE, they were present in 7 of the patients with MPE. The rates of distinction between the MPE and BPE cases were as follows: the sensitivity of the TBRp value was 95.2% and specificity was 72.7%; the sensitivity of pleural thickness was 80.9% and specificity was 81.8%; the sensitivity of supradiaphragmatic lymph node was 38% and specificity was 90.9%; and the sensitivity of the pleural nodule was 33.3% and specificity was 100%. There were no significant differences between two groups in any other factors. Conclusion Pleural thickening and TBRp values ascertained through PET/CT may aid the distinction between MPE-BPE, especially in patients with advanced stage OC with a poor general condition, or those who cannot undergo surgery (AU)

Density functional theory study on the identification of 3-[(2-morpholinoethylimino)methyl]benzene-1,2-diol.

This study deals with the identification of a title compound, 3-[(2-morpholinoethylimino)methyl]benzene-1,2-diol by means of quantum chemical calculations. The optimized molecular structures, vibrational frequencies and corresponding vibrational assignments, thermodynamic properties, charge analyses, nuclear magnetic resonance (NMR) chemical shifts and ultraviolet-visible (UV-vis) spectra of the title molecule in the ground state were evaluated using density functional theory (DFT) with the standard B3LYP/6-311++G(d,p) method and basis set combination for the first time. Theoretical vibrational spectra of the title compound were interpreted with the aid of normal coordinate analysis based on scaled density functional force field. The results show that the obtained optimized geometric parameters (bond lengths, bond angles and bond dihedrals) and vibrational frequencies were observed to be in good agreement with the available experimental results. Moreover, the calculations of the electronic spectra, (13)C and (1)H chemical shifts were compared with the experimental ones. Furthermore, we not only simulated the frontier molecular orbitals (FMO) and molecular electrostatic potential (MEP) but also determined the transition states and energy band gaps, as well. It was found that charge analyses supported the evidences of MEP. Infrared intensities and Raman activities were also reported.

Papel de la PET/TC con 18F-FDG en la detección del tumor primario en pacientes con metástasis óseas de origen desconocido / Role of 18F-FDG PET/CT in the detection of primary malignancy in patients with bone metastasis of unknown origin

OBJETIVO: Este trabajo analiza el papel de la PET/TC con 18F-FDG en la detección del tumor primario en pacientes con metástasis óseas de origen desconocido (MOOD). MATERIAL Y MÉTODOS: Este estudio retrospectivo consideró al análisis histopatológico o el seguimiento clínico como datos de referencia en el diagnóstico de tumores primarios y estos resultados fueron comparados con los resultados de la PET/TC. RESULTADOS: Se incluyeron 100 pacientes con MOOD (74 hombres, 26 mujeres; edad media de 61 años). El tumor primario se identificó en 92 de los 100 pacientes. El tipo histopatológico más común en los pacientes en los que se detectó el tumor primario fue el adenocarcinoma (65,2%). El tumor primario más frecuente fue el cáncer de pulmón (n=52) seguido por los tumores de próstata (n=13), mama (n=7), colon (n=4), estómago (n=3), ovario (n=2), riñón (n=2), suprarrenal (n=1), tiroides (n=1), endometrio (n=1), parótida (n=1), carcinoma hepatobiliar (n=2), leiomiosarcoma (n=2) y tumor del seno maxilar (n=1). Para la PET/TC, el número de pacientes con resultados verdaderos positivos, verdaderos negativos, falsos positivos y falsos negativos fue de 72, 7, 8 y 13, respectivamente. La sensibilidad, especificidad, exactitud e índice de detección de la PET/TC en la detección del tumor primario fue de 84,7, 46, 79 y 72%, respectivamente. La supervivencia global fue significativamente inferior en el grupo con cáncer de pulmón cuando se comparó con el grupo no-cáncer de pulmón, mientras que fue significativamente más elevada en el grupo con cáncer de próstata que en el grupo no-cáncer de próstata. CONCLUSIONES: La PET/TC, como método no invasivo, podría ser la técnica de elección en la detección del tumor primario en pacientes con MOOD

OBJECTIVE: The present study investigates the role of 18F-FDG PET/CT in the detection of primary malignancy in patients with bone metastasis of unknown primary origin (BMUO). MATERIAL AND METHODS: This retrospective study considered histopathological examination findings or clinical follow-up data as the standard reference in the diagnosis of primary tumors, and results were compared with results of PET/CT scans. RESULTS: The study included 100 patients with BMUO (74 males, 26 females, mean age 61 years). The primary origin was identified in 92 of the 100 patients. Adenocarcinoma was the most common histopathological subtype in patients in whom the primary origin of tumor was detected (65.2%). The most common primary tumor was lung carcinoma (n=52) followed by prostate (n=13), breast (n=7), colon (n=4), gastric (n=3), ovarian (n=2), renal cell (n=2), adrenal (n=1), thyroid (n=1), endometrial (n=1) and parotid (n=1) carcinoma, hepatobiliary cancers (n=2), leiomyosarcoma (n=2) and maxillary sinus tumor (n=1). The numbers of patients in whom PET/CT showed true positive, true negative, false positive (FP) and false negative (FN) results were 72, 7, 8 and 13, respectively. The sensitivity, specificity, accuracy and detection rate of PET/CT in detecting the primary tumor were 84.7%, 46%, 79% and 72%, respectively. The overall survival was significantly lower in lung cancer group when compared to non-lung cancer group, whereas it was significantly higher in prostate cancer group than in non-prostate cancer group. CONCLUSIONS: PET/CT, as a non-invasive method, can be preferred as the first choice in the detection of primary tumor in patients with BMUO

El papel pronóstico de la PET/TC en el cáncer pulmonar de células pequeñas / The prognostic role of PET/CT in small-cell lung cancer

OBJETIVO: El propósito del presente estudio es determinar el valor pronóstico de los parámetros metabólicos relacionados con los tumores primarios detectados en los exámenes por tomografía por emisión de positrones/tomografía computarizada (PET/TC) del pretratamiento flúor-18 2-fluoro-2-desoxi-D-glucosa (18F FDG) de pacientes a los que se les ha diagnosticado cáncer pulmonar de células pequeñas (SCLC, por sus siglas en inglés). MATERIALES Y MÉTODOS: En este estudio retrospectivo se inscribieron 63 pacientes con un diagnóstico histopatológicamente confirmado de SCLC a los que se les aplicó un escáner PET/TC con 18F FDG en la línea basal. Se registraron la etapa de la enfermedad, la edad en su diagnóstico, el sexo, el nivel de albúmina y el valor máximo de captación estándar (SUVmax), SUVmean, el volumen de tumor metabólico (MTV) y los valores de glucólisis total de la lesión) relacionados con el tumor primario en el escáner PET de línea basal y se evaluó la relación de estos factores con la supervivencia libre de progresión (PFS) y la supervivencia global (OS). RESULTADOS: El estudio incluyó un total de 63 pacientes (10 mujeres, 53 hombres, con una edad media de 64,8 y un rango de edad de 43-82 años), 22 de los cuales tenía enfermedad limitada (LD) y 41 tenía enfermedad extendida (ED). Los OS y PFS fueron significativamente mayores en pacientes con LD que en pacientes con ED (15+/-2,9 ante 10+/-0,9 meses, p = 0,002 para OS; 10+/- 0,7 ante 6+/-0,6 meses, p = 0,014 para PFS). Sin embargo, no se identificó una relación estadísticamente significativa entre el sexo, el nivel de albúmina, la edad y los niveles SUVmax, SUVmean, MTV y TLG relacionados con el tumor primario y PFS u OS. CONCLUSIÓN: El presente estudio descubrió que los parámetros PET del pretratamiento no tenían valor predictivo para el PFS y OS en pacientes con SCLC

OBJECTIVE: The aim in the present study is to determine the prognostic value of metabolic parameters related to the primary tumors detected in pretreatment Fluorine-18 2-fluoro-2-Deoxy-D-glucose (18F FDG) positron emission tomography/computerized tomography (PET/CT) scans of patients diagnosed with small-cell lung cancer (SCLC). MATERIAL AND METHODS: Enrolled in this retrospective study were 63 patients with a histopathologically confirmed diagnosis of SCLC who underwent an 18F FDG PET/CT scan at baseline. Disease stage, age at diagnosis, gender, albumin level and maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values related to the primary tumor at the baseline PET scan were recorded, and the relationship of these factors with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The study included a total of 63 patients (10 female, 53 male, mean age of 64.8 and age range of 43-82 years), 22 of which had limited disease (LD) and 41 had extensive disease (ED). The OS and PFS were significantly higher in patients with LD than in patients with ED (15+/-2.9 vs. 10+/-0.9 months, p = 0.002 for OS; 10+/- 0.7 vs 6+/-0.6 months, p = 0.014 for PFS). However, no statistically significant relationship was identified between gender, albumin level, age and SUVmax, SUVmean, MTV, TLG values related to the primary tumor and PFS or OS. CONCLUSION: The present study found that pretreatment PET parameters were of not predictive value for PFS and OS in patients with SCLC

Correlation between placental bed biopsy findings, vascular cell adhesion molecule and fibronectin levels in pre-eclampsia.

OBJECTIVE: To determine the correlation between placental bed biopsy findings, and blood levels of the vascular cell adhesion molecule (VCAM-1) and fibronectin in pre-eclampsia/eclampsia, and to evaluate the relationship between these variables and severity of the disease. DESIGN: A prospective case-control study. SETTING: Department of Obstetrics and Gynaecology, Cerrahpasa Medical Faculty, Istanbul. SAMPLE: Thirty-five women with pre-eclampsia/eclampsia were compared with 25 healthy women with uncomplicated pregnancies. Twenty-one placental bed biopsies from pre-eclamptic pregnancies were compared with 17 from normal pregnancies. MAIN OUTCOME MEASURES: Peripheral venous blood levels of VCAM-1 and fibronectin, measured by enzyme-linked immunoassay and radial immune diffusion technique. RESULTS: In pre-eclampsia/eclampsia, blood VCAM-1 and fibronectin levels were higher than in normal pregnancy. Levels of both fibronectin and VCAM-1 correlated significantly with the diastolic blood pressure (r = 0.49 and r = 0.65, P < 0.001). There was also a significant direct linear correlation between plasma fibronectin and VCAM-1 levels (r = 0.57, P < 0.001). Normotensive women all had normal placental bed biopsy findings and the incidence of pathological placental bed biopsy findings increased with the severity of the pre-eclampsia. CONCLUSION: Inadequate trophoblastic invasion of spiral arteries, and elevated levels VCAM-1 and fibronectin were found in women with pre-eclampsia. The magnitude of defective trophoblastic invasion, and blood levels of VCAM-1 and fibronectin correlate with the clinical severity of pre-eclampsia.

Significance of yolk sac measurements with vaginal sonography in the first trimester in the prediction of pregnancy outcome.

BACKGROUND: The purpose of this prospective clinical study was to determine and evaluate the prognostic value of secondary yolk sac diameter of the embryo on pregnancy outcome. METHODS: One hundred and thirty pregnant women in the first trimester were included in the study. Crown-rump length (CRL) and yolk sac diameters were measured in every patient and the outcome of the pregnancies were compared with the measurements. Intact normal pregnancy (group A), threatened abortion (group B) and missed abortion (group C) were diagnosed in 67, 43 and 20 pregnancies, respectively. RESULTS: We detected a significant linear correlation between secondary yolk sac diameter and gestational age in group A (r = 0.5085; p < 0.0001) and a moderate correlation in group B (r = 0.4048; p = 0.007) and C patients (r = 0.3478; p = 0.1333). When the groups were evaluated irrespective of gestational age, a significant difference in secondary yolk sac diameters among the groups was noted (p = 0.037). When confidence intervals for secondary yolk sac diameters of intact normal pregnancies (group A) were calculated by linear regression, two patients in group B were below the 5% confidence interval. However, in group C patients, the yolk sac diameter of six patients were detected below the 5% confidence interval, while two of the measurements were above 95% confidence interval. Therefore, eight measurements (40%) of group C patients were outside the 5-95% confidence interval. CONCLUSION: In the first trimester, when discrepancy is detected between secondary yolk sac diameter and gestational age, additional sonographic investigation should be performed one or two weeks later, in order to estimate the pregnancy outcome.

High-dose medroxyprogesterone acetate for the treatment of dysfunctional uterine bleeding in 24 adolescents.

The objective of the study was to evaluate the effectiveness of high-dose oral medroxyprogesterone acetate therapy in the management of excessive dysfunctional uterine bleeding in adolescents. The study group consisted of 24 adolescents who were hospitalized with the diagnosis of excessive uterine bleeding and anaemia. Oral medroxyprogesterone acetate tablets were administered at a total dose of 60-120 mg during the first day of admission and 20 mg per day for the following 10 days. The blood loss was reduced to acceptable levels in all patients, and actually stopped in 6 (25%) within the first 24 hours of the treatment; bleeding ceased in 29.2%, 20.8% and 25% on the second, third and fourth days respectively. Significant correlation was identified between the initial haemoglobin concentration and the time required for cessation of bleeding (r2 = 0.5, p = 0.001). Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in adolescents.