Search PubMed⌕ Search

Biomedical subjects

A Fortuny

Publications and source records attributed to A Fortuny.

At least 73 records · Page 4Linked to original sources
PubMed1994

Maternal primary pulmonary hypertension associated with pregnancy.

Primary pulmonary hypertension (PPH) is a very uncommon clinical entity, with a high mortality when associated with pregnancy. Three cases of PPH associated with gestation and different outcomes are reported, and a literature review concerning its management and outcome is made. We emphasize the importance of a strict control of such patients, with the supportive cardiovascular measures and surveillance of fetal well-being. The peculiar handling of the course of delivery and the type of anaesthesia is discussed.

Adolescent↗
PubMed1994

Antagonism of oestrogen-induced prolactin release by medroxyprogesterone acetate.

Previous studies conducted at our clinic suggested that the administration of hormone replacement therapy (HRT) in postmenopausal women could result in the inhibition of oestrogen-induced prolactin (PRL) release. The aim of this study was to determine how the pituitary function is affected by the sequential addition of medroxyprogesterone acetate (MPA) to oestrogen replacement therapy. Twenty-one postmenopausal women receiving no other medication were treated with a standard dose (0.625 mg/day) of conjugated equine oestrogens (CEE) for a period of 24 days, plus 5 mg/day MPA added sequentially during the last 12 days of the oestrogen therapy. Blood samples were collected before treatment, during oestrogen and oestrogen-progestogen administration and after cessation of treatment. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17 beta-oestradiol (E2) and PRL levels were studied. During treatment gonadotrophin concentrations decreased significantly, while after cessation of HRT the levels of FSH and LH increased. These gonadotrophin fluctuations indicated a sharp rise in E2 levels during therapy and a significant decrease during the treatment-free period. PRL levels were found to be higher during CEE therapy, but they fell when patients received CEE in combination with MPA. These observations suggest that the role of progestogens in a variety of experimental and clinically relevant situations needs to be investigated not only as regards their direct action but also their modulation of the effect of oestrogen.

Climacteric↗
PubMed1994

Transvaginal sonography of the endometrium in postmenopausal women: monitoring the effect of hormone replacement therapy.

BACKGROUND: It is well known that progestins given in sufficient dosage reduce the risk of endometrial cancer and endometrial hyperplasia. It is also not uncommon that patients receiving hormone replacement therapy (HRT) require endometrial biopsy in order to evaluate the effects of oestrogens and progestogens on endometrium. However, endometrial biopsy is often associated with pain and discomfort, and transvaginal sonography has been suggested as a new and painless method of monitoring the effects of HRT on the endometrium. METHODS: Transvaginal ultrasonography was performed in a series of women on several regimens of HRT immediately prior to endometrial biopsy (Cornier cannula). We correlated the morphology and thickness of the endometrium as assessed by transvaginal ultrasonography with the endometrial histology. Patients were assigned into four groups. The first (n = 15) received 0.6 mg/day of conjugated equine oestrogen (CEE) cyclically and the second (n = 6) received 50 micrograms/day of transdermal oestradiol cyclically. All these groups also received 5 mg of medroxy-progesterone acetate (MPA) sequentially for the last 12 days of HRT, while the third therapy group (n = 7) received 0.625 mg/day of CEE and 5 mg/day of MPA uninterruptedly. The fourth group (n = 8) constituted a treatment-free control group. In total 36 biopsies were taken. Our initial results suggest that endometrial thickness under 4 mm measured by ultrasonography is not associated with endometrial abnormalities and that transvaginal ultrasonographic scanning of the endometrium may be a useful tool in determining which patients require endometrial histologic evaluation and perhaps in detecting those who need adjustment in the progestin dosage.

Administration, Cutaneous↗
PubMed1994

Relationship between skin collagen and bone changes during aging.

There is evidence that skin collagen content and bone mass are influenced by estrogen deficiency, both of them declining in the years following menopause. The aim of our study was to analyze the relationship between changes in skin collagen content and bone mass during aging. A total of 76 nulliparous women who had been admitted for surgery of non-malignant processes were studied. All subjects were arranged into five age-groups (from 20 to 60 years). Bone mineral density was measured by dual photon absorptiometry and expressed in g/cm2 as the mean of the second to fourth lumbar vertebrae. Additionally, in all patients skin biopsies were taken from a non-sun exposed site in the lower abdomen (4 cm above the pubic symphysis) and osteocalcin levels were determined. Collagen decreased significantly with age after the 40s (P < 0.001) and after menopause (P < 0.001). Changes in bone mass were closely related to those detected in collagen (r = 0.586; P < 0.0001). In conclusion, our data suggest that bone mass and skin collagen decline in parallel with aging and that the hypoestrogenism developing in postmenopausal years has a significant effect on skin collagen content. Nevertheless, the question of whether osteoporosis is an intrinsic collagen disorder remains to be demonstrated.

Adult↗
PubMed1993

Unusual segregation for 11q;22q parental translocation in a triplet pregnancy: prenatal diagnosis in chorionic villi and amniotic fluid.

The prenatal diagnosis of an 11q;22q translocation in a triplet pregnancy detected at the time of chorionic villus sampling (CVS) because of advanced maternal age is reported. Karyotypes obtained from two apparently different CV samples showed the balanced form of translocation, while the one obtained from a third empty sac showed the unbalanced form: 46,XX,-22,+der(22)t(11;22). Second-trimester amniocentesis confirmed the balanced translocation in one of the two viable fetuses and a normal karyotype in the other. The detected karyotypes derived from two different types of meiotic segregation, alternate and adjacent 1. To our knowledge, this is the first reported case of an unbalanced karyotype not due to a 3:1 meiotic segregation of this specific translocation.

Adult↗
PubMed1993

Effects of oophorectomy and hormone replacement therapy on pituitary-gonadal function.

The purpose of this study was to determine how oophorectomy and different hormone replacement therapy (HRT) regimens using low doses of medroxyprogesterone acetate (MPA, 2.5 mg/day) influence the pituitary-gonadal axis function. Ninety (90) women, who had had regular menses prior to surgery, completed a 1-year follow-up period. Patients were assigned to 5 groups. The first (n = 16) received 0.625 mg/day conjugated equine oestrogens (CEE) cyclically, the second (n = 20) 50 micrograms day transdermal oestradiol (E2) cyclically and the third (n = 15) 0.625 mg/day CEE continuously. These 3 groups also received 2.5 mg MPA sequentially for the last 12 days of HRT administration. The fourth group (n = 20) received 0.625 mg/day CEE and 2.5 mg/day of MPA continuously, while the fifth (n = 19) constituted a control group. After oophorectomy all patients showed increases in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and decreases in those of E2, oestrone (E1), prolactin (PRL), sex-hormone-binding globulin (SHBG), androstenedione (delta A4) and testosterone (T). No changes were detected in dehydroepiandrosterone sulphate (DHEA-S) levels. After HRT, decreases in FSH, LH and PRL levels and increases in those of E2, E1 and SHBG were observed, but no changes were seen in T, delta A4 or DHEA-S plasma levels. As the differences that were found cannot be attributed to the presence of ovaries, it is reasonable to assume that they were perhaps due to the treatment. All these changes, with the exception of a decrease in PRL levels, are therefore to be expected after HRT.

Estradiol↗
PubMed1988

Detection of balanced chromosome rearrangements in 445 couples with repeated abortion and cytogenetic prenatal testing in carriers.

Cytogenetic studies were performed in 445 couples presenting because of repetitive abortion. The authors detected a balanced translocation in 19 (4.2%) of the couples, pericentric inversions in 8 (1.8%), and polymorphisms in 52 (11.4%). The results were compared with those obtained in a series of 600 consecutive normal liveborns. Significantly higher frequencies for translocations and polymorphisms were present in couples with repetitive abortion. No sex predominance in translocation carriers was observed, and reciprocal translocations were more common (16 of 19) than the robertsonian type (3 of 19). Contrary to other reports, all of the translocations and inversions were detected among couples without previous abnormal offspring. Cytogenetic prenatal testing in 17 pregnancies from a carrier parent showed that none of the fetuses had the unbalanced karyotype, 13 carried the balanced rearrangement, and 4 had a normal karyotype. Although a risk profile can be obtained for these couples, prenatal testing must be offered to avoid anxiety and unjustified pregnancy interruptions.

Abortion, Habitual↗
PubMed1988

Total LDH and its isoenzymes in gynecological malignancies and other gynecological conditions.

Total LDH and its five Isoenzymes have been evaluated in 354 patients from a Gynecological Ward. These patients had uterine fibroids, benign ovarian tumors, tubo-ovarian abscesses (T.O.A.), endometrial cancers, cancers of the cervix and ovarian cancers. 90 patients had no gynecological disease and served as controls. A statistical analysis was performed comparing each group of patients with the control group. A significant elevation in total LDH and Iso-IV and a significant decrease in Iso-I was observed in patients with uterine fibroids. Patients with benign ovarian tumors had a significant elevation of total LDH. Patients with T.O.A., Endometrial cancer, cancer of the cervix and cancer of the ovary had a significant elevations of total LDH and Iso-V and a significant decrease in Iso-I. When the group of patients with endometrial cancer, cancer of the cervix and cancer of the ovary were compared with each other, no differences could be found in total LDH and Isoenzyme values. We conclude that total LDH and Isoenzyme serum levels are not useful clinical indicators for the diagnosis and management of gynecological malignancies and particularly of ovarian cancer.

Female↗
PubMed1985

Demonstration of a gradient in inhibin activity, estrogen, progesterone, and delta 4-androstenedione in follicular fluid, ovarian vein blood, and peripheral blood of normal women.

Ovarian vein serum from 3 subjects during the late follicular phase of the menstrual cycle had detectable inhibin activity, whereas ovarian vein serum of 12 other subjects during the early follicular phase and luteal phase had no detectable inhibin activity in a rat anterior pituitary cell culture assay. Subjects having detectable inhibin activity (102 +/- 47 U/100 microliters) had 1257 +/- 582 U/100 microliters inhibin activity in FF, whereas subjects having no detectable inhibin activity had FF levels of 711 +/- 203 U/100 microliters of inhibin activity. Estrogen levels of FF and ovarian vein serum of the group having detectable inhibin activity in ovarian vein serum were 282 +/- 239 ng/ml and 4.8 +/- 1.77 ng/ml, respectively. The estrogen content of FF and ovarian vein blood of the group having nondetectable inhibin activity in ovarian vein blood was 127 +/0 45 ng/ml and 3.03 +/- 0.6 ng/ml, respectively.

Adult↗
PubMed1983

Levels of inhibin-F activity and steroids in human follicular fluid from normal women and women with polycystic ovarian disease.

To examine inhibin-F activity (FSH-suppressing activity) in human follicular fluid of polycystic ovary (PCO) patients, 13 follicles from 5 documented PCO patients and an additional 31 follicles from normal women in the follicular phase of the menstrual cycle were sampled, and inhibin-F activity was measured in rat anterior pituitary cell cultures. Inhibin-F activity was measured in follicular fluid after stripping steroids from the fluids using treatment with dextran and activated charcoal. Estrogen, progesterone, and delta 4-androstenedione in the follicular fluid were also determined by RIA. Estrogen and progesterone levels in follicular fluid from PCO follicles 3.9 +/- 0.34 mm in diameter were comparable with those in follicular fluid obtained from viable follicles (which had a delta 4-androstenedione to estrogen ratio of 10 or less) from normal women. delta 4-Androstenedione levels in PCO follicles were higher (P less than 0.01) than those in viable and atretic follicles of normal women. Inhibin-F levels in PCO follicles were comparable to those in viable follicles, but significantly greater (P less than 0.01) than levels in atretic follicles of normal women. If inhibin-F levels in both atretic and viable follicles of normal women were pooled, the levels were less (P less than 0.05) compared to the level in PCO follicular fluid. As an additional control, follicular fluid was collected from 90 follicles of normal women throughout the menstrual cycle, and follicular size was determined as well as inhibin-F and steroid content. Small follicles less than 8 mm; (comparable in size to the PCO follicles examined) obtained at each stage represented 79%, 24%, 0%, and 94% of the total follicles obtained in the early to midfollicular, late follicular, preovulatory, and luteal phases of the cycle, respectively. Inhibin-F activity in the fluids of these follicles was less than that in PCO follicular fluid. The average inhibin content of all of the small normal follicles was 197 +/- 34 U/10 microliter, which was significantly less (P less than 0.05) than the level in PCO follicles (332 +/- 13 U/10 microliters). These data represent the first observation of inhibin-F activity in PCO follicular fluid and suggest the possibility of involvement of inhibin-F in bringing about low or normal basal levels of FSH in the presence of elevated basal LH levels often observed in PCO patients.

Animals↗
PubMed1980

[Septic abortion. Complications and therapeutic considerations (author's transl)].

A study is presented on the incidence and complications of septic abortion in a group of patients admited on the 1st. Obstetric and Gynecologic Clinic of the University of Barcelona during a period of 5 years (1971-1975). Abortion is the cause of admision of 20,2% of patients in the gynecology ward and represents the 12,3% of the overall number of patients during the same period. In 7,8% of the patients admited because of abortion we found the criteria for establishing the diagnosis of septic complication and in 15,2% of those extrapelvic involvement is found, mainly endotoxic shock, acute renal failure and difuse peritonitis. Endocervical cultures were positive in 73% of cases and in 65,7% gram negative germs were isolated, being the most common E. coli. The different clinical patterns are discussed in cases in which anaerobics are implicated and the diagnostic and therapeutic aproaches in the different complications are reviewed particularly in concern to the indications of surgery when this may be the only lifesaving procedure.

Abortion, Septic↗