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Biomedical subjects

A R Ayala

Publications and source records attributed to A R Ayala.

At least 19 recordsLinked to original sources
PubMed1995

Effect of insuflated Nafarelin (D-Nal-6-GnRH) upon uterine leiomyomata.

A nasal spray containing the GnRH analog Nafarelin (D-Nal-6-GnRH) was used to treat 20 patients of reproductive age with clinical and ultrasonographic diagnosis of uterine leiomyomata. Nafarelin showed a high index of efficacy (approximately 65%) in decreasing the volume of myomas. The collateral effects observed were scarce; among these were predominant a decrease of libido and vasomotor symptoms. Although bone pain was not referred, the impact upon osteodensity was not assessed. The effect upon pituitary gonadotropin production as well as that of sexual steroids by GnRH was practically null, and one patient became pregnant. Nonetheless, those symptoms associated with the use of Nafarelin were apparently due to a moderate hypoestrogenism, despite not being substantiated in the laboratory studies. With such disparity, we assume it was given by the route of administration of nasal Nafarelin, which is known to have erratic effects due to limitations in its absorption. Thus, far from being a disadvantage it could be useful in regimes of long term therapy (1-2 years) to avoid the impact of estrogen shortage upon bone turnover. We conclude that Nafarelin through insuflation was highly effective for decreasing the size of uterine leiomyomata.

Adult↗
PubMed1994

[Dermatomyositis and eclampsia. Analysis of a case and review of the literature].

Dermatomyositis is an inflammatory disease of unknown etiology whose association to pregnancy is uncommon. The impact of dermatomyositis with uncomplicated pregnancy while active is very high for the fetus without major maternal consequences. The monitoring of cases with pregnancy associated hypertension and dermatomyositis, must be performed independently for the mother and the fetus, since fetal prognosis is usually bad and does not modify with treatment. The case presented herein is to our knowledge the first with eclampsia and dermatomyositis which ended in a normal product delivered and the mother decreased.

Adult↗
PubMed1992

[The diurnal rhythm of the arterial pressure in normal pregnancy and in hypertension].

An alteration upon the daily rhythm of blood pressure in patients with gestational hypertension has been reported, albeit inconsistently. Hence we have evaluated the daily rhythm of blood pressure in women with normal gestation (n = 100) and with pregnancy associated hypertension (n = 111). In an attempt to delineate a possible etiology of the hypertension, patients were subdivided according to a classification of the American College of Obstetricians and Gynecologists. (Group I. Preeclampsia-eclampsia; group II. Chronic hypertension; group III. Chronic hypertension with superimposed preeclampsia; group IV. Late gestational hypertension). Blood pressure quantitation was made with sphygmomanometer and by different observes. Those with normal pregnancy showed a higher increase in both systolic and diastolic pressure in the morning with a peak at 1200 H, that contrasted with a very low level registered at 2400 H. Altogether the hypertensive group exhibited a loss of rhythm; whereas by group: in I. There was absence of rhythm without a predominant pattern; II. & III. An increase of systolic pressure which was accetuated at 0600 H. group IV. Showed the lowest tensional levels without special characteristics. Through these data, it seems that the central nervous system loses control upon daily regulation of blood pressure in preeclamptic women.

Blood Pressure↗
PubMed1991

[Endothelin: preliminary data on its concentration in normal pregnancies and with arterial hypertension].

A peptide of endothelial origin derived from blood vessels named endothelin with vasoactive properties has been recently described. Since pregnancy associated hypertension (pre-eclampsia) is a disease of unknown etiology characterized by glomerular vasospasm and altered venous capacitance we decided to investigate the plasma levels of endothelin contained in patients with preeclampsia and normal pregnancy throughout diverse stages of gestation in order to recognize differences of peptide concentration that could explain the appearance of hypertension. Endothelin was significantly increased in preeclamptic women at term; hence, it is possible that it may play a role in the toxemic syndrome.

Endothelins↗
PubMed1989

[Human chorionic somatomammotropin (HCS) and placental volume].

Human chorionic somatomammotropin (HCS), is synthesize and secreted by the syncytiotrophoblast. Its effects on maternal metabolism are significant but the role of this hormone upon fetal development remains unknown. Nonetheless its measurement during final stages of pregnancy has proved to be useful for prediction of outcome. Since HCS serum levels exhibit progressive augmentation throughout gestation and taking into account its site of origin it has been proposed that could be dependent of changes in placental mass. This has not been totally ascertained, due to the lack of precision of studies designed for this purpose. If a correlation between HCS secretion and placental growth cold be established, it might be expected that determination of both indexes would contribute to obtain a more accurate diagnosis of abnormalities in retroplacental of fetal circulating blood volume. Therefore we studied 55 females without complicated pregnancy whose placental volumes were measured through ultrasound scanning. Serum samples were also collected for HCS quantitation by radioimmunoassay. Determinations were made starting on the 12th week of pregnancy. A progressive as well as a parallel increase of placental volume (154.12-825.01 ml) and HCS (0.48-7.0 Ug/ml) was observed during gestation. The correlation coefficient (r = 0.546) was significant (p less than 0.01). Both parameters correlated also with those obtained for fetal biparietal diameters. These findings support the notion that HCS secretion is proportional to the volume/mL of placental tissue which might be related to the amount of syncytiotrophoblast cells. It was not possible to establish causation upon the correlation observed between HCS and fetal parietal diameters.

Adult↗
PubMed1986

Evidence that a toxemia-related organism (Hydatoxi lualba) is an artifact.

Preeclampsia-eclampsia and trophoblastic disease have been associated with a wormlike organism, Hydatoxi lualba, recently discovered in smears from circulating blood, trophoblastic tumor tissue, and placental tissue of toxemic patients. To investigate these findings peripheral blood smears from patients with preeclampsia-eclampsia, patients with hydatidiform mole, normal pregnant patients, and nonpregnant subjects were studied. The smears were stained with toluidine blue-O and Giemsa. The average size of wormlike forms found was 2.5 by 0.23 mm. None stained with Giemsa. The frequency of positivity for toxemic patients was 56.5% and 81.8% for normal pregnant patients. Samples from molar pregnancies were negative. Observations performed directly in fresh blood were also negative. The forms were observed not only in peripheral blood but also in serum obtained after centrifugation or passage through Millipore filters. No evidence of reproductive elements was found, and electron microscopy revealed no particular structure. The results suggest that the organism is an artifact.

Eclampsia↗
PubMed1984

Daily rhythm of serum human chorionic gonadotropin and human chorionic somatomammotropin in normal pregnancy.

We have quantified the human chorionic gonadotropin (HCG) and human chorionic somatomammotropin (HCS) serum levels in normal pregnant women at 1-h intervals during 24 h, through radioimmunoassay procedures. The HCG levels were higher during the first trimester, although no circadian variations were detected. Some variations exceeded by ten fold; these variations decreased with advanced periods of gestation. No diurnal fluctuations in serum HCS were apparent; in a case nearly at term, there was an increase from 05:00 h to 09:00 h simulating a circadian pattern, although it was not statistically significant. These data indicate that the placental protein secretion is autonomous and that HCG levels of fluctuation during early stages of pregnancy might be regulated by factors other than the trophoblast.

Chorionic Gonadotropin↗