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Biomedical subjects

S Diaz

Publications and source records attributed to S Diaz.

At least 109 records · Page 6Linked to original sources
PubMed1982

A five-year clinical trial of levonorgestrel silastic implants (Norplant TM).

Silastic implants containing the progestin, levonorgestrel, were tested as a long-term contraceptive system in 101 women. During five full years of use, no pregnancies occurred. The 5-year continuation rate was 54%. Menstrual irregularities were the most frequent reason for termination of use but only during the first year. More than half of the terminations for this reason were in the first year. Some of the subjects elected to continue use of the implants beyond 5 years, allowing release rate data to be obtained through 6 years. From the second through the sixth year of use, the implants delivered a constant 30 micrograms per day of levonorgestrel to the subjects, and even after six years 57% of the original steroid content remained in the capsules. Return of fertility following removal was essentially immediate and not related to time of use. Medical reasons for removal were infrequent and no pattern was discernible.

Adult↗
PubMed1982

Plasma progesterone levels during long-term treatment with levonorgestrel silastic implants.

Plasma progesterone levels were measured in 113 women using a subdermal implant containing 200 mg levonorgestrel (NORPLANT) in an attempt to assess the roles of anovulation and inadequate luteal function in the contraceptive action of this method. Twenty-two women using an IUD (Copper T 200) served as a control group. Blood samples were taken twice a week for 6 consecutive weeks. This was done one to four times in each subject during the first 7 years after insertion of NORPLANT. Plasma progesterone was measured by a specific RIA and criteria based upon normal values in this laboratory were used to define each set of samples as ovulatory, uncertain or anovulatory. The rate of anovulation varied between 25 and 80% throughout the 7 years. The highest rate was observed during the first year of treatment of treatment. The rate of anovulation was significantly correlated with the plasma levels of levonorgestrel. Varying degrees of inadequate corpus luteum function were detected among NORPLANT users. All sets of samples in the control group were ovulatory and compatible with normal luteal function. These results clearly show that continuous administration of levonorgestrel by means of NORPLANT interferes with ovulation and/or luteal function in a significant proportion of cycles throughout the first 7 years of use.

Adult↗
PubMed1981

A multicenter study of levonorgestrel-estradiol contraceptive vaginal rings. II-Subjective and objective measures of effects. An international comparative trial.

Comparative clinical trials of 2 sizes of contraceptive vaginal rings and of an oral contraceptive were undertaken at 8 investigational sites (9 clinics). More than 500 women enrolled on each of the 3 study regimens. Side effects of the rings and of Nordette, the oral contraceptive, were evaluated by noting spontaneous complaints, by recording medications taken and by physical examination. Inquiries about changes in the frequency of specific conditions were made at the end of the subjects participation in the first year of the study. The incidence of spontaneous complaints was similar among users of the 2 different-sized rings and of the pill.

Adolescent↗
PubMed1981

A multicenter study of levonorgestrel-estradiol contraceptive vaginal rings. III-Menstrual patterns. An international comparative trial.

Menstrual events among users of contraceptive vaginal rings (CVRs), releasing levonorgestrel and estradiol, were studied in comparison with a combined oral contraceptive, Nordette, in multicentered trials. CVRs were made with outside diameters of 50 and 58 mm and released about 250 micrograms and 290 microgram of levonorgestrel and 150 microgram and 180 microgram of estradiol per day, respectively. The CVRs were used continuously for 3 weeks and then removed for 1 week. Both the CVRs and Nordette were perceived to reduce menstrual flow and days of menstrual bleeding. Twenty to 25% of CVR users perceived increased intermenstrual bleeding or spotting. Diaries indicate, however, that on average, CVR users experienced about 1 day per month of bleeding or spotting with the ring in place. CVRs and Nordette produced approximately the same total number of bleeding and spotting days during 6 cycles of use, 27-29, but the small (50-mm OD) ring was associated with somewhat more spotting. This ring was also associated with somewhat more prolonged bleeding and spotting runs and with more prolonged nonbleeding intervals than reported by users of the larger (58-mm OD) ring or of Nordette. Differences among regimens, however, tended to be small even when statistically significant. Evidence from menstrual diaries indicates that these CVRs, and in particular 58-mm ring, provide control over the menstrual cycle comparable to the Nordette.

Adolescent↗
PubMed1979

A three-year clinical trial with levonorgestrel silastic implants.

Silastic implants containing the progestin, levonorgestrel, were tested as long-term contraceptives in 101 women. After three full years of exposure and 2,998 woman-months of use, no pregnancies had occurred. The continuation rates were 87% at 12 months, 79% at 24 months and 66% at 36 months. The most important side effect was excessive or irregular bleeding during the first year. No treatment was offered for this side effect other than vitamins and iron or change of method, with the exception of 3 cases where ethinyl estradiol was used one time for 2 weeks each. Bleeding disturbances led 8 patients to ask for removal of implants. Other side effects were headache, acne and lower abdominal pain. Blood and urine analysis tested 17 different parameters and all but plasma cortisol remained within normal limits throughout the study. A general tendency toward lowered cortisol values was observed and two subjects had more than one value below the normal limit for the population during the study. Glucose tolerance tests during the second year were abnormal in two women with familial diabetes but they returned to normal values spontaneously at the next test. It is concluded that levonorgestrel implants offer effective protection against pregnancy during the first three years of continuous use. Their acceptability and few side effects justify larger trials, especially if treatment of bleeding irregularities is introduced.

Abdomen↗
PubMed1978

Clinical trial with subdermal implants containing norgestrienone.

Norgestrienone implants delivering approximately 225 microgram/ day were tested clinically for contraceptive effectiveness and acceptability in 145 women. Five pregnancies occurred in 2259 woman-months of use, one in the 11th month, one in the 15th and three in the 16th month of use. Continuation rate at 12 months was 86.7. The number of bleeding runs and bleeding days was increased in approximately 12% of the subjects. Ten percent of the patients had no bleeding in the first 90 days of treatment. Changes in bleeding pattern led to closures in four cases. Headache and signs of mild androgenicity were among the leading side effects. Blood and urine analysis throughout the study showed normal values of 17 different parameters, but a tendency to lower cholesterolemia not associated with changes in thyroid hormone levels, was observed in several patients. Cortisol was found slightly under the lower normal range in one subject without clinical manifestations of hypoadrenalism. It is concluded that norgestrienone implants should be replaced every twelve months for maximal contraceptive effect and because of their efficacy and good acceptability, evaluation of their long term use is warranted.

Adolescent↗
PubMed1978

Clinical chemistry in women treated with progestogen implants.

Effects on metabolic parameters of six subdermal implants of d-norgestrel, norgestrienone (R2010) and methylnorgestrienone (R2323) were studied in women. In general, tests remained within the normal range. An exception was increases in serum transaminase levels in several subjects on R2323 implants. Average cortisol values showed a tendency to decrease on all three regimens, but remained within the significance only with R2323 at six months and R2010 at 12 months. Serum cholesterol levels showed significant decreases on R2010 implants.

Cholesterol↗
PubMedDate not supplied

Role of nitric oxide in salivary secretion.

Since nitric oxide has been found to control the function of many organs of the body by the non-adrenergic, non-cholinergic branch of the autonomic nervous system, we hypothesized that it might play a role in salivary secretion. Therefore, we investigated the distribution of nitric oxide synthase (NOS) throughout the submaxillary gland and also studied the ability of inhibitors of NOS to interfere with salivation induced by a cholinergic agonist, metacholine, and by a polypeptide, substance P. The secretory responses were determined in rats anesthetized with chlorolose following intravenous injection of the various pharmacological agents. There was no basal flow of saliva and dose-response curves were obtained by sequential intravenous injection of increasing doses of the drugs. Then, in the same animal, the same dose-response curves were performed in the presence of NOS inhibitors. L-Nitro-arginine-methyl-ester (L-NAME; 20 mg/kg) produced an over 50% inhibition of the dose-related salivation induced by metacholine. Similar results were produced with L-NG-monomethyl-L-arginine (L-NMMA; 5 mg/kg). The salivation induced by much lower molar doses of substance P was dramatically greater than that obtained with metacholine. The response to substance P was almost completely inhibited by L-NMMA at the lowest dose (0.3 mg/kg), but at higher doses (1 mg/kg), the inhibition was only around 60% and at the highest dose (3 mg/kg) only about 20%. In control rats, there were roughly equal amounts of calcium-dependent and calcium-independent NOS in the gland at this time. At the end of the experiment, the effect of the inhibitor of NOS, L-NMMA, on the NOS activity in the submandibular gland was determined. At this time, the Ca2+-dependent NOS was decreased and the Ca2+-independent NO was increased. The prior injection of L-NMMA reduced calcium-dependent NOS activity by approximately 70% but calcium-independent activity by only 30%. These results indicate that, at least at the end of the experiment, the blockade of NOS imposed by NMMA was incomplete. This could account in part for the failure of the inhibitors to block completely the stimulatory effect of the two secretagogues. Analysis of the distribution of NOS in the salivary gland revealed that it was not present in the acinar cells, but in neural terminals within the gland and also in the ductile system which contained neural (n) NOS in the apical membrane of the excretory and striated ducts, the cytoplasm of granular convoluted tubules and, to a lesser extent, in the cytoplasm of excretory and striated ducts. Macrophage (inducible) NOS was also found not only in the macrophages, but also in the tubules and ducts. Since drugs were used that would act on the receptors in the gland, the role of NO in our conditions is probably mediated by nNOS and iNOS in the ductile and tubular structures. Since iNOS would already be active, it is unlikely to play a role in this acute secretory activity. Rather the nNOS in these non-neural cells is probably activated by muscarinic or K1 receptors by metacholine and substance P, respectively, leading to an increase in intracellular free calcium that activates NOS leading to the generation of cGMP that opens ion channels to initiate the secretory process.

Animals↗
PubMedDate not supplied

Ozone and UV radiation over southern South America: climatology and anomalies.

Ozone and UV radiation were analyzed at eight stations from tropical to sub-Antarctic regions in South America. Ground UV irradiances were measured by multichannel radiometers as part of the Inter American Institute for Global Change Radiation network. The irradiance channels used for this study were centered at 305 nm (for UV-B measurements) and 340 nm (for UV-A measurements). Results were presented as daily maximum irradiances, as monthly averaged, daily integrated irradiances and as the ratio of 305 nm to 340 nm. These findings are the first to be based on a long time series of semispectral data from the southern region of South America. As expected, the UV-B channel and total column ozone varied with latitude. The pattern of the UV-A channel was more complex because of local atmospheric conditions. Total column ozone levels of < 220 Dobson Units were observed at all sites. Analysis of autocorrelations showed a larger persistence of total column ozone level than irradiance. A decreasing cross-correlation coefficient between 305 and 340 nm and an increasing cross-correlation coefficient between 305 nm and ozone were observed at higher latitudes, indicating that factors such as cloud cover tend to dominate at northern sites and that ozone levels tend to dominate at southern sites. These results highlight the value of long-term monitoring of radiation with multichannel radiometers to determine climatological data and evaluate the combination of factors affecting ground UV radiation.

Journal Article↗