Use of corticosteroids and the outcome of infants with bronchopulmonary dysplasia

Ventilator-dependent premature infants are often treated with dexamethasone. Several trials showed that steroids while improve pulmonary compliance and facilitate extubation, some treated infants may have adverse effects, such as alterations of growth curves. We conducted this retrospective study to evaluate the effects of steroids on mechanical ventilation, oxygen therapy, hospital length stay and mortality, in ventilator-dependent infants with bronchopulmonary dysplasia (BPD) (defined as the need of oxygen supplementation at 28 days of life). Twenty-six newborns with BPD were evaluated during 9 -- 42 days postpartum (mean = 31 days) and were divided into two groups: Group I - 14 newborns that did not receive dexamethasone, and Group II - 12 newborns that received dexamethasone at 14 --21 days of life. Dexamethasone was given at a dose of 0.25 mg per kilogram of body weight twice daily intravenously for 3 days, after which the dose was tapered. RESULTS: There were no statistically significant differences in the mean length of mechanical ventilation (Group I - 37 days, Group II - 35 days); oxygen supplementation (Group I - 16 days, Group II - 29 days); hospital stay (Group I - 72 days, Group II - 113 days); mortality (Group I - 35.7%, Group II - 41.6%). At birth, Group II was lighter (BW: Group I - 1154 grams ± 302, Group II - 791 grams ± 165; p < 0.05) and smaller (height: Group I - 37.22 cm ± 3.3, Group II - 33.5 ± 2.4; p< 0.05) than Group I. At 40 weeks, there were no statistically significant differences between groups in relation to anthropometric measurements. CONCLUSIONS: The use of corticosteroids in bronchopulmonary dysplasic infants may influence the somatic growth during its use. However, after its suspension, a recovery seems to occur, suggesting that its influence could be transitory.

Premature thelarche: identification of clinical and laboratory data for the diagnosis of precocious puberty

PURPOSE: Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could distinguish between a benign, nonprogressive premature thelarche and a true precocious puberty. METHODS: The clinical outcome of 88 girls with breast enlargement before 6.1 years of age was analyzed. Taking into account the progression of their sexual maturation, we allocated the children into 2 groups: "Isolated Premature Thelarche" (n = 63) and "Precocious Puberty" (n = 25) groups. Chronological and bone ages, height and growth velocity centiles, computerized tomography of hypothalamus-pituitary area, pelvic ultrasonography, gonadotropin response to luteinizing hormone-releasing hormone stimulation as well as basal levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and prolactin were studied in both groups. Statistical analysis were performed using the Student t test to compare the sample means. Fisher's exact test and chi² test were used to analyze the nonparametric variables. RESULTS: Isolated premature thelarche most frequently affected girls younger than 2 years who presented exaggerated follicle-stimulating hormone response to luteinizing hormone-releasing hormone stimulation test. The precocious puberty group had higher initial stature, accelerated growth rate and bone age, increased uterine and ovarian volumes, high spontaneous luteinizing hormone levels by immunofluorimetric assay, as well as a high luteinizing hormone response and peak luteinizing hormone/follicle-stimulating hormone ratio after luteinizing hormone-releasing hormone stimulation. CONCLUSION: At initial presentation, girls who undergo true precocious puberty present advanced bone age, increased uterine and ovarian volumes in addition to breast enlargement, as well as an luteinizing hormone-predominant response after a luteinizing hormone-releasing hormone stimulation test.

Hypothyroidism following struma ovarii tumor resection: a case report

Struma ovarii is an infrequent ovarian tumor, and there are only few reports with detailed data of thyroid function. In several cases, malignant struma ovarii have been shown to produce hyperthyroidism, but there is no reported case of hypothyroidism following struma ovarii tumor resection. A 62-year-old white woman underwent right ovary resection that had a pathologic diagnosis of struma ovarii. After 6 days, she developed weakness, myalgia, somnolence, nausea, and arterial hypotension. Laboratory tests showed a high level of thyroid-stimulating hormone (TSH) and a decreased level thyroxin. Thyroxin replacement therapy was initiated, and the patient became completely asymptomatic. This is the first reported case of a previously asymptomatic woman who developed a definite clinical hypothyroidism after resection of a struma ovarii tumor.

Hormone replacement therapy and the risk of breast cancer: assessment of therapy acceptance in a cohort of previously treated breast cancer patients

INTRODUCTION: In the postmenopausal period, an average of 25% of women will present symptomatic ovarian failure requiring hormonal replacement therapy. Estrogen can relieve vasomotor symptoms. Hormonal replacement therapy is generally not recommended for breast cancer patients due to the potential risk of tumor recurrence. To answer the questions about the safety of hormonal replacement therapy in this subgroup of women, it is necessary to establish the acceptance of treatment. METHODS: Between September 1998 and February 2001, a cohort of 216 breast cancer patients were asked to complete a questionnaire. All patients had completed their treatment and were informed about survival rates after breast cancer and hormonal replacement therapy. RESULTS: Among the 216 patients, 134 (62%) would refuse hormonal replacement therapy. A hundred patients were afraid of relapse (74.6%). Adjuvant tamoxifen therapy was the only statistically significant variable (70.3% versus 29.7% p=0.003). Understanding clinical stage (p= 0.045) and type of medical assistance (private versus public , p=0.033) also seemed to influence the decision. Early stage disease (p= 0.22), type of surgical procedure (radical versus conservative, p=0.67), adjuvant chemotherapy (p=0.082) or marital status (p=0.98 ) were not statistically significant in decision making. Several patients submitted to adjuvant chemotherapy (41.6%) would accept hormonal replacement therapy under medical supervision, as did most of advanced clinical stage patients (58.3%; p=0.022). CONCLUSION: There is a high level of rejection for hormonal replacement therapy among breast cancer patients when current data on tumor cure rates, and potential risks of estrogen use is available. Adverse effects of tamoxifen in the adjuvant setting may be the reason for refusal of hormonal replacement therapy .

Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor

A case of malignant neoplasm is described in which the initial manifestations were mental dysfunction and meningeal irritation, mimicking chronic or subacute meningitis. Physical examination showed cranial nerve involvement and a pelvic tumor. There was progressive deterioration, and death occurred in 2 weeks. The autopsy revealed a gallbladder adenocarcinoma, meningeal carcinomatosis, and ovarian metastasis presenting as a Krukenberg tumor. The authors emphasize the importance of including meningeal carcinomatosis as a possibility in the differential diagnosis of non-characteristic clinical pictures, as well as the importance of the cerebrospinal fluid cytologic examination, repeated as needed, in order to confirm this diagnosis.

Trends in male contraception

Methods that are available for male contraception, namely coitus interruptus, condoms, and vasectomy, have been used since the 19th century. With the exceptions of a few improvements of these methods, no major progress has been made with respect to introducing new male contraceptives since then. It is extremely urgent to develop new, safe, effective, and reversible male contraceptive methods. Among all male contraceptive methods that are being investigated, the hormonal approach is the closest to clinical application. Hormonal contraception provides pregnancy protection by means of spermatogenic suppression. Androgen-progestin regimens currently represent the best available hormonal combination for induction of a profound suppression of spermatogenesis. Further development of new steroids is mandatory for increasing the choices of available contraceptive formulations and to optimize long-term safety of these regimens.

Adnexal torsion following gonadotropin-releasing hormone analog therapy: a case report

Adnexal torsion may occur in girls and adolescents. Often it is associated with ovarian diseases resulting in ovarian enlargement. Adnexal torsion may involve the ovary, fallopian tube or both, and the main sympton is acute pelvic pain. An 8-year-old girl complaining of acute pelvic and abdominal pain, who was previously diagnosed with precocious puberty and who received treatment with a GnRH analog, is reported. Ultrasound demonstrated a normal-sized uterus and bilaterally enlarged ovaries with multiple internal cysts. At laparotomy, we found a complete torsion in the right adnexa. The histological examination revealed massive edema associated with multiple antral follicles and reduction of the follicular reserve.

Estimate of Physiological Age in Females of PASSALUS (Insecta, Coleoptera)

Studies on development of female reproductive system insects have shown its utility in physiological age grading. The irreversible charocter of ovarian alterations correlated with mandibular wear and presence of yellow body, were applied to estimate the physiological age of Passalus convexus and Passalus latifrons females, giving results comparable to other studies and indicating the value of these methods in determination of physiological age.

Triterpenes of leaves from Piranhea trifoliata (Picrodendraceae)

ABSTRACT The Amazon forest is rich in plant species diversity, among them,Piranhea trifoliata stands out, which is popularly known as piranheira, because their fruits are eaten by fish. Their barks are used as bath composition on uterus inflammation and as tea in malaria treatment. This study aimed to fractionate the dichloromethane and dichloromethane phase from methanolic extract of leaves of Piranhea trifoliata. The leaves were dried, grounded and extracted with dichloromethane, methanol and water. The methanol extract was partitioned with dichloromethane and ethyl acetate. The chromatographic fractionation yielded six pentacyclic triterpenoids: friedelan-3-one, 28-hydroxy-friedelan-3-one, 30-hydroxy-friedelan-3-one, lupeol, α- and β-amyrin mixture, besides the mixture of the steroids: β-sitosterol and stigmasterol. The substances structures were identified by 1H- and13C-Nuclear Magnetic Resonance (NMR) analysis and literature data comparison. This is the first report describing the chemical study of P. trifoliata leaves.

Padrão reprodutivo de Elachistocleis bicolor (Anura, Microhylidae) na Serra da Bodoquena, Mato Grosso do Sul, Brasil

The reproductive pattern of Elachistocleis bicolor (Guérin Méneville, 1838) was studied at Serra da Bodoquena, from October 2000 to September 2001. Reproduction occurred in the wet season (October to April) and was correlated to high continuous pluviometric precipitation. The species presents sexual size dimorphism, with females larger than males. The number of mature eggs per ovary was 620 ± 251 (n=39) and mature eggs measured 1.15 ± 0.30 mm (n=40). Elachistocleis bicolor presented significant relations between snout-vent length and number of mature eggs (n=39; r²=0.25; p=0.001), individual weight and number of mature eggs (n=41, r²=0.30; p=0.002), snout-vent length and ovarian weight (n=35; r²=0.47; p<0.01), and individual weight and ovarian weight (n=36; r²=0.55; p<0.01). Weight and volume are better to study size-fecundity relationships than snout-vent length. The females invested 22.7 ± 6.3 % (n=35) of their weights in reproduction and the variance associated to this variable was high, related to the reproductive mode of the species.

Molt cycle of the natural population of Palaemonetes argentinus (Crustacea, Palaemonidae) from Los Padres Lagoon (Buenos Aires, Argentina)

The molt cycle of the natural population of Palaemonetes argentinus Nobili, 1901 from Los Padres Lagoon, Buenos Aires, Argentina, was studied in relation to age, sex, and environmental factors. A total of 1645 individuals (740 females, 539 males, and 366 juveniles) were collected and analyzed between December 1995 and December 1996. The results indicate that the sex ratio (males:females) remains around 1:1.4 throughout most of the year. The reproductive period extends from September until February (spring and summer), with maximum sexual activity in October and November. Two cohorts originated in the spring and in the summer were differentiated. Ovigerous females arrest their molt cycle during the intermolt period to restart it after oviposition. The duration of the intermolt period does not differ between adults and juveniles. Since the percentage of premolt individuals represents 60% of the total cycle, it was classified as a diecdysic cycle. Within the studied range of water temperatures, the observed variations in the span of the different stages, indicate that this factor does not alter the molt frequency. Like in the rest of decapods, the intermolt duration of P. argentinus is modified by ovarian maturation.

Variação anual do sistema reprodutor de fêmeas de Bothrops jararaca (Serpentes, Viperidae)

The morphological changes of the ovary and oviduct of 238 tropical snakes Bothrops jararaca (Wied, 1824) were determined. The ovarian mass presented a remarkable decrease in October, after ovulation, staying in low levels from November to March, during the gestational period. From April to September, it increased because of the ovarian follicles maturation. A gradual increase in oviduct weight was observed from October to March due to stages of embryonic development. A significant difference was observed between right and left ovary weight, and oviduct length, independently of the months considered.

Gonad development in females of fiddler crab Uca rapax (Crustacea, Brachyura, Ocypodidae) using macro and microscopic techniques

The morphology of the ovaries in Uca rapax (Smith, 1870) was described based on macroscopic and microscopic analysis. Females were collected in Itamambuca mangrove, Ubatuba, state of São Paulo, Brazil. In the laboratory, 18 females had their ovaries removed and prepared for histology. Each gonad developmental stage was previously determined based on external and macroscopic morphology and afterwards each stage was microscopically described. The ovaries of U. rapax showed a pronounced macroscopic differentiation in size and coloration with the maturation of the gonad, with six ovarian developmental stages: immature, rudimentary, developing, developed, advanced and spent. During the vitellogenesis, the amount of oocytes in secondary stage increases in the ovary, resulting in a change in coloration of the gonad. Oogonias, primary oocytes, secondary oocytes and follicular cells were histologically described and measured. In female’s ovaries of U. rapax the modifications observed in the oocytes during the process of gonad maturation are similar to descriptions of gonads of other females of brachyuran crustaceans. The similarities are specially found in the morphological changes in the reproductive cells, and also in the presence and arrange of follicle cells during the process of ovary maturation. When external morphological characteristics of the gonads were compared to histological descriptions, it was possible to observe modifications that characterize the process in different developmental stages throughout the ovarian cycle and, consequently, the macroscopic classification of gonad stages agree with the modifications of the reproductive cells.

Advertisement call and female sexual cycle in Uruguayan populations of Physalaemus henselii (Anura, Leiuperidae)

Physalaemus henselii (Peters, 1872) is a little known leiuperid frog that has not been studied since the 1960’s. Herein, we redescribe its advertisement call, and assess the female sexual cycle and the reproductive period on the basis of the macroscopic analysis of the ovaries and field observations. The Ovarian Size Factor (OSF) was calculated. The study was made in Departamento de Rivera, northern Uruguay. The advertisement call consists of short (177 ± 21ms), multipulsed (20 ± 3 pulses/note) notes, with a note repetition rate of 1.57 ± 0.13 notes/s. Physalaemus henselii has a female sexual cycle with unimodal distribution of gravid females, which are present from February to September. The OSF and the ratio "females with mature oocytes / females without mature oocytes" reached the highest values from April to June. The number and size of oocytes were positively correlated with female size. The smallest female (SVL =18.94mm, weight =0.78g) with mature oocytes was found in July. The observed sexual cycle with a single annual reproductive period during the cold season (autumn and early winter), is an uncommon fact for anuran species in the region.

Morphological aspects of cell reabsorption in laying queens and workers of Apis mellifera (Hymenoptera, Apidae)

The occurrence of cell reabsorption in the ovaries of queens in several rates of laying eggs, artificially impeded of laying, and in nurse workers, of Apis mellifera (Linnaeus, 1758), was studied with light (LM) and transmission electron microscopy (TEM). Two types of structures were described and named by analogy with vertebrates ovarian structures, as corpus luteus, when resulting from the reabsorption of the follicular cells after ovulation, and corpus atresicus when resulting from total follicular reabsorption at any oocyte developmental stage. These structures have the same morphological characteristics and physiological signification in both castes. The corpus luteus occurrence indicates ovulation and its number is correspondent to the queen's rates of oviposition. The presence of this structure in nurse workers ovarioles shows that this caste may lay eggs. The incidence of corpus atresicus in queens decay with the increasing of the oviposition indicating that the inhibition of the normal sequence of oocyte maturation in the ovaries is deleterious. Both, corpus luteus and corpus atresicus incidence may be influenced by environmental factors.