Efectividad y seguridad de atosiban en mujeres embarazadas con trabajo de parto pretérmino / Dexrazoxane to Prevent Cardiac Damage in Patients Under 18 with Hodgkin's Lymphoma or Acute Lymphoid Leukemia on Chemotherapy with Anthracyclines

Introducción: el parto pretérmino es definido como el parto producido antes de la semana 37 de edad gestacional. En Colombia es la principal causa de la morbilidad y mortalidad en el período neonatal. La incidencia del parto prematuro es cercana al 12%, con tasas estables en las últimas décadas, que se pueden deber a la complejidad de fisiopatología o a la falta de conocimientos de la condición. Es responsable a nivel mundial de la muerte en menores de 1 año. Objetivo: evaluar la efectividad y seguridad del atosiban en mujeres gestantes con trabajo de parto pretérmino. Metodología: la evaluación fue realizada de acuerdo con un protocolo definido a priori. Se realizó una búsqueda sistemática hasta noviembre de 2014 en MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects y LILACS, sin restricciones de idioma ni fecha de publicación. Se identificaron las RSL y ECA que cumplieran los criterios de elegibilidad. La calidad de los estudios fue valorada con la herramienta AMSTAR. Las características de los estudios fueron extraídas a partir de las publicaciones originales. Los resultados se presentan de acuerdo al reporte de la RSL. Resultados: el atosiban no disminuye la proporción de parto antes de las 48 horas de inicio del tratamiento comparado contra placebo con un RR=1.05 (IC 95% 0,15-7,43), ni comparado contra betamiméticos RR=0,89 (IC 95% 0,66-1,22), ni comparado contra nifedipino RR=1,09 (IC 95% 0,44-2,73). Tampoco disminuye el parto antes de la semana 37 con un RR=1,17 (IC 95% 0,99-1,37) al compararlo contra el placebo y de 1,56 (IC 95% 1,13-2,14) al compararlo contra la nifedipina. Aumentó la probabilidad de parto antes de la semana 28 al compararse contra el placebo RR=3,11 (IC 95% 1,02-9,51). Mostró un mejor perfil de seguridad para eventos adversos maternos al compararlo contra betamiméticos RR=0,47 (IC 95% 0,35-0,62) y contra nifedipino RR=0,38 (IC 95% 0,21-0,68), pero no contra placebo. Conclusiones: no existe evidencia a favor del uso de atosiban en vez de placebo, betamiméticos o nifedipino para la disminución del parto pretérmino antes de la semana 37 ni 28 de edad gestacional. Tampoco disminuye la proporción de partos pretérminos antes de las 48 horas de inicio del tratamiento. El atosiban no fue superior a los comparadores para disminuir los eventos adversos neonatales. Mostró beneficio para la disminución de los efectos adversos maternos cuando se comparó contra betamiméticos o nifedipino. Los ECA incluidos en la RSL identificada tienen alta probabilidad de sesgos por lo cual los resultados se deben evaluar con precaución.(AU)

[Spasmolytic effect of zataria multiflora boiss leaf extract on rat uterus]

Zataria multiflora Boiss is used in traditional medicine to treat gastrointestinal disorders and menrrhalgia. The inhibitory effect of this herb on rat ileuni contractions has also been reported. The aim of this study was to investigate the effect of Zataria multiflora Boiss hydroalcoholic leaf extract [ZHLE] on isolated rat uterus in the presence of some known uterus stimulants. Pieces of virgin adult rat uterus were mounted in an organ bath containing Tyrode or De Jalon solutions. Uterus contractions were induced by KCI, oxytocin and BaC1[2] in presence and absence of ZHLE. Animals in oxytocin studies received an injection of oestradiol valerate [5mg/kg, s.c.] 24 h prior experiment. ZHLE [0.125, 0.25, 0.5, 1 and 2 mg/ml] relaxed the uterus precontracted by KC1 [60mM] in a dose-dependent manner [p<0.0001] and at 2mg/mi attenuated the BaC1[2] [4mM]-induced uterus contraction significantly [p<0.001]. The inhibitory effect of ZLHE on KC1-induced uterus contraction was unaffected by propranolol [1 micro M]. in normal IDe Jalon solution, ZHLE [0.125, 0.25, 0.5, and 1 mg/ml] reduced the oxytocin [10mU/ml]-induced contraction dose-dependently [p<0.0001] but in Ca[2+]-free Dc Jalon solution, the stimulatory effect of oxytocin was weaker and also the inhibitory effect of ZHLF was more consistent. In presence of atropine [0.5jiM], acetylcholine [0.5jiM] failed to induce contraction but KC1 [30mM]-evoked contraction and extract diminished the contractile response of KC1. The spasmolytic effect of extract [2mg/ml] on KC1-induced contraction was unaffected by naloxone [1 micro M]. From the obtained results it may be concluded that, the ZHLE may induce its inhibitory effect through blockage of the voltage dependent calcium channels and releasing calcium from intracellular stores in rat uterus smooth muscle. The ineffectiveness of propranolol and naloxone on ZLHE inhibitory effect indicates that adrenergic and opoids agonist substance[s] did not exist in the extract. it seems that there was no anticholinergic substance[s] in the extract. The results support the usage of this plant in traditional medicine

The effect of oxytocin antagonist on uterus in response to exogenous oxytocin

This study was performed to determine the action mode of oxytocin antagonist. In Study 1, the duration of in vivo action of oxytocin antagonist I (AI) was examined. After infusing AI, oxytocin was given and repeated every hour for 5 hr. Uterine activities were monitored with a polygraph. Study 2 determined the effect of AI on uterine oxytocin receptor number (Rn) and binding affinity (Kd). AI treated rats were sacrificed at 0.5 and 4 hr later for receptor assay. In Study 1, the uterine contractile response to oxytocin was significantly inhibited (p>0.05) compared to controls at five min, 1 and 2 hr after injection of AI. No differences in response were detected compared to controls (p>0.05) at later hours. In Study 2, no differences (p>0.05) between the AI and control animals in either oxytocin receptor number or binding affinity was found. These data suggest that the major mode of AI action is via competitive inhibition at the uterine oxytocin receptor and not by altering receptor number or binding affinity. AI is suggested to have the potential of being a potent and specific tocolytic agent for prevention of preterm labor in human.

The effect of oxytocin antagonist on uterus in response to exogenous oxytocin

This study was performed to determine the action mode of oxytocin antagonist. In Study 1, the duration of in vivo action of oxytocin antagonist I (AI) was examined. After infusing AI, oxytocin was given and repeated every hour for 5 hr. Uterine activities were monitored with a polygraph. Study 2 determined the effect of AI on uterine oxytocin receptor number (Rn) and binding affinity (Kd). AI treated rats were sacrificed at 0.5 and 4 hr later for receptor assay. In Study 1, the uterine contractile response to oxytocin was significantly inhibited (p>0.05) compared to controls at five min, 1 and 2 hr after injection of AI. No differences in response were detected compared to controls (p>0.05) at later hours. In Study 2, no differences (p>0.05) between the AI and control animals in either oxytocin receptor number or binding affinity was found. These data suggest that the major mode of AI action is via competitive inhibition at the uterine oxytocin receptor and not by altering receptor number or binding affinity. AI is suggested to have the potential of being a potent and specific tocolytic agent for prevention of preterm labor in human.

Effect of calcium channel blockers and salbutamol on oxytocin and PGF2 alpha induced uterine contractions in rats.

Calcium channel blockers verapamil (2, 10nM), diltiazem (11, 22nM), nifedipine (2.9, 14nM) and salbutamol (21, 42nM) produced concentration dependent inhibition of oxytocin induced contractions in non-pregnant rats. With verapamil and nifedipine the effect was more marked at both low and high doses. Verapamil (1,2nM), diltiazem (2.2, 11nM), nifedipine (1.4, 2.9nM) and salbutamol (2.1, 4.2nM) produced significant inhibitory effect on PGF2 alpha (0.3 microgram) induced phasic tension. However, basal tension was significantly reduced by salbutamol and nifedipine only.

An analysis of hypotensive effect of synthetic oxytocin in rabbit.

Intravenous injection of synthetic oxytocin (Syntocinon) causes a fall of blood pressure in rabbit. The hypotensive response was potentiated after vagotomy and atropine. Beta-adrenergic and 5-HT blockers reduced the hypotensive response to oxytocin. Hypotensive response of oxytocin in rabbit involves two factors, activation of beta-adrenergic receptor and release of 5-HT.