Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , Buffaloes/metabolism , Fluoroquinolones/pharmacokinetics , Animals , Animals, Newborn , Anti-Bacterial Agents/blood , Anti-Bacterial Agents/pharmacology , Anti-Inflammatory Agents, Non-Steroidal/blood , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Area Under Curve , Drug Interactions , Fluoroquinolones/blood , Fluoroquinolones/pharmacology , Injections, Intramuscular/veterinary , KineticsABSTRACT
Over the last two decades, easier and less expensive stimulation treatments have been largely replaced by more complex and more demanding protocols. Since the mid-nineties, long-term gonadotrophin-releasing hormone agonist stimulation protocols have been widely used. Such lengthy expensive regimens are not free from short- and long-term risks and complications. Mild stimulation protocols reduce the mean number of days of stimulation, the total amount of gonadotrophins used and the mean number of oocytes retrieved. The proportion of high quality and euploid embryos seems to be higher compared with conventional stimulation protocols and the pregnancy rate per embryo transfer is comparable. Moreover, the reduced costs, the better tolerability for patients and the less time needed to complete an IVF cycle make mild approaches clinically and cost-effective over a given period of time. However, further prospective randomized studies are needed to compare cumulative pregnancy rates between the two protocols. Natural cycle IVF, with minimal stimulation, has been recently proposed as an alternative to conventional stimulation protocols in normo- and poor responder patients. Although acceptable results have been reported, further large prospective randomized studies are needed to better evaluate the efficacy of these minimal regimens compared with conventional stimulation approaches.
Subject(s)
Ovulation Induction/methods , Adult , Embryo Transfer , Female , Fertilization in Vitro/methods , Gonadotropin-Releasing Hormone/agonists , Humans , Ovarian Follicle/physiology , Pregnancy , Pregnancy RateABSTRACT
Italian legislation regarding reproductive medicine limits the number of embryos transferred per attempt to three. Thus, in order to achieve pregnancy, more IVF cycles may be required, generating a need for methods of ovarian stimulation with fewer side effects. The gonadotrophin-releasing hormone (GnRH) antagonists have several advantages in this respect, but there is a debate regarding a possible lower pregnancy rate from resulting cycles. This study evaluated the clinical applicability of GnRH antagonists for ovarian stimulation in young women undergoing intracytoplasmic sperm injection (ICSI) in which only three oocytes can be fertilized. The 200 women treated with GnRH antagonist had a significantly shorter stimulation and lower gonadotrophin consumption, oestradiol concentration, total and mature oocyte recovery as compared with 200 matched controls treated with GnRH agonist. No differences were found between the groups in the number of normal zygotes, total cleaved, transferred and high quality embryos, or in the clinical outcomes. Thus, the previously reported lower pregnancy rate in GnRH antagonist cycles may be related to the oocyte characteristics. Finally, under conditions of oocyte number restriction, the GnRH antagonist-based cycles may be proposed as an efficacious, safe and minimally invasive alternative to GnRH agonist in a standard long protocol.
Subject(s)
Gonadotropin-Releasing Hormone/antagonists & inhibitors , Ovulation Induction/methods , Sperm Injections, Intracytoplasmic , Adult , Embryo Transfer , Female , Gonadotropin-Releasing Hormone/agonists , Humans , Italy , Legislation, Medical , Male , Matched-Pair Analysis , PregnancySubject(s)
Anti-Infective Agents/pharmacokinetics , Buffaloes/metabolism , Cattle/metabolism , Sulfamethazine/pharmacokinetics , Animals , Animals, Newborn/metabolism , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/blood , Area Under Curve , Infusions, Intravenous/veterinary , Injections, Intravenous/veterinary , Male , Species Specificity , Sulfamethazine/administration & dosage , Sulfamethazine/bloodABSTRACT
La enfermedad de perthes en niños presenta como un desafío de tratamiento aún en la actualdad. A pesar de enumerarse varias causas todavía, evitar el colapso de la cabeza femoral es el paradigma que genera múltiples investigaciones. La base de este trabajo de investigación fue provocar en forma mecánica la necrosis avascular de la cabeza femoral y mediante el uso de ácido ibandrónico y concentrado plaquetario demostrar sus beneficios en esta patología.
Subject(s)
Animals , Femur Head/pathology , Legg-Calve-Perthes Disease , Necrosis , Growth Substances/administration & dosage , Growth Substances/therapeutic useABSTRACT
El síndrome de hipersensibilidad a drogas o síndrome DRESS es una reacción rara y potencialmente fatal; se caracteriza por presentar la tríada de fiebre, rash y compromiso de órganos internos. Fenitoína, fenobarbital y carbamazepina son los anticonvulsivantes aromáticos que con más frecuencia causan esta reacción. Dicho síndrome ocurre entre la 1ra y 8va semanas después de la exposición al fármaco. La eliminación inmediata de la droga es esencial para el manejo de estos pacientes. Presentamos una paciente de sexo femenino, de 62 años, medicada con carbamazepina durante un mes, que consulta por fiebre, mal estado general y rash máculopapuloso que se generalizó hasta abarcar el 90% de la superficie cutánea.
Anticonvulsivant hypersensitivity syndrome (AHS) is a rare and potentially fatal reaction characterized by the appearance of fever, skin rash and internal organ involvement. Phenytoin, phenobarbital and carbamazepine are the most frequent aromatic anticonvulsivant causing the reaction. This syndrome occurs 1-8 weeks after the initial drug exposure.
Subject(s)
Humans , Female , Middle Aged , Carbamazepine/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Anticonvulsants/poisoning , Skin ManifestationsABSTRACT
La enfermedad de perthes en niños presenta como un desafío de tratamiento aún en la actualdad. A pesar de enumerarse varias causas todavía, evitar el colapso de la cabeza femoral es el paradigma que genera múltiples investigaciones. La base de este trabajo de investigación fue provocar en forma mecánica la necrosis avascular de la cabeza femoral y mediante el uso de ácido ibandrónico y concentrado plaquetario demostrar sus beneficios en esta patología.(AU)
Subject(s)
Animals , Legg-Calve-Perthes Disease , Necrosis , Femur Head/pathology , Growth Substances/administration & dosage , Growth Substances/therapeutic useABSTRACT
Congenital or acquired feline femoral dysplasia have seldom been reported in the literature. This report describes two cases of femoral dysplasia involving the proximal epiphyses. Bilateral agenesis of the femoral head and neck (case 1) constituted an incidental finding during a post-traumatic radiographic examination, while right proximal femoral dysplasia (case 2) was observed during an orthopaedic examination for lameness. To the authors' knowledge, such imaging findings have not been reported before in cats.
Subject(s)
Bone Diseases, Developmental/veterinary , Cat Diseases/diagnostic imaging , Animals , Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/pathology , Bone Diseases, Developmental/surgery , Cat Diseases/pathology , Cat Diseases/surgery , Cats , Femur Head/diagnostic imaging , Femur Head/pathology , Femur Head/surgery , Femur Neck/diagnostic imaging , Femur Neck/pathology , Femur Neck/surgery , Lameness, Animal/etiology , Male , Radiography , Treatment OutcomeABSTRACT
Recombinant FSH (r-FSH) used for ovarian stimulation can currently be self-administered either by a conventional syringe or by a pen device. This randomized controlled trial compares the efficacy and convenience of a new, more sophisticated and fully automated injection device (Softinject(trade mark)) with the conventional syringe for r-FSH self-administration. A total of 300 women needing ovarian stimulation for IVF/intracytoplasmic sperm injection were randomized to the automated injector or the conventional syringe group. Patients of both groups had ovarian stimulation with follitropin alpha after pituitary desensitization with a gonadotrophin-releasing hormone agonist. State anxiety score, overall pain score and pregnancy rate were chosen as the main outcome measures. Patients in the automated injector group showed lower state anxiety (P < 0.01) and overall pain (P < 0.01) scores and a comparable pregnancy rate per started cycle as compared with the conventional syringe group. They needed lower doses of r-FSH (P < 0.05) and their stimulation was shorter (P < 0.05). It is concluded that the use of a fully automated injector for r-FSH self-administration reduces pain and stress as compared with the conventional syringe. This device can be used for any subcutaneously administered drug employed in ovarian stimulation.
Subject(s)
Fertilization in Vitro/instrumentation , Fertilization in Vitro/methods , Follicle Stimulating Hormone/administration & dosage , Sperm Injections, Intracytoplasmic/instrumentation , Sperm Injections, Intracytoplasmic/methods , Adult , Anxiety , Automation , Embryo Transfer , Female , Humans , Male , Ovary/drug effects , Ovulation Induction , Pain , Pregnancy , Pregnancy Rate , Recombinant Proteins/administration & dosage , Treatment OutcomeABSTRACT
Radiographic examination and subsequent dual-energy X-ray absorptiometry scans of the hips were performed in seven dogs with monolateral Legg-Perthes-Calvé disease to quantify bone changes produced by osteonecrosis in the proximal femur on the affected and unaffected side. All dogs were found to be affected with grade 2 and 3 of the radiographic classification proposed by Ljunggren. Bone mineral density (g/cm(2)) of the femoral neck and proximal femoral metaphysis were evaluated on the affected and unaffected side; we detected no differences in bone mineral density for both regions of interest within the population studied in relation to gender, body weight and side analysed nor between the affected and the unaffected limb. We therefore assume that radiographic areas of decreased density in the proximal femoral epiphysis during chronic stages of Legg-Calvé-Perthes disease do not alter the global mineral content of the scanned region.
Subject(s)
Absorptiometry, Photon/veterinary , Dog Diseases/diagnostic imaging , Legg-Calve-Perthes Disease/veterinary , Absorptiometry, Photon/methods , Animals , Bone Density , Densitometry/methods , Densitometry/veterinary , Dog Diseases/pathology , Dogs , Female , Femur Head Necrosis/diagnostic imaging , Femur Head Necrosis/pathology , Femur Head Necrosis/veterinary , Hip Joint/diagnostic imaging , Hip Joint/pathology , Legg-Calve-Perthes Disease/diagnostic imaging , Legg-Calve-Perthes Disease/pathology , MaleABSTRACT
Correct controlled ovarian stimulation is of paramount importance in assisted reproductive technologies. Therefore, analysis of the ovarian reserve of the patient is mandatory to tailor the best ovarian stimulation regimen. When the ovarian reserve is reduced, the induction of a multifollicular growth remains a challenge. Several factors could be associated with reduced ovarian response. However, reduced ovarian reserve either in older patients or in young patients represents the most frequent aetiological factor. Whatever is the aetiology, one of the main problems is how to predict a reduced ovarian response, and although several tests have been suggested, no very accurate predictive test is available. A variety of different stimulation protocols have been suggested but the lack of any large-scale, prospective, randomized, controlled trials of the different management strategies and the lack of a uniform definition of the population may result in comparisons of heterogeneous groups of patients, making it difficult to draw any definitive conclusions. Natural cycle IVF may represent an easy and cheap approach in the management of this group of patients. Although no controlled large prospective randomized studies are available to compare the natural IVF procedure with ovarian stimulation IVF in poor responder patients, the efficacy of natural cycle IVF is hampered by high cancellation rates mainly due to untimely LH surge. The use of gonadotrophin-releasing hormone antagonists in the late follicular phase, which reduces the premature LH rise rate, and the improvements in laboratory conditions and fertilization techniques, increase the embryo transfer rates, making this procedure more cost-effective.
Subject(s)
Fertilization in Vitro/methods , Gonadotropins/therapeutic use , Infertility/therapy , Ovulation Induction/methods , Female , Follicle Stimulating Hormone/blood , Gonadotropin-Releasing Hormone/agonists , Humans , PregnancyABSTRACT
Se presenta un caso de dermatosis acantolítica trnsitoria o enfermedad de Grover, descripta por Grover en 1970; la misma se trata de una dermatosis acantolítica papulosa benigna, de inicio en la edad adulta y de regresión espontánea. Se comentan los distintos mecanismos desencadenantes, las características clínicas, los diagnósticos diferenciales, los patrones histológicos y su terapéutica. Se comunica este caso de enfermedad de Grover debido a que es una dermatosis infrecuente que obliga a plantear numerosos diagnósticos diferenciales desde el punto de vista clínico e histológico
Subject(s)
Humans , Male , Aged , Pruritus , Skin Diseases , Upper ExtremityABSTRACT
Se presenta un caso de dermatosis acantolítica trnsitoria o enfermedad de Grover, descripta por Grover en 1970; la misma se trata de una dermatosis acantolítica papulosa benigna, de inicio en la edad adulta y de regresión espontánea. Se comentan los distintos mecanismos desencadenantes, las características clínicas, los diagnósticos diferenciales, los patrones histológicos y su terapéutica. Se comunica este caso de enfermedad de Grover debido a que es una dermatosis infrecuente que obliga a plantear numerosos diagnósticos diferenciales desde el punto de vista clínico e histológico(AU)
Subject(s)
Humans , Male , Aged , Skin Diseases , Upper Extremity , PruritusABSTRACT
Frozen-thawed embryo transfer is an effective procedure that allows further possibilities of pregnancy in addition to those obtained after the fresh in vitro fertilization (IVF). In our follow-up study we analysed all fresh embryo transfer procedures and every frozen-thawed embryo transfer performed from January 2000 to December 2001 evaluating the cumulative pregnancy rates. The study population was divided into two groups according to the female age: <38 years (group I) and >38 years (group II). All the best embryos were chosen for transfer and all the supernumerary good quality embryos were cryopreserved on the day of transfer. The embryos were then thawed and manipulated using a new technique. In group I, 527 patients (619 cycles) underwent fresh embryo transfer and in 232 of them (238 cycles) the embryos were frozen (44% per patients and 38.4% per cycle). In group II, 156 patients (193 cycles) underwent fresh embryo transfer and in 14 of them (15 cycles) the embryos were frozen (9% per patient and 7.8% per cycle). The pregnancy rate of group I patients that had their supernumerary embryos frozen (232 patients and 238 cycles) was 47.4% per cycle and 48.7% per patient whereas in the same population of group II patients (14 patients and 15 cycles) the clinical pregnancy rate was 35.7% per cycle and 38.5% per patients. The cumulative clinical pregnancy rate after transfer of fresh and thawed embryos was: group I, 74% per cycle and 76% per patients; group II, 42.8% per cycle and 46.1% per patient. Frozen-thawed embryo transfer is a cost-effective practice.
Subject(s)
Cryopreservation , Embryo Transfer , Embryo, Mammalian , Adult , Female , Follow-Up Studies , Humans , Male , Pregnancy , Pregnancy OutcomeABSTRACT
There is an evident decline of female fertility with age. This decline is mainly due to increased risk of pregnancy termination either after conception or after embryo implantation. Very likely the major cause of this embryo and pregnancy loss is chromosomal aneuploidies caused mostly by increasing rates of 'poor quality' oocytes. This phenomenon can be explained either by an age dependent accumulation of damage and/or by the hypothesis that the defective oocytes are there in the ovaries from the fetal life. 'Good quality' oocytes are ovulated first, leaving 'poor quality' oocytes to be ovulated later in life. Besides the quality of the oocytes which is mainly responsible of the embryo quality (we have not to forget a paternal effect) the process of implantation is dependent upon two variables: the probability of a viable embryo and that of a receptive uterine environment. From the oocyte donation model it seems that the endometrium also plays a minor role in human reproductive ageing as it does in some laboratory animals. However, besides some macroscopic possible causes which may play a role in the reduction of the age-related endometrial receptivity, there are so many endometrial factors possibly related to its receptivity which need to be further studied especially in older women.
Subject(s)
Aging/physiology , Embryo Implantation/physiology , Follicle Stimulating Hormone/physiology , Maternal Age , Ovary/physiology , Pregnancy, High-Risk , Adult , Aging/blood , Female , Follicle Stimulating Hormone/blood , Humans , PregnancyABSTRACT
The pharmacokinetics of tylosin were compared in cattle (Bos taurus) and buffaloes (Bubalus bubalis). Six animals received each a single dose of 10 mg/kg of tylosin tartrate by the intramuscular route. The serum concentration (Cmax) and the volume of distribution (Vd) presented significant differences between the two species. Cmax was 0.40 +/- 0.046 microg/ml for buffaloes and 0.64 +/- 0.068 microg/ml for cattle. Vd was 1.91 +/- 0.12 L/kg and 1.33 +/- 0.09 L/kg for buffaloes and cattle, respectively. However, as the present study did not show considerable differences in the pharmacokinetics of tylosin in buffaloes and cattle, similar dosage regimes of this drug can be recommended for both species.
Subject(s)
Buffaloes/metabolism , Cattle/metabolism , Tylosin/pharmacokinetics , Animals , Anti-Bacterial Agents/blood , Anti-Bacterial Agents/pharmacokinetics , Area Under Curve , Male , Species Specificity , Time Factors , Tylosin/bloodABSTRACT
BACKGROUND: The aim of our study was to explore luteal phase hormone profiles in gonadotrophin-stimulated cycles with or without gonadotrophin-releasing hormone (GnRH) antagonist therapy during intrauterine insemination (IUI). Forty-one infertile couples were recruited in this randomized clinical study. METHODS: The 19 patients included in group A were treated for 21 cycles with recombinant FSH 150 IU/day starting from day 3 of the cycle and with the GnRH antagonist cetrorelix at the dose of 0.25 mg/day starting from the day in which a follicle with a mean diameter of > or =14 mm was seen at ultrasound scan. Cetrorelix was administered until human chorionic gonadotrophin (HCG) administration. The 22 patients included in group B were administered recombinant FSH alone at the same dosage for 27 cycles. RESULTS: The two treatment groups showed a similar increase in progesterone concentration during the luteal phase. In the mid-luteal phase (day 6 after HCG), oestradiol concentrations in group B were significantly higher compared with group A (P < 0.05) but the oestradiol:progesterone ratio was similar in the two groups. Serum LH was completely suppressed during the follicular phase only in group A, concomitantly with GnRH antagonist administration. A total of six pregnancies, all ongoing, were achieved (14.3% per patient and 12.2% per cycle), equally distributed in group A and in group B. CONCLUSION: GnRH antagonists can be safely administered in gonadotrophin-stimulated IUI cycles without luteal phase supplementation because no deleterious effects of GnRH antagonist administration were noted on luteal progesterone concentration or on the duration of the luteal phase.
Subject(s)
Follicle Stimulating Hormone/therapeutic use , Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Gonadotropin-Releasing Hormone/therapeutic use , Hormone Antagonists/therapeutic use , Luteal Phase , Ovulation Induction , Adult , Chorionic Gonadotropin/administration & dosage , Estradiol/blood , Female , Follicle Stimulating Hormone/administration & dosage , Follicular Phase , Gonadotropin-Releasing Hormone/administration & dosage , Hormone Antagonists/administration & dosage , Humans , Infertility, Male/therapy , Insemination, Artificial , Luteinizing Hormone/blood , Male , Pregnancy , Progesterone/blood , Recombinant Proteins/administration & dosage , Recombinant Proteins/therapeutic useABSTRACT
In this paper we report the results of surveys conducted in Argentina between 1997 and 1998 to know the Cd concentrations in kidney from horses of different age, sex, and origin. Cd in renal cortex and medulla was positively correlated, and higher concentrations in the cortex were found. No significant differences between values from left and right kidneys of the same animal were found. An increase in Cd levels with age of animals were observed, and no sex incidence was verified in renal Cd composition. No detectable residues were found in the fetuses tested. Levels observed in Argentine equines (n = 102) ranged from 4.3 to 83.8 microg Cd/g in kidney cortex, lower than those reported by other authors but higher than the action levels proposed by Argentine meat tissue species regulations. Therefore, the study remarks on the convenience of monitoring Cd in Argentine equines and gives relevant information for regulatory purposes to consider the limitation in the use of horse kidney as food for either human or animals.
Subject(s)
Cadmium/analysis , Cadmium/pharmacokinetics , Horses , Kidney/chemistry , Abattoirs , Animal Feed , Animals , Argentina , Female , Food Contamination , Humans , Male , Tissue DistributionABSTRACT
The therapy of anovulatory infertility is not meant to obtain a pregnancy at any cost, but to restore an ovulation as physiological as possible. This involves the use of drugs and therapeutical protocols to obtain monofollicular cycles. Monofollicularity reduces the two main risks of induction of ovulation: ovarian hyperstimulation syndrome and multiple pregnancy. The aim of this study is a review of the Literature on ovulation induction and a comparison with the data of our Sterility Service. The importance of the question will be examined together with the most used ovulation induction drugs: clomiphene citrate, gonadotrophins and pulsatile GnRH. The parameters considered are: the number of follicles, single or multiple pregnancies and ovarian hyperstimulation. After a review about ovarian stimulation, the results of our Sterility Service are presented: 364 cycles of ovulation induction with clomiphene citrate, low-dose gonadotrophins or pulsatile GnRH were monitored; monofollicularity was obtained in 58,48% of ovulatory cycles. Differences between drugs will be described in the text. The therapy of anovulatory infertility aims to restore a physiological ovulation and to obtain a single pregnancy, not a pregnancy at any cost.
Subject(s)
Fertility Agents, Female/therapeutic use , Ovulation Induction/methods , Clomiphene/therapeutic use , Female , Gonadotropin-Releasing Hormone/therapeutic use , Gonadotropins/therapeutic use , HumansABSTRACT
In this study we investigated the effect of heparin on renal injury and renal transforming growth factor-beta (TGF-beta) production in adriamycin (AD)-injected rats. Thirty-nine female Wistar rats were injected with AD (3.5 mg/kg body weight, i.v.) and 27 with 0.15 M NaCl solution (group C). Fifteen days later we started to inject heparin, 500 U/day, s.c., in 20 of the AD-injected animals (AD-H group). Three months after beginning treatment, urine samples were collected to quantify albumin, creatinine and TGF-beta. The rats were killed and the kidneys removed for histological, immunohistochemical, ELISA and RNA studies. All AD-injected animals showed structural renal changes (p < 0.05). However, the glomerular alterations were less intense in rats from group AD-H (p < 0.05). The percentage of glomerulosclerosis was 0.11 +/- 0.08 in group C, 14.7 +/- 12.8 in group AD (treated only with AD) and 3.42 +/- 2.3 in group AD-H. Renal cortex immunostaining for TGF-beta and mRNA content of this polypeptide was higher in both groups of animals injected with AD compared to controls (p < 0.05). These animals also presented a higher rate of urinary TGF-beta excretion (p < 0.05), which was 202 +/- 11 in group C, 1,103 +/- 580 in group AD and 1,564 +/- 328 pg/mg Ucreat in group AD-H. However, TGF-beta activity in the glomerular-conditioned media from the rats of group AD was higher than in the glomerular-conditioned media from the rats of group AD-H. In conclusion, treatment with heparin reduces glomerular damage in rats with AD-induced nephropathy but does not modify tubulointerstitial lesions or the renal production of TGF-beta.
