[Clinical comparision of alpha dihydroergocryptine against cabergoline in the treatment of the fibrocystic mastopathy]. / Comparación clínica de alfa dihidroergocriptina contra cabergolina en el tratamiento de la mastopatía fibroquística.

BACKGROUND: Fibrocystic breast disease is one of the most frequent conditions of the breast among women from 30 to 49 years, with a frequency of about 60%, hence the interest in studying and treating it with the most advanced and effective resources. OBJECTIVE: To compare the efficacy and adverse events of alpha dihydroergocryptine with cabergoline in patients with fibrocystic breast disease. MATERIAL AND METHODS: A prospective, longitudinal, open, comparative study between alpha-dihydroergocryptine and cabergoline, made in the service of Gynecology and Obstetrics at the Dr. Miguel Silva General Hospital in Morelia, Michoacán. 171 patients diagnosed with fibrocystic breast disease were randomly assigned to the alpha-dihydroergocryptine or the cabergoline group. Assessments were made at baseline and every month subsequently. The following symptoms were evaluated: breast tenderness, breast pain, lumps and nipple discharge. The concentrations of prolactin were determined and an ultrasound was performed at baseline and at 3 and 6 months, patients were questioned about adverse events. RESULTS: 171 patients were included (81treated with alpha-dihydroergocryptine and 90 with cabergoline); 156 completed the study. The age limits were 18 and 51 years. The evolution time prior to study entry was 17.71 +/- 18.3 months for the alpha-dihydroergocryptine group and 18.57 +/- 20.35 for the cabergoline group. 15 patients discontinued treatment due to adverse events (8 of the alpha-dihydroergocryptine group and 7 of the cabergoline group). The most common adverse event was headache. CONCLUSIONS: In this study alpha-dihydroergocryptine was better tolerated and had better clinical response compared with cabergoline; breast pain and breast tenderness disappeared within the first month of treatment. Adverse events were similar for both treatments.

[Ketoconazole and clindamycin efficacy vs oral clindamycin in premature membranes rupture prevention]. / Eficacia del ketoconazol y la clindamicina vaginal vs clindamicina oral en la prevención de la rotura prematura de membranas.

BACKGROUND: Vulvovaginitis is one of the main causes of premature membrane rupture. OBJECTIVE: To evaluate effectiveness of a combination of ketoconazole (400 mg) and clindamycin (100 mg) in vaginal tablets, compared with clindamicyn alone (600 mg/daily) orally, for six days, to prevent premature membrane rupture in patients with vulvovaginitis. PATIENTS AND METHOD: Longitudinal, prospective, comparative, randomized, double-blind, double-dummy study in patients older than 18 years, during them third trimester of normoevolutive pregnancy with symptomatic vulvovaginitis. Patients were monitored as out patient. Genital secretion culture and fresh studies were made. Signs and symptoms were evaluated in regular intervals: 4, 7 and 11 days. Pregnancy control was performed every three weeks, until childbirth or premature membrane rupture. RESULTS: 105 patients were included: 53 in the group of ketoconazole and clindamicyn (1), and 52 in the group of clindamycin alone (2). Symptoms were similar in both groups of treatment, without statistically significant differences. A case of group 2 has premature membrane rupture (p = 0.495). C. albicans was cultured in 35% of group 2 and in 11% of group 2. No adverse events with treatments were reported. CONCLUSIONS: The combination of ketoconazole and cindamycin was effective to prevent premature membrane rupture in patients with vulvovaginitis.

Embarazo abdominal: un caso insólito / Abdominal pregnancy: a case report

Se hace una revisión del concepto , clasificación y frecuencia del embarazo abdominal en el extrajero y en México. Se hacen algunas consideraciones sobre el cuadro clínico, el curso evolutivo y se hace hincapié en la dificultad del diagnóstico. Se menciona el valor de la radiología, ultrasonoecografía y resonancia magnética, como métodos auxiliares de diagnóstico. Se presenta el caso de una joven de 17 años, primigesta, estudiada en el Hospital General "Dr Miguel Silva", SSA, de la ciudad de Morelia, Mich., Méx., con un embarazo abdominal secundario, cuyo feto se momificó y se fragmentó y cuya mitad inferior fue expulsada a través del intestino. La mitad superior del feto se extranjo por laparotimía, así como 60% de la placenta. La evolución del caso fue muy favorable y se hacen comentarios sobre la posible explicación de la ausencia de peritonitis. El comentario final se refiere a las posibilidades del manejo de la placenta en el embarazo abdominal ya que ello depende la supervivencia o el afrontar las complicaciones infecciosas o hemorrágicas