ABSTRACT
Se realiza una revisión de la patología susceptiblede diagnóstico y tratamiento histeroscópicoen mujeres con esterilidad o infertilidad.La alta prevalencia de patología uterina y lamejora en los resultados reproductivos tras sutratamiento endoscópico, hacen que la histeroscopiasea el método diagnóstico y terapéuticode elección en el útero septo, miomas submucosos,sinequias, pólipos endometriales y algunasoclusiones tubáricas proximales
We perform a review of the pathology capableof improvement with diagnostic and treatmenthysterocopy in women with infertility orprimary infertility. The high prevalence of intrauterinepathology and the reproductive improveresults subsequent to endoscopy treatmentshow that hysteroscopy is the choice methodfor diagnostic and treatment of the septateuterus, submucosal fibroids, synequias, endometrialpolyps and some proximal tubal obstructions
Subject(s)
Female , Humans , Infertility, Female/diagnosis , Hysteroscopy/methods , Uterine Diseases/diagnosis , Uterine Diseases/surgery , Uterus/abnormalities , Uterine Cervical Diseases/diagnosis , Uterine Cervical Diseases/surgeryABSTRACT
Evaluar el valor pronóstico de los marcadores tumorales en el cáncer de mama y su utilidad en la selección de diferentes modalidades terapéuticas. Se ha realizado una revisión bibliográfica mediante la base de datos MEDLINE, entre 1988 y Enero de 2002. Se han estudiado la utilidad individual de los nuevos marcadores, combinados entre sí o en combinación con los marcadores clásicos. Se han seleccionado los estudios de asociación entre la presencia del nuevo marcador y la supervivencia y/o periodo libre de recurrencia que cumplen los criterios de utilidad aceptados en la conferencia de consenso del Instituto Nacional de la Salud de Estados Unidos en 1990 (NIH). Los principales indicadores pronósticos siguen siendo los clasicamente establecidos: tamaño tumoral, número de adenopatías, el grado histológico, la invasión linfática y probablemente, aunque débil, el estado hormonal. La utilidad de los nuevos marcadores más utilizados en sangre periférica (CEA, CA 15.3, CA 27.29) se limita a la monitorización de las recurrencias o la eficacia del tratamiento en enfermedad diseminada. La amplificación y/o sobre-expresión de C-erbB-2 es importante en pacientes con tumores no resecables, metastásicos y recurrentes porque implica una sensibilidad relativa o resis-tencia a diversas terapias. La uroquinasa activadora del plasminógeno (uPA) y el inhibidor 1 del activador del plasminógeno son marcadores prometedores que precisan confirmar su utilidad. Los nuevos marcadores tumorales no han demostrado aún superioridad pronóstica en el cáncer de mama con respecto a los establecidos. Debe confirmarse la utilidad del uPA y PAI-1 para la selección de pacientes N0 candidatas a quimioterapia adyuvante. El c-erb-B2 permite seleccionar a los pacientes candidatos a quimioterapia con antraciclinas y trastuzumab (AU)
Subject(s)
Female , Humans , Biomarkers, Tumor/analysis , Breast Neoplasms/diagnosis , Prognosis , Mucin-1/analysis , Carcinoembryonic Antigen/analysis , Urokinase-Type Plasminogen Activator/analysis , Genes, erbB-2 , Receptor, ErbB-2/analysis , Cathepsin D/analysis , Ki-67 Antigen/analysis , Tumor Suppressor Protein p53/analysisSubject(s)
Breast Diseases/microbiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/microbiology , Adult , Aged , Aged, 80 and over , Breast Diseases/mortality , Breast Diseases/pathology , Breast Diseases/physiopathology , Fatal Outcome , Female , Humans , Tuberculosis/drug therapy , Tuberculosis/mortality , Tuberculosis/physiopathologyABSTRACT
The value of adenosine deaminase activity (ADA) in ascitic fluid was examined in 12 patients with confirmed peritoneal tuberculosis and compared with that of 96 patients with ascites of other different etiologies as an age-matched control group, to determine the diagnostic value of the ADA activity in tuberculous ascites. The mean adenosine deaminase activity (ADA) value in ascitic fluid of the tuberculous peritonitis group was 47.9 +/- 21.9 IU/L and in the control group 9.6 +/- 5 U/L (mean +/- SD); p less than 0.01. A different method than that usually reported in tuberculous peritonitis was used for ascites ADA estimation. The best sensitivity and specificity was obtained when greater than 32 U/L was used as a cutoff point. The ascites ADA activity correlated with the ascites total protein concentration in the tuberculosis group (r = 0.842). Our findings confirm other results and support the ADA activity determination in ascitic fluid as a useful noninvasive screening test in the diagnosis of peritoneal tuberculosis in endemic areas or in high risk patients. However, false-negative results may occur in those patients in which ascites total protein concentration is low.
Subject(s)
Adenosine Deaminase/metabolism , Ascitic Fluid/enzymology , Clinical Enzyme Tests , Peritonitis, Tuberculous/diagnosis , Proteins/metabolism , Adult , Aged , Aged, 80 and over , Analysis of Variance , Female , Humans , Male , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
A group of pregnant women living in the south of the province of Pontevedra (Spain) have been studied in order to determine the prevalence of hepatitis B virus biological markers. For that respect we have prospectively studied HBsAg and other markers in 535 pregnant women from June 1987 to March 1988. The prevalence of HBsAg was 0.75%, and in 6.12% certain biological markers were detected. Only one carrier fulfilled the current criteria recommended by the Advisory Committee on Immunization Practices (ACIP) for selective screening of pregnant women. Although the prevalence and costs of the detection are similar to those for voluntary blood donors of the same region (1%), the frequency with which infected neonates develop chronic antigenemia along with the low sensitivity of the selective screening justifies the systematized serological study of the pregnant women.
