Effects of a combined oral contraceptive containing 20 mcg of ethinylestradiol and 3 mg of drospirenone on the blood pressure, renin-angiotensin-aldosterone system, insulin resistance, and androgenic profile of healthy young women.

Combined oral contraceptives (COCs) may increase the risk for cardiovascular disease depending on the ethynyl estradiol (EE) dose and the androgenicity of the progestogens. Our objective was to evaluate the impact of a COC containing 20 mcg EE + 3 mg drospirenone on blood pressure (BP), renin-angiotensin-aldosterone system, insulin resistance, and androgenic profile of healthy young women. Eighty-one healthy young women aged 30 ± 1 years (case group, n = 49, received COC; control group, n = 32, used no COC) were assessed twice, before and after the 6-month study. Statistical analysis employed the paired t-tests and expressed the data in mean and standard deviation. Results were as follows: no changes in BP or in BMI; a significant increase in aldosterone, plasma renin activity, triglycerides, and total cholesterol levels, but a non-significant increase in HDL and no significant changes in LDL levels (these parameters remained within normal ranges); a significant increase in the HOMA-IR index and a significant decrease in dehydroepiandrosterone sulfate (SDHEA), androstenedione, total testosterone, and free testosterone levels; no significant variations in the control group parameters. An oral contraceptive combination of a low EE dose and an anti-androgenic progestogen does not negatively influence the risk factors for a cardiovascular disease.

Effects of a contraceptive containing drospirenone and ethinylestradiol on blood pressure, metabolic profile and neurohumoral axis in hypertensive women at reproductive age.

UNLABELLED: The use of combined oral contraceptives is widespread among hypertensive women despite being associated with increased cardiovascular risk. Contraceptives containing drospirenone, which has antimineralocorticoid properties, may have a positive or neutral effect on neurohumoral activation and metabolic homeostasis of hypertensive women at reproductive age. OBJECTIVES: To evaluate the effect of combined oral contraceptive containing drospirenone+ethinylestradiol on the systemic blood pressure, metabolic variables and neurohumoral axis in hypertensive women in reproductive age. DESIGN: Prospective controlled trial with 56 hypertensive women allocated in two groups: 30 volunteers under oral combined contraceptive use and 26 volunteers using non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings and, for the biochemical and hormonal analyses two blood samples were obtained. Student's t test was used to determine differences between groups and moments and p<0.05 was considered statistically significant. RESULTS: Comparing antropometric and blood pressure measurements, cardiac sympatho-vagal modulation, baroreceptor sensitivity, metabolic and neurohumoral axis variables between baseline and after 6 months, no significant difference was detected in each group or between groups. Except serum triglyceride levels which increased in the group of women using EE+DRSP after 6 months of use. CONCLUSION: A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical and autonomic parameters, metabolic variables and neurohumoral axis of hypertensive women.

Effects of a contraceptive containing drospirenone and ethinyl estradiol on blood pressure and autonomic tone: a prospective controlled clinical trial.

BACKGROUND: The use of combined oral contraceptives has been associated with an increased risk of adverse cardiovascular events. Whether these drugs alter cardiac autonomic nervous system control is not completely determined. OBJECTIVE: To evaluate the effect of a contraceptive containing 20mcg of ethinyl estradiol and 3mg of drospirenone on the heart rate variability, baroreflex sensitivity and blood pressure of healthy women. STUDY DESIGN: Prospective controlled trial with 69 healthy women allocated in two groups: 36 volunteers under oral combined contraceptive use and 33 volunteers using of non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings. Multiple ANOVA was used to determine differences between groups and moments and p< 0.05 was considered statistically significant. RESULTS: At baseline, there were no differences in demographic and autonomic parameters between groups. Comparing cardiac sympatho-vagal modulation, baroreceptor sensitivity and blood pressure measurements between baseline and after 6 months, no significant difference was detected in each group or between groups. CONCLUSION: A contraceptive containing 20mcg of ethinyl estradiol and 3mg of drospirenone causes no significant changes in clinical, hemodynamic and autonomic parameters of normal women.

Recomendações para contracepção em mulheres hipertensas / Recommendations for contraception in women with hypertension

Um significante número de mulheres em faixa etária reprodutiva é hipertensa. O uso de um método contraceptivo eficaz nestas pacientes é fundamental. O método contraceptivo escolhido deve associar alta eficácia contraceptiva e baixo risco de piora dos níveis pressóricos e de doença cardiovascular.

A significant number of women in reproductive age are hypertensive. The use of effective contraception is essential in these patients. The contraceptive method chosen should involve high contraceptive efficacy and low risk of worsening of blood pressure and risk of cardiovascular disease.

Terapia de reposição hormonal na mulher hipertensa / Hormone replacement therapy in hypertensive woman

Mulheres na pós-menopausa têm uma maior prevalência de hipertensão arterial sistêmica que mulheres na prémenopausa, o que lhes impõe, consequentemente, maior risco de doença cardiovascular. O tratamento com a terapia de reposição hormonal (TRH) convencional, aparentemente, não teve efeitos significantes na pressão arterial em estudos. De qualquer maneira, na mulher hipertensa pós- menopausa,deve-se dar especial atenção à escolha do esquema, da dose, do tipo e da via de administração da TRH a ser prescrita, para que se obtenha bom controle dos sintomas menopausais, sem que haja descontrole dos níveis pressóricos e não se aumente o risco de doença cardiovascular.

Postmenopausal women have a higher prevalence of hypertension than women in pre-menopause, which imposes, consequently, a higher risk of cardiovascular disease. The treatment with conventional hormone replacement therapy (HRT), apparently, had no significant effects on blood pressure in studies. Nevertheless, in hypertensive postmenopausal woman, special attention should be paid to the choice of scheme, the dose, type and route of administration of HRT to be prescribed, in order to obtain good control menopausal symptoms, without increasing blood pressure nor the risk of cardiovascular disease.

Distances walked in the six-minute walk test: suggestion of defining characteristic for the nursing diagnosis Ineffective Peripheral Tissue Perfusion.

Distances walked in walking tests are important functional markers, although they are not accepted as defining characteristics of Ineffective Peripheral Tissue Perfusion. The aims of this study were to verify the distances participants with and without this nursing diagnosis walked in the six-minute walk test and if these measures may be considered defining characteristics of this phenomenon. Participants with (group A; n=65) and without (group B; n=17) this nursing diagnosis were evaluated regarding physical examination, vascular function and functional capacity. Participants of group A seemed to have worse vascular function and functional capacity compared with those of group B. Pain-free travelled distance was predictive of the nursing diagnosis. These results are important for the refinement of this diagnosis. In conclusion, this study provides evidences that the distances walked in the six-minute walk test may be considered defining characteristics of Ineffective Peripheral Tissue Perfusion.

A combined oral contraceptive containing drospirenone changes neither endothelial function nor hemodynamic parameters in healthy young women: a prospective clinical trial.

BACKGROUND: Combined oral contraceptives (COCs) may lead to a rise in cardiovascular disease risk, possibly associated with changes in blood pressure and endothelial function. STUDY DESIGN: The objective was to evaluate the impact of COC containing 20 mcg of ethinylestradiol (EE) and 3 mg of drospirenone (DRSP) on the arterial endothelial function, systolic and diastolic blood pressure (SBP and DBP , respectively), heart rate (HR), cardiac output (CO) and total peripheral resistance (TPR) of healthy young women. Of the 71 women in the study, 43 were evaluated before the introduction of COC and after 6 months of its use (case group) and 28, COC nonusers, were assessed for the same parameters at the same time interval (control group). RESULTS: No significant changes in endothelium-dependent and endothelium-independent functions or in measures of SBP, DBP, HR, CO and TPR caused by COC use were observed in the case group (p>.05 for all variables) or in the control group. CONCLUSION: These data suggest COC with 20 mcg EE and 3 mg DRSP does not alter arterial endothelial function or hemodynamic parameters in healthy young women.

Distances walked in the six-minute walk test: suggestion of defining characteristic for the nursing diagnosis Ineffective Peripheral Tissue Perfusion / Distâncias percorridas no teste de caminhada de seis minutos: proposta de característica definidora para o diagnóstico de enfermagem Perfusão Tissular Periférica Ineficaz / Distancias recorridas en la prueba de caminata de los seis minutos: propuesta de característica definitoria para el diagnóstico de enfermería Perfusión Tisular Periférica Inefectiva

Distances walked in walking tests are important functional markers, although they are not accepted as defining characteristics of Ineffective Peripheral Tissue Perfusion. The aims of this study were to verify the distances participants with and without this nursing diagnosis walked in the six-minute walk test and if these measures may be considered defining characteristics of this phenomenon. Participants with (group A; n=65) and without (group B; n=17) this nursing diagnosis were evaluated regarding physical examination, vascular function and functional capacity. Participants of group A seemed to have worse vascular function and functional capacity compared with those of group B. Pain-free travelled distance was predictive of the nursing diagnosis. These results are important for the refinement of this diagnosis. In conclusion, this study provides evidences that the distances walked in the six-minute walk test may be considered defining characteristics of Ineffective Peripheral Tissue Perfusion.

Distâncias percorridas em testes de marcha são importantes marcadores funcionais, porém, não são aceitos como características definidoras de Perfusão Tissular Periférica Ineficaz. Os objetivos foram verificar as distâncias percorridas no teste de caminhada de seis minutos, por participantes com e sem esse diagnóstico de enfermagem, e se tais medidas podem ser consideradas características definidoras desse fenômeno. A amostra foi composta por sujeitos com (grupo A, n=65) e sem (grupo B, n=17) Perfusão Tissular Periférica Ineficaz, avaliados quanto ao exame físico, à função vascular periférica e à capacidade funcional. Os participantes do grupo A apresentaram pior função vascular e capacidade funcional do que os do grupo B. Verificou-se que a distância percorrida livre de dor foi preditiva para a ocorrência do diagnóstico de enfermagem. Os resultados deste estudo são importantes para o refinamento desse diagnóstico. Conclui-se que as distâncias percorridas no teste de caminhada de seis minutos podem ser características definidoras de Perfusão Tissular Periférica Ineficaz.

Las distancias en pruebas de marcha son importantes marcadores funcionales, pero no son aceptados como características de definición de la Perfusión Tisular Periférica Inefectiva. Los objetivos fueron determinar las distancias recorridas en la prueba de caminata de los seis minutos por los participantes con e sin el diagnóstico de enfermería y si esas medidas se pueden considerar características de definición de este fenómeno. Los participantes con (grupo A, n=65) y sin (grupo B, n=17) el diagnóstico fueron evaluados mediante examen físico, función vascular periférica y capacidad funcional. Los participantes del grupo A ha presentado peor función vascular y desempeño en la prueba de marcha do que aquellos del grupo B. La distancia recorrida libre de dolor fue predictiva del diagnóstico de enfermería. Los resultados de este estudio pueden contribuir para el refinamiento de este diagnóstico. Las distancias recorridas en la prueba de marcha se pueden considerar características de definición de este diagnóstico.

Limitação funcional e claudicação intermitente: impacto das medidas de pressão arterial / Functional limitation and intermittent claudication: impact of blood pressure measurements

FUNDAMENTO: A hipertensão arterial é importante fator de risco para Doença Arterial Obstrutiva Periférica dos Membros Inferiores (DAOMI). Entretanto, a correlação entre pressão arterial e Pressão de Pulso (PP) com a gravidade da DAOMI e o prejuízo funcional decorrente dessa doença ainda não está bem estabelecida na população brasileira. OBJETIVO: Verificar se há correlação entre pressão arterial, PP, gravidade da DAOMI e capacidade funcional de pacientes com DAOMI sintomática. MÉTODOS: FORAM avaliados 65 pacientes (62,2 ± 8,1 anos; 56,9 por cento do sexo masculino), divididos em dois grupos: pressão arterial normal (A) e elevada (B). A gravidade da DAOMI foi avaliada por meio do Índice Tornozelo-Braquial (ITB) e a capacidade funcional, pelas distâncias total e livre de dor percorridas em teste de marcha. RESULTADOS: O grupo A foi constituído por 17 (26,1 por cento) pacientes. A Pressão Arterial Sistólica (PAS), diastólica e a PP foram, respectivamente, 125,4 ± 11,7; 74,5 ± 9,1 e 50,9 ±10,0 mmHg, para o grupo A, e 160,7 ± 19,6; 90,0 ± 12,2 e 70,7 ± 20,2 mmHg, para o grupo B. O ITB foi significativamente menor no grupo B (0,66 ± 0,12 vs 0,57 ± 0,13, p < 0,05). PAS e PP correlacionaram-se com a gravidade da DAOMI e com as distâncias percorridas em teste de marcha. Pacientes com PP > 40 mmHg percorreram menores distâncias. CONCLUSÃO: A PAS e a PP correlacionaram-se de forma significativa com as distâncias percorridas em teste de marcha, sugerindo que sejam marcardores clínicos da limitação da capacidade funcional em pacientes com DAOMI sintomática.

BACKGROUND: Arterial hypertension is an important risk factor for Lower-Limb Occlusive Arterial Disease (LLOAD). However, the correlation between blood pressure and pulse pressure (PP) with LLOAD severity and functional impairment resulting from this disease is not well established in the Brazilian population. OBJECTIVE: To verify whether there is a correlation between blood pressure, PP, LLOAD severity and functional capacity in patients with symptomatic LLOAD. METHODS: A total of 65 patients (62.2 + 8.1 years, 56.9 percent males) were evaluated. They were divided into two groups: normal (A) and high (B) blood pressure. LLOAD severity was assessed using the ankle-brachial index (ABI) and functional capacity by the total and pain-free walking distance at the 6-minute walking test (6MWT). RESULTS: Group A consisted of 17 (26.1 percent) patients. The systolic (SBP), diastolic blood pressure (DBP), and PP were, respectively, 125.4 ±11.7, 74.5 ± 9.1 and 50.9 ± 10.0 mmHg in group A and 160.7 ± 19.6, 90.0 ± 12.2 and 70.7 ± 20.2 mmHg in group B. The ABI was significantly lower in group B (0.66 ± 0.12 vs. 0.57 ± 0.13, p <0.05). SBP and PP correlated with LLOAD severity and the distances walked at the 6MWT. Patients with PP > 40 mmHg walked shorter distances. CONCLUSION: SBP and PP significantly correlated with the distances walked in the 6MWT, suggesting they are clinical markers of functional capacity impairment in patients with symptomatic LLOAD.

Functional limitation and intermittent claudication: impact of blood pressure measurements.

BACKGROUND: Arterial hypertension is an important risk factor for Lower-Limb Occlusive Arterial Disease (LLOAD). However, the correlation between blood pressure and pulse pressure (PP) with LLOAD severity and functional impairment resulting from this disease is not well established in the Brazilian population. OBJECTIVE: To verify whether there is a correlation between blood pressure, PP, LLOAD severity and functional capacity in patients with symptomatic LLOAD. METHODS: A total of 65 patients (62.2 + 8.1 years, 56.9% males) were evaluated. They were divided into two groups: normal (A) and high (B) blood pressure. LLOAD severity was assessed using the ankle-brachial index (ABI) and functional capacity by the total and pain-free walking distance at the 6-minute walking test (6MWT). RESULTS: Group A consisted of 17 (26.1%) patients. The systolic (SBP), diastolic blood pressure (DBP), and PP were, respectively, 125.4 ±11.7, 74.5 ± 9.1 and 50.9 ± 10.0 mmHg in group A and 160.7 ± 19.6, 90.0 ± 12.2 and 70.7 ± 20.2 mmHg in group B. The ABI was significantly lower in group B (0.66 ± 0.12 vs. 0.57 ± 0.13, p <0.05). SBP and PP correlated with LLOAD severity and the distances walked at the 6MWT. Patients with PP > 40 mmHg walked shorter distances. CONCLUSION: SBP and PP significantly correlated with the distances walked in the 6MWT, suggesting they are clinical markers of functional capacity impairment in patients with symptomatic LLOAD.

Função e disfunção endotelial: da fisiopatologia às perspectivasde uso em pesquisa e na prática clínica / Endothelial function and dysfunction: pathophysiology and perspectives for use in research and clinical practice

A alteração da função endotelial precede o desenvolvimento das alterações ateroscleróticas morfológicas e pode contribuir para o desenvolvimento da lesão e das complicações clínicas finais. Essa observação levou ao desenvolvimento de diversos métodos com o objetivo de testar os diferentes aspectos da função endotelial. Apesar da importância de seu estudo, os testes disponíveis ainda não são adequados para screening ou para decisão clínica individual, visto que ainda são de difícil execução e de alto custo e apresentam certa variabilidade que ainda limita seu uso na rotina clínica. Porém, deve-se ressaltar que há clara necessidade de novas estratégias de testes clínicos que possam refinar a avaliação de risco cardiovascular individualmente, portanto o estudo da função endotelial, com o avançar das pesquisas, provavelmente virá a se tornar uma ferramenta importante na avaliação do risco cardiovascular, na detecção precoce da doença, além de julgar respostas às intervenções designadas para prevenir a progressão da doença em estágios precoces e reduziros eventos adversos tardios.

Changes in endothelial function precedes the development of morphological atherosclerotic changes and can also contribute to lesion development and later clinical complications. This observation has led to the development of arange of methods to test different aspects of its function. Despite the importance of endothelial function testing, it is not yet suitable for screening or individual clinical decision--making, because currently the available tests are difficult, expensive, and variable for routine clinical use. However it must be emphasized that there is a clear need for clinical testing strategies that refine risk assessment in individual subjects. In this context, in a near future, endothelial function testing will become an important diagnostic tool in cardiovascular risk evaluation, and also in early disease detection, and judgment of response to interventions designed to prevent progression of early disease, and reduce later adverse events in patients.

Drospirenone/ethinylestradiol: a review on efficacy and noncontraceptive benefits.

Considerable advances have been made in the field of combined oral contraceptives since their introduction 50 years ago. This ongoing evolution has been focused on reducing the estrogen dose and synthesizing new progestogens. A recently launched combination of ethinylestradiol 20 µg and drospirenone 3 mg demonstrates the advantages of a lower estrogen dose with the antimineralocorticoid activity of drospirenone that is responsible for the drug's significant antiandrogenic and antimineralocorticoid effects, reflected clinically in lower rates of adverse events including less fluid retention. In addition to the drug's contraceptive efficacy, its effects on the skin and other classic noncontraceptive benefits, the ethinylestradiol 20 µg and drospirenone 3 mg combination has demonstrated highly satisfactory results in women with premenstrual dysphoric syndrome.

Avaliação hemodinâmica e da função endotelial em mulheres jovens normotensas em uso de anticoncepcional hormonal combinado oral contendo drospirenona / Assessment of hemodynamic and endothelial function in normotensive young women using a combined hormonal oral contraceptive containing drospirenone

Importância. Anticoncepcionais hormonais combinados orais (AHCO) podem levar ao aumento do risco da doença cardiovascular, que pode estar associado a alterações na pressão arterial e na função endotelial. Objetivos. O objetivo deste estudo foi avaliar o impacto do uso de AHCO contendo 20 mg de etinilestradiol (EE) e 3 mg de drospirenona (DRSP) por mulheres jovens normotensas sobre a função endotelial arterial, pressão arterial sistólica (PAS, mmHg) e diástólica (PAD, mmHg), frequência cardíaca (FC, bpm), débito cardíaco (DC, L/min), e sobre a resistência periférica total (RPT, NU). Métodos. Setenta e uma mulheres jovens saudáveis com idade média de 29 ± 1 ano foram avaliadas. Quarenta e três foram analisadas antes da introdução do AHCO e ao final de 6 meses de uso (grupo-caso) e vinte e oito, não usuárias de nenhum método hormonal de contracepção, foram avaliadas quanto aos mesmos parâmetros no mesmo intervalo de tempo (grupo-controle). Resultados. Não se observaram mudanças significantes na função endotélio-dependente (VMF%) e independente (VIE%) e nas medidas de PAS, PAD, FC, DC e da RPT com o uso do AHCO (p> 0,05 para todas as variáveis). Não houve variações significantes nestes parâmetros no grupo-controle. Conclusão: O uso desta formulação de AHCO não causou alterações deletérias na reatividade vascular, e nas variáveis hemodinâmicas em mulheres jovens normotensas.

Background: Combined oral contraceptives (COCs) may lead to a rise in cardiovascular disease risk, possibly associated with changes in blood pressure and endothelial function. Objective: The objective was to evaluate the impact of COC containing 20 mcg of ethinyl estradiol (EE) and 3 mg of drospirenone (DRSP) on the arterial endothelial function, systolic and diastolic blood pressure (SBP and DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) of normotensive young women. Methods: Of the 71 women in the study, 43 were evaluated before the introduction of COC and after 6 months of its use (case group) and 28, COC nonusers, were assessed for the same parameters at the same time interval (control group). Results: No significant changes in endothelium-dependent and -independent functions or in measures of SBP, DBP, HR, CO, and TPR caused by COC use were observed in the case group (P> 0.05 for all variables) or in the control group. Conclusion: These data suggest COC with 20 mcg EE and 3 mg DRSP does not alter arterial endothelial function or hemodynamic parameters in normotensive young women.

Preparo Cervical com Misoprostol em Histeroscopias Diagnósticas / Cervical Priming using Misoprostol prior to Diagnostic Hysteroscopy

Introdução: A histeroscopia diagnóstica é considerada o exame padrão ouro para avaliação de lesões da ca­vidade endometrial. Algumas situações podem dificultar sua realização, como estenose ou cicatrizes cervicais e atrofia senil. O misoprostol é uma prostaglandina sintética que pode ser utilizada no preparo cervical para diversos procedimentos cirúrgicos. Objetivo: Avaliar a eficácia e os efeitos clínicos do misoprostol em grupo selecionado de pacientes submetidas à tentativa sem sucesso de histeroscopia ambulatorial, devído à estenose ou a atrofia cervical. Material e métodos: Em 192 pacientes previamente submetidas a histeroscopia díagnóstica, nas quais o procedimento não foi possível, foi admínistrado 1 comprimido de misoprostol de 200 miug foi admininstrado por via vaginal 8-10 horas antes de outra tentativa de histeroscopia. Resultados: Entre as 192 pacientes incluídas no estudo, houve dilatação e passagem do hísteroscópio em 127 (66,2%). A introdução foi considerada fácil em 111 (87,4%). Não houve relato de dor em 115 pacientes (59,8 %), enquanto que 77 (40,2 %) referiram alguma dor durante o exame, sendo necessária anestesia local em cinco pacientes (2,6%). As complicações observadas durante e imediatamente após o procedimento foram sangramento vaginal em três pacientes (1,56%), dois casos de perfuração uterina (1,04%) e outro de falso trajeto (0,52 %). Conclusões: Em casos selecionados, o misoprostol pode ser utilizado antes da histeroscopia diagnóstica, tomando viável a realízação do exame graças à dilatação do colo do útero e, consequentemente, gerando menor desconforto global e menor índice de complicações.

Impacto do tratamento do câncer de mama sobre a fertilidade e saúde reprodutiva / Impact of breast cancer treatment on fertility and reproductive healty

O tratamento do câncer de mama, incluindo a quimioterapia e hormonioterapia, pode induzir a amenorréia e infertilidade nas mulheres em idade reprodutiva. A ciclofosfamida e a idade materna avançada são os principais fatores de risco para amenorréia. As opções de preservação da fertilidade, em mulheres com câncer de mama, são divididas em antes, durante e após o tratamento. Ensaios clínicos têm reportado a habilidade da terapia com agonistas hormonais da gonadotrofina coriônica, com finalidade de preservar a função ovariana relacionada à quimioterapia. A análise da tecnologia reprodutiva envolve o congelamento de embriões, oócitos maduros, oócitos imaturos ou tecido ovariano. Cada um destes procedimentos têm vantagens e desvantagens relativas que serão discutidas.

Effect of a low-dose oral contraceptive on venous endothelial function in healthy young women: preliminary results.

BACKGROUND: A possible increase in the incidence of venous thromboembolic events has been reported among users of third generation oral contraceptives. The objective of this study was to evaluate the effect of a low dose oral contraceptive (15 microg ethinyl estradiol/60 microg gestodene) on the venous endothelial function of healthy young women. METHODS: Prospective case control study using the dorsal hand vein technique. Venous endothelial function was evaluated at baseline and after 4 months in the oral contraceptive users group (11 women) and in a control group (9 women). After preconstriction of the vein with phenylephrine, dose-response curves for acetylcholine and sodium nitroprusside were constructed. RESULTS: In the contraceptive users group, a reduction occurred in the maximum venodilation response to acetylcholine and sodium nitroprusside after 4 months of oral contraceptive use, but this difference was not statistically significant (P > 0.05). No significant changes were detected in maximum venodilation responses to acetylcholine and sodium nitroprusside at the 4-month time point in the control group. CONCLUSION: This study found no significant impairment of endothelium-dependent or independent venodilation in healthy young women following oral contraceptive use. Further studies are necessary using the same methodology in a larger sample over a longer follow-up period.

Effect of a low-dose oral contraceptive on venous endothelial function in healthy young women: preliminary results

BACKGROUND: A possible increase in the incidence of venous thromboembolic events has been reported among users of third generation oral contraceptives. The objective of this study was to evaluate the effect of a low dose oral contraceptive (15 æg ethinyl estradiol/60 æg gestodene) on the venous endothelial function of healthy young women. METHODS: Prospective case control study using the dorsal hand vein technique. Venous endothelial function was evaluated at baseline and after 4 months in the oral contraceptive users group (11 women) and in a control group (9 women). After preconstriction of the vein with phenylephrine, dose-response curves for acetylcholine and sodium nitroprusside were constructed. RESULTS: In the contraceptive users group, a reduction occurred in the maximum venodilation response to acetylcholine and sodium nitroprusside after 4 months of oral contraceptive use, but this difference was not statistically significant (P > 0.05). No significant changes were detected in maximum venodilation responses to acetylcholine and sodium nitroprusside at the 4-month time point in the control group. CONCLUSION: This study found no significant impairment of endothelium-dependent or independent venodilation in healthy young women following oral contraceptive use. Further studies are necessary using the same methodology in a larger sample over a longer follow-up period.

Um aumento no risco de tromboembolismo venoso têm sido descrito em usuárias de anticoncepcionais hormonais oral de terceira geração. OBJETIVO: Avaliar o efeito de um anticoncepcional combinado hormonal oral de baixa dose (15 æg etinil estradiol/60 æg gestodeno) na função endotelial venosa de mulheres jovens saudáveis. MÉTODOS: Realizou-se um estudo caso-controle prospectivo em vinte mulheres jovens saudáveis que foram avaliadas pela técnica da complascência venosa. A função endotelial venosa foi avaliada em um momento basal e após 4 meses no grupo das usuárias de anticoncepcional oral (11 mulheres) e em um grupo controle (9 mulheres). Foram construídas curvas dose resposta para acetilcolina e nitroprussiato de sódio após a pré-constrição da veia com fenilefrina. RESULTADOS: No grupo de usuárias de anticoncepcional combinado hormonal oral houve diminuição da venodilatação máxima em resposta a acetilcolina e nitroprussiato de sódio, porém esta mudança não foi estatisticamente significante (p> 0,05). No grupo controle não foram detectadas mudanças significantes na venodilatação máxima, em resposta a acetilcolina e nitroprussiato de sódio no intervalo de 4 meses. CONCLUSÃO: Este estudo não observou redução significante da venodilatação endotélio dependente e independente após os uso de anticoncepcional combinado hormonal oral. Mais estudos são necessários utilizando a mesma metodologia em uma amostra maior e com maior tempo de seguimento.

Utero bicorno com duplicacao cervical e septo vaginal obliquo: relato de caso / Bicornuate uterus with cervical duplication and obliquoe vaginal septum: case report

As anormalidades Mullerianas sao problemas clinicos encontrados com baixa frequencia ocorrendo em cerca de l(por cento) a 6(por cento) de todas as mulheres. Para a classificacao das anormalidades...