[Therapeutic efficacy of vaginal administration of bromocryptin in patients with hyperprolactinemia]. / Efectividad terapéutica de la bromocriptina (BEC) administrada por vía vaginal en pacientes con hiperprolactinemia.

Oral bromoergocriptine (BEC) is currently the treatment of choice in women with hyperprolactinemia secondary to a prolactinoma. However, undesirable side effects (of variable type and intensity) are frequently present in these women due to both local irritation and to a direct effect upon the central nervous system. The present work was undertaken as a pilot study to assess the therapeutic effectiveness of vaginally administered BEC and to corroborate if the side effects are less frequent and of minor intensity when compared to oral BEC. Initially, 16 women were included, but two of them did not accept to continue in the study; thus, a total of 14 women with hyperprolactinemia (> or = 40 ng/ml) were divided in two groups: Group A encompassed five women, aged 27 to 36 years old, two with normal menstrual cycles and three with oligomenorrhea; all had primary or secondary sterility during 3 to 12 years and galactorrhea from 6 months to 3 years; in only one patient a brain computerized axial tomography (CAT) was performed which showed the existence of a macroprolactinoma. All received oral BEC (2.5-5 mg/day, except one patient with 10 mg/day). Group B included nine women, aged 26 to 36 years old, four had normal menstrual cycles and five had oligomenorrhea; all had primary or secondary sterility during the last 2 to 7 years and eight out of nine, also had galactorrhea during 1 to 8 years; in four of them a CAT was performed showing a pituitary microadenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

[Multifactorial analysis of the blood levels of LH, FSH and estradiol in relation to ovular harvesting rates, fertilization and segmentation in patients undergoing assisted reproduction (GIFT-FIVTE)]. / Análisis multifactorial de los niveles séricos de LH, FSH y Estradiol en relación a las tasas de captura ovular, fertilización y segmentación en pacientes de reproducción asistida (GIFT-FIVTE).

This study shows that there is certain tendency to asssign more value to the observation of follicular growth by ultrasound than to hormonal levels "per se". However, the appreciation of growth is only part of the phenomenon of development and ovarian maturity, for that, surveillance with hormonal monitor of ovarian response keeps with a most important role in Assisted Reproduction Clinica. The basal levels, mainly of FSH and in a less degree LH, inversely correlate with the amount of retrieved ovocytes. Estradiol values should be interpreted with a fixed point of reference, as the day of HCG administration, and a direct relation is seen between estradiol levels and captured ovocytes; however, is of highest usefulness to value the conduct of estradiol level, with the knowledge that the prognosis for good capture rates improves with ascending values and above 700 pg in the day of HCG administration.

[The influence of psychosocial deprivation and body composition on plasma gonadotrophins in children and adolescents]. / La influencia de la deprivación psicosocial y la composición corporal sobre las gonadotrofinas plasmáticas en niños y adolescentes.

The plasma concentrations of FSH and LH were measured in 250 boys with psychosocial deprivation (PSD) aged 9.0-15.9 years and in 357 clinically healthy boys of the same age. The results were correlated with chronological age (CA), weight, height and calculated lean body mass (LBM) and total body fat (TBT). On a group basis, PSD boys had the clinical onset of puberty at 13.9 years, while healthy boys did so at 11.9 years. In both groups, the mean weights at time of initiation of the adolescent growth spurt and time of peak velocity of weight gain were very close to each other and the same phenomenon was true for their heights and the amount of LBM. Based on CA mean plasma FSH concentrations in PSD boys and a steep rise two years later than in healthy boys; however, when analyzed as a function of body weight, height or LBM, no such difference emerged. On the other hand, mean plasma LH concentrations in PSD boys were higher than in healthy boys only up to 12.9 years, 42.9 kg of body weight, a height of 142.0 cms and LBM of 32.0 kg; however, no steep rise in plasma LH was observed in contrast to healthy boys. No correlations was observed between TBF and plasma gonadotropins. Therefore, although on the basis of CA, PSD boys had a delayed onset in plasma gonadotropins changes, this occurred in association with the attainment of similar body weight, height and LBM as in healthy boys.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hypothalamo-hypophyseal amenorrhea. I. The clinical and laboratory manifestations]. / Amenorrea hipotálamo-hipofisaria. I. Manifestaciones clínicas y de laboratorio.

This study included 15 women 18-36 years old with primary or secondary amenorrhea, low FSH and LH, a negative response to clormadinone and serum prolactin (Prl) levels less than 20.0 ng/ml. The following tests were performed on alternate days: LH and FSH determinations every 20 minutes (pulses) during 2-4 hours (n = 15); LH and FSH response to a single dose of GnRH 100 micrograms IV (n = 15) and after administration of 100 micrograms IM of GnRH daily during four consecutive days (n = 7); TRH test 200 micrograms IV (n = 9); oral metoclopramide-Prl induced response (10 mg) (n = 2); one to three basal determinations of cortisol, estradiol (E2), T3, T4, and TSH (n = 15). All patients had serum E2 levels less than 10.0 pg/ml and none showed a regular LH or FSH pulsatility. In seven patients (group A) serum LH had a 10-30 fold increase above basal levels in response to GnRH, while the other eight patients (group B) showed no response at all; serum FSH changes were most irregular in both group. In group A no other hormonal deficiencies were detected, while in group B only three patients had an isolated LH-FSH deficiency, and in the other five this deficiency was accompanied by Prl, TSH, and/or ACTH lack. The present results suggest that: 1) group A represents isolated GnRH deficiency and the amenorrhea has hypothalamic etiology; 2) group B had LH-FSH deficiency of pituitary origin, in most cases associated to other pituitary hormone deficiencies; 3) the lack of LH response to an initial single dose of GnRH is not an absolute indicator of hypophyseal amenorrhea.

Human pituitary hormones extraction.

In order to know the efficiency of the human pituitary hormone extraction method utilized in the laboratory, six batches of 100 pituitaries each, were collected in acetone. Its delipidization and the initial acid extraction (0.3 M KCl, pH 5.5) of the powder were performed in the presence of 0.1 per cent thioethanol and the extraction was completed with an alkaline solution (0.1 N NaOH + H2O, v/v, pH 10.5). Hields in weight of powder and protein concentration for each fraction were similar to those previously reported by Elrick. Characterization of fractions with disc-gel-electrophoresis demonstrated a reproducible pattern for GH, and some differences among the samples containing the glycoproteins. The hormonal activities determined by radioimmunoassay showed a low contamination of GH in the fractions rich in glycoproteins, but these latter were similarly distributed between the acid and the alkaline extracts. The glycoprotein fraction had an important activity of TSH. The hormonal content per pituitary was calculated from the addition of activities in both extracts and the last residue; GH = 3 mg (4.494 IU); FSH = 761 micrograms (13.410 IU); LH = 782 micrograms (46.920 IU); TSH = 2.939 mg (9.350 IU). It is concluded that the technique is useful since there was a low GH contamination in the glycoprotein fraction and the TSH yield was important.