Conjugated equine estrogen, raloxifene and arterial stiffness in postmenopausal women.

METHODS: We analyzed the influence of conjugated equine estrogen (CEE) and raloxifene on arterial stiffness. Sixty-seven healthy, normotensive women 1-10 years into menopause were assigned to receive oral placebo, conjugated equine estrogen 0.625 mg, or raloxifene 60 mg. Arterial stiffness was evaluated by measuring the carotid-femoral and femoral-dorsalis pedis pulse wave velocity (CF PWV, FP PWV). Systolic pressure augmentation index (AI) at the carotid artery was obtained with applanation tonometry. RESULTS: Arterial stiffness was not affected by any treatment regimen: placebo (CF PWV before vs. after: 644 vs. 626 cm/s, p = 0.09; FP PWV before vs. after: 1006 vs. 1012 cm/s,p = 0.77; AI before vs. after = 30 vs. 29%, p = 0.55), CEE (CF PWV before vs. after: 642 vs. 600 cm/s, p = 0.11; FP PWV before vs. after: 952 vs. 971 cm/s, p = 0.66; AI before vs. after: 25 vs. 32%, p = 0.82), and raloxifene (CF PWV before vs. after: 636 vs. 601 cm/s, p = 0.12; FP PWV before vs. after: 964 vs. 941 cm/s, p = 0.62; AI before vs. after: 25 vs. 25%, p = 0.65). A correlation occurred between basal stiffness and the degree of reduction in indexes measured, indicating that the higher the basal stiffness, the greater the degree of reduction, particularly in the CEE group: CF PWV (r = - 0.602, p = 0.001); FP PWV (r = - 0.455, p = 0.022); AI (r = - 0.410, p = 0.042). CONCLUSIONS: Conjugated equine estrogen and raloxifene do not seem to affect arterial stiffness of healthy normotensive women less than 10 years since menopause. Reduction in arterial stiffness seems related to its basal level.

[Breast cancer in the pregnancy-puerperal cycle]. / Câncer de mama no ciclo grávido-puerperal.

From 1978 to 1988, 611 cases of breast cancer were seen by the Mastology Department of the Beneficência Portuguesa Hospital in São Paulo, Brazil. Thirteen (2.12%) cases were associated to pregnancy, and nine (2.4%) became pregnant after treatment. The patients were submitted to surgery and the authors waited till the end of pregnancy to perform the Rt and/or Qt. Two cases could not be submitted to any kind of treatment. Whenever tests indicated fetal maturity, the option was to perform a caesarean section, and oophorectomy was performed in the most advanced cases. Among patients who became pregnant after treatment, initial cases were predominant and their pregnancies went to term with no problem. The authors compare their results to data found in literature and draw attention to anticonception in mastectomized patients.

[Dermatologic drill biopsy (punch): diagnostic procedures in advanced carcinoma of the breast]. / Pinça de biópsia dermatológica ("punch"): procedimento diagnóstico no carcinoma avançado da mama.

Thirty-seven patients with breast tumors in stage III and IV were selected, and a new method to remove fragments of tissue for anatomopathologic study was used. The "punch" of Keyes was introduced towards the tumor, under strong pressure, with clockwise and counter-clockwise rotational movements. In thirty-eight biopsies, the anatomopathologic study allowed the authors to make a perfect evaluation of the structure, and the diagnosis made was of infiltrating carcinoma of the breast. This method proved to be a quick, safe and simple procedure, free of complications, and it allows for anatomopathologic diagnosis in 100% of the cases.

Endometrial damage in acute salpingitis.

Histologic and bacteriologic analyses of endometrium were performed before and on day 15 after minocycline treatment of 20 patients with acute salpingitis. Endometritis was diagnosed in 15 patients before and in nine after treatment. Neisseria gonorrhoeae was recovered from the cervix and endometrium of seven patients but was not isolated after treatment. Chlamydia trachomatis was recovered from the cervix of eight, and from the endometrium of three patients, two of whom had negative cervical cultures. After treatment C. trachomatis was recovered from the cervix of three patients, although two of them had taken aluminum hydroxide for gastric symptomatology during minocycline treatment. Culture of an endometrial specimen revealed no growth of C. trachomatis. The histologic study revealed plasma cell infiltrates in specimens from patients who had cultures positive for C. trachomatis. The results showed that although endometritis is an important manifestation of acute salpingitis, there is no correlation between severity of endometritis and degree of tubal damage.

Procedimentos de diagnostico e ensaio terapeutico com tinidazol na leucorreia por Gardnerella vaginalis. / Diagnostic procedures and therapeutic assay with tinidazole in leukorrhea by Gardnerella vaginalis

Foram estudadas 71 pacientes portadoras de leucorreia vaginal que apresentavam caracteristicas clinicas compativeis com a presenca de Gardnerella vaginalis. O estudo incluia procedimentos para diagnostico clinico e laboratorial; na terapeutica ulitizou-se o tinidazol administrado em dose unica de 2,0g, sendo tambem tratados os parceiros sexuais destas pacientes com esta mesma dose. Das 71 pacientes incluidas, em 18 (25,3%) foi confirmado o diagnostico da vaginite por Gardnerella atraves de esfregaco e cultura de secrecao vaginal. Do ponto de vista clinico, 72 horas apos administracao do medicamento, 56% das pacientes estavam curadas; no 7o. dia, 72% e ao termino da 2a. semana 100%. Microbiologicamente, ja no 7o. dia, 83% das pacientes apresentavam culturas negativas e na avaliacao do 14o dia, 100% das pacientes analisadas estavam curadas.Com relacao a reacoes adversas foram observados dois casos de nauseas e dois de epigastralgia, todos com desaparecimento espontaneo. O tinidazol mostrou um elevado grau de eficacia e uma boa tolerabilidade no tratamento da vaginite por Gardnerella vaginalis, constituindo-se em fundamentada escolha no tratamento deste tipo de vaginite